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The development of aggressive and depressive problems during adolescence

Periodic Report Summary - PSYCHOPATHOLOGY (The development of aggressive and depressive problems during adolescence)

Project objectives
Three objectives were proposed for the current project:

(1) to identify groups of adolescents exhibiting differential levels of distinct or combined aggressive and depressive problems across time,
(2) to investigate the relationship of risk and protective factors to pure or co-occurring aggressive and depressive problems, and
(3) to identify differential outcomes of distinct or combined aggressive and depressive problems.

Description of the work performed
Initially, an application for approval to conduct the study was submitted to the Cyprus Ministry of Education. In the mean time, research assistants were recruited and were trained, and the instruments which were not available in the Greek language were translated, back translated, and validated based on established validation procedures. After approval of the study by the ministry, the researcher randomly selected 17 schools in three Cypriot towns (Larnaca, Limassol, and Nicosia). The school boards and personnel were informed about the study and their long-term cooperation was secured. The students attending the different schools were then informed about the purpose of the study by the researcher and the research assistants, and they were given a consent form for their parents to sign.

After parental consent was obtained, the researcher and his research assistants met with different groups of students in the participants' familiar school setting. Before data collection, assent was taken from the students. Initially 2 356 (51 % girls) participants were recruited from grades 7, 8, 9, and 10. The first year data collection enabled the cross-sectional comparisons of children of different ages in terms of their reports of behavioural and emotional problems. Following the grant proposal, only middle school students attending grades 7 and 8 were followed longitudinally. From 1 480 students attending grades 7 and 8 during year 1, we managed to collect data from 1 348 (50 % girls) children during year 2. Therefore, we only had 8.9 % attrition.

During both reporting years identical questionnaires were employed to measure aggressive and depressive problems, risk and protective processes, and adolescent outcomes. The questionnaires employed for the purposes of the study included: the youth self-report questionnaire, the inventory of Callous-unemotional traits, the antisocial process screening device, the student survey of bullying behaviour, the media violence exposure questionnaire, the state self-esteem questionnaire, the social support microsystems scale, and the adolescent symptom inventory. After each reporting year, the data were entered in the SPSS statistical package by trained assistants, and the researcher performed the data analyses. The findings from the first and second year data collection were presented in different conferences, published, and submitted for conference presentations and publications.

Description of the main results achieved so far
In trying to explain co-occurrence, it has been proposed that co-occurring psychopathology might represent distinct, meaningful syndromes, and that co-occurrence can be regarded as a single diagnostic entity. In support of this idea, the current study provides evidence of the existence of pure depressive and aggressive problems and co-occurring problems, both cross-sectionally and longitudinally.

Furthermore, older adolescents were characterised by higher levels of both emotional and behavioural problems. In addition, adolescence is a time of individual and social-environmental changes, and the current study associated these processes with both aggression and depression.

More specifically, hierarchical linear regression analyses suggested that positive relationships with parents and teachers were negatively associated with aggression and depression, although positive relationships with peers were positively associated with aggression, but negatively with depression. Moreover, Callous-unemotional traits, impulsivity and narcissism were positively associated with aggression, after taking context into account. A different set of findings were found for depression, since children scoring low on Callous-unemotional traits but high on impulsivity were more likely to experience depression.

After taking into account co-occurrence, with the use of multinomial logistic regression analyses, evidence suggested that the adolescents exhibiting pure aggressive behaviour were more likely to report positive peer relationships in comparison to depressed adolescents and adolescents experiencing both types of problems. The pure aggression group and the combined group scored higher on measures of callous-unemotional traits and narcissism compared to the pure depression group and the low risk group.

All higher risk groups scored higher on impulsivity compared to the low risk group, suggesting that impulsivity is a common risk factor for both aggressive and depressive problems. In addition, adolescents are exposed to high levels of violence in the media and their schools, and our findings indicated that adolescents' violence exposure is associated with both depression and aggression.

Furthermore, findings suggested that individuals reporting high self-esteem and supportive social relationships during early adolescence were less prone to experiencing pure and co-occurring psychopathological symptoms, suggesting that these factors can also function as protective processes. These protective processes also mediated the effects of violence exposure and individual negative traits to adolescent psychopathology. In terms of outcomes, the findings suggested that adolescents who exhibited high and continuous levels of co-occurring problems reported higher levels of delinquency, substance use and social problems.

Expected final results and their potential impact
The current study's goal is to employ a longitudinal four-wave design, and the participating middle school students will be followed for two additional time points. This design is important because it allows for reliable estimation of linear and non-linear (e.g. quadratic) trajectories. More specifically, the study with the use of general growth mixture modelling will be able to investigate the predictors, course, and outcomes of normative, pure and co-occurring emotional and behavioural problems during adolescence, therefore enhancing the understanding of co-occurrence and the development of depressive and aggressive psychopathology. In the case that the current study detects high levels of co-occurrence between aggressive and depressive problems, can indicate that revisions of the taxonomy of constructs are needed. This finding is expected to have an impact on the classification system used by psychologists.

Furthermore, findings on factors related to co-occurrence can have implications for etiological theories, since risk factors associated with one disorder might in fact be risk factors for another disorder or a combination of two disorders. The findings will also extend the researchers previous work that investigated the development of behavioural and emotional problems during childhood. Investigating the development of behavioural and emotional problems during adolescence is imperative, because adolescence is an important ecological transition marked by increases in the prevalence of aggressive and depressive problems, and the current study expects to identify increases in the co-occurrence of these problems as well. Aggressive and depressive symptoms have negative effects on children, their families, and the communities they live in.

The public costs associated with aggressive and depressive problems are tremendous, with co-occurring problems having a higher cost to society compared to pure problems. Individuals exhibiting co-occurring problems exceed individuals exhibiting pure problems in terms of chronic history of mental illness, higher use of treatments, more physical health problems, greater functional interference in daily life, more encounters with the justice system, unemployment, welfare dependence, and generally more impaired adaptation across domains such as work, education, health, and social-support networks.

Findings of the current study can inform future studies of the complex and diverse nature of co-occurring disorders and can provide evidence that promote healthy behaviours and lead to effective preventions, interventions and treatments. Thus, the study's findings are expected to have an important social impact. The researcher along with the research assistants already started applying these findings to interventions, and we are finding that changes in how children process social information and emotions may lead to better adjustment.

Contact details
Kostas A. Fanti, Lecturer of Developmental Psychology, Department of Psychology, University of Cyprus, PO Box 20537, Nicosia, 1678 Cyprus
Email: Tel.: +357-228-92067