Alisha O'Neill

Background: There is increased interest in early intervention and prevention of mental health difficulties during adolescence; thus, we are seeing increased efforts to optimize well-being during this epoch. Positive emotional experiences are a central component of overall well-being. However, research exploring what adolescents perceive to be the cause(s) of their emotional difficulties is lacking. Improving understanding of this issue within non-clinical adolescent groups may provide useful insight into how to develop strategies to support young people as they navigate emotional difficulties. Objectives: The aim of this research was to explore if meaningful categories of perceived cause(s) for emotional distress exist for non-clinical adolescent groups. Methods: The data for this study were drawn from interviews across 6 sites in England conducted as part of the 5-year national evaluation of the HeadStart Learning Programme. The sample comprised of 32 young people aged 11–12 years from the first annual wave of qualitative data collection in 2017. Ideal type analysis—a qualitative form of person-centered analysis—was used to construct a typology of adolescents perceived cause(s) for emotional distress. Findings: We identified five distinct categories of perceived cause: (1) perceived lack of control; (2) unfair treatment; (3) others, their actions and judgements as the catalyst; (4) concerns for self and others; and, (5) self as cause. Conclusions: Our findings illustrate that distinct categories for perceived cause of emotional distress exist among adolescents considered to be “at risk” of developing mental health difficulties, which provides a foundation for future necessary work seeking to investigate the possible link between perceived cause for emotional distress and help-seeking behavior among sub-clinical groups.

The prevalence of mental health difficulties among children and adolescents is rising. This study aimed to explore early adolescents’ lived experiences of a school- and community-based prevention program, including what helps, why, and when. Seventy-eight semi-structured interviews were conducted with early adolescents (aged 10 to 13) as part of the evaluation of HeadStart, a UK-based program. A reflexive thematic analysis was conducted and a typology was developed to facilitate comparisons between participants' experiences. The typology consisted of five groups, including early adolescents who described positive or helpful experiences of HeadStart support, those who wanted more support, those who described more mixed or unhelpful experiences of support, and those who did not report receiving much or any support. Cross-group themes highlighted the ‘bridges’ that interventions can build to promote mental health and wellbeing, e.g. learning new coping or problem-solving skills. There was more variation between the groups in terms of the ‘walls’ (e.g. issues with intervention content, timing, or location) that may limit intervention effectiveness. There were also some group differences in terms of the other sources of social support that participants had access to and the level of difficulties that they were facing in their lives. The findings suggest that intervention developers should tailor design and delivery according to different profiles of early adolescents who may be more or less able or willing to accept help, and who may experience different formats, structures, and content of support as either more or less useful.

Background Help-seeking is intrinsic to efforts to manage the onset, maintenance, or escalation of mental health difficulties during adolescence. However, our understanding of adolescent help-seeking remains somewhat nebulous. A greater comprehension of help-seeking behavior from the perspective of adolescents is needed. It is also prudent to explore help-seeking behavior in the context of perceived cause for emotional distress, particularly as causal beliefs have been found to influence help-seeking behavior in adults. Objectives The present study sought to categorize adolescents' experiences of help-seeking, and to examine the extent to which these categories (or “types”) of help-seeking behavior are associated with their perceptions of causal factors for emotional distress. Methods The data for this study were drawn from interviews conducted as part of the HeadStart Learning Programme. The sample comprised of 32 young people aged 11–12 years. Ideal-type analysis, a qualitative form of person-centered analysis, was used to construct a typology of adolescent help-seeking. Participants' help-seeking “type” was then compared with their perceived cause for emotional distress “type.” Findings We developed four distinct categories of help-seeking: (1) guided by others who have taken notice; (2) skeptical with unmet needs; (3) motivated and solution focused; and (4) preference for self-regulation. Simultaneously, we identified principal associations between perceived cause of emotional distress—(1) perceived lack of control; (2) unfair treatment; (3) others: their actions and judgements as the catalyst; (4) concern for self and others; and (5) self as cause—and help-seeking approaches. “Perceived lack of control” was most likely to be associated with “others who have taken notice”; “Unfair treatment” with “skeptical with unmet needs”; “others: their actions and judgements as the catalyst” with “motivated and solution focused”; “concern for self and others' with ‘guided by others who have taken notice”; finally, “self as cause” was most likely to be associated with “preference for self-regulation.” Conclusions This study demonstrates meaningful and distinct categories of adolescent help-seeking and offers empirical evidence to support the assertion that perceived cause for emotional distress may influence the help-seeking approaches of adolescents.

Causal attributions and help-seeking is not well explored among adolescents, despite evidence of perceived causes for difficulties influencing how adults engage with treatment and seek help. This study reviewed extant literature to understand what adolescents at increased risk of developing mental health difficulties and those with clinically significant symptoms perceive to be the cause of emotional distress; to determine the extent to which perceived cause influences help-seeking; and to identify potential differences/commonalities between these groups. A systematic review and qualitative thematic synthesis were conducted. 3,691 articles were identified, 18 were eligible to be included and were synthesized using thematic synthesis. Six main themes related to perceived cause are reported. Three of those themes were shared between the clinical and at-risk groups: (1) challenging social factors and perceived difference, (2) problematic family dynamics, and (3) cause is complex and multifaceted. Three themes were not: (4) unfairness and perceived lack of agency and (5) concern for self and others, were exclusive to the at-risk group, and (6) coping with a mental health difficulty was exclusive to the clinical group. Four main themes related to causal attributions and help-seeking were found, including: (1) cause and implications for self-preservation; (2) the degree of personal and wider knowledge and understanding of cause; (3) perceived extent of control in managing cause; and (4) cause having potential to affect others. The findings of this review demonstrate that perceived cause for emotional distress plays a role in help-seeking among adolescent groups and highlights likely differences in how adolescents at-risk of mental health difficulties and those with clinically significant symptoms attribute cause for their difficulties and subsequently seek help. This has important implications for how to support young people experiencing or at risk of mental health difficulties and presents a strong case for pursuing more research in this area.

For older adolescents, the COVID-19 pandemic and UK restrictions arrived during a critical period in the transition to adulthood. Early research exploring impact of the pandemic paints a picture of worsened adolescent wellbeing and mental health. We explore the subjective experiences of 16- to 19-year-olds during the first UK lockdown, with an emphasis on wellbeing and coping, to complement quantitative evidence and inform strategies and provision for support. In May 2020, we invited UK-based 16- to 19-year-olds to share written accounts of their experiences of the initial UK lockdown for The TELL Study. A total of 109 participants engaged, submitting anonymous written accounts via an online survey portal. We used inductive reflexive thematic analysis to develop rich experiential themes. We constructed seven main themes: heightened emotionality; feelings of loss, change, and uncertainty; recognizing the value of self-care; efforts to think positively; opportunities for relief, growth, and development; the importance of togetherness; and frustration with government and media. Findings highlight the multifaceted nature of adolescents’ lockdown experiences, and offer insight into emotional impact and new concerns alongside the value placed on self-care and staying connected. We offer directions for supporting adolescents as pandemic consequences continue.

Previous experimental work showed that young adults reporting loneliness performed less well on emotion recognition tasks (Diagnostic Analysis of Nonverbal Accuracy [DANVA-2]) if they were framed as indicators of social aptitude, but not when the same tasks were framed as indexing academic aptitude. Such findings suggested that undergraduates reporting loneliness possessed the social monitoring skills necessary to read the emotions underlying others’ facial expressions, but that they choked under social pressure. It has also been found that undergraduates reporting loneliness have better recall for both positive and negative social information than their non-lonely counterparts. Whether those effects are evident across different age groups has not been examined. Using data from the British Broadcasting Corporation (BBC) Loneliness Experiment that included participants aged 16–99 years ( N = 54,060), we (i) test for replication in a larger worldwide sample and (ii) extend those linear model analyses to other age groups. We found only effects for participants aged 25–34 years: In this age group, loneliness was associated with increased recall of negative individual information, and with choking under social pressure during the emotion recognition task; those effects were small. We did not find any such effects among participants in other age groups. Our findings suggest that different cognitive processes may be associated with loneliness in different age groups, highlighting the importance of life-course approaches in this area.