To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Recently, there has been a significant rise in potency (% tetrahydrocannabinol (THC)) of cannabis products globally. As such, there is a need for a better understanding of the relationship between cannabis potency and mental health outcomes, especially in a developmentally vulnerable population such as adolescents and young adults.
Aims
The objective of this scoping review was to summarise existing literature investigating the potency of cannabis products as it relates to mental health outcomes in adolescents and young adults aged 14–25.
Method
Systematic searches of MEDLINE, Embase, CINAHL and PsycINFO were conducted for relevant manuscripts up to October 2025. Following PRISMA-ScR guidelines, retrieved studies were then screened and data extracted by two independent reviewers.
Results
Out of 11 225 studies identified by our searches, 71 were included in the review after screening. Compared with low-potency cannabis, our findings suggest that high-potency cannabis is more strongly associated with severe mental health issues, such as cannabis dependence, psychosis and cognitive deficits.
Conclusions
Overall, it was found that high-potency cannabis use (>15% THC) was associated with a great number and magnitude of adverse mental health outcomes. As such, the potency of cannabis products should be measured in future cannabis research that investigates short- and long-term outcomes. Additionally, the potency of cannabis products should be a consideration in any future cannabis regulatory policy discussions.
This study examines how linguistic differences between Chinese and European languages influence cognitive functions. Two experiments compared cognitive performance between Chinese and European undergraduates. Experiment 1 compared Chinese and European bilinguals (e.g., Chinese-English versus French-English) studying at an English university. Chinese bilinguals exhibited stronger executive control, inhibitory control and mental rotation, suggesting that greater linguistic distance enhances cognitive control. Experiment 2 examined native Chinese and English speakers in their respective countries, isolating language-script effects. Chinese speakers performed better in visual attention (i.e., orienting and facilitation) and mental rotation, while English speakers exhibited superior performance in auditory attention (i.e., attentional switching). These differences likely stem from language-script characteristics: logographic Chinese engages visuospatial processing, while alphabetic English reinforces auditory attention flexibility. Collectively, these findings underscore specific cognitive effects associated with linguistic distance and language script and provide comprehensive insights into how language structure modulates domain-specific cognitive adaptations.
Individuals aged 15–24 years, defined by WHO (2019) as “youth,” experience elevated mental health risks, yet most do not access timely support due to barriers including stigma, poor symptom recognition and limited help-seeking confidence. Mental health literacy (MHL) interventions aim to address these barriers, but evidence regarding their effectiveness, delivery modalities, cultural adaptation and methodological quality remains fragmented. This systematic review followed PRISMA 2020 guidelines and examined the characteristics and effectiveness of MHL interventions for youth aged 15–24 across Jorm’s (2000) three core domains of recognition, knowledge and attitudes. Five databases (CINAHL, APA PsycArticles, APA PsycInfo, Scopus and PubMed) were searched on 4 September 2024 for randomized and quasi-experimental studies, with narrative synthesis conducted due to heterogeneity and risk of bias assessed using a standardized tool. Twenty-four studies involving 13,624 participants were included. Mental health knowledge improved consistently across interventions and delivery formats, whereas recognition and attitudinal outcomes showed greater variability and were more strongly associated with diagnosis-specific content, contact-based elements and cultural adaptation. Only five studies explicitly reported cultural or contextual adaptation, and eight incorporated positive mental health components, of which only one evaluated positive mental health outcomes. The evidence base was dominated by high-income Western settings, with sparse representation from low- and middle-income countries. Most studies demonstrated moderate-to-high risk of bias, limiting definitive conclusions about efficacy. Overall, youth MHL interventions reliably improve knowledge, but evidence for sustained effects on recognition, stigma reduction and help-seeking remains mixed. Future research should prioritize culturally responsive, developmentally appropriate and methodologically rigorous designs, including systematic measurement of positive mental health outcomes, to strengthen the global evidence base.
Increasing survival probabilities among children and young adults with acute lymphoblastic leukemia (ALL) have led to a growing population at risk for long-term neurocognitive sequelae. This study investigated cognitive functioning among individuals treated for ALL under the Nordic Society of Paediatric Haematology and Oncology ALL2008 protocol in Eastern Denmark, including performance across multiple domains and associations with age at diagnosis, sex, time since end of treatment, hematopoietic stem cell transplantation (HSCT), and neurotoxic events during treatment.
Method:
Eighty-three survivors of ALL diagnosed before age 25 underwent neurocognitive testing at a median of 7.24 years post-treatment (interquartile range: 4.20–8.78). Performance was measured as age-standardized Z scores derived from normative data. Impairment was defined as Z ≤ −1.3 and severe impairment as Z ≤ −2.0. Multiple linear regression was used to investigate associations between cognitive outcomes and clinical risk factors.
Results:
Average performance was generally comparable to norms, but at least 38.6% of participants showed severe impairment in one or more domains, and at least 12% in two or more. Younger age at diagnosis was associated with poorer processing speed, executive functions, and non-verbal reasoning, while HSCT was associated with poorer processing speed and non-verbal reasoning.
Conclusions:
Although average performance of the participants was generally comparable to norms, a notable proportion exhibited multi-domain, severe cognitive impairment. Associations with age at diagnosis and HSCT indicate potential for risk-stratified cognitive monitoring and targeted interventions.
To provide insights into the motivations, challenges, and preferred methods of contact that influence the recruitment and retention of young adults (YAs) in health research.
Methods:
We designed, collected, and analyzed two surveys targeting YAs aged 18–39 years through the Amazon MTurk platform, to assess factors influencing recruitment and retention in health studies. The recruitment survey (n = 477) examined initial engagement motivations, while the retention survey (n = 473) explored factors that sustain long-term participation. Descriptive analyses were stratified by age group and sex.
Results:
The recruitment survey indicated that 88% of YAs were willing to participate in health studies, with a preference for online formats (78%). Social media, particularly Facebook (53%), was endorsed as the most common platform for discovering research opportunities. Monetary incentives were reported as the top motivator across all age groups, especially for those aged 35–39 years, with gift cards endorsed as the most appealing to participants aged 18–34. Retention survey results indicated that email (100%) was the most preferred method for maintaining engagement, followed by text messages (78.9%) and social media (62.2%). Text messages (65%), regular updates (56%) and sharing of study results (54%) were identified as key factors for maintaining participant engagement.
Conclusion:
Our findings identify that YA participation is driven by a mix of altruistic motivations, such as contributing to the community and research, and personal motivations, including personal health benefits and financial incentives, emphasizing the need for strategies that address both aspects of recruitment and retention motivations.
Mental ill-health has a major impact on young people, with pain often co-occurring. We estimated the prevalence and impact of pain in young people with mental ill-health.
Methods
Longitudinal data (baseline and three-month follow-up) of 1,107 Australian young people (aged 12–25 years) attending one of five youth mental health services. Multi-level linear mixed models estimated associations between pain characteristics (frequency, intensity, and limitations) and outcomes with false discovery rate (FDR) adjustment. Pain characteristics were baseline-centered to estimate if the baseline score (between-participant effect) and/or change from baseline (within-participant effect) was associated with outcomes.
Results
At baseline, 16% reported serious pain more than 3 days, 51% reported at least moderate pain, and 25% reported pain-related activity limitations in the last week. Between participants, higher serious pain frequency was associated with greater anxiety symptoms (β[95%CI]: 0.90 [0.45, 1.35], FDR-p=0.001), higher pain intensity was associated with greater symptoms of depression (1.50 [0.71, 2.28], FDR-p=0.001), anxiety (1.22 [0.56, 1.89], FDR-p=0.002), and suicidal ideation (3.47 [0.98, 5.96], FDR-p=0.020), and higher pain limitations were associated with greater depressive symptoms (1.13 [0.63, 1.63], FDR-p<0.001). Within participants, increases in pain intensity were associated with increases in tobacco use risk (1.09 [0.48, 1.70], FDR-p=0.002), and increases in pain limitations were associated with increases in depressive symptoms (0.99 [0.54, 1.43], FDR-p<0.001) and decreases in social and occupational functioning (−1.08 [−1.78, −0.38], FDR-p=0.009).
Conclusions
One-in-two young people seeking support for mental ill-health report pain. Youth mental health services should consider integrating pain management.
Major depressive disorder (MDD) is marked by significant changes to the local synchrony of spontaneous neural activity across various brain regions. However, many methods for assessing this local connectivity use fixed or arbitrary neighborhood sizes, resulting in a decreased capacity to capture smooth changes to the spatial gradient of local correlations. A newly developed method sensitive to classical anatomo-functional boundaries, Iso-Distant Average Correlation (IDAC), was therefore used to examine depression associated alterations to the local functional connectivity of the brain.
Method
One-hundred and forty-seven adolescents and young adults with MDD and 94 healthy controls underwent a resting-state functional magnetic resonance imaging (fMRI) scan. Whole-brain functional connectivity maps of intracortical neural activity within iso-distant local areas (5–10, 15–20, and 25–30 mm) were generated to characterize local fMRI signal similarities.
Results
Across all spatial distances, MDD participants demonstrated greater local functional connectivity of the bilateral posterior hippocampus, retrosplenial cortex, dorsal insula, fusiform gyrus, and supplementary motor area. Local connectivity alterations in short and medium distances (5–10 and 15–20 mm) in the mid insula cortex were additionally associated with expressive suppression use, independent of depressive symptom severity.
Conclusions
Our study identified increased synchrony of the neural activity in several regions commonly implicated in the neurobiology of depression. These effects were relatively consistent across the three distances examined. Longitudinal investigation of this altered local connectivity will clarify whether these differences are also found in other age groups and if this relationship is modified by increased disease chronicity.
The Asexual Exile trope positions asexual characters outside of society by portraying them as loners, inhuman, or adjacent to death. This research identifies trends in these portrayals by considering a corpus of 42 traditionally published novels of Young Adult fiction featuring asexual protagonists. A distant reading of this corpus finds that the Asexual Exile trope is employed in approximately two-thirds of cases. The author analyses how this trope permutates across genres, and the frequency of its endorsement and subversion by these narratives. Presenting the first extensive investigation into the Asexual Exile trope in YA fiction, this research investigates how asexual characters are Othered as not truly alive, and how these messages then rebound into necropolitical cultural understandings of asexual people as expendable. The results prompt the questions: how does the Asexual Exile trope influence Young Adult readers in the formation of their ideologies? How can publishers do better?
In this chapter we reflect on core components of an immersive program for young adults focused on how to come of age in and be in service to the complex matrix of demands of these times. Our program, called the Earth Leadership Cohort (ELC), was an adaptation of the Work That Reconnects for North American 18- to 30-year-olds. We describe the rationale and framework of the Work That Reconnects that shaped our curriculum. We focus on two features of ELC that we found to be essential when working with young adults in the context of the climate crisis. First, paradigms must shift from anthropocentric to ecocentric. Second, we must meet the generational demand for an intersectional approach. We describe challenges that required our willingness to adapt to our participants’ call for greater intersectionality and to attend to the role of systemic racism in the history and practice of climate activism. Throughout, we offer a sampling of our practices and processes for illustration. We conclude with a discussion of inherent limitations and possible applicability and relevance of our program for those working with young adults across multiple settings.
To estimate the effect of income change on difficulty accessing food since the COVID-19 pandemic for South African youth and evaluate whether this effect was modified by receiving social grants.
Design:
A cross-sectional, online survey was conducted between December 2021 and May 2022. Primary outcome was increased difficulty accessing food since the COVID-19 pandemic. Income change was categorised as ‘Decreased a lot’, ‘Decreased slightly’ and ‘Unchanged or increased’. Multivariable logistic regressions were used, with an interaction term between social grant receipt and income change.
Setting:
eThekwini district, South Africa.
Participants:
Youth aged 16–24 years.
Results:
Among 1,620 participants, median age was 22 years (IQR 19–24); 861 (53 %) were women; 476 (29 %) reported increased difficulty accessing food; 297 (18 %) reported that income decreased a lot, of whom 149 (50 %) did not receive social grants. Experiencing a large income decrease was highly associated with increased difficulty accessing food during the COVID-19 pandemic (adjusted OR [aOR] 3·63, 95 % CI 2·70, 4·88). The aOR for the effect of a large income decrease on difficulty accessing food, compared to no income change, were 1·49 (95 % CI 0·98, 2·28) among participants receiving social grants, and 6·63 (95 % CI 4·39, 9·99) among participants not receiving social grants.
Conclusions:
While social grant support made a great difference in lowering the effect of income decrease on difficulty accessing food, it was insufficient to fully protect youth from those difficulties. In post-pandemic recovery efforts, there is a critical need to support youth through economic empowerment programming and food schemes.
The increased survival rate among individuals with CHD has sparked interest in their transition to adult healthcare. Although there is a general agreement on the importance of transition interventions, the empirical evidence supporting them is insufficient. Therefore, this study aimed to conduct a systematic review and meta-analysis of transition interventions for adult healthcare in adolescents and young adults.
Methods and results:
A literature search was conducted for studies comparing the quantitative effects of transition interventions with control groups, published up to March 15, 2023, in major databases (CENTRAL, Embase, PubMed, Web of Science, CINAHL, KISS, and KMbase), major clinical trial registries, academic journal sites related to the topic, and grey literature databases. Ten studies involving a total of 1,297 participants were identified. Transition interventions proved effective in enhancing disease-related knowledge (Hedge’s g = 0.89, 95% CI = 0.29−1.48) and self-management (Hedge’s g = 0.67, 95% CI = 0.38−0.95), as well as reducing loss to follow-up (OR = 0.41, 95% CI = 0.22−0.77). The certainty of evidence for the estimated values of each major outcome was low or very low.
Conclusions:
This study supports the implementation of transition interventions by demonstrating that they can improve patients’ disease knowledge and self-management, while also promoting treatment continuity. However, since the available data on transition interventions for adolescents and young adults with CHD remain limited, the widespread adoption of structured transition interventions in the future may alter the conclusions of this study.
We conducted a literature review to identify commonly used recruitment and retention strategies in research among adolescent and young adult (AYA) cancer survivors 15-39 years of age and examine the effectiveness of these strategies based on the reported recruitment and retention rates. We identified 18 publications published after 2010, including 14 articles describing recruitment strategies and four articles discussing retention strategies and addressing reasons for AYA cancer patients dropping out of the studies. In terms of recruitment, Internet and social networking strategies were used most frequently and resulted in higher participation rates of AYA cancer survivors compared to other conventional methods, such as hospital-based outreach, mailings, and phone calls. In terms of retention, investigators used monetary incentives in all four studies and regular emails in two studies. There was no association between the number of strategies employed and the overall recruitment (p = 0.09) and retention rates (p = 0.33). Future research and planned studies testing recruitment and retention strategies are needed to identify optimal, modern communication procedures to increase AYA participation and adherence. More education should be provided to AYAs to increase their knowledge of research studies and strengthen the connection between AYA cancer survivors and their health providers.
This chapter studies the developments of autobiography as a literary genre in the graphic novel production since the 1960s. It analyzes the formal connections between author, narrator, and character, paying attention to the pragmatic aspects of the contract between author and reader, whose commitment to authenticity distinguishes autobiography from autofiction or semi-autobiography. The chapter starts with a historical overview of the genre, absent in comics for a long time, then rapidly coming to prominence in the graphic novel. It emphasizes the role of underground comix and engages in a close reading of two works: Justin Green’s Binky Brown Meets the Holy Virgin (1972) and Craig Thompson’s Blankets (2001). Although both share a similar (critical) concern with the role of religion, their stylistic and narrative features and context are widely divergent. Green’s work is a clear example of countercultural transgression, whereas Blankets exemplifies the growing overlap between the graphic novel and young adult literature.
Describe how dietary intake patterns of US young adults align with the EAT-Lancet Planetary Health Diet (PHD) sustainable diet goals and identify personal, behavioural, and socio-environmental correlates of sustainable intake.
Design:
Data on past-year dietary intake were captured using a FFQ. The PHD was applied to specific food groups, and a total PHD score was calculated. Linear regression models were used to identify associations between personal, behavioural and socio-environmental factors and PHD scores.
Setting:
This cross-sectional analysis uses data from the second wave of EAT 2010–2018 (Eating and Activity over Time), a population-based longitudinal study recruited in Minnesota.
Participants:
Ethnically/racially diverse group of participants (n 1308) with a mean age of 22·1 (sd 2·0) years.
Results:
The mean PHD score was 4·1 (sd 1·4) on a scale of 0–14, with 14 representing the most sustainable. On average, participants consumed fewer whole grains, fish, legumes, soya, and nuts than ideal for a sustainable diet, and an excess of eggs, added sugar, and meat. The PHD score was higher for participants with higher socio-economic status (SES) and greater educational attainment. Higher home availability of healthy food (β = 0·24, P < 0·001) and less frequent fast-food consumption (β = –0·26, P < 0·001) were the strongest correlates of PHD scores.
Conclusions:
Results suggest that a high percentage of participants may not be achieving the sustainable diet goals defined by the PHD. Reductions in meat consumption and increases in plant-based foods are necessary to increase the sustainability of US young adults’ diets.
The objective of the present study was to evaluate the efficacy of oral administration of vitamin D supplementation in reducing BMI and lipid profile in adolescents and young adults from a cohort in Bucaramanga, Colombia. One hundred and one young adults were randomly assigned to one of two doses of vitamin D [1000 international units (IU) or 200 IU] administered daily for 15 weeks. The primary outcomes were serum 25(OH)D levels, BMI and lipid profile. The secondary outcomes were waist-hip ratio, skinfolds and fasting blood glucose. We found a mean ± sd plasma concentration of 25-hydroxyvitamin D [25(OH)D] was 25⋅0 ± 7⋅0 ng/ml at baseline, and after 15 weeks, it increased to 31⋅0 ± 10⋅0 ng/ml in the participants who received a daily dose of 1000 IU, (P < 0⋅0001). For the participants in the control group (200 IU), it went from 26⋅0 ± 8⋅0 ng/ml to 29⋅0 ± 8⋅0 ng/ml (P = 0⋅002). There were no differences between groups in body mass index. There was a statistically significant decrease in LDL-cholesterol between the intervention group v. the control group (mean difference −11⋅50 mg/dl (95 % CI −21⋅86 to −1⋅15; P = 0⋅030). The conclusions of the present study were two different doses of vitamin D supplementation (200 IU v. 1000 IU) produced changes in serum 25(OH)D levels over 15 weeks of administration in healthy young adults. No significant changes were found in the body mass index when the effect of the treatments was compared. A significant reduction in LDL-cholesterol was found when comparing the two intervention groups.
Youth suicide rates have increased markedly in some countries. This study aimed to estimate the population-attributable risk of psychiatric disorders associated with suicide among Taiwanese youth aged 10–24 years.
Methods
Data were obtained from the National Death Registry and National Health Insurance (NHI) claims database between 2007 and 2019. Youth who died by suicide were included, and comparisons, 1:10 matched by age and sex, were randomly selected from the Registry for NHI beneficiaries. We used multivariable logistic regression to estimate suicide odds ratios for psychiatric disorders. The population-attributable fractions (PAF) were calculated for each psychiatric disorder.
Results
A total of 2345 youth suicide and 23 450 comparisons were included. Overall, 44.8% of suicides had a psychiatric disorder, while only 7.9% of the comparisons had a psychiatric disorder. The combined PAF for all psychiatric disorders was 55.9%. The top three psychiatric conditions of the largest PAFs were major depressive disorder, dysthymia, and sleep disorder. In the analysis stratified by sex, the combined PAF was 45.5% for males and 69.2% for females. The PAF among young adults aged 20–24 years (57.0%) was higher than among adolescents aged 10–19 years (48.0%).
Conclusions
Our findings of high PAF from major depressive disorder, dysthymia, and sleep disorder to youth suicides suggest that youth suicide prevention that focuses on detecting and treating mental illness may usefully target these disorders.
This Element examines the early years of British Young Adult (YA) publishing at three strategic publishing houses: Penguin, Heinemann and Macmillan. Specifically, it discusses their YA imprints (Penguin Peacocks, Heinemann New Windmills and Macmillan Topliners), all created at a time when the population of Britain was changing and becoming more diverse. Migration of colonial and former colonial subjects from the Caribbean, India, and Africa contributed to a change in the ethnic makeup of Britain, especially in major urban centres such as London, Birmingham and Manchester. While publishing has typically been seen as slow to respond to societal changes in children's literature, all three of these Young Adult imprints attempted to address and include Black British and British Asian readers and characters in their books; ultimately, however, their focus remained on white readers' concerns.
TBT-S helps parents and other Supports to be aware of unique YA developmental needs and conflicts to offer appropriate assistance toward AN recovery. An experiential activity on guided reflections can enhance empathy for YA development along with skill development and the Young Adult Behavioral Agreement.
Multi-family therapy is a significant backdrop for YA TBT-S, and the format that has been studied to date. The data collected in trials suggests that TBT-S delivered in a multi-family context may play an important role in positive outcomes. Conducting TBT-S in multi-family groups is an effective way to facilitate peer-to-peer consultation, to enrich the learning process and potentially improve outcomes.The multi-family milieu improves participants’ understanding of the illness when they hear from multiple perspectives. It broaden viewpoints on effective ways to manage recovery and to generate new ideas. This method of treatment can assist in identifying and practicing productive actions in a safe environment.