DeNovoSeer:a deep learning framework for pathogenicity prediction of De novo mutations.

American Samoa is an unincorporated US territory in the South Pacific. Though many youth are thriving in this context, recent studies have noted a high prevalence of mental health problems among adolescents [,]. In 2021, a community-led survey of  1,125 high school students in American Samoa found that almost 30% of adolescents had made a suicide attempt in the past year []. Qualitatively, Samoan adolescents report dealing with a number of stressors, ranging from school-related pressure to family conflict and challenges navigating their cultural identity []. In many other settings, coping skills have been explored as predictors of mental health outcomes, including the risk of suicidal ideation and the likelihood of a fatal suicide attempt. To date, the behaviors used by Samoan youth to manage their stress have been unexplored. An understanding of how adolescents cope would be especially important in this setting; with limited mental health treatment available [], there is a need for feasible and scalable mental health promotion initiatives to support adolescents in coping with life stressors. A longstanding body of research has both theorized and empirically demonstrated that coping styles tend to fall along two dimensions: approach and avoidance, each defined by cognitive and emotional activities that are oriented either toward - or away from - a given threat, respectively [–]. Approach coping includes strategies that aim to understand and ultimately resolve the threat, such as information gathering and problem solving []. In contrast, avoidance coping includes strategies that foster cognitive and emotional distance from a stressor, including distraction, denial, and emotion-focused coping. Although approach and avoidance coping can each be advantageous depending on the potential to control a given situation, there is evidence that individuals who consistently use avoidance coping are at risk of a range of negative behavioral outcomes, including suicidality, self-harm, and substance misuse [–]. Much of the existing research that applies this model to adolescent coping in other settings utilizes quantitative methods. For instance, studies have examined associations between coping strategies and psychopathology among adolescents [], the role of gender, social support, and age in coping [], and the relationships between coping styles, peer victimization, and health outcomes []. While quantitative methods have allowed researchers to measure the prevalence of general coping styles among adolescent samples and identify which coping behaviors function within specific contexts, they limit the depth of understanding gained from individual perspectives. In contrast, qualitative research designs allow adolescents to provide specific insight into how they prefer to manage common stressors. Further, while the two-dimensional approach versus avoidance model of coping has been previously applied to samples of adolescents in Western contexts, it has not to our knowledge been studied in the context of Samoan or Polynesian communities. In Western societies, individualistic approaches to coping, such as managing challenges alone, with private emotional outlets, or individualized counseling are commonly used []. However, in cultures rooted in collectivism, approaches to coping generally rely more heavily on social and community support systems, as the self is viewed as interconnected with other [,]. Among Polynesian communities, cultural values based on pluralism, communalism, and associated religious and spiritual beliefs have been shown to influence strategies to cope with mental health challenges []. In the only study, to our knowledge, to examine coping strategies specifically, Allen and Heppner examined religiosity, collectivist coping, and psychological well-being among  = 94 Polynesian adults residing in the Midwestern US and found, for example, that those who were committed to their religious faith were more likely to use collectivist coping styles, including relying on family support []. Further, Allen and Smith examined associations between collectivist coping styles and mental distress among Polynesian Americans and found that the reliance on family support among this group was significantly more predictive of positive psychological well-being compared to the use of private emotional outlets [].