Nonsuicidal Self-Injury Among African American and Hispanic Adolescents and Young Adults: a Systematic Review.

While African American and Hispanic adolescents and young adults living in the USA are exposed to myriad stressors that may increase their risk for mental health difficulties, few studies have examined nonsuicidal self-injury (NSSI) among these youth. The purpose of this systematic review was to critically examine and synthesize current literature on NSSI among these understudied youth. Using multiple search terms related to NSSI, race/ethnicity, and developmental stage, electronic literature searches of PubMed, PsychINFO, and Google Scholar databases retrieved 3036 relevant articles published in the English language between 2000 and 2018; manual reference checks yielded an additional 17 articles. Ultimately, a total of 52 full-text studies were assessed for eligibility, and 15 articles were included in the present review. Although the majority of studies reported higher prevalence of NSSI among non-Hispanic White youth, evidence suggests that African American males are also at high risk of engaging in self-harm. Emotional dysregulation emerged as a common risk factor, while social support and feelings of connection were protective for some African American and Hispanic youth. Although racism and discrimination were not linked to NSSI in the reviewed studies, this remains an important area of future research for prevention and intervention efforts.

Radical Acceptance and Obesity-Related Health Conditions: A Case Report.

The current report presents the case of "Tisha," an 18-year-old African American young woman with severe obesity and cardiomyopathy. While the emotional distress associated with chronic health conditions can lead youth to engage in maladaptive behaviors as well as impede adherence to medical recommendations, psychological interventions have shown promise in improvement of both negative affect and adherence. Tisha reported engaging in maladaptive overeating patterns in response to emotional distress associated with her medical conditions. Upon participating in an intervention that applied dialectical behavior therapy skills to address binge-eating behaviors, Tisha reported that radical acceptance was a particularly useful skill that taught her the importance of acknowledging and accepting the reality of her health condition and thereby reducing engagement in binge-eating behaviors. Post-intervention behavioral ratings also demonstrated clinically significant improvement in depressive problems. The results of this case report highlight the need for simultaneous treatment of physical and psychological symptoms and underscore the importance of early intervention.

Implementing a condensed dialectical behavior therapy skills group for binge-eating behaviors in adolescents.

PURPOSE: Subthreshold binge-eating disorder (BED) symptoms can lead to additive physical and psychological health challenges and may put youth at risk for developing BED during the early adulthood. We examined the implementation of a condensed dialectical behavior therapy (DBT) skills intervention for subthreshold binge-eating behaviors in adolescents. METHODS: Fifteen 14-18 years old participated in a 10-week DBT skills group, which experientially introduced mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness skills in the context of emotionally driven overeating behaviors. Adolescents and caregivers completed measures of emotional eating and binge-eating behaviors at baseline and post-intervention, including the Eating Disorder Examination Questionnaire and Emotional Eating Scale for Children and Adolescents. Eleven participants were retained at 3-month follow-up. RESULTS: Descriptive statistics were compared at all three time points. Results suggested a reduction in emotional eating and binge-eating behaviors based on youth self-report and caregiver report. Acceptability ratings of the treatment were high among participants completing the intervention. CONCLUSIONS: Using DBT skills to target emotionally driven overeating behaviors in youth may be useful in the treatment of subthreshold BED behaviors and potentially deter future development of full-criteria BED. LEVEL OF EVIDENCE: Level IV, uncontrolled pilot trial.

Description of an intervention to treat binge-eating behaviors among adolescents: Applying the Template for Intervention Descriptions and Replication.

Binge-eating disorder (BED) is related to deleterious physical, social, and psychological outcomes among adolescents, and is more common among racial and ethnic minorities. Dialectical behavior therapy (DBT), an evidence-based treatment for disorders of emotion dysregulation, has demonstrated efficacy in treating disordered eating patterns. While DBT interventions have demonstrated success among adults with BED, less is known about adaptation of DBT for adolescents presenting with BED and subthreshold binge-eating behaviors. This paper describes the Emotional Overeating Intervention, a 10-week DBT skills-based group intervention for adolescents exhibiting binge-eating behaviors. The Template for Intervention Description and Replication (TIDieR) checklist is used to describe the intervention with the intention of providing necessary details to implement the intervention in clinical practice or replicate the intervention for further study. The rationale for a condensed version of DBT, potential modifications for future implementation, and the importance of adapting the intervention in a developmentally and culturally responsive manner are discussed. This adapted treatment modality can guide future studies examining interventions for adolescents exhibiting binge-eating behaviors.

Endorsement of Binge Eating Symptoms in a Sample of Predominantly Non-Hispanic Black Adolescents.

Binge eating disorder (BED) as well as individual subthreshold binge eating symptoms are related to deleterious physical and socioemotional outcomes among adolescents. The present study examined the prevalence of specific binge eating behaviors among a sample of primarily non-Hispanic Black outpatients presenting to weight management and endocrinology clinics. Analyses are based on 103 adolescents (69.9% female, 66.9% non-Hispanic Black) who endorsed one or more binge eating symptoms on a nonstandardized clinical assessment patterned after Diagnostic Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. The most commonly endorsed symptom was eating in excess of what is considered normal (71.8%), while least commonly endorsed symptoms included guilt, distress, and embarrassment due to overeating (17.5% to 26.2%). More than half of the participants endorsed multiple specific binge eating symptoms. The level of subthreshold symptomatology reported underscores the importance of developmental and cultural tailoring of prevention and intervention efforts to address these behaviors as a means of curbing clinical-level onset of BED.

Disordered Eating Among Trans-Masculine Youth: Considerations Through a Developmental Lens.

As with male populations more generally, eating disorder symptom expression among trans-masculine youth is understudied. Gender minority individuals are at increased risk for eating disorders; however, culturally responsive and developmentally tailored research is limited. Although all gender minority individuals may experience elevated risk for developing eating disorders, the focus of this article is trans-masculine youth. We provide a theoretical conceptualization of eating disorder symptom expression among this understudied group, and propose novel directions for research, particularly for youth at pubertal onset. Adolescence as a critical developmental period for intervention is highlighted.