A Comprehensive Scoping Review of Empirical Studies on Earned Secure Attachment.

Earned-Secure Attachment (ESA) can be defined as the process by which individuals with insecure childhood attachment rise above malevolent childhood experiences to develop secure relationships pattern in adulthood. To our knowledge, no previous review has summarized findings from empirical literature about this topic. To fill this gap, we conduct a preregistered scoping review (research published until 2023) following the PRISMA Extension for Scoping Reviews, to find how ESA has been defined, assessed, and studied in the empirical literature. Four databases were searched (Scopus, PsycInfo, PubMed and Web of Science), 24 studies were included in the review and were assessed using the Mixed Methods Appraisal Tool. Findings from our review reveal a more formal than substantial agreement on the conceptualization of ESA and the conclusions that can be made, considering the heterogeneity of our results, are only preliminary. Developmental factors, the association between ESA and depressive symptoms and the role of fathers remain poorly defined, although the importance of secondary attachment figures and reflective functioning as factors that may contribute to earned-security in attachment is clear. Recommendations and future steps for researchers and practitioners are highlighted.

Clinical cut-off scores for the Borderline Personality Features Scale for Children to differentiate among adolescents with Borderline Personality Disorder, other psychopathology, and no psychopathology: a replication study.

BACKGROUND: Despite being one of the most popular measures of borderline pathology in adolescents, only one study has evaluated clinical cut-off scores for the Borderline Personality Features Scale for Children (BPFS-C) using a small sample without a healthy comparison group (Chang B, Sharp C, Ha C. The Criterion Validity of the Borderline Personality Features Scale for Children in an Adolescent Inpatient Setting. J Personal Disord. 2011;25(4):492-503. https://doi.org/10.1521/pedi.2011.25.4.492 .). The purpose of the current study was to replicate and improve on the limitations of the prior study conducted by Chang et al. to more definitively establish clinical cut-off scores for the self- and parent-report versions of the BPFS-C to detect clinical and sub-clinical borderline personality disorder (BPD) in a large sample of adolescents with BPD, other psychopathology, and no psychopathology. METHODS: A total of 900 adolescents ranging from ages 12-17 participated in this study. The clinical sample consisted of 622 adolescents recruited from an inpatient psychiatric facility, and the healthy control sample consisted of 278 adolescents recruited from the community. All participants completed the BPFS-C and were administered the Child Interview for DSM-IV Borderline Personality Disorder (CI-BPD). RESULTS: Using three-way ROC analyses, cut-off scores on the self- and parent-report versions of the BPFS-C distinguishing adolescents with BPD from those with subclinical BPD, and those with subclinical BPD from healthy adolescents were established. CONCLUSIONS: These findings support the use of both versions of the BPFS-C to detect adolescents with BPD and sub-clinical BPD.

Examining the Validity of the Levels of Personality Functioning Questionnaire for Adolescents Aged 12-18 (LOPF-Q 12-18): A Replication and Extension With a Sample of Lithuanian Adolescents.

With the shift to the dimensional model of personality pathology, the need for measures assessing personality functioning in adolescence has emerged. The Levels of Personality Functioning Questionnaire 12-18 (LoPF-Q 12-18) was developed specifically for adolescents, tailoring the Alternative Model of Personality Disorders in the DSM-5. Using the Lithuanian LoPF-Q 1218, we further investigate its validity by reexamining its factorial structure and extending convergent, discriminant, and incremental validity analyses. A total of 1,048 community-based and clinically referred 12-18-year-old adolescents completed the LoPF-Q 12-18 along with other self-report measures of personality pathology, psychopathological symptoms, and psychosocial functioning. In line with previous findings, the results supported the bifactor model consisting of a strong general factor and little multidimensionality caused by the group factors, overall suggesting an essentially unidimensional structure. Further analyses provided additional information on the construct validity of the LoPF-Q 12-18.

Mental Flexibility and Epistemic Trust Through Implicit Social Learning - A Meta-Model of Change Processes in Psychotherapy With Personality Disorders.

This position paper follows the call for transtheoretical meta-models of general clinical change by concentrating on severe mental illness such as Personality Disorders (PDs). We have identified a core process of change related to mental flexibility through implicit learning and propose recommendations for stance and technique that are informed by research on Mentalization-Based-Treatment (MBT) and the learning components as represented in the Mediational Intervention for Sensitizing Caregivers (MISC). While the idea of corrective emotional experience as a general change mechanism involves discriminating between an old and new relationship to update relationship knowledge, the capacity to understand and process corrective emotional experiences may be limited and even iatrogenic in patients with PDs. By integrating MBT and MISC, a meta-model of change is created that allows training in and observation of the granular-level, behaviorally anchored, actions taken by the therapist to open up social learning. Here, social learning is conceptualized as epistemic trust, increasing the client's reflective functioning during sessions to ultimately enhance cognitive flexibility outside the therapy room. This opens the possibility to implement and observe micro changes in what should be termed now implicit cognitive and emotional corrective experiences. Thus, we propose to shift towards implicit learning within professional relationships; that is, internalizing a new way of thinking about any life-event that requires adaption thereby creating adaptive capacities via mental flexibility as the general change mechanism of Personality Disorder (PD) treatment.

Trauma-related symptoms in adolescents: the differential roles of sexual abuse and mentalizing.

Introduction: Major gaps remain in our knowledge regarding childhood sexual abuse (CSA) related symptoms in adolescent psychiatric inpatients, as well as potential resilience factors like mentalizing. CSA is a risk factor for the early emergence of borderline personality features, posttraumatic stress, and sexual concerns. Mentalizing, which involves the capacity to understand our reactions and that of others in psychological terms, is a resilience factor for self and interpersonal functioning. The aim of this study was to address knowledge gaps by examining the contributions of CSA and mentalizing in a latent factor composed of borderline personality features, posttraumatic stress, and sexual concerns in a sample of adolescent psychiatric inpatients. We hypothesized that CSA and mentalizing would independently explain the variance in this latent factor. Method: Participants were 273 adolescents aged 12-17 recruited from an adolescent inpatient psychiatric clinic. They completed the Reflective Function Questionnaire for Youth (RFQ-Y), the Trauma Symptom Checklist for Children (TSCC), and the Borderline Personality Features Scale for Children (BPFS-C). CSA was assessed using the Child Attachment Interview (CAI), the Computerized Diagnostic Interview Schedule for Children (C-DISC), as well as the Childhood Trauma Questionnaire (CTQ). Results: 27.5% of adolescent psychiatric inpatients reported CSA. CSA and mentalizing were independently associated with a latent factor consisting of posttraumatic stress, borderline personality features, and sexual concerns. CSA explained 5.0% and RF explained 16.7% of the variance of the latent factor. When we consider both the unique and the shared contribution of CSA and mentalizing, the model explained 23.0% of the variance of this factor. Discussion: CSA and mentalizing independently explained variance in a latent factor constituted of borderline personality features, posttraumatic stress, and sexual concerns. The direct effect of mentalizing was stronger and mentalizing explained comparatively more variance of trauma-related symptoms in adolescent psychiatric inpatients. The findings are consistent with the theory that mentalizing is an internal resilience factor in adolescent psychiatric inpatients. By implication, clinical interventions focused on promoting the development of mentalizing, such as Mentalization Based Treatment, may palliate mental health difficulties manifested by adolescent psychiatric inpatients including those associated with CSA.

Maternal Borderline Personality Disorder Severity and Parenting Behaviors During Conflict Discussions With Adolescent Offspring.

Examining the impact of maternal borderline personality disorder (BPD) on parent-child interactions could elucidate pathways of intergenerational risk and inform intervention. The current study used an expanded version of the Observing Mediational Interactions to investigate (a) associations between maternal BPD symptom severity and mediational parenting behaviors during conflict discussions with clinically referred early adolescent offspring (N = 56, age = 10-15, 54% female) and their mothers, and (b) the potential moderating role of early adolescent BPD symptom severity in those associations. Consistent with hypotheses, mothers with higher levels of BPD symptom severity engaged in fewer positive emotional/attachment-based behaviors and more negative (i.e., invalidating, controlling, coercive, or insensitive) parenting behaviors. Only parent-reported, but not self-reported, adolescent BPD severity moderated these associations; maternal BPD severity was significantly associated only with negative parenting in dyads with low-to-moderate levels of parent-reported adolescent BPD severity. We discuss implications including targeting attachment-based and negative parenting behaviors in intervention.

First psychometric evaluation of the Level of Personality Functioning Scale-Brief Form 2.0 in adolescents.

Reflecting the recent consensus that challenges in personality functioning often onsets in adolescence, and the move toward dimensional models of personality pathology such as the level of personality functioning (LPF) of the alternative model for personality disorders, it is important to have validated measures that can assess LPF in young people. The Level of Personality Functioning Scale-Brief Form 2.0 (LPFS-BF 2.0) is the briefest measure of LPF and may be particularly well suited for assessing LPF in youth; however, it has yet to be formally validated in youth. Therefore, the current investigation evaluated the psychometric properties of the LPFS-BF 2.0 in adolescents drawn from a community sample of ethnically diverse North American youth (N = 194, age 12-18; 58% female). Factor structure, gender invariance, reliability, convergent validity, incremental validity, and criterion validity were evaluated. Results demonstrated support for the LPFS-BF 2.0's unidimensional factor structure, as well as high internal consistency. Configural, metric, and scalar measurement invariance was supported across male and female genders, as well as convergent validity. Relative to the Personality Inventory for the DSM-5 Brief Form and Levels of Personality Functioning Questionnaire 12-18, the LPFS-BF 2.0 demonstrated additional variance in predicting borderline personality features, and internalizing and externalizing problems. Study findings support the English version of the LPFS-BF 2.0 as a brief and psychometrically sound instrument for assessing LPF in youth and adolescents. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Prospective prediction of treatment outcomes in adolescents: A head-to-head comparison of alternative model for personality disorder versus borderline personality disorder.

Despite substantial evidence in support of the alternative model for personality disorder (AMPD) that has accumulated over the last decade, a gap remains in terms of head-to-head comparisons of the predictive power of Section II categorical diagnoses versus Section III AMPD diagnoses for clinical outcomes. The current study uses archival data from a naturalistic treatment outcome study in an adolescent psychiatric inpatient sample to compare the predictive power of the Section III AMPD (combined Criterion A and B assessment) versus Section II borderline personality disorder (BPD) in predicting treatment outcomes from admission to discharge. Outcomes in general psychiatric severity and emotion dysregulation were assessed in a sample of 59 adolescents (76.3% female, Mage = 15.27, SD = 1.17) at admission and at discharge on average about a month later. Results showed that, on average, predictive power of both AMPD measures and BPD were relatively modest. However, the AMPD, operationalized through combined measures of identity diffusion and maladaptive traits, was a stronger predictor of reduction in general psychiatric severity than a measure of BPD. The findings of the study add to a growing body of literature pointing to the advantages of Section III AMPD over Section II categorical diagnosis for clinical utility in predicting treatment response. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

First Psychometric Evaluation of the English Version of the Semi-Structured Interview for Personality Functioning (STiP-5.1).

The Alternative Model for Personality Disorders provides a dimensional framework for the conceptualization of personality disorders where Criterion A concerns the assessment of one's level of personality functioning (LPF). This study examines the psychometric properties of the English translation of the Semi-Structured Interview for Personality Functioning (STiP-5.1) to validate this translation for the assessment of LPF in English-speaking populations; and examine whether this measure increments self-report measures of LPF and personality pathology in predicting general functioning. The sample consisted of 129 emerging adults between 18 and 25 years of age (M = 20.54, SD = 2.08) from a mixed college and clinical sample. Results support a unidimensional factor structure of the STiP-5.1, good internal consistency, and high inter-rater reliability. Construct validity was supported through associations of the STiP-5.1 with self-report measures of LPF and personality pathology. The STiP-5.1 incremented self-report measures of personality pathology in predicting functional impairment, though additional variance explained was modest. Finally, STiP-5.1 scores differentiated individuals who obtained a score at or above the clinical cutoff from those below on self-report measures of personality pathology and LPF with large effect sizes. Findings support the validity of the English translation of the STiP-5.1 for the assessment of LPF.

The reflective function questionnaire for youth: Hungarian adaptation and evaluation of associations with quality of life and psychopathology.

An important correlate of mental health problems is mentalizing capacity, which appears to be particularly influential during adolescence. However, quality of life has not been studied in relation to mentalizing capacity among adolescents. This study aimed to translate the Reflective Function Questionnaire for Youth (RFQY) into Hungarian, present its psychometric properties, and assess its relationship with demographic characteristics, psychopathology and quality of life. A community sample of 384 youths aged 12-18 years completed the RFQY, the Measure of Quality of Life for Children and Adolescents, and the Strengths and Difficulties Questionnaire. First, we conducted an exploratory factor analysis with direct oblimin rotation on the RFQY items. Next, we assessed the associations between the RFQY and demographics, quality of life, and psychopathology. The EFA resulted in four factors: Internal-self, Internal-other, Self-other, and Strong emotions. The Cronbach's alpha coefficients of the scales were .81, .82, .67, and .80, respectively. The subscales were uniquely associated with psychopathology and quality of life. Our study provides the first psychometric support for the Hungarian version of the RFQY and indicates that adolescents suffering from internalizing, externalizing symptoms or lower levels of quality of life could benefit from interventions aimed at enhancing mentalizing capacity.

An important correlate of mental health problems is mentalizing capacity, which appears to be particularly influential during adolescence. However, quality of life has not been studied in relation to mentalizing capacity among adolescents. This study aimed to translate the Reflective Function Questionnaire for Youth (RFQY) into Hungarian, present its psychometric properties, and assess its relationship with demographic characteristics, psychopathology and quality of life. A community sample of 384 youths between the ages of 12 and 18 completed the RFQY, the Measure of Quality of Life for Children and Adolescents, and the Strengths and Difficulties Questionnaire. Our study provides the first psychometric support for the Hungarian version of the RFQY and indicates that adolescents suffering from internalizing, externalizing symptoms or lower levels of quality of life could benefit from interventions aimed at enhancing mentalizing capacity.

Considerations in cultural adaptation of parent-child interventions for African American mothers and children exposed to intimate partner violence.

African American women are at disproportionate risk of experiencing intimate partner violence (IPV) and consistently report more severe and recurrent IPV victimization in comparison to their White and Hispanic counterparts. IPV is more likely to occur in families with children than in couples without children. Parenting in the wake of IPV is a challenging reality faced by many African American women in the United States. Despite the urgent need to support mothers who have survived IPV, there is currently no culturally adapted parenting intervention for African American mothers following exposure to IPV. The aim of this review is to summarize and integrate two disparate literatures, hitherto unintegrated; namely the literature base on parenting interventions for women and children exposed to IPV and the literature base on parenting interventions through the lens of African American racial and cultural factors. Our review identified 7 questions that researchers may consider in adapting IPV parenting interventions for African American women and children. These questions are discussed as a possible roadmap for the adaptation of more culturally sensitive IPV parenting programs.

The assessment of pathways towards suicide in adolescent patients: A PDM-2-oriented approach.

OBJECTIVES: Increasing evidence has supported the mutual relationship between suicidal motivations and personality pathology, especially in adolescence. Distinctive aspects of personality functioning can explain the tendency to resort to suicidal ideation and behaviours, which, in turn, may play a specific role in exacerbating severe impairments in self-regulation mechanisms that underlie personality pathology. DESIGN: This study illustrates, through two clinical cases, the clinical utility of using the Psychodynamic Diagnostic Manual - Second Edition (PDM-2) to better understand distinct pathways of suicidal processes. METHODS: Two adolescents, named Luis and Gael, who attempted suicide multiple times were assessed using the Psychodiagnostic Chart Adolescent (PDC-A) of the PDM-2 to evaluate their mental functioning, emerging personality styles or syndromes, and symptom patterns. They were interviewed using the Motivational Interview for Suicidality in Adolescence (MIS-A) to identify the motivations underpinning their suicidal behaviour. RESULTS: The results showed that Luis presented a narcissistic personality characterized by the need to deny his vulnerabilities through suicidal fantasies as a form of escape, while Gael presented a borderline personality characterized by the use of suicide attempts to express her inner and unspeakable pain. CONCLUSION: The study seems to support the reciprocal interconnections between personality functioning and suicidal motivations that should be better identified to plan tailored and more effective interventions.

Assessing Criterion A of the Alternative Model for Personality Disorders: The Potential of Performance-Based Personality Measures.

The conceptualization of personality disorder has been refined through recent nosological advances introduced in the Alternative Model for Personality Disorders (AMPD). These advances locate self and interpersonal (dys)function at the core of personality pathology. Self-report personality assessment instruments have demonstrated promise in the assessment of Criterion A domains. However, research highlighting the utility of performance-based personality assessment instruments has been largely absent in these advances, despite acknowledgment of their potential. We adhered to PRISMA review guidelines to survey and assess the potential relevance and utility of select performance-based personality instruments in assessing Criterion A domains of the AMPD. We conclude that performance-based personality measures are uniquely positioned to assess maladaptive self- and interpersonal functioning and may address some limitations of self-report measures. Toward this end, we propose a working model that provides ranges of test scores that correspond to the 5-point scale of the Criterion A domains of the AMPD.

Experiential avoidance in participants with borderline personality disorder and other personality disorders.

BACKGROUND: The present study has descriptive and predictive aims. The descriptive aims were to determine if participants with borderline personality disorder (BPD) reported higher levels of experiential avoidance (EA) than participants with other personality disorders (OPD) as well as determine if non-recovered participants with BPD reported higher levels of EA than participants with BPD who have recovered symptomatically and psychosocially. The predictive aim was to determine if the level of EA reported by participants with BPD was predicted by the severity of aspects of childhood or adult adversity and/or aspects of temperament. METHODS: The Overall Anxiety Severity and Impairment Scale (OASIS) was administered to 248 participants at 24-year follow-up in the McLean Study of Adult Development (MSAD). Adversity and temperament were assessed during index admission using interviews (Revised Childhood Experience Questionnaire [CEQ-R], Adult History Interview [AHI], and the NEO-FFI self-report measure). RESULTS: Participants with BPD reported significantly higher levels of EA than those with OPD. Within the BPD group, non-recovered participants reported significantly higher levels of EA than recovered participants. Severity of childhood sexual abuse and lower levels of extraversion were found to be significant multivariate predictors of levels of EA in those with BPD. CONCLUSIONS: Taken together, these results suggest that EA is a serious problem for participants with BPD, particularly those who have not recovered. They also suggest that both the severity of childhood adversity and a temperament marked by lower levels of extroversion are significantly related to levels of EA reported by participants with BPD.

Patient personality and therapist responses in the psychotherapy of adolescents with depressive disorders: toward the Psychodynamic Diagnostic Manual - third edition.

Depressive disorders in adolescence pose unique challenges for assessment and treatment, particularly due to their high comorbidity with various personality disorders. Moreover, young depressed patients may elicit very intense and difficult-to-manage emotional responses in therapists (in this context, countertransference). This study aimed at empirically identifying specific personality disorders (or subtypes) among adolescents with depressive pathology and exploring distinct countertransference patterns emerging in their psychotherapy: 100 adolescents (58 with depressive disorders; 42 with other clinical conditions) were assessed by their respective clinicians (n=100) using the psychodiagnostic chart-adolescent of the Psychodynamic Diagnostic Manual (PDM) - second edition, and the therapist response questionnaire for adolescents. Results showed that depressed adolescent patients exhibited marked traits of four personality subtypes (i.e., depressive, anxious-avoidant, narcissistic, and borderline) characterized by different levels of mental functioning and personality organization. These subtypes were predictably related to specific clinicians' emotional responses, even when controlling for the intensity of depressive symptomatology. Patients with depressive or anxious-avoidant personality subtypes evoked more positive countertransference responses, whereas patients with narcissistic or borderline subtypes elicited strong and hard-to-face emotional responses in therapists. Consistent with the next edition of the PDM, the study emphasizes the importance of comprehensive psychodynamic assessment in the developmental age, which frames depressive disorders in the context of accurate emerging personality and mental functioning profiles. This approach, which also relies heavily on the clinician's subjective experience in therapy, provides crucial information on how to specifically tailor interventions that more effectively meet the needs of adolescents with these heterogeneous and complex clinical conditions.

Familism moderates the association between parent-child conflict, interpersonal needs, and suicidal ideation among adolescents.

Within the framework of the interpersonal theory of suicide, parent-child conflict in adolescence may be associated with suicidal ideation through increases in thwarted interpersonal needs (i.e., perceived burdensomeness and thwarted belongingness). Familism, a cultural value that emphasizes prioritizing familial interconnectedness and honor, may moderate the association between parent-child conflict and thwarted interpersonal needs. This study examined the relationship between parent-child conflict, familism, and suicidal ideation through the interpersonal theory of suicide. Participants were N = 250 psychiatrically hospitalized adolescents aged 12-17 years (Mage = 14.84, 60.8% female; 41.9% Hispanic, 21.5% African American/Black, 26.0% Caucasian). Participants completed survey and interview measures prior to discharge from psychiatric hospitalization. There was a significant conditional indirect effect of parent-child conflict on suicidal ideation through thwarted interpersonal needs [F (3, 246) = 54.41, p < .01], such that the strength of the indirect effects family conflict on suicidal ideation via thwarted interpersonal needs increased as familism increased. Findings indicate that the relationship between parent-child conflict and thwarted interpersonal needs may be exacerbated when levels of familism are also high. For youth who endorse high levels of familism, parent-child conflict may be particularly pernicious. Interventions targeting the family environment are needed to potentially improve adolescents' interpersonal functioning and protect against suicidal ideation.

Child and adolescent suicide is a growing and pressing problem, and it is currently the second leading cause of death among people aged 10­34. One theory of suicide, called the interpersonal theory of suicide, proposes that suicide ideation is related to two main risk factors: feeling that one's life is a burden on others (called perceived burdensomeness) and feeling like one is disconnected from others (called thwarted belongingness). In this theory, risk factors like parent-child conflict may be related to suicide ideation through increases in perceived burdensomeness and thwarted belongingness. It is possible that cultural values that prioritize family connectedness and honor (called familism) may also impact these relationships. The current study looked at how parent-child conflict, familism, and adolescent suicide ideation were related to one another in the context of the interpersonal theory of suicide. Participants in the study were 250 adolescents in a psychiatric hospital who completed survey and interview measures before being discharged. Results found parent-child conflict was related to suicide ideation through increases in one's perceived burdensomeness and thwarted belongingness (higher parent-child conflict was related to higher ratings of perceived burdensomeness and thwarted belongingness, which was related to higher ratings of suicide ideation), and the strength of the relationship between parent-child conflict, perceived burdensomeness, and thwarted belongingness increased as ratings of familism increased. These results indicate that parent-child conflict may have an especially strong relationship with thoughts of suicide in adolescents who also report a high level of familism. Therefore, suicide-related interventions that target the family environment may help prevent and treat adolescent suicide ideation.

Attachment-Based Mentalization Profiles of Iranian Children: A Mixed-Method Approach.

Mentalization, operationalized as reflective functioning (RF), is the ability to understand one's own and another's mental world implicitly or explicitly. RF is a newly discovered research field in Iran and is largely under-studied in Eastern cultures in general, underscoring the high need for cross-cultural studies in this field of research. A qualitative method was used to examine the ability to understand, process, and respond to high-arousal attachment situations in typical and clinical populations of Iranian children recruited from a Tehran primary school. A well-known semi-structured interview commonly used to assess RF in children was used to collect data. Required information on internalizing and externalizing symptoms, demographic information, and all formal diagnoses of children were collected by parents. The results indicated the identification of four different profiles of RF in children, one of which was adaptive, while the other three were maladaptive. Also, the results showed that typically developing children and those having a high social and economic status (SES) were characterized as having a more adaptive profile of RF, while children from the clinical population and those with a low SES reported a more maladaptive profile (passive mentalizing, helpless mentalizing, narcissistic mentalizing) of RF. The present study is an important step in increasing our understanding of the development of mentalization in children and has significant educational and clinical implications.

Pregnancy and STI/HIV prevention intervention preferences of South African adolescent girls: findings from a cultural consensus modelling qualitative study.

South African adolescent girls experience high rates of unintended pregnancy and sexually transmitted infections including HIV. To inform culturally-tailored dual protection interventions to prevent both unintended pregnancy and STIs/HIV, this study qualitatively examined girls' sexual health intervention preferences. Participants were aged 14-17 years old and Sesotho-speaking (N = 25). To elucidate shared cultural beliefs, individual interviews examined participants' perceptions about other adolescent girls' pregnancy and STI/HIV prevention intervention preferences. Interviews were conducted in Sesotho and translated into English. Two independent coders identified key themes in the data using a conventional content analysis approach with discrepancies resolved by a third coder. Participants indicated that intervention content should include efficacious pregnancy and STI/HIV prevention methods and ways to navigate peer pressure. Interventions should be accessible, avoid criticism and provide high-quality information. Preferred intervention formats included online, SMS/text, or delivery by social workers or older, knowledgeable peers, with mixed acceptability for delivery by parents or same-age peers. Schools, youth centres and sexual health clinics were preferred intervention settings. Results highlight the importance of cultural context in tailoring dual protection interventions to address the reproductive health disparities among adolescent girls in South Africa.

Awareness of Narrative Identity Questionnaire (ANIQ) in Early Adolescents: Psychometric Evaluation and Association with Features of Personality Disorder.

Identity formation is central to adolescent development. Challenges in establishing a stable sense of self is associated with maladaptive identity function, which has been recognized as a core feature of personality pathology. The narrative identity framework offers a unique lens to garner salient information about one's sense of self. The Awareness of Narrative Identity Questionnaire (ANIQ) is a self-report measure of narrative identity validated in adults but is yet to be validated in adolescents. The current study aimed to conduct the first psychometric evaluation of the ANIQ in a sample of 205 youth aged 10-14 years (M = 12.1 ± 1.06 years; 50.7% female; 73.7% Hispanic) recruited from a public charter school. Results confirmed the four-factor structure of the ANIQ and showed high internal consistency. Convergent validity was supported through negative associations between the ANIQ and borderline personality features and identity diffusion. Incremental validity of the ANIQ over identity diffusion in predicting borderline personality features was also examined, but not supported. Overall, results support the ANIQ as a promising instrument for the assessment of narrative identity in youth. However, some improvements to the ANIQ might be necessary in order to use it as a clinical tool in identifying youth with personality pathology.