The experiences of parents in an early-intervention program for young people with borderline personality disorder features.

Previous research demonstrates that parents' communication skills may contribute to the development and maintenance of their young person's borderline personality disorder (BPD). Carers of people with BPD also experience their own psychosocial stressors and feel unsupported. Consequently, Dialectical Behavior Therapy for adolescents (DBT-A) invites parents to partake in group therapy alongside their young person. Despite this involvement, little research exists examining parents' perspective of engaging in a DBT-A program, and specifically whether they experience their own benefits and changes from being part of the program. To examine this, the current study interviews 34 parents who engaged in an early intervention DBT-A program. Thematic analysis resulted in seven key themes and 16 subthemes beginning with parents' expectations of the program, followed by the key elements of the program that facilitated change, and the actual changes and benefits attributed to these elements. Overall, parents were surprised by their own gains from the program, and how the skills they learned facilitated personal development that improved family communication and functioning with their young person and more broadly. This study addresses the gap in understanding the parent perspective with clinical implications for the benefits of involving parents in therapy more generally.

The distinct affect regulation functions of body image flexibility and inflexibility: A prospective study in adolescents and emerging adults.

Body image flexibility and inflexibility are alternative ways of responding to body image threats. Affect regulation offers a framework for understanding how these responses impact health outcomes; however, research in young people is limited. This prospective study tested two potential affect regulation functions in adolescents and emerging adults (N = 351, 66.7% female) via online surveys completed five months apart. Specifically, body image flexibility and inflexibility were tested as (a) direct predictors of adaptive (body appreciation, intuitive eating) and maladaptive (muscle-building strategies, disordered eating) outcomes, and (b) moderators of the indirect effect of a social comparison threat via body appreciation. Results from hierarchical linear and conditional process models showed that body image flexibility and inflexibility served distinct affect regulation functions. Whereas body image inflexibility directly predicted adaptive and maladaptive body- and eating-related outcomes, body image flexibility protected against the negative effects of social comparison on intuitive eating via body appreciation. Findings suggest that adolescents and emerging adults could benefit from learning body image flexibility skills and reducing inflexibility to promote positive body image and prevent body- and eating-related disturbances. Future research should investigate how body image flexibility and inflexibility relate to other established threats and outcomes in diverse demographic groups.

Psychosocial impacts of training to provide professional help: Harm and growth.

Introduction: Research has consistently demonstrated professionals in helping roles ("helping professionals") experience vicarious trauma, moral injury, compassion fatigue, secondary traumatic stress, and burnout. Vicarious post-traumatic growth has also been identified in the literature. This article aimed to contribute to understanding the experiences of these constructs of trainee helping professionals. Emphasis was placed on how to foster vicarious post-traumatic growth. Methods: A qualitative semi-structured interview was designed to enable the researchers to explore the experiences of 14 trainee psychologists from an Australian Master of Clinical Psychology program. Results: It was identified that burnout, and beginning stages of vicarious trauma, moral injury, compassion fatigue, and secondary traumatic stress might occur during psychologists' training. Five elements underpin vicarious post-traumatic growth, four of which were reflected in this article. A need and suggestions for how to further develop vicarious post-traumatic growth are discussed. Conclusion: This research could go on to be applied to curriculum development and practice policy, ultimately leading to improved early-intervention and ongoing systems of support for helping professionals. This, in turn, would improve quality of care in communities.

Structured data vs. unstructured data in machine learning prediction models for suicidal behaviors: A systematic review and meta-analysis.

Suicide remains a leading cause of preventable death worldwide, despite advances in research and decreases in mental health stigma through government health campaigns. Machine learning (ML), a type of artificial intelligence (AI), is the use of algorithms to simulate and imitate human cognition. Given the lack of improvement in clinician-based suicide prediction over time, advancements in technology have allowed for novel approaches to predicting suicide risk. This systematic review and meta-analysis aimed to synthesize current research regarding data sources in ML prediction of suicide risk, incorporating and comparing outcomes between structured data (human interpretable such as psychometric instruments) and unstructured data (only machine interpretable such as electronic health records). Online databases and gray literature were searched for studies relating to ML and suicide risk prediction. There were 31 eligible studies. The outcome for all studies combined was AUC = 0.860, structured data showed AUC = 0.873, and unstructured data was calculated at AUC = 0.866. There was substantial heterogeneity between the studies, the sources of which were unable to be defined. The studies showed good accuracy levels in the prediction of suicide risk behavior overall. Structured data and unstructured data also showed similar outcome accuracy according to meta-analysis, despite different volumes and types of input data.

Therapeutic interventions in Australian primary care, youth mental health settings for young people with borderline personality disorder or borderline traits.

BACKGROUND: This study aimed to investigate what therapeutic interventions were being applied by clinicians working with young people with a diagnosis of Borderline Personality Disorder or borderline traits in Australian primary mental health care settings. Given the current lack of evidence-based guidelines for treatment with this client population, investigating what is being implemented is needed. The study also aimed to determine whether the interventions clinicians are using are effective in reducing distress and increasing functioning for these clients. METHODS: Participant data came from the national minimum data set for headspace youth mental health centers across Australia. Young people's data were included in the study if the young person was diagnosed with Borderline Personality Disorder or borderline traits during their first episode of care (N = 701). Clinician data that indicated the type of intervention used at each client session and outcome measures routinely captured were analyzed to determine interventions used and outcomes achieved. RESULTS: Results demonstrated that CBT was the most frequently used modality of intervention followed by supportive counselling and IPT, but that most clients received a variety of intervention types. There were no or only weak relationships between changes in outcomes and the amount of any type of intervention that was provided. No significant relationship was found with the amount of CBT a client received and changes in symptoms or functioning, despite being the most commonly employed modality. CONCLUSIONS: The study highlights the need for evidence-based treatment guidelines for early intervention in young people with borderline personality disorder traits.

Exploring young people's expectations of a youth mental health care service.

UNLABELLED: Client expectations about mental health services relate to the client's and the therapist's role, the therapeutic process and therapeutic outcomes. Research with adults shows that such expectations affect service engagement and clinical outcomes. AIM: The present study investigated expectations for adolescents and young adults, which have not been adequately investigated and may partly explain the reluctance of young people to seek professional help. METHODS: Participants included 20 young people aged 12-24 attending their initial session at a youth mental health service, who were interviewed immediately prior to their initial session. Data were analysed using qualitative methods to draw main themes around each of the four expectancy types. RESULTS: Overall, the strongest theme was that young people were unsure of what to expect from attending a mental health service. The key theme for expectations of their role as a client was readiness for therapy, and for the therapist's role the key themes were who they expected to see, the directiveness and likeability of the therapist, and the type of help they expected they would receive. The young people expected that the therapy process would involve simply talking and expected their engagement to be dependent on how much they liked their first few sessions. Outcome expectations were non-specific and the theme of hopefulness was most evident. CONCLUSION: As unrealistic and unmet expectations can lead to poorer engagement and outcomes in therapy, the study highlights a need for young people to be better informed about what to expect when coming to mental health services.