Adverse and benevolent childhood experiences among adults in the United Kingdom: a latent class analysis.

BACKGROUND: Adverse childhood experiences (ACEs) are important factors for population mental and physical health. While considerable public health literature demonstrates the global relevance of ACEs, more recent research shows that benevolent childhood experiences (BCEs) might be important to consider in their direct and mitigating roles for psychological distress and other mental health outcomes. There is little evidence of latent class examinations involving both ACEs and BCEs among adults in western nations. The present study sought to replicate and extend prior literature by: (1) assessing the extent to which past latent class groupings reproduce in present samples, and (2) analyzing the association of latent classes of childhood experiences with psychological distress and suicidal thoughts and behaviours (STBs). We examined psychological distress (i.e., depression, anxiety, post-traumatic stress, general wellbeing) and STBs (i.e., suicidal ideation, self-harm ideation and behaviour, entrapment, and defeat). METHOD: Data were drawn from two nationwide cross-sectional online survey studies in the United Kingdom. The first sample (N = 488) was drawn from a study on suicidal behaviour, and the second sample (N = 447) was from a study concerning risk for interpersonal violence. RESULTS: Results largely replicated an existing four class solution of childhood experiences: Class 1 (Moderate ACEs/High BCEs; 17.6%), Class 2 (High ACEs/Moderate BCEs; 15.3%), Class 3 (Low ACEs/High BCEs; 48.3%), and Class 4 (Low ACEs/Moderate BCEs; 18.8%). Class 2 (High ACEs/Moderate BCEs) was associated with consistently worse psychological distress and STBs. Classes containing high BCEs (1 and 3) were characterized by generally lower levels of psychological distress and STBs. CONCLUSIONS: Results affirm the potential value for jointly considering ACEs and BCEs to understand psychological distress and STBs. ACEs and BCEs may serve foundational roles in theories of suicide. The protective role of BCEs hypothesized in resiliency theory may be supported. Prevention practice and research implications are discussed.

Psycholinguistic profiling of children with sluggish cognitive tempo.

Language disorders are frequently comorbid with attention deficit/hyperactivity disorder (ADHD). Sluggish cognitive tempo (SCT), a second attention disorder, may potentially explain some of the links between language disorders and ADHD. In this study we examined the psycholinguistic abilities of 207 children (mean age 7;10) with and without clinically significant levels of SCT symptoms to determine the degree to which symptoms of language disorder co-occur in cases of SCT. Analyses of children's tense-marking, nonword repetition, and sentence recall indicated that deficits in these areas were not associated with SCT. Instead, SCT appears to be more closely aligned with features of social (pragmatic) communication disorder.

Fostering community engagement, participation and empowerment for mental health of adults living in rural communities: a systematic review.

INTRODUCTION: Poor mental health is an under-recognised burden in rural locations. This is evident in suicide rates that are 40% higher in rural communities than in urban ones, despite a similar prevalence of mental disorders. The level of readiness and engagement of rural communities to adapt or even acknowledge poor mental health can impact effective interventions. For interventions to be culturally appropriate, community engagement should include individuals, their support networks and relevant stakeholders. Community participation guides people living in rural communities to be aware of and take responsibility for community mental health. Community engagement and participation foster empowerment. This review examines how community engagement, participation and empowerment were used in the development and implementation of interventions aimed at improving mental health of adults residing in rural communities. METHODS: Databases CINAHL, EmCare, Google Scholar, Medline, PsychInfo, PubMed and Scopus were systematically searched from database inception to July 2021. Eligible studies included adults living in a rural cohort where community engagement was used to develop and implement a mental health intervention. RESULTS: From 1841 records identified, six met the inclusion criteria. Methods were both qualitative and quantitative, including participatory-based research, exploratory descriptive research, community-built approach, community-based initiative and participatory appraisal. Studies were located in rural communities of the USA, UK and Guatemala. Sample size ranges was 6-449 participants. Participants were recruited using prior relationships, project steering committee, local research assistants and local health professionals. All six studies underwent various strategies of community engagement and participation. Only two articles progressed to community empowerment where locals influenced one another independently. The underlying purpose of each study was to improve community mental health. The duration of the interventions ranged from 5 months to 3 years. Studies on the early stages of community engagement discovered a need to address community mental health. Studies where interventions were implemented resulted in improved community mental health. CONCLUSION: This systematic review found similarities in community engagement when developing and implementing interventions for community mental health. Community engagement should involve adults residing in rural communities when developing interventions - if possible, both with a diverse gender representation and a background in health. Community participation can include upskilling adults living in rural communities and providing appropriate training materials to do so. Community empowerment was achieved when the initial contact with rural communities was through local authorities and there was support from community management. Future use of the strategies of engagement, participation and empowerment could determine if they can be replicated across rural communities for mental health.

A Social-Ecological Approach to Understanding Adolescent Sexting Behavior.

This study examined the extent to which active and passive sexting behaviors are associated with family-, school-, peer-, and romantic-level variables. Young people (N = 3,322; 49.1% female, 48.3% male, 2.6% other) aged 11 to 15 years old (M = 12.84, SD = 0.89) took part, and all attended mainstream secondary schools in Scotland. Participants completed self-report measures of school connectedness, parental love and support, perceived susceptibility to peer- and romantic-pressure (e.g., to display behaviors just to impress others), and their involvement in active and passive sexting. The importance of both school- and family-level factors was evident, though perceived romantic-pressure had the largest effect. However, neither school- nor family-level variables were moderated by either perceived romantic-pressure or perceived peer-pressure. Efforts to reduce sexting or increase its safety should primarily seek to tackle young people's ability to respond effectively to romantic-pressure. It may also be helpful to develop school connectedness and to help families provide support that is constructive and not intrusive.

A prospective examination of sleep chronotype and future suicide intent among adults in the United Kingdom: A test of the integrated motivational volitional model of suicide.

OBJECTIVES/BACKGROUND: Prior research identified a connection between evening chronotype and suicidality, but the mechanism underlying that connection is not well understood. The Integrated Motivational Volitional (IMV) Model of Suicide may provide a theoretical explanation for this link. The current project includes a three-time point longitudinal survey to examine whether 1) suicide intent likelihood varies across time, 2) chronotype affects suicide intent likelihood prospectively, and 3) defeat and entrapment explain the association between chronotype and suicide intent likelihood. PATIENTS/METHODS: Participants (n = 187 UK adults) completed a baseline survey (demographics, chronotype (morning-eveningness; MEQ), defeat and entrapment, and perceived intent to make a future suicide attempt), and follow-up surveys (MEQ and suicide intent likelihood) 3 and 6 months later. RESULTS: Results indicated that suicidal intent at 6-month follow-up was lower than baseline or 3-month follow-up. It was also found that strong evening chronotype at baseline is associated with increased suicidal intent 6 months later, and that defeat mediates this relationship. CONCLUSION: Our theoretically informed findings shed light on the psychological mechanisms linking chronotype (i.e., eveningness) and future suicide intent by highlighting the role of defeat and entrapment. We propose that feelings of defeat might be derived from evening types' experiences of social jetlag (resulting from conflict between biologically driven sleep schedules and externally dictated social schedules), which consequently drives entrapment and greater future suicide intent. Within this context, defeat and entrapment may be good transdiagnostic and modifiable target variables for future intervention development.

Examining mental health correlates of hate-motivated behaviour in Scotland: An investigation of victims, perpetrators and victim-perpetrators.

BACKGROUND: Hate-motivated behaviour (HMB) ranges from microaggressions to criminal acts and is a public health concern with wide-ranging consequences. AIMS: The current study aimed to examine the mental health correlates of HMB perpetration, victimisation and co-occurring victimisation/perpetration. METHODS: Participants (n = 447) completed an online cross-sectional survey assessing demographic factors, HMB (perpetration and victimisation), positive mental wellbeing and symptoms of depression and anxiety. RESULTS: HMB victimisation was associated with lower positive mental wellbeing and increased symptoms of anxiety and depression. However, neither HMB perpetration nor co-occurring perpetration/victimisation were associated with any of the three mental health outcome measures. CONCLUSION: Experiencing HMB as a victim is linked to increased psychological distress. Additional research, which focuses on sampling populations who are known to be at greater risk for involvement in HMB, is needed to fully understand the impact of the victim-offender overlap on mental health outcomes.

An Examination of Hate-Motivated Behavior Among Adults in Scotland and Associations with Risk Factors for Self-Directed Violence.

Hate-motivated behavior (HMB) ranges from microaggressions to criminal acts and is a public health concern with consequences for the physical and mental well-being of individuals, families, and communities. The Hate-Motivated Behavior Checklist (HMBC) was developed with the goal of advancing the measurement of HMB perpetration. To provide insights into perpetration and victimization across the HMB continuum in Scotland, the present study sought to examine the factor structure of both the original HMBC and our adapted victimization version in a sample of adults currently living in Scotland. It also aimed to test associations between HMB and cognitions, which are related to self-directed violence (defeat and entrapment). Participants (n = 447) completed an online cross-sectional survey assessing demographic factors, HMB (perpetration and victimization), and perceptions of defeat and entrapment. Confirmatory factor analysis was used to examine the factor structure of the HMBC and the adapted victimization version of this checklist and path analyses were implemented to provide insights into potential links between HMB, defeat, and entrapment. In line with previous work, results provided support for interpreting the HMB Checklist as a single-factor total score. This was also true for the victimization version of the checklist. Results indicated that HMB victimization (but not perpetration) was associated with increased perceptions of defeat and entrapment. These findings suggest that the HMBC (for assessing both perpetration and victimization) represents potentially useful tools for HMB research and supports their applicability outside of an American context. Furthermore, by examining HMB through the lens of a contemporary model of suicidal behavior, our findings also provide insights into potential psychological mechanisms linking interpersonal and self-directed violence. Future research should implement prospective research designs and integrate measures of self-directed violence outcomes alongside HMB, defeat, and entrapment, to further advance understanding of this association.

Efficacy of Complexity-Based Target Selection for Treating Morphosyntactic Deficits in Children With Developmental Language Disorder and Children With Down Syndrome: A Single-Case Experimental Design.

PURPOSE: Selecting targets for morphosyntactic intervention is a critical component of treatment planning. The complexity approach suggests that, by treating a complex morphosyntactic target, improvements will occur for the treated structure and for related, simpler structures. This study evaluated the efficacy of the complexity approach for treating morphosyntactic deficits by targeting a complex BE verb question structure for children with developmental language disorder (DLD) and children with Down syndrome (DS) and observing its impact on treated and untreated BE verb structures. We also explored whether etiology impacted our participants' treatment responses. METHOD: Three participants with DLD and three with DS received treatment for the BE verb question structure in the context of a single-case multiple-baseline design across participants. Accuracy of production for the treated structure and untreated BE verb structures was measured across baseline, treatment, and posttreatment phases. RESULTS: Treatment of the complex BE verb question structure resulted in change on the treated structure for three participants (i.e., two with DLD and one with DS). Generalization of treatment to untreated, related BE verb structures occurred for all six participants. Outcomes indicated participants from both etiologies benefited from treatment. CONCLUSIONS: This study provides evidence supporting the use of a complexity-based approach for selecting morphosyntactic treatment targets for children with DLD and children with DS. Additional research is needed to identify specific characteristics that may influence individual treatment responses. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.27018124.

Pattern-Based Target Selection for Treatment of Irregular Past Tense: A Single-Case Experimental Design for Children With Developmental Language Disorder.

PURPOSE: Many children with developmental language disorder (DLD) demonstrate difficulty inflecting irregular past tense verbs. We evaluated using phonological-based patterns (i.e., schemas) to select targets for treatment of irregular verb inflection for children with DLD. We hypothesized this approach would result in acquisition of treated verbs, generalization to untreated verbs within the same phonological schema, and increased use of correct irregular verbs in naturalistic contexts. METHOD: Treatment was provided to three 7-year-old participants with DLD in the context of multiple baseline designs across behaviors and participants. Phonological schemas included vowel change, final alveolar, and dual change irregular verbs. Treatment was provided using established therapeutic approaches, including narrative generation, sentence imitation, and naturalistic play activities. Acquisition of treated and untreated targets was assessed at the beginning of sessions, and use of verbs in naturalistic contexts was observed throughout treatment sessions. RESULTS: Positive acquisition effects were noted for two of three participants. Generalization to untreated items occurred within and across treatment sets for two participants, whereas increases in accurate irregular verb production in naturalistic contexts were not observed. CONCLUSIONS: Outcomes demonstrated support for a pattern-based approach to target selection for treatment of irregular past tense verbs. One participant, who demonstrated general difficulty with the probe and treatment tasks, showed no treatment effect, suggesting that the treatment may be effective for some children with DLD. Further research is warranted to determine what factors might have influenced these variable outcomes across participants. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.23671500.

Defeat and Entrapment Mediate the Relationship Between Insomnia Symptoms and Suicidal Ideation in Young Adults.

AIM: In recent years, there has been a growing interest in understanding the relationship between sleep disturbance and suicide. The current study aimed to advance understanding of the psychological processes driving these relationships by examining whether insomnia symptoms are related to suicidal ideation via perceptions of defeat and entrapment. METHODS: Young adults (n = 259; 202 students [78.0%], 45 employed [17.4%], 12 unemployed [4.6%]) completed an anonymous self-report survey that was advertised via social media, university participant pools, and fliers. The survey was described as being related to sleep and mood/mental health. Validated measures were used to assess insomnia symptoms, chronotype, defeat, entrapment, suicidal ideation, and affective covariates. RESULTS: Bivariate associations found insomnia severity to be related to poorer affective outcomes including severity of suicidal ideation. Insomnia and depression were significant independent variables in multiple linear regression with suidical ideation as the dependent variable. The relationship between insomnia and suicidal ideation was mediated by perceptions of defeat and entrapment. CONCLUSION: Taken together, these findings shed light on the psychological mechanisms linking sleep disturbance and suicidal ideation by highlighting the role of defeat and entrapment. These findings have the potential to improve suicide risk assessment and prevention in young adults experiencing difficulties initiating or maintaining sleep.HighlightsDefeat and entrapment mediate relationship between insomnia and suicidal ideationEvidence for Integrated Motivational-Volitional Model of Suicidal Behavior in community sampleUses validated multi-item suicide measure.

Defeat, Entrapment, and Hopelessness: Clarifying Interrelationships between Suicidogenic Constructs.

Psychological theories of suicide posit conceptually similar constructs related to the development of suicidal thinking. These constructs often evince high-magnitude interrelationships across studies. Within these theories, defeat, entrapment and hopelessness standout as conceptually and quantitatively similar. Theoretical improvements may be facilitated through clarifying the subscale and item-level similarities among these constructs. Factor analytic and phenomenological work has demonstrated equivocal evidence for a distinction between defeat and entrapment; hopelessness is not typically analyzed together with defeat and entrapment despite evidence of large-magnitude interrelationships. This study explored the interrelationships among the foregoing constructs within a sample of undergraduate students (N = 344) from two universities within the Southeastern United States. Participants, oversampled for lifetime history of suicidal ideation and attempts, completed an online cross-sectional survey assessing defeat, entrapment, hopelessness and SI. Exploratory factor and parallel analyses demonstrated support for a one factor solution when analyzed at subscale level of the three measures as well as when all items of the three measures were analyzed together. Ad hoc exploratory structural equation modeling (ESEM) bifactor results evinced support for the existence of a single, general factor at the item level. Item level communalities and bifactor fit indices suggest that hopelessness may be somewhat distinct from defeat and entrapment. Clinical and theoretical implications are discussed in the context of study limitations.

A systematic review and meta-analysis of poor sleep, insomnia symptoms and stress in undergraduate students.

University students experience high prevalence of mental health problems and exacerbation of mental health difficulties, including sleep disturbances and stress during their studies. Stress and poor sleep quality and/or insomnia are interlinked outcomes for this population. The aim was to conduct a systematic review, and meta-analyses, of the relationships between sleep quality and/or insomnia with stress in students. Full-text articles of studies exploring the associations of stress with poor sleep quality and/or insomnia in undergraduate students using validated tools and published in peer-reviewed journals were eligible for inclusion. Thirty-four studies, resulting in 37 effect sizes, included and all were suitable for meta-analysis. The weighted pooled effect size between sleep quality and stress was for 0.39 (25 studies, n = 10,065), whereas a slightly higher pooled association of 0.41 was demonstrated for insomnia and stress (12 studies, n = 5564.5). Pooled associations show moderate effects for associations between sleep quality, insomnia and stress in undergraduate students. High heterogeneity in meta-analyses was found, suggesting the findings should be considered cautiously. Future research should focus on longitudinal studies exploring sleep difficulties across the academic year, whilst university services should consider psychoeducation for stress and sleep in university students, especially during transition to university.

Suicide rates amongst individuals from ethnic minority backgrounds: A systematic review and meta-analysis.

Background: Existing evidence suggests that some individuals from ethnic minority backgrounds are at increased risk of suicide compared to their majority ethnic counterparts, whereas others are at decreased risk. We aimed to estimate the absolute and relative risk of suicide in individuals from ethnic minority backgrounds globally. Methods: Databases (Medline, Embase, and PsycInfo) were searched for epidemiological studies between 01/01/2000 and 3/07/2020, which provided data on absolute and relative rates of suicide amongst ethnic minority groups. Studies reporting on clinical or specific populations were excluded. Pairs of reviewers independently screened titles, abstracts, and full texts. We used random effects meta-analysis to estimate overall, sex, location, migrant status, and ancestral origin, stratified pooled estimates for absolute and rate ratios. PROSPERO registration: CRD42020197940. Findings: A total of 128 studies were included with 6,026,103 suicide deaths in individuals from an ethnic minority background across 31 countries. Using data from 42 moderate-high quality studies, we estimated a pooled suicide rate of 12·1 per 100,000 (95% CIs 8·4-17·6) in people from ethnic minority backgrounds with a broad range of estimates (1·2-139·7 per 100,000). There was weak statistical evidence from 51 moderate-high quality studies that individuals from ethnic minority groups were more likely to die by suicide (RR 1·3 95% CIs 0·9-1·7) with again a broad range amongst studies (RR 0·2-18·5). In our sub-group analysis we only found evidence of elevated risk for indigenous populations (RR: 2·8 95% CIs 1·9-4·0; pooled rate: 23·2 per 100,000 95% CIs 14·7-36·6). There was very substantial heterogeneity (I2  > 98%) between studies for all pooled estimates. Interpretation: The homogeneous grouping of individuals from ethnic minority backgrounds is inappropriate. To support suicide prevention in marginalised groups, further exploration of important contextual differences in risk is required. It is possible that some ethnic minority groups (for example those from indigenous backgrounds) have higher rates of suicide than majority populations. Funding: No specific funding was provided to conduct this research. DK is funded by Wellcome Trust and Elizabeth Blackwell Institute Bristol. Matthew Spittal is a recipient of an Australian Research Council Future Fellowship (project number FT180100075) funded by the Australian Government. Rebecca Musgrove is funded by the NIHR Greater Manchester Patient Safety Translational Research Centre (PSTRC-2016-003).

Insomnia symptoms mediate the association between eveningness and suicidal ideation, defeat, entrapment, and psychological distress in students.

Chronotype describes a person's general preference for mornings, evenings, or neither. It is typically conceptualized as a continuous unidimensional spectrum from morningness to eveningness. Eveningness is associated with poorer outcomes across a myriad of physical and mental health outcomes. This preference for later sleep and wake times is associated with increased risk of depression, anxiety, and suicidal ideation in both clinical and community samples. However, the mechanisms underlying the negative consequences of this preference for evenings are not fully understood. Previous research has found that sleep disturbances may act as a mediator of this relationship. The present study aimed to explore the associations between chronotype and affective outcomes in a sample of students. Additionally, it aimed to investigate the potential role of insomnia as a mediator within these relationships. Participants (n = 190) completed an anonymous self-report survey of validated measures online which assessed chronotype, insomnia symptoms, and a range of affective outcomes (defeat, entrapment, suicide risk, stress, and depressive and anxious symptomology). Eveningness was associated with more severe or frequent experiences of these outcomes, with participants that demonstrated a preference for eveningness more likely to report poorer affective functioning and increased psychological distress. Mediation analysis found the relationship between chronotype and these outcome measures was completely or partially mediated by insomnia symptom severity measured by the validated Sleep Condition Indicator insomnia scale. Taken together, these findings add further evidence for the negative consequences of increased eveningness. Additionally, our results show that chronotype and sleep disturbances should be considered when assessing mental well-being. Implementing appropriate sleep-related behavior change or schedule alterations can offer a tool for mitigation or prevention of psychological distress in students that report a preference for later sleep and wake times.

Does Mental Well-Being Protect against Self-Harm Thoughts and Behaviors during Adolescence? A Six-Month Prospective Investigation.

Mental well-being protects against the emergence of suicidal thoughts. However, it is not clear whether these findings extend to self-harm thoughts and behaviors irrespective of intent during adolescence-or why this relationship exists. The current study aimed to test predictions-informed by the integrated motivational-volitional (IMV) model of suicide-concerning the role of perceived defeat and entrapment within the link between mental well-being and self-harm risk. Young people (n = 573) from secondary schools across Scotland completed an anonymous self-report survey at two time points, six months apart, that assessed mental well-being, self-harm thoughts and behaviors, depressive symptomology and feelings of defeat and entrapment. Mental well-being was associated with reduced defeat and entrapment (internal and external) and a decrease in the likelihood that a young person would engage in self-harm thoughts and behaviors. The relationship between mental well-being and thoughts of self-harm was mediated by perceptions of defeat and entrapment (internal and external). Mental well-being was indirectly related to self-harm behaviors via decreased feelings of defeat and internal (but not external) entrapment. Taken together, these findings provide novel insights into the psychological processes linking mental well-being and self-harm risk and highlight the importance of incorporating the promotion of mental well-being within future prevention and early intervention efforts.

Sleep problem, suicide and self-harm in university students: A systematic review.

Suicide and self-harm behaviours represent public health concerns, and university students are a particularly high risk group. Identifying modifiable risk factors for the development and maintenance of suicidal thoughts and behaviours is a research priority, as prevention is crucial. Research examining the relationship between poor sleep and self-harm/suicidality within university students is, for the first time, systematically evaluated, critically appraised, and synthesised. This literature consistently demonstrates that insomnia and nightmares are associated with elevated suicide risk of suicidal thoughts and behaviours within this subpopulation of young adults. However, as findings are predominantly derived from cross-sectional investigations, the directionality of this relationship is not yet clear. While research investigating the psychological processes driving these relationships is in its infancy, preliminary findings suggest that thwarted belongingness, socio-cognitive factors and emotional dysregulation could be partly responsible. Methodological limitations are highlighted and a research agenda suggesting the key directions for future research is proposed. Continued research in this area - employing longitudinal designs, and testing novel theoretically derived hypotheses - will be crucial to the development of suicide prevention and intervention efforts.

Insomnia and Nightmares as Markers of Risk for Suicidal Ideation in Young People: Investigating the Role of Defeat and Entrapment.

STUDY OBJECTIVES: Although converging evidence has identified sleep problems as robust predictors of suicidal ideation in young people, the psychological processes driving these associations are not yet known. The current study aimed to test predictions, informed by the Integrated Motivational-Volitional (IMV) Model of Suicidal Behavior, concerning the role of feelings of defeat and entrapment within the sleep-suicide relationship. METHODS: Volunteers aged 15 to 17 years (n = 1,045) from Scottish secondary schools completed an anonymous self-report survey assessing insomnia symptoms, nightmares, suicidal ideation, depressive symptomology, and feelings of defeat and entrapment. RESULTS: Both insomnia symptoms and nightmares were associated with an increased likelihood of reporting suicidal ideation (independent of depression). Perceptions of both defeat and entrapment were elevated in young people who reported clinically salient insomnia and/or nightmares, relative to those who did not. The relationship between insomnia and suicidal ideation was fully mediated by perceptions of defeat and entrapment, whereas nightmares were indirectly associated with suicidal ideation through perceptions of defeat and entrapment. CONCLUSIONS: Taken together, these findings provide novel insights into the psychological mechanisms linking sleep disturbance and suicidality by highlighting the role of defeat and entrapment. Clinically, these findings have the potential to improve suicide risk assessment and prevention in young people experiencing difficulties with their sleep.