Eating disorder symptoms and comorbid mental health risk among teens recruited to a digital intervention research study via two online approaches.

INTRODUCTION: It is crucial to identify and evaluate feasible, proactive ways to reach teens with eating disorders (EDs) who may not otherwise have access to screening or treatment. This study aimed to explore the feasibility of recruiting teens with EDs to a digital intervention study via social media and a publicly available online ED screen, and to compare the characteristics of teens recruited by each approach in an exploratory fashion. METHOD: Teens aged 14-17 years old who screened positive for a clinical/subclinical ED or at risk for an ED and who were not currently in ED treatment completed a baseline survey to assess current ED symptoms, mental health comorbidities, and barriers to treatment. Bivariate analyses were conducted to examine differences between participants recruited via social media and those recruited after completion of a widely available online EDs screen (i.e., National Eating Disorders Association [NEDA] screen). RESULTS: Recruitment of teens with EDs using the two online approaches was found to be feasible, with 934 screens completed and a total of 134 teens enrolled over 6 months: 77% (n = 103) via social media 23% (n = 31) via the NEDA screen. Mean age of participants (N = 134) was 16 years old, with 49% (n = 66) identifying as non-White, and 70% (n = 94) identifying as a gender and/or sexual minority. Teens from NEDA reported higher ED psychopathology scores (medium effect size) and more frequent self-induced vomiting and driven exercise (small effect sizes). Teens from NEDA also endorsed more barriers to treatment, including not feeling ready for treatment and not knowing where to find a counselor or other resources (small effect sizes). DISCUSSION: Online recruitment approaches in this study reached a large number of teens with an interest in a digital intervention to support ED recovery, demonstrating the feasibility of these outreach methods. Both approaches reached teens with similar demographic characteristics; however, teens recruited from NEDA reported higher ED symptom severity and barriers to treatment. Findings suggest that proactive assessment and intervention methods should be developed and tailored to meet the needs of each of these groups. PUBLIC SIGNIFICANCE: This study examined the feasibility of recruiting teens with EDs to a digital intervention research study via social media and NEDA's online screen, and demonstrated differences in ED symptoms among participants by recruitment approach.

Factors associated with not ready to stop using substances among adults with an unmet treatment need: findings from the National Survey of Drug Use and Health 2015-2019.

Background: A better understanding of factors associated with not ready to stop using substances may inform provider engagement with clients who have an unmet treatment need.Objectives: This study explores how treatment barriers, the number of SUD symptoms, and types of substances used are associated with not ready to stop using substances among adults with an unmet treatment need.Methods: The data came from the 2015-2019 National Survey on Drug Use and Health. Eligible adults met DSM-IV criteria for substance abuse and dependence and reported an unmet need for treatment. Among our sample (N = 1,017), a majority self-identified as male (weighted 59.3%). We employed multivariable logistic regression to examine individual-level factors associated with not being ready to stop using substances.Results: About 38% of the respondents reported that they were not ready to stop using substances. Reporting access barriers (aOR = 0.44, 95% CI: 0.29, 0.68) and attitudinal barriers (aOR = 0.47, 95% CI: 0.28, 0.80) was associated with a lower odds of not ready to stop using. Each additional increase in SUD symptoms was associated with 23% higher odds of not being ready to stop using (aOR = 1.22, 95% CI: 1.12, 1.34). Having a diagnosis of alcohol and/or marijuana abuse or dependence was associated with higher odds of not being ready to stop using when compared to respondents without these diagnoses (aOR = 2.13, 95% CI: 1.33, 3.40; aOR = 1.82 95% CI: 1.11, 2.99).Conclusion: Not ready to stop using substances may be impacted by the type of SUD, number of SUD symptoms, and certain barriers like access and attitude to care.

How do teens with a history of suicidal behavior and self-harm interact with social media?

BACKGROUND: This study examines how engagement with depression-related social media content varies by teens who report suicidal ideation, suicide attempts, and nonsuicidal self-injury (NSSI) versus those who had not experienced each behavior. METHODS: Teens aged 15-17 years old (N = 93) were recruited from social media platforms from October 2016 to August 2018. Participants were asked three open-ended questions about the advantages and disadvantages of networking about depression-related content on social media. We conducted a qualitative analysis to capture themes in responses by question item. Univariate analyses were conducted to compare differences in the frequency of themes endorsed among the behavioral groups versus their counterparts. RESULTS: Among participants (female, 73%; non-White, 45%; sexual minority, 57%), most (93%, n = 87) endorsed depressive symptoms. Sixty-five percent (n = 60) endorsed suicidal ideation within the past year, who were more likely to indicate unhelpful social interactions (p = .02) as a disadvantage of following depression content than peers who did not endorse suicidal ideation within the past year. Eighty percent (n = 74) endorsed lifetime experience of NSSI, who were more likely to indicate negative impact on relationships (p = .01) from posting depression content than peers who did not experience NSSI. Fifty-eight percent (n = 54) endorsed a lifetime suicide attempt, who were more likely to mention offering solutions (p = .03) to someone posting concerning content than peers who did not endorse a lifetime suicide attempt. CONCLUSIONS: This study provides diverse and unique perspectives on how engagement with depression-related social media varies by mental health behaviors and informs the use of social media for recruitment and outreach for teens.

Association between Sexual Violence Victimization and Electronic Vaping Product Use among Adolescents: Findings from a Population-based Study.

BACKGROUND: Although studies have investigated the association between sexual violence (SV) victimization and substance use, few studies have examined the association between SV victimization and electronic vaping product (EVP) use among adolescents in the United States. The objective of this study was to examine the cross-sectional association between SV victimization and EVP use among adolescents. METHODS: Data were pooled from the 2017 and 2019 Youth Risk Behavior Survey. An analytic sample of 28,135 adolescents (51.2% female) was analyzed using binary logistic regression. The outcome variable investigated was EVP use, and the main explanatory variable was SV victimization. RESULTS: Of the 28,135 adolescents, the prevalence of past 30-day EVP use and SV victimization was 22.7% and 10.8%, respectively. Controlling for other factors, adolescents who experienced SV had 1.52 times higher odds of being EVP users when compared to their counterparts who did not experience SV (AOR = 1.52, p < .001, 95% CI = 1.27-1.82). Other factors associated with EVP use included cyberbullying victimization, symptoms of depression, and current use of cigarettes, alcohol, and marijuana. CONCLUSIONS: Experiencing SV was associated with EVP use. Future studies that employ longitudinal designs may offer more insight into the mechanisms underlying the association between SV victimization and EVP use. In addition, school-based interventions that focus on sexual violence prevention and reducing substance use among adolescents are warranted.

Suicidal Ideation among Youths at Risk of School Dropout: Impact of Student Demographics, Stressors, and Academic Self-Concept.

In the United States, suicidal ideation is an issue for high school-age youths. Research supports that youths who have learning difficulties and who are at risk of high school dropout are at greater risk for suicidal ideation. Although alternative high schools address both student academics and emotional health, they are underused, nonclinical settings for understanding and addressing suicidal ideation. This study aimed to examine the impact of student identity, external stressors, and academic self-concept on suicidal ideation among sexual and ethnic minority and underserved students enrolled in an alternative education public high school. The student sample (N = 103) completed a onetime survey comprised of the Suicidal Ideation Questionnaire-Junior, the Cultural Assessment of Risk of Suicide, the Coddington Life Events Scale for Adolescents, and the Piers Harris 2. Results of hierarchical linear regression indicated that identifying as nonheterosexual and experiencing discrimination were associated with greater student reporting of suicidal ideation. Identifying as Latino and other non-White was associated with lower reporting of suicidal ideation. Controlling for student demographics and external stressors, positive academic self-concept was associated with a lower reporting of suicidal ideation. Findings have future implications for health social work, suicide prevention and intervention, and education policy.

Hotline Use in the United States: Results from the Collaborative Psychiatric Epidemiology Surveys.

Crisis hotlines are a fixture in providing mental health services to individuals experiencing mental and behavioral problems in the United States (U.S.). Despite this, and the growing need for easily-accessible, anonymous, and free services amidst the suicide and opioid crises, there is no study reporting U.S. national prevalence and correlates of hotline use. Data on n = 18,909 participants from the Collaborative Psychiatric Epidemiology Surveys (CPES), a group of three nationally-representative, population-based studies, were used to estimate the prevalence of lifetime and past 12-month hotline use. A series of logistic regression models examined sociodemographic, clinical history and service use correlates of hotline use. Lifetime and past 12-month hotline use was estimated at 2.5% and 0.5%, respectively. Being female, having a mental or behavioral disorder, experiencing suicidality, or interacting with other formal and informal sectors of the mental health service system were significant correlates of use. This study provides the first national estimates of crisis hotline usage in the U.S. Hotlines are more likely to be used by certain sociodemographic subgroups, but these differences may be due to differing psychiatric history and service use patterns. Efforts should be made to ensure that crisis hotlines are being utilized by other marginalized populations at high risk of suicide or overdose amidst the current public health crises in the U.S., such as racial/ethnic minorities or youth. To evaluate the role that crisis hotlines play in the mental health service system, national surveys should aim to monitor trends and correlates over time.

Trajectories of Well-Being Among Latina Adolescents Who Attempt Suicide: A Longitudinal Qualitative Analysis.

Significant research questions persist regarding the short- and long-term outcomes of Latina adolescents who attempt suicide. To address these limitations, we utilize an ecodevelopmental framework to identify potential factors that shape differential outcomes following a suicide attempt. Through an exploratory, longitudinal, qualitative research design, we investigate two research questions: How do trajectories of well-being vary among Latina teens after a suicide attempt? What risk and protective factors might contribute to different trajectories? We conducted qualitative interviews with 17 Latina participants living in predominantly low-income households in New York City. Interviews took place within the 6 months following their suicide attempts, and again, 12 months later. Analysis revealed three distinct trajectories after a suicide attempt: resilience, tenuous growth, and chronic stress. Our findings elucidate potential factors that contribute to resilience following a suicide attempt and underscore the importance of prevention and intervention programs that foster adolescents' connectivity across ecodevelopmental contexts.

"I Just Kept It to Myself": The Shaping of Latina Suicidality Through Gendered Oppression, Silence, and Violence.

Suicide is a critical issue among Latina youth. In this study, we use family case analysis to explore how gendered oppression, silencing, and violence shape suicidal behaviors among a sample of Latina daughters (n = 10), and their parents. For comparison, we include family narratives from Latina adolescents with no histories of suicide attempts (n = 10). Results suggest how secrets and silence, as indicative of gendered oppression, may catalyze a suicide attempt. The risks are particularly salient when daughter and mother both have experienced violence that conflicts with gendered cultural scripts. Findings highlight the importance of parental engagement and exploration of histories of violence in the treatment of Latina suicide attempters. Future research should incorporate the risk factors of gendered oppression and violence to better understand the development of suicidality among Latina women.

El suicidio es un problema crítico entre las jóvenes latinas. En este artículo, usamos un análisis de casos familiares para averiguar cómo la opresión de género, el silenciamiento y la violencia determinan conductas suicidas entre una muestra de hijas latinas (n = 10) y sus padres. Para comparar, incluimos relatos familiares de adolescentes latinas sin historias de intentos de suicidio (n = 10). Los resultados sugieren cómo los secretos y el silencio, como indicadores de la opresión de género, pueden catalizar un intento de suicidio. Los riesgos son particularmente prominentes cuando la madre y la hija han sufrido una violencia que contradice los guiones culturales de género. Los resultados destacan la importancia de la participación de los padres y del análisis de las historias de violencia en el tratamiento de mujeres latinas que han intentado suicidarse. Las investigaciones futuras deberían incorporar los factores de riesgo de la opresión de género y de la violencia para comprender mejor el desarrollo de las tendencias suicidas entre las mujeres latinas.

Leveraging Digital Media to Promote Youth Mental Health: Flipping the Script on Social Media-Related Risk.

Purpose of Review: Despite growing public concern about the negative impact of digital media for mental health problems, there are key ways in which digital media can be leveraged to prevent such outcomes. This article reviews research exploring the ways that digital media, particularly social media, can be used to prevent negative mental health outcomes and promote youth mental health and well-being. Recent findings: Research indicates that media can be protective against mental health problems and promote mental health by enabling social support and destigmatizing mental illness, especially for youth with limited resources. Media also can be leveraged to identify those at risk, to educate, provide resources, and promote well-being, and to track symptoms and intervene to prevent or mitigate negative mental health outcomes. There is limited research on interventions designed to reduce the negative effects of digital media on mental health, especially those that harness media itself, a critical area of future research. Summary: This article provides a summary of the current evidence on this topic, highlights key directions for future research, and provides evidence-based recommendations for adolescents, families, educators, clinicians, industry, and policy-makers to prevent mental health problems related to media.