Psychological Resilience in Young Female Athletes.

Psychological resilience is an important construct that can enhance athletic performance and foster valuable life skills. Through positive adaptation to adversity and stressors in the athletic arena, athletes are able to cultivate their ability to effectively respond to negative stimuli, ultimately evolving to personal growth. For young female athletes, development of resilience may be particularly important. Young female athletes face distinct challenges in sport including sport inequity, body image issues, eating disorders, increased mental distress, and internalization of emotions. The aim of this review is to define and describe the construct of resilience and discuss the implications and applications relevant to young female athletes. By understanding how to foster resilience strategies in this population, we can enhance sport performance and enjoyment, as well as bolster valuable life skills that facilitate personal growth.

Associations of Discrimination, Suicide Ideation Severity and Attempts, and Depressive Symptoms Among Sexual and Gender Minority Youth.

We examined the unique associations among discrimination, suicidal thoughts, suicide attempts, and depressive symptoms in a sample of sexual and gender minority (SGM) youth as well as interpersonal mediators of these associations. Participants included 94 SGM youth (Mage = 18; SD = 2.88) recruited from SGM-specific drop-in centers. We used mediation analyses to test the mediating effects of perceived burdensomeness and thwarted belongingness on the associations between discrimination and suicidal ideation, suicide attempts, and depressive symptoms, accounting for childhood trauma and sociodemographic variables (age, gender identity, race, and sexual orientation). Within our nonclinical community sample of SGM youth, 49% reported a lifetime suicide attempt, 84% reported current suicide ideation, and 82% reported current depressive symptoms. Experiencing discrimination was associated with greater likelihood of suicide attempts and depressive symptoms, and greater perceived burdensomeness and thwarted belongingness, over and above the effects of childhood trauma and sociodemographic variables. Discrimination was indirectly associated with greater depressive symptoms through perceived burdensomeness and thwarted belongingness, and with greater severity of suicidal ideation through perceived burdensomeness. Findings suggest clinicians should assess for discrimination and include a focus on perceived burdensomeness and thwarted belongingness as targets of intervention for suicide and depression.

An mHealth approach to extend a brief intervention for adolescent alcohol use and suicidal behavior: Qualitative analyses of adolescent and parent feedback.

Mobile health (mHealth) tools that supplement inpatient psychiatric care can maintain and enhance intervention effects following hospitalization. Adolescents hospitalized following a suicidal event represent a vulnerable population who could greatly benefit from such an mHealth intervention. In specific, suicidal adolescents who drink alcohol are in need of robust interventions that address the bidirectional relationship between alcohol use and suicidal thoughts and behaviors, because it puts them at especially high risk for suicide upon discharge. The purpose of this study was to conduct qualitative interviews to gather feedback to improve a brief alcohol intervention provided to suicidal adolescents during psychiatric hospitalization, and to develop a mHealth tool to extend care after discharge. Participants, eight adolescents and their parents, identified the need for a smartphone application to deliver intervention content to adolescents and parents during the post-hospitalization period. Adolescents sought support in meeting alcohol- and mood-related goals, while parents desired general resources as well as tips for conversations with their adolescent about mood and alcohol use.

Function and progression of non-suicidal self-injury and relationship with suicide attempts: A qualitative investigation with an adolescent clinical sample.

AIM: To investigate the function and progression of non-suicidal self-injury (NSSI) and its relationship with suicide attempts. METHOD: Qualitative in-depth interviews were conducted with 15 adolescents psychiatrically hospitalized following a suicide attempt who reported NSSI. Applied thematic analysis was used to identify and examine themes from the interview data. RESULTS: Thematic analysis revealed that the primary function of NSSI was relief from emotional pain, though the function often changed over time. NSSI was often not directly related to patients' suicide attempts, yet risk of suicidal behavior seemed to increase once NSSI lost its effectiveness, and suicide became the only option. CONCLUSION: Clinicians need to understand and monitor the functions of NSSI, and its relationship with suicidality, to prevent suicide attempts among adolescents.

Feasibility, acceptability, and preliminary effects of a brief alcohol intervention for suicidal adolescents in inpatient psychiatric treatment.

Alcohol use, both short-term intoxication and longer-term use, is a notable risk factor for suicide. Despite the strong relationship between alcohol use and suicidal thoughts and behaviors, providers typically treat these two problems independently. In particular, acute psychiatric care hospitalizations for adolescents are typically brief, and many only cursorily address alcohol use. Integrating a brief motivational enhancement intervention for alcohol use into an inpatient psychiatric hospitalization treatment protocol has the potential to enhance motivation to stop or reduce drinking if adolescents can more fully understand how it increases risk for suicidal behavior. This study tested the feasibility, acceptability, and preliminary effects of the Alcohol and Suicide Intervention for Suicidal Teens (ASIST), a brief motivational enhancement intervention targeting alcohol use and suicidal thoughts and behaviors for suicidal adolescents receiving inpatient psychiatric treatment. Results from a randomized pilot trial of ASIST (N = 50) revealed that the intervention was both feasible and acceptable, with 92% of those in the ASIST condition reporting that the intervention helped them to understand how their alcohol use is related to their suicidal thoughts and behaviors. Study findings suggest a larger randomized controlled trial may be warranted to test the effectiveness of ASIST with psychiatrically hospitalized adolescents.

Adolescent Alcohol Use: The Effects of Parental Knowledge, Peer Substance Use, and Peer Tolerance of Use.

OBJECTIVE: Parents and peers exert significant influence on a young person's decision to consume alcohol. This study examines the relationship between parental monitoring and adolescent alcohol consumption and tests whether peer substance use and tolerance of use mediates the relationship between monitoring and drinking. METHOD: Participants included 116 adolescents (53.5% female; Mage = 15.6). All participants reported drinking alcohol in the past 6 months, and 96 participants had been previously admitted to a hospital emergency department for an alcohol-related event. Mediation analyses were used to test the study hypotheses. RESULTS: The total effect of baseline parental monitoring on 6-month alcohol use was -1.15 (p < .01), with higher monitoring related to less use. Controlling for peer use and tolerance of use, the effect of parental monitoring was reduced to .46, leaving an indirect effect of .69 (p < .01). Peer use and tolerance of use had no effect on participant alcohol use when controlling for parental monitoring. CONCLUSIONS: Study findings extend current knowledge about the interactive effects of parental supervision and peer influence on the drinking patterns of adolescents. Results underscore the importance of addressing both parental monitoring and peer influence in interventions that target adolescent alcohol use, recognizing peer factors as a potential mechanism of the effect that parental monitoring has on adolescent drinking.

A Pilot Study of the Acceptability and Usability of a Smartphone Application Intervention for Suicidal Adolescents and Their Parents.

Interconnectedness through technology presents both challenges and opportunities for suicide prevention and intervention with adolescents and families. The time following discharge from acute care facilities represents a critical period of suicide risk for adolescents, which could be buffered by a technological intervention they could use post-discharge. Crisis Care is a smartphone application intervention developed specifically for suicidal adolescents and their parents to use during this period of increased risk. A web-based prototype of Crisis Care was pilot tested with 20 adolescent-parent dyads. Results demonstrated acceptability and usability, suggesting the utility of technological interventions, such as Crisis Care, as an adjunct to treatment for suicidal adolescents and their parents following discharge from acute care settings.

Rethinking Adolescent Inpatient Psychiatric Care: The Importance of Integrated Interventions for Suicidal Youth With Substance Use Problems.

Adolescents psychiatrically hospitalized following a suicide attempt are at high risk for a repeat attempt or suicide completion, and substance use is consistently implicated as a risk factor for continued suicidal behavior in adolescents. Despite this knowledge, there have been few studies that have investigated the effectiveness of combined suicidality and substance use interventions within acute psychiatric care settings for suicidal youth with substance use problems. While social workers are well-positioned to deliver such interventions, greater emphasis on teaching integrated therapeutic techniques in social work curriculum and professional training is needed to ensure their implementation.

Childhood exposure to a parental suicide attempt and risk for substance use disorders.

Childhood exposure to parental suicidal behavior has been linked to a variety of adverse behavioral and health outcomes. However, relatively little is known about the degree to which such exposure may place individuals at risk for a substance use disorder (SUD). Employing data from the National Epidemiologic Survey on Alcohol and Related Conditions, we compared the prevalence of SUDs among those who experienced childhood exposure to parental suicide attempts. Childhood exposure to parental suicide attempts was not associated with increased risk for the development of alcohol, cannabis, or cocaine use disorders. However, individuals who were exposed to a parental suicide attempt as children were significantly more likely to have met criteria for stimulant (AOR=1.40, 95% CI=1.18-1.67), sedative (AOR=1.24, 95% CI=1.04-1.47), tranquilizer (AOR=1.78, 95% CI=1.45-2.20), and opioid (AOR=1.41, 95% CI=1.19-1.67) use disorders in their lifetime. No significant gender differences were identified with respect to the magnitude of the relationship between exposure to parental suicide attempts and SUD risk among men and women. Findings suggest that, controlling for an array of sociodemographic, parental, mental health, and childhood adversity confounds, childhood exposure to parental suicide attempts is a vulnerability factor for low prevalence illicit drugs (i.e. stimulants, sedatives, tranquilizers, opioids), but not for more commonly used substances.

Differentiating adolescent suicide attempters from ideators: examining the interaction between depression severity and alcohol use.

Depressed mood, frequency of alcohol use, and their combination were examined to see if they differentiated nonsuicidal adolescents from those with suicidal ideation and adolescents with suicidal ideation from those who have made a suicide attempt. Hierarchical logistic regressions indicated that frequency of alcohol use did not differentiate nonsuicidal adolescents from those with current suicidal ideation, but severity of depressed mood did so. In contrast, alcohol use was a significant differentiating factor between adolescents who had attempted suicide compared to those with suicidal ideation only, with severity of depressed mood not being significant. However, there was also a significant interaction effect such that for adolescents with suicidal ideation and low levels of depression, increased frequency of alcohol use was associated with increased odds of a suicide attempt. These findings suggest that alcohol use may hasten the transition from suicidal ideation to suicide attempt in adolescents with low levels of depressed mood.

Examining the impact of psychiatric diagnosis and comorbidity on the medical lethality of adolescent suicide attempts.

Specific psychiatric diagnoses and comorbidity patterns were examined to determine if they were related to the medical lethality of suicide attempts among adolescents presenting to an urban general hospital (N=375). Bivariate analysis showed that attempters with substance abuse disorders had higher levels of lethality than attempters without substance abuse. Regression results indicated having depression comorbid with any other diagnosis was not associated with medical lethality. However, having a substance abuse disorder was associated with higher suicide attempt lethality, highlighting the importance of substance abuse as a risk factor for lethal suicide attempts in adolescents. This finding stimulates critical thinking around the understanding of suicidal behavior in youth and the development and implementation of treatment strategies for suicidal adolescents with substance abuse disorders.