How Do Adolescents Manage Information in the Relationship with Their Parents? A Latent Class Analysis of Disclosure, Keeping Secrets, and Lying.

The use of disclosure and concealment strategies by adolescents in the relationship with their parents may have important implications for their adjustment. Few studies of adolescents' information management have taken a person-centered approach, yet it is a useful way to understand variations in how they regulate information shared with their parents. This study explored adolescents' information management constellations with their mothers and fathers, and how these patterns differ in terms of perceived need-supportive parenting, autonomous reasons for disclosure, and problematic alcohol use. Three hundred thirty-two Swiss adolescents (45% female; Mage = 15.01 years) reported information management strategies used with each parent (disclosure, keeping secrets, lying), perceptions of maternal and paternal need-supportive parenting (involvement, autonomy support, structure), autonomous reasons for disclosure, and problematic alcohol use. Latent class analyses revealed three classes: Reserved (37%), Communicators (36%), and Deceptive (27%). Comparisons across classes showed that adolescents in the Communicators class reported the highest levels of parental involvement and autonomy support, as well as autonomous reasons for disclosure. Adolescents in the Deceptive class reported the lowest levels of parental involvement and autonomy support, as well as autonomous reasons for disclosure. Associations between classes and problematic alcohol use were also found, such that the likelihood of problem drinking was greater for adolescents in the Deceptive class. These findings underscore the importance of continued information sharing with both parents, and underline how a need-supportive parenting context may encourage adolescents to talk voluntarily.

Clinical significance of assertive community treatment among adolescents.

PURPOSE: The efficacy of assertive community treatment for children and adolescents is proven in the United States, but remains controversial in Europe. Moreover, most studies showing positive outcomes of assertive community treatment are limited to statistically significant differences and do not consider whether the treatment is also subjectively clinically meaningful for the patient. Using a naturalistic sample, the present study aims to assess statistical and clinical significance of an assertive community treatment unit for adolescents in Europe. METHODS: Linear mixed-effects models and reliable change indices were used to respectively assess the statistical and clinical significance of assertive community treatment in 179 adolescents (mean age = 15.76, SD = 1.76) with severe mental illnesses. RESULTS: Difficulties related to mental health (measured by the Health of the Nation Outcome Scales for Children and Adolescents, HoNOSCA) and overall functioning (measured by the Global Assessment of Functioning scale) statistically improved (all ps < 0.001) from admission to discharge. Additionally, a considerable proportion of patients (from 14% to 21%) clinically recovered to functional levels. CONCLUSION: Our results support the fact that assertive community treatment can have convincing and positive clinical outcomes in European settings.

Substance-use disorders, personality traits, and sex differences in institutionalized adolescents.

BACKGROUND: Substance-use disorder (SUD) was found to be an aggravating factor to delinquency and is closely related to personality disorders (PDs). OBJECTIVES: The aim of this study was to investigate sex differences in the relationship between PD traits and SUD in adolescents institutionalized in child welfare and juvenile justice institutions. METHODS: PD traits were measured dimensionally in a sample of 282 boys (69 with an SUD diagnosis) and 143 girls (45 with an SUD diagnosis) from child welfare and juvenile-justice institutions. RESULTS: Logistic regressions showed that antisocial, borderline, and paranoid personality traits were positively associated with SUD, while obsessive compulsive personality traits were negatively related with SUD. Additionally, in institutionalized girls, self-defeating personality traits were associated with less risk of SUD. CONCLUSION: This study provides a relative evidence for sex specificities in the relation between PD traits and SUD.

Predictors and Moderators of Clinical Outcomes in Adolescents with Severe Mental Disorders After an Assertive Community Treatment.

Previous studies have shown that stressful life events (SLEs), gender, social functioning and pretreatment severity are some of the predictors and/or moderators of treatment outcome in psychiatric care. The current study explored the effect of these predictors and moderators on the treatment outcome related to assertive community treatment (ACT) proposed to young people with severe mental disorders. 98 patients were assessed for externalizing and emotional difficulties, at admission and then at discharge of an ACT. Analyses revealed significant improvements in terms of symptomatology. In particular, regression analyses showed that pretreatment severity is a significant predictor of the outcome on emotional symptoms and is moderated by SLE on the outcome on externalizing symptoms. Furthermore, higher social functioning proved to predict better outcome on externalizing symptoms. Our results further evidence that these factors can explain inter-individual differences in outcome related to ACT. The theoretical and clinical implications of these results are discussed.

Brief report: The Identity Style Inventory (ISI-3) and the Utrecht-Management of Identity Commitments Scale (U-MICS): factor structure, reliability, and convergent validity in French-speaking university students.

The purpose of this study was to evaluate the factor structure and the reliability of the French versions of the Identity Style Inventory (ISI-3) and the Utrecht-Management of Identity Commitments Scale (U-MICS) in a sample of college students (N = 457, 18-25 years old). Confirmatory factor analyses confirmed the hypothesized three-factor solution of the ISI-3 identity styles (i.e. informational, normative, and diffuse-avoidant styles), the one-factor solution of the ISI-3 identity commitment, and the three-factor structure of the U-MICS (i.e. commitment, in-depth exploration, and reconsideration of commitment). Additionally, theoretically consistent and meaningful associations among the ISI-3, U-MICS, and Ego Identity Process Questionnaire (EIPQ) confirmed convergent validity. Overall, the results of the present study indicate that the French versions of the ISI-3 and UMICS are useful instruments for assessing identity styles and processes, and provide additional support to the cross-cultural validity of these tools.

Talking to the Dead in the Classroom: How a Supposedly Psychic Event Impacts Beliefs and Feelings.

Paranormal beliefs (PBs) are common in adults. There are numerous psychological correlates of PBs and associated theories, yet, we do not know whether such correlates reinforce or result from PBs. To understand causality, we developed an experimental design in which participants experience supposedly paranormal events. Thus, we can test an event's impact on PBs and PB-associated correlates. Here, 419 naïve students saw a performer making contact with a confederate's deceased kin. We tested participants' opinions and feelings about this performance, and whether these predicted how participants explain the performance. We assessed participants' PBs and repetition avoidance (PB related cognitive correlate) before and after the performance. Afterwards, participants rated explanations of the event and described their opinions and feelings (open-ended question). Overall, 65% of participants reported having witnessed a genuine paranormal event. The open-ended question revealed distinct opinion and affect groups, with reactions commonly characterized by doubt and mixed feelings. Importantly, paranormal explanations were more likely when participants reported their feelings than when not reported. Beyond these results, we replicated that 1) higher pre-existing PBs were associated with more psychic explanations (confirmation bias), and 2) PBs and repetition avoidance did not change from before to after the performance. Yet, PBs reminiscent of the actual performance (spiritualism) increased. Results showed that young adults easily endorse PBs and paranormal explanations for events, and that their affective reactions matter. Future studies should use participants' subjective experiences to target PBs in causal designs (e.g., adding control conditions).

Assessing Online and Offline Adolescent Social Skills: Development and Validation of the Real and Electronic Communication Skills Questionnaire.

Studies examining the associations between Internet use and social skills are increasingly frequent. However, most of them only evaluate offline social skills and consider them as equivalents to online social skills. So far, no instrument allowed differentiating social skills depending on online versus offline contexts. This study aimed to develop and validate the Real and Electronic Communication Skills questionnaire (RECS), a new measure evaluating several dimensions of social skills in two different contexts (i.e., face-to-face and computer-mediated communication). Results of exploratory and confirmatory factor analyses among a sample of 657 adolescents and young adults (mean age = 17.68 years; 67% female) showed that the best fitting model for each context is a bifactor solution, with one general factor (Social Competence) and four specific factors (Sociability, Emotion Decoding, Disclosure, and Assertiveness). Each specific factor was differentially correlated with theoretically relevant subscales of the Social Skills Inventory, confirming the external validity of the RECS. The RECS is the first instrument allowing not only to assess social competence in online settings but also to quantify the relationships between offline social skills and their online counterpart. Given its ease of use and brevity, the RECS is a useful and promising instrument to capture social skills in both online and offline contexts.

Can the Health of the Nation Outcome Scales for Children and Adolescents predict the necessity of inpatient stay during assertive community treatment?

Understanding the trajectories of youths within Child and Adolescents Mental Health Service (CAMHS) is of primary importance. Our objective is to assess the usefulness of the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) to predict inpatient (IP) stay for youths followed by assertive community treatment (ACT) teams. 82 youths followed exclusively by ACT and 42 who needed IP were assessed with the HoNOSCA at admission to the program. The HoNOSCA allowed the computing of three scores: a total score, an externalizing symptoms (Ext) score and an emotional problems (Emo) score. Logistic regressions revealed that the three HoNOSCA scores at admission of ACT predicted later need for hospitalization. Using ROC curve analyses, we set up cut off scores with appropriate sensitivity and specificity for the HoNOSCA Total and Ext to optimally predict the need for hospitalization. This study revealed that the HoNOSCA may be a useful tool to predict the need for later IP during ACT. Such knowledge is important to set up the best therapeutic strategies.

The French adaptation of the Health of the Nation Outcome Scale for Children and Adolescents Self-Rated Form (F-HoNOSCA-SR): validation and clinical routine use.

The current study aimed to explore the validity of an adaptation into French of the self-rated form of the Health of the Nation Outcome Scales for Children and Adolescents (F-HoNOSCA-SR) and to test its usefulness in a clinical routine use. One hundred and twenty nine patients, admitted into two inpatient units, were asked to participate in the study. One hundred and seven patients filled out the F-HoNOSCA-SR (for a subsample (N=17): at two occasions, one week apart) and the strengths and difficulties questionnaire (SDQ). In addition, the clinician rated the clinician-rated form of the HoNOSCA (HoNOSCA-CR, N=82). The reliability (assessed with split-half coefficient, item response theory (IRT) models and intraclass correlations (ICC) between the two occasions) revealed that the F-HoNSOCA-SR provides reliable measures. The concurrent validity assessed by correlating the F-HoNOSCA-SR and the SDQ revealed a good convergent validity of the instrument. The relationship analyses between the F-HoNOSCA-SR and the HoNOSCA-CR revealed weak but significant correlations. The comparison between the F-HoNOSCA-SR and the HoNOSCA-CR with paired sample t-tests revealed a higher score for the self-rated version. The F-HoNSOCA-SR was reported to provide reliable measures. In addition, it allows us to measure complementary information when used together with the HoNOSCA-CR.

Reflections on coma: man deprived of his consciousness.

In this paper the authors reflect on the phenomena produced by the surprising communication between the unconscious of a therapist and that of a comatose patient. In a particularly disturbing context, when the patient's sternum is open and exposed, the therapist communicates empathically with the comatose person, identifying the patient's inexpressible experience and generating signs of a response from him in the form of the blinking of his eyelids. The absence of any reaction to pain, a pathognomonic sign of the comatose condition, could be related to the splitting-off of the trauma, as if the situation were frozen, through a denial of the sensory and neurological perception of pain - a kind of self-anaesthesia as a defence against the catastrophic anxieties raised by the threat of the return of the primary trauma. Starting from this encounter a relationship is formed whose guiding thread emerges in the shared illusion of a regression that makes it possible. It involves a process of returning to the past and a re-actualization of the past that includes the question of its change through representation.