Building Resilience and Attachment in Vulnerable Adolescents: The Feasibility of a Virtually Delivered Group Intervention for Adolescents with Suicidal Ideation and Their Caregivers.

Background: The COVID-19 pandemic required many interventions to be conducted virtually. Building Resilience and Attachment in Vulnerable Adolescents (BRAVA) is a group intervention designed for adolescents and their caregivers to reduce adolescent suicidal ideation (SI). Objective: We aimed to adapt BRAVA for virtual delivery and evaluate its acceptability and feasibility. Methods: We conducted an 8-week pre-post trial between October and December 2020. Six adolescents and six primary caregivers were recruited from a pediatric hospital in Ontario, Canada. Families completed a virtual intake and exit assessment together and 6 weekly BRAVA group sessions separately. Satisfaction feedback was collected after each group session and during their exit, and clinical outcomes were collected at intake and exit. Weekly team meetings were conducted to gather clinician feedback. Results: The study uptake rate was 42.9% of eligible participants. There were no dropouts. Adolescent and caregiver attendance rates for group sessions were high (median = 6). Most youth (83.4%) and caregivers (66.7%) reported that the virtual process worked well. All caregivers (100%) agreed they would participate in a virtual group session again, compared with youth (50%). Providers approved of the virtual adaptation but identified potential improvements (e.g., manual content, safety procedures). Adolescent SI decreased significantly post-treatment (Mpre = 50.7, Mpost = 29.7, p = 0.002). Conclusions: Virtual delivery of BRAVA is acceptable and feasible and may help reduce SI in adolescents. Uptake, retention, and satisfaction were high for adolescents and caregivers. Feedback collected will improve BRAVA for future evaluations, including a randomized controlled trial.

The relationship between difficulties in the regulation of positive and negative emotions and binge-eating symptoms in young adults.

It is well-established that binge-eating (BE) is linked to emotion regulation (ER) difficulties. However, research to date has focused almost exclusively on difficulties regulating negative emotions, with little attention to the relationship between positive emotion dysregulation and BE. Further, research is inconclusive regarding which specific facets of ER difficulties are most strongly associated with BE behaviour. Therefore, the current study examined whether difficulties regulating both negative as well as positive emotions explained unique variance in BE among young adults. The study also aimed to identify which particular dimensions of negative and positive ER difficulties were most strongly related to BE symptoms. Participants (N = 449) ages 18-25 completed self-report measures of difficulties regulating positive and negative emotions, BE symptoms, and psychological distress. Hierarchical regression analyses showed that BE was related to difficulties regulating both positive emotions and negative emotions, after controlling for psychological distress and BMI. Lack of emotional clarity and lack of access to ER strategies when faced with strong negative emotions were the facets of negative ER difficulties most strongly associated with BE. Impulsivity when experiencing strong positive emotions was the facet of positive ER difficulties most strongly associated with BE. These findings support the ER model of BE and suggest that difficulties regulating both positive and negative emotions contribute to BE among young adults.

Relational bullying and disordered eating: Testing a moderated mediation model of the role of shame and self-compassion.

Objective: Experiences of relational bullying (RB) in adolescence are associated with the development of disordered eating. This association may be related to heightened shame resulting from perceived social inferiority, low social rank, and/or negative evaluation by others. Self-compassion may act as a protective factor against the influence of RB on shame and disordered eating. In the current study, we investigated whether shame mediated the relationship between recalled RB and current disordered eating in a sample of young adults. Then, using conditional process analysis, we examined whether the observed mediation was moderated by self-compassion. Method: Participants were 359 young adults (aged 17-25) who completed online self-report measures of recalled RB experiences and current disordered eating, shame, and self-compassion. Results: Experiences of RB were positively related to current shame and disordered eating, and negatively related to current self-compassion, with small-to-medium effect sizes. The association between RB and disordered eating was partially mediated by shame, and this mediation was moderated by self-compassion. Discussion: Our results suggest that young adults with lower self-compassion are more likely to demonstrate a relationship between recalled RB and disordered eating through the mechanism of shame. These findings have important implications for both anti-bullying awareness and eating disorder prevention programs.