Implementation of a Risk Reduction Protocol in Youth Violence Research.

This article presents data from the Growing up with Media study related to the implementation of a risk reduction protocol that resulted in three groups of youth: low-risk youth (no flags), youth flagged because of violence involvement and not clinically referred; and flagged youth who were referred to a team clinician due to additional risk considerations. Data is from 3,979 U.S. youth 14-15 years of age recruited through social media between October 2018-August 2019. Four in ten youth were flagged for review. Findings suggest that this methodology of identifying and reviewing cases appears to be working as intended: Not only did referred youth have more flags than non-referred youth, but post-hoc analyses suggested that these youth also had higher rates of psychosocial problems (e.g., non-victimization adversity, substance use and depressed mood). The implementation of a risk reduction protocol such as the one described in this article adds a layer of human subject protection beyond the more standard list of websites and hotlines provided to all participants in most studies. This protocol leads the way for future studies to recreate a similar process to address concerning responses collected from survey research.

"An escape from the isolation": Youth thoughts about the impact of COVID-19 on adolescent sexual behavior and alcohol use.

INTRODUCTION: The COVID-19 pandemic likely affected adolescent sexual behaviors and alcohol use, although how is not well understood. METHOD: Youth were sampled from the national, online longitudinal Growing up with Media study. They responded via text messaging to open-ended questions about how the COVID-19 pandemic may have impacted the sexual behavior and alcohol use of adolescents. Conventional content analysis summarized open-ended responses. RESULTS: 416 responses were analyzed from 335 participants (aged 15-30, US residents), 81 of whom provided data for both topics. Participants suggested that the pandemic affected some youths' sexual health precautions (increased and varying) and attitudes about sex (positive and negative). They discussed how adolescents met partners during the pandemic, including increased use of online platforms. Participants also suggested researchers investigate sexual risk in the realm of COVID-19 transmission and the practice of "safe sex." Many participants believed adolescents were drinking alcohol more as a result of the pandemic, both alone and with friends; however, others perceived adolescents were drinking less. Participants proposed researchers investigate adolescent drinking habits during the pandemic, as well as how this compares to before the pandemic and the type and quantity of alcohol consumed. CONCLUSIONS: Young people believe adolescent sexual relationships and drinking behaviors changed due to the pandemic, though how varied. Future research could examine the contexts and individual differences that shape these varying behaviors. Overall, this study highlights the importance of directly asking youth about their pandemic experiences and the diversity of views on how the pandemic has influenced adolescent behavior.

Cybervictimization in Relation to Self and Other Protection and Response Behaviors: A Cross-Sectional Look at an Age-Diverse National Sample.

This study considered whether experiencing cybervictimization is associated with increased recognition of cybervictimization intervention opportunities (i.e., witnessing others' cybervictimization), as well as greater engagement in self-protective (e.g., changing usernames and privacy settings) and other-protective cybervictimization bystander response behaviors. We collected cross-sectional self-report data from an age-diverse (M = 46.29 years, SD = 19.14, range = 15-93) national sample (n = 3002). We hypothesized that: (1) personal experiences with cybervictimization would be associated with increased reports of witnessing opportunities to intervene when others are cybervictimized, greater self-reported use of active bystander behaviors in witnessed situations, and greater use of self-protective strategies; (2) We also expected that engagement in self-protective behaviors would be positively associated with engagement in other-protective bystander behaviors in response to witnessed cybervictimization. To test our hypotheses, we estimated a structural equation model wherein four latent variables were constructed: cybervictimization experienced, witnessed opportunities to intervene, engagement in self-protective behaviors, and engagement in other-protective cybervictimization bystander behaviors. As hypothesized, cybervictimization was associated with witnessing more opportunities to intervene in other's cybervictimization, greater self-reported use of active cyber bystander behaviors, and greater engagement in self-protective strategies. However, the strength of two associations was moderated by age, with stronger relationships between cybervictimization and witnessing opportunities to intervene as well as engaging in bystander behavior for older as compared to younger participants. Contrary to hypothesis, there were no significant associations between use of self and other protective behaviors. Furthermore, greater witnessing of cybervictimization was associated with less engagement in bystander behavior in the final model. The implications for existing bystander intervention programs are described. Longitudinal studies of these associations in multiple age groups and among different cultural groups remain necessary.

Correction: Mobile Phone Technology for Preventing HIV and Related Youth Health Problems, Sexual Health, Mental Health, and Substance Use Problems in Southwest Uganda (Youth Health SMS)- Protocol for a Pilot Randomized Controlled Trial.

[This corrects the article DOI: 10.2196/49352.].

Sexual decision making of Ugandan young adults: findings from national online discussions.

Fifty-one 18-22-year-old Ugandans took part in asynchronous online discussions about sexual decision-making. To increase generalizability and variability of experience, youth were recruited across the country using social media advertising. Participants were stratified into 8 groups by sex and sexual experience (e.g., women who had not had sex). Participants were asked questions such as, "What role do you think [men/women] play in deciding when a couple is going to play sex?" Several themes emerged. Both young men and women articulated social pressures to be abstinent, particularly to avoid STIs and pregnancy moreso than saving oneself for marriage. That said, women noted pressures to be seen as "pure". There also were pressures to have sex: Men were expected to have sex to demonstrate their virility. Women were expected to have sex if they accepted gifts or other commodities from their partners. It seemed that the specter of HIV and other STIs, as well as unwanted pregnancy, served to mitigate these expectations however, resulting in self-efficacy to use condoms among both men and women. Nonetheless, both men and women acknowledged that it could be hard for women to negotiate condoms. Implications for HIV prevention are discussed.

Mobile Phone Technology for Preventing HIV and Related Youth Health Problems, Sexual Health, Mental Health, and Substance Use Problems in Southwest Uganda (Youth Health SMS): Protocol for a Pilot Randomized Controlled Trial.

BACKGROUND: East and Southern Africa have the highest HIV incidence and prevalence in the world, with adolescents and young adults being at the greatest risk. Despite effective combination prevention tools, including the recently available pre-exposure prophylaxis (PrEP), HIV incidence among adolescents and young adults in Uganda remains high, and PrEP use remains low. Mental health and substance use (behavioral health) play a role in sexual behavior and decision-making, contributing to an increase in the risk for acquiring HIV. Interventions that target multiple HIV risk factors, including sexual and mental health and problematic substance use, are crucial to ending the HIV epidemic. Yet few interventions addressing HIV related health disparities and comorbidities among adolescents and young adults in East and Southern Africa currently exist. OBJECTIVE: This study aims to evaluate the acceptability and feasibility of Kirabo, an SMS text message intervention informed by the information, motivation, and behavior model and to be disseminated through secondary schools. The study will gather preliminary estimates of Kirabo's effectiveness in increasing HIV testing and linking users to mental health counselors. METHODS: We identified Mobile 4 Reproductive Health for adaptation using the assessment, decision, administration, production, topical experts, integration, training, testing (ADAPT-ITT) framework. Mobile 4 Reproductive Health is an evidence-based automated 2-way SMS text messaging and interactive voice response platform that offers sexual and reproductive health information and links users to HIV clinics in East Africa. Through ADAPT-ITT we refined our approach and created Kirabo, an SMS text message-based intervention for linking adolescents and young adults to health services, including HIV testing and mental health counseling. We will conduct a 2-arm randomized controlled trial in Masaka, Uganda. Adolescents (N=200) will be recruited from local schools. Baseline sociodemographic characteristics, HIV test history, and behavioral health symptoms will be assessed. We will evaluate acceptability and feasibility using surveys, interviews, and mobile phone data. The preliminary efficacy of Kirabo in increasing HIV testing and linking users to mental health counselors will be evaluated immediately after the intervention and at the 3-month follow-up. We will also assess the intervention's impact on self-efficacy in testing for HIV, adopting PrEP, and contacting a mental health counselor. RESULTS: Intervention adaptation began in 2019. A pretest was conducted in 2021. The randomized controlled trial, including usability and feasibility assessments and effectiveness measurements, commenced in August 2023. CONCLUSIONS: Kirabo is a tool that assists in the efforts to end the HIV epidemic by targeting the health disparities and comorbidities among adolescents in Uganda. The intervention includes local HIV clinic information, PrEP information, and behavioral health screening, with referrals as needed. Increasing access to prevention strategies and mitigating factors that make adolescents and young adults susceptible to HIV acquisition can contribute to global efforts to end the HIV epidemic. TRIAL REGISTRATION: ClinicalTrials.gov NCT05130151; https://clinicaltrials.gov/study/NCT05130151. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/49352.

Event Characteristics of Sexual Violence Perpetration Against Romantic Partners Versus Non-Romantic Partners.

Tactics used to perpetrate sexual violence may be crucial to understanding when and why sexual violence occurs. Moreover, most sexual violence occurs between people who know each other-including in the context of dating or sexual relationships. Little is known about the context of sexual violence that occurs with non-romantic partners. To address these research gaps, we examined online survey data from 786 young adults (weighted n = 763) aged 19 to 27 years, living across the United States. Findings suggest that 60% of sexual assault, 40% of attempted rape, 42% of rape, and 67% of coercive sex were perpetrated against a romantic partner, defined as a current or ex-boyfriend, girlfriend, spouse, or domestic partner. Contextual differences were noted by relationship type: Those who perpetrated against romantic partners were more likely than those who targeted non-romantic partners to report that it occurred because they were feeling sad or angry. They were also more likely to say that the other person was completely responsible for what happened. Conversely, those who aggressed against non-romantic partners were more likely to say that someone else found out about what happened. Making the other person feel guilty was the most common tactic for both groups. The most frequently endorsed reason for perpetrating sexual violence was "feeling really horny," although feeling "good" or being drunk/high were also common reasons noted by aggressors. Afterward, many said they felt guilty or ashamed and were worried about the other person's feelings. Fear of getting caught was universally absent. Findings support the importance of building emotion regulation and emotional awareness skills in sexual violence prevention programming. Prevention programs should also discuss coercion as a violence tactic, since perpetrators may not always recognize this to be sexual violence. More generally, violence prevention programs should also address healthy relationships, consent, and taking responsibility.

Polyvictimization Among Sexual and Gender Minority Youth.

INTRODUCTION: Polyvictimization is a significant public health issue. Sexual and gender minority youth are important to include in polyvictimization research because they report higher rates of victimization than nonsexual and gender minority youth. This study examines whether polyvictimization attenuates the associations between individual types of victimization and depressed mood and substance use across gender and sexual identities. METHODS: Data were collected cross-sectionally from 3,838 youth aged 14-15 years. Youth were recruited through social media between October 2018 and August 2019 across the U.S. Analyses were conducted in July 2022. Sexual and gender minority youth were oversampled. Depressed mood and substance use were dependent variables. RESULTS: Transgender boys were the most likely to be polyvictims (25%). Transgender girls (14.2%) and cisgender sexual minority girls (13.4%) also reported high rates. Cisgender heterosexual boys were the least likely to be classified as polyvictims (4.7%). When adjusting for polyvictimization, existing relationships between individual types of victimization (e.g., theft) and depressed mood became nonsignificant in most cases. Of exception, witnessing violence and peer victimization remained significant predictors of the odds of depressed mood. Most associations between individual types of victimization and substance use became nonsignificant after considering polyvictimization, with the exception of cisgender heterosexual boys and girls, for whom many remained significant but attenuated (e.g., emotional interpersonal violence). CONCLUSIONS: Sexual and gender minority youth experience a disproportionate number of victimizations across multiple domains. A comprehensive assessment of victimization exposure may be important when considering prevention and intervention approaches for depressed mood and substance use.

Subgroup Analyses of Girl2Girl, a Text Messaging-Based Teen Pregnancy Prevention Program for Sexual Minority Girls: Results from a National RCT.

This study aims to investigate whether Girl2Girl, a text messaging-based pregnancy prevention program for cisgender LGB+ girls, had different effects on subgroups based on age, sexual identity, and experience with penile-vaginal sex. A total of 948 girls, 14-18 years old, were recruited nationally via social media and enrolled over the telephone. Once they completed the baseline, they were randomized to either Girl2Girl or an attention-matched control program that discussed "healthy lifestyle" topics (e.g., self-esteem). Both programs were 5 months long: Girls received daily messages for 8 weeks, and then went through a "latent" period of 3 months, and finished with a 1-week review. Outcome measures included condom-protected sex, uptake of other types of birth control, abstinence, and pregnancy. Measures were collected at baseline; 3-month, 6-month, 9-month, and 12-month post-intervention end, which was 17 months after enrollment. Effect modification was examined using longitudinal mixed effects models. Overall, results suggested significant moderating effects of age, (f2 = .12), sexual identity (f2 < .14), and sexual experience (f2 = .11) on rates of condom use and use of other contraception. Although there were no significant moderating effects on pregnancy, abstinence, or intentions to use condoms, use birth control, or be abstinent, (p's > .16), patterns of effects were in the same direction as for significant findings. For example, at 9-month post-intervention, among those who identified as bisexual, the incidence rate of protected sex events was 39% higher for intervention vs. control (IRR = 1.39, 95% CI: 1.06-2.70), adjusting for baseline rate of condom use and sexual experience. Similarly, at 12 months, among bisexual participants, intervention participants had a significantly higher IRR of condom-protected sexual events (IRR = 2.65, 95% CI: 1.31-5.34). There were also higher odds of uptake of birth control use other than condoms for intervention vs. control at 6- (OR = 1.10, 95% CI: 1.01-1.77), 9 m (OR = 1.11, 95% CI: 1.07-1.89), and 12-month (OR = 1.13, 95% CI: 1.07-1.78) follow-up. Girl2Girl appears to be particularly effective for older adolescents, bisexual girls, and those who have already had penile-vaginal sex. No one single approach is going to affect teen pregnancy. Instead, it is more likely that different intervention content and delivery methods will be more accessible and salient to some but not other youth. Understanding for whom the intervention works is just as important as understanding for whom the intervention does not, as this can inform opportunities for future intervention development.Clinical Trial Registration: ClinicalTrials.gov ID# NCT03029962.

Sexual Fluidity in Identity and Behavior Among Cisgender Youth: Findings from the Longitudinal Growing up with Media Study.

OBJECTIVES: To examine fluidity in sexual orientation identity and behavior among cisgender youth. STUDY DESIGN: Data were analyzed from 5 survey waves of the longitudinal US Growing Up with Media Study (2010-2019). Participants were 989 cisgender youth, aged 13-20 years at baseline, who completed online surveys assessing sexual orientation identity and behavior (gender of sexual partners). Amount of change (mobility) and patterns of change across waves were assessed for identity and behavior. RESULTS: Consistently heterosexual was the most common sexual orientation identity (89%-97% for boys, 80%-90% for girls), followed by gay (3%) for boys, and bisexual (8%) for girls. Sexual minority identities increased (3%-11% for boys, 10%-20% for girls) over time, same-gender sexual behavior also increased. Girls had more identity mobility than boys; no gender difference was found for behavior mobility. Movement from heterosexual to a sexual minority identity occurred for 9% of girls and 6% of boys; movement from different-gender sexual behavior to same-gender sexual behavior occurred for 2% of girls and boys. CONCLUSIONS: Findings highlight the need to assess multiple dimensions and patterns of change of youth sexual orientation in research and clinical care. Recognizing and creating space for conversations about changes in sexual identity and behavior over time will help providers accurately and effectively address the health needs of all patients.

Minor Consent Laws for Sexually Transmitted Infection and Human Immunodeficiency Virus Services in the United States: A Comprehensive, Longitudinal Survey of US State Laws.

Objectives. To assess changes in minor consent laws for sexually transmitted infection (STI) and HIV testing, treatment, and prevention services in all 50 US states and the District of Columbia from 1900 to 2021. Methods. We coded laws into minor consent for (1) health care generally; (2) STI testing, treatment, and prevention; (3) HIV testing, treatment, and prevention; and (4) pre- or postexposure prophylaxis for HIV prevention. We also coded confidentiality protections and required conditions (e.g., threshold clinician judgments). Results. The largest increase in states allowing minors to consent to STI services occurred during the 1960s and 1970s. By 2021, minors could consent independently to STI and HIV testing and treatment in all 50 states plus DC, STI prevention services in 32 jurisdictions, and HIV prevention services in 33 jurisdictions. Confidentiality protections for minors are rare. Prerequisites are common. Conclusions. Although the number of states allowing minors to consent independently to STI and HIV services has increased considerably, these laws have substantial limitations, including high complexity, prerequisites requiring clinician judgments, and neglect of confidentiality concerns. (Am J Public Health. 2023;113(4):397-407. https://doi.org/10.2105/AJPH.2022.307199).

Impact of the COVID-19 pandemic for youth with a history of exposure to self-directed violence.

OBJECTIVE: The coronavirus disease 2019 (COVID-19) pandemic created a sudden shift in the social lives of youth with important negative impacts on mental health. The current article aims to understand how the pandemic may have differentially impacted the mental health of adolescents and young adults with recent (1 year or less) and past (> 1 year) exposure to self-directed violence (SDV). METHOD: Data were collected online from 990 youth and young adults, aged 13-23 years between November 27, 2020 and December 11, 2020. RESULTS: Participants who had recently been exposed to SDV reported being more impacted by the pandemic and had poorer mental health indicators. Participants with past SDV exposure who engaged in a high number of prosocial activities (e.g., talking with friends) were less likely to report depressive symptoms (ß = -.13, p = .01) than similarly engaged nonexposed participants; the same was true for recently exposed participants (ß = -.14, p = .02). CONCLUSIONS: Findings highlight that the effects of the COVID-19 pandemic on the mental health of young people are compounded by exposure to mental health concerns of people in their network. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Youth Characteristics Associated With Sexual Violence Perpetration Among Transgender Boys and Girls, Cisgender Boys and Girls, and Nonbinary Youth.

Importance: Gender minority adults experience higher rates of sexual violence (SV) than cisgender adults. How this disparity extends to youths, including perpetration rates, is unknown. Objective: To compare rates of experience and perpetration of SV by gender identity and investigate characteristics associated with odds of perpetration within gender identity categories. Design, Setting, and Participants: This cross-sectional study used baseline data from a national online longitudinal survey collected in 2018 to 2020. Eligible participants were youths ages 14 to 16 years who read English and had internet access. Data were analyzed in November 2021 and March 2022. Exposures: Youth characteristics included stressors associated with being marginalized (eg, internalized transphobia), general stressors (eg, trauma not associated with experiencing SV), other marginalized statuses (eg, identifying as a girl), factors associated with protection (eg, social support), environmental characteristics (eg, community violence exposure), and risk factors associated with SV (eg, consumption of violent pornography). Main Outcomes and Measures: Self-reported rates of experiencing and perpetrating SV, defined as sexual assault, rape, attempted rape, and coercive sex, among cisgender, transgender, and nonbinary youths. Results: Among 4193 youths in the sample (mean [SD] age, 14.8 [0.7] years), 3282 participants (78.3%) were cisgender, 329 participants (7.9%) were transgender, and 582 participants (13.9%) were nonbinary. The odds of SV perpetration were not statistically significantly different for transgender boys and girls (odds ratio [OR], 0.90; 95% CI, 0.57-1.41; P = .64) or nonbinary youths (OR, 0.78; 95% CI, 0.54-1.12; P = .18) compared with cisgender boys and girls. By contrast, transgender boys and girls (OR, 2.31; 95% CI, 1.83-2.91; P < .001) and nonbinary youths (OR, 2.37; 95% CI, 1.98-2.83; P < .001) were more than 2-fold as likely as cisgender boys and girls to report experiencing SV. Aggressive behavior was associated with higher odds of SV perpetration for transgender boys and girls (adjusted OR [aOR], 1.87; 95% CI, 0.75-4.65; P = .18) and nonbinary youths (aOR, 1.61; 95% CI, 0.78-3.32; P = .20). Indications of hostile masculinity were associated with higher odds of SV perpetration among cisgender youths (ie, positive attitudes for boys to engage in rape behaviors: aOR per unit increase in score, 1.15; 95% CI, 1.07-1.25; P < .001; sexual dominance: aOR per unit increase in score, 1.03; 95% CI, 1.01-1.04; P < .001) but not among transgender or nonbinary youths. Conclusion and Relevance: These findings may suggest an important foundation for the development of inclusive, research-based SV prevention programs and methods for incorporating gender identity effectively into SV research.

Violent Media in Childhood and Seriously Violent Behavior in Adolescence and Young Adulthood.

PURPOSE: To quantify the relative odds of self-reported seriously violent behavior in adolescence and young adulthood given one's self-reported violent media diet in childhood. METHODS: Baseline data were collected nationally online from 1,586 youth 10-15 years of age in 2006. Follow-up data were collected in 2010-2011 and 2016. Children reported the amount of music, video games, television, websites with real people, and cartoons that depicted "physical fighting, hurting, shooting, or killing." Seriously violent behavior was assessed 5 and 10 years later. RESULTS: 887 adolescents completed the survey at baseline and 5-year follow-up. The relative odds of reporting seriously violent behavior over time were 2.45-fold higher (p < .001) with each incremental increase in one's baseline violent media diet. After adjusting for other potentially influential characteristics, results persisted (aOR = 1.70, p = .01). The relative odds also were elevated for those frequently exposed to violence in music (aOR = 3.28, p = .03), television (aOR = 3.51, p < .001), and video games (aOR = 3.27, p = .02). 760 young adults completed measures at baseline and 10-year follow-up. The relative odds of seriously violent behavior increased 2.18-fold (p = .001) with each incremental increase in one's baseline violent media diet. After adjusting for other factors, the association persisted (aOR = 1.72, p = .03). Frequent exposure to violence in video games (aOR = 3.28, p = .03) and television (aOR = 3.14, p = .02) also were implicated. DISCUSSION: Exposure to violent media in childhood may be one modifiable influence on seriously violent behavior in adolescence and adulthood, even for those who have other risk factors.

Voices of Youth and Emerging Adults on Suicide Prevention: Experiences and Expectations.

Self-directed violence (SDV) is a significant public health issue for adolescents and emerging adults, and yet youth exposure to prevention messaging and youth perspectives on SDV prevention needs are understudied. The current study sought to better understand the ways in which a national sample of youth and emerging adults were exposed to suicide prevention programs or conversations. A sample of 1031 young people ages 13-23 were recruited nationally through social media. Survey questions asked about SDV prevention exposure. Open-ended questions asked youth to suggest additional information they desired about SDV. A majority of participants (87%) reported that they had received prevention exposure from at least one source (i.e., family, online, attending a talk, or formal program) with few differences by demographic characteristics. However, sexual and gender minority (SGM) youth reported accessing more SDV prevention information online compared to other youth. Overall, youth had many ideas about what additional information they needed, including how to help someone at risk for SDV and how to access information about mental health. While the majority of youth are receiving some SDV prevention messages, there is variation in how they get this information, and survey participants still felt they were missing important information. Findings highlight the need to resource more comprehensive SDV prevention for youth and young adults.

Impact of the COVID-19 Pandemic on Perceptions of Health and Well-Being Among Sexual and Gender Minority Adolescents and Emerging Adults.

Purpose: The study purpose was to examine how the COVID-19 pandemic may be differentially impacting the well-being of sexual and gender minority (SGM) youth compared with their non-SGM counterparts. Specifically, we looked at perceptions of mental and physical health impact and relevant aspects of coping with the pandemic such as engagement in prosocial activities that might ultimately promote resilience. Methods: Survey data were collected between November 27, 2020, and December 11, 2020, from 990 adolescents and emerging adults aged 13-23 years. Participants were recruited through advertisements on Facebook and Instagram with an effort to overrecruit SGM youth. Questions asked youth about their perception of the impact of the COVID-19 pandemic on their physical and mental health, the types of prosocial activities engaged in during the pandemic, and how they felt they were doing now versus before the pandemic. Results: SGM youth reported a significantly greater impact from the pandemic than non-SGM youth. Both SGM youth and cisgender heterosexual females reported greater impact on their mental health compared with cisgender heterosexual males, with cisgender sexual minority females and gender minority youth reporting the highest mental health impact. Gender minority youth also reported feeling less connected to their families and less safe at home as a result of the pandemic. Conclusion: Health professionals, educators, and advocates need to help assess SGM youth for negative impact from the pandemic and help them connect with other youth and support resources online as they move forward. Youth may also benefit from programs connecting them to volunteer work and neighbors.

Are the Bystanders Okay? Exploring the Impact of Bystander Behavior for Self-directed Violence.

PURPOSE: The purpose of this study was to understand the range of emotions reported by youth bystanders, as well as the reactions they received from the at-risk individual engaging in self-directed violence. METHODS: A national sample of 1,031 youth and young adults (aged 13-23 years) was recruited online between November 27, 2020 and December 4, 2020. Sixty-two percent (n = 638) reported intervening with someone engaging in self-directed violence and comprise the analytical sample. Suicidal ideation, nonsuicidal self-injury, and suicide attempts were examined separately. RESULTS: One in five (21.9%) who engaged in bystanding behavior with someone attempting suicide felt really good about their helping; 42.9% said they felt somewhat good. About half (51%) said that the at-risk person responded negatively, however. Similar percentages were noted for bystanders of people with suicidal ideation and nonsuicidal self-injury. Singularly positive responses from the at-risk person were associated with increased odds of the bystander feeling somewhat/really good about their decision to help and feeling like what they did really helped. For every additional type of bystander behavior, the odds of feeling good about helping increased. Bystander behaviors most consistently associated with increased odds of feeling good about helping were "encouraging the person to talk to their family" and "telling the person they were important to them." CONCLUSIONS: Future research should work to better understand what forms of bystander behavior are most successful at protecting at-risk individuals, how one's perceptions of their bystander behavior change over time, and how effective forms of helping relate to how they are perceived.

Acceptability of Texting 4 Relapse Prevention, Text Messaging-Based Relapse Prevention Program for People With Schizophrenia and Schizoaffective Disorder.

ABSTRACT: We report process outcomes of the pilot randomized controlled trial of Texting 4 Relapse Prevention (T4RP), a text messaging-based relapse prevention program for people with schizophrenia or schizoaffective disorder (SAD). Forty people were randomized to either the intervention or treatment as usual control group at a 2:1 ratio. Process indicators were collected at 6 months post enrollment.Over 90% of patients agreed or strongly agreed that the text messages were easy to understand, easy to answer, positive, and helped them feel supported. Patient acceptability was positively associated with recovery (ß = 0.29, p = <0.001) and patient-provider communication scores (ß = 1.04, p < 0.001), and negatively associated with symptoms of the disorder (ß = -0.27, p = 0.07). Acceptability was similar by diagnosis (ß, SAD diagnosis = 0.40, p = 0.90) and age (ß = 0.05, p = 0.67). Findings suggest that a text messaging intervention aimed at preventing relapse is feasible and perceived as beneficial in individuals with schizophrenia and SAD. Future research might include a targeted study of T4RP within the context of hospital discharge when people with schizophrenia/SAD are at highest risk of relapse.

Understanding Sexual Harassment Through an Individual and Relational Lens: Are Risk Factors the Same for Female and Male Perpetrators?

Given widespread recognition of sexual violence as a public health concern, sexual harassment has garnered considerable attention from researchers and the public. Yet research with adolescent samples has typically focused on the experiences of victims rather than perpetrators, and males as perpetrators and females as victims. In the current article, we consider whether risk and protective factors operate similarly within and across sex assigned at birth. A national sample of youth, ages 14 and 15, were recruited via social media and surveyed online (N = 1,981). At the individual level, girls who sexually harassed others, were more likely to have a propensity to respond to stimuli with anger compared to boys who sexually harassed. At the relational level, girls who sexually harassed were more likely to be victims of sexual harassment compared to boys, and having a negative peer environment (have delinquent peers, seen someone get attacked, and know someone who has been sexually assaulted) was of particular importance in understanding why girls harass others. For boys who harass, family relations, having seen or heard about peer physical or sexual assault and bullying perpetration were important for contextualizing boys' sexual harassment. As empathy increased, the relative odds of sexually harassing decreased for girls. Future research should explore motivations for perpetrating sexual harassment, bystander interventions, and longitudinal frameworks to identify causal patterns to determine which factors inhibit or facilitate sexual harassment.