Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 43
Filtrar
1.
J Marital Fam Ther ; 2021 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-34608653

RESUMO

In a sample of suicidal adolescents (N = 117), we sought to identify how adolescents' attachment to their parents related to a key mechanism of suicide from the Interpersonal Theory of Suicide (IPTS). We tested both attachment-anxiety and attachment-avoidance, to both mother- and father-figures as correlates of the IPTS construct, perceived burdensomeness (PB). In addition, we tested PB as a mediator between these attachment variables and adolescent suicide ideation in a path analysis. Our path analysis indicated both mother- and father-related attachment anxiety were associated with PB and PB was related to suicide ideation. We also found an indirect effect of father-related attachment anxiety on suicide ideation. This study provides empirical support for earlier systemic work that proposes how family relationships may influence an adolescent's suicidal ideation. Finally, we provide practical clinical suggestions for how therapists may implement a systemic framework to address a suicidal adolescent and their family relationships.

2.
J Consult Clin Psychol ; 89(6): 528-536, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34264700

RESUMO

OBJECTIVE: Despite considerable evidence that supports perceived burdensomeness (PB) and thwarted belongingness (TB) as risk factors for suicidal ideation (SI), far less is known about the direction of effects between these constructs in treatments for suicidal adolescents. The present study examined bidirectional relations between PB, TB, and adolescents' suicidal ideation (SI) during a 16-week randomized clinical trial. METHOD: 129 depressed and suicidal adolescents completed PB, TB, and SI measures at three time points: baseline (T1), mid-treatment (T2), and treatment completion (T3). Random-intercept cross-lagged panel models (RI-CLPM) examined within-subject direction of effects between interpersonal variables (PB & TB) and suicidal ideation (SI) in the first and second halves of treatment. RESULTS: Within-subjects, autoregressive paths indicated significant carryover in PB and SI. In the first half of treatment, a significant cross-lagged path indicated that T1 PB predicted change in T2 SI, and in the last half of treatment change in T2 SI predicted change in T3 PB. There were no significant auto-regressive or cross-lagged effects for TB. CONCLUSIONS: In the first half of treatment, baseline PB predicted fewer reductions in SI suggesting that PB initially moderated adolescents' response to treatment. However, in the last half of treatment, initial reductions in SI predicted subsequent reductions in PB suggesting that adolescents' initial response to treatment decreased their perceptions of burdening others. The clinical and treatment implications of these bidirectional findings are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Depressão/terapia , Terapia Familiar/métodos , Suicídio/prevenção & controle , Suicídio/psicologia , Adolescente , Feminino , Humanos , Relações Interpessoais , Masculino , Relações Pais-Filho , Teoria Psicológica , Psicoterapia/métodos , Fatores de Risco , Ideação Suicida , Inquéritos e Questionários
3.
Psychother Res ; 31(2): 267-279, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32228168

RESUMO

Objective: This study examined proposed sequential pathways through which suicidal adolescents are thought to shift from secondary global distress and rejecting anger to primary adaptive hurt, grief and assertive anger in the context of attachment-based family therapy (ABFT). Method: Participants were 39 suicidal adolescents who had received 16 weeks of ABFT as part of a randomized clinical trial, and who had been assigned to one of three outcome groups (i.e., good responders, slow responders and non-responders). Adolescents' in-session emotions were observationally coded using the Classification of Affective-Meaning States. Results: Across outcome groups, adolescents evidenced shifts from global distress to maladaptive shame, from maladaptive rejecting anger to adaptive assertive anger, and from adaptive assertive anger to adaptive grief/hurt. Adolescents who did not respond to treatment evidenced higher rates of maladaptive global distress. Conclusions: Findings are discussed in the context of ABFT and sequential emotional processing theories.


Assuntos
Terapia Familiar , Ideação Suicida , Adolescente , Emoções , Pesar , Humanos , Apego ao Objeto
4.
Fam Process ; 59(2): 428-444, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-30908627

RESUMO

Productive emotional processing is considered a key change mechanism in attachment-based family therapy (ABFT). This study examined the impact of attachment-based family therapy therapist interventions aimed to promote productive emotional processing of primary adaptive emotions in a sample of 30 depressed and suicidal adolescents who had participated in a larger randomized clinical trial. Results of sequential analyses revealed that relational reframes and therapists' focus on primary adaptive emotions were associated with the subsequent initiation of adolescents' productive emotional processing of primary adaptive emotions. In contrast, interpretations, reassurances, and therapists' focus on adolescents' rejecting anger toward their parents were all followed by the discontinuation of adolescents' emotional processing that had already begun. Finally, therapists' general encouragement of affect and focus on adolescents' unmet attachment/identity needs were associated with both the initiation of adolescents' productive emotional processing, and with the discontinuation of such processing once it had already begun. Theoretical and clinical implications are discussed.

5.
Suicide Life Threat Behav ; 50(2): 372-386, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31600010

RESUMO

OBJECTIVE: Suicide is a leading cause of death in adolescence. The mechanisms of adolescent suicidality, however, are not fully understood. Although the Interpersonal-Psychological Theory of Suicide, as assessed by the Interpersonal Needs Questionnaire-15 (INQ), may be a promising framework, systematic study of its utility during adolescence is lacking. METHOD: To this end, we utilized factor analyses and hierarchical regression analyses to test the factor structure, correlates, and predictive validity of the INQ in a sample of clinically depressed and suicidal adolescents (N = 120, aged 12-18). The sample was mostly female (81.9%), ethnically diverse (68.2% non-White) and with nearly a third identifying as a sexual minority (31.8%). RESULTS: Contrary to studies including adult samples in which a two-factor solution is identified, results within this sample indicated three factors: perceived burdensomeness, thwarted belongingness, and perceived isolation. Perceived burdensomeness and the interaction between perceived burdensomeness and perceived isolation predicted suicide ideation above and beyond depression, but thwarted belongingness and perceived isolation did not. CONCLUSION: Perceived burdensomeness appears to play a role in adolescent suicidality and may be a point of intervention, yet the notable deviation from previous findings and the relative weakness of two of the factors warrant further study.


Assuntos
Relações Interpessoais , Ideação Suicida , Adolescente , Adulto , Criança , Análise Fatorial , Feminino , Humanos , Masculino , Teoria Psicológica , Fatores de Risco , Inquéritos e Questionários
6.
J Consult Clin Psychol ; 87(12): 1137-1148, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31647277

RESUMO

OBJECTIVE: Although there are currently several efficacious treatments for depressed and suicidal adolescents, less is known about predictors and moderators of adolescents' treatment response. A growing literature has identified family functioning as a prognostic indicator of adolescents' likelihood of benefiting from treatment. The current study tested both observational and perceived measures of family functioning as indicators of adolescents' response to 2 treatment conditions. METHOD: The sample consisted of 129 depressed and suicidal adolescents (Mage = 14.96, 82.9% female, 56% Black/African American) who were randomized to attachment-based family therapy or family-enhanced nondirective supportive therapy (Diamond et al., 2019). Baseline assessments of family functioning included ratings of parent-adolescent communication coded with the Goal-Corrected Partnership in Adolescence Coding System (Lyons-Ruth, Hennighausen, & Holmes, 2005) and adolescent and parent reports of Family Conflict and Cohesion from the Self-Report of Family Functioning (Bloom, 1985). RESULTS: Adolescents who engaged in more uncooperative communication with their parents during a 10-min conflict discussion showed greater reductions in depressive symptoms in both treatments. Adolescents from traditionally underserved (non-White or lower income) families showed greater reductions in suicidal ideation in both treatments. CONCLUSIONS: Attachment-based family therapy and family-enhanced nondirective supportive therapy were most effective for adolescents from traditionally underserved families and adolescents who engaged in less cooperative communication with their caregivers. Observational ratings of parent-adolescent communication were better prognostic indicators of treatment response than were self-reported indicators of global family functioning. Implications for generalizing these results to other treatments for depressed and suicidal adolescents are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Comportamento do Adolescente , Comunicação , Depressão/terapia , Terapia Familiar/métodos , Apego ao Objeto , Avaliação de Resultados em Cuidados de Saúde , Relações Pais-Filho , Ideação Suicida , Adolescente , Técnicas de Observação do Comportamento , Feminino , Humanos , Masculino , Autorrelato
7.
J Am Acad Child Adolesc Psychiatry ; 58(7): 733-734, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31229183

RESUMO

The Letter to the Editor by Verhees et al. raises interesting questions about how to potentiate the mechanism of change in attachment-focused therapies.1 The basic assumption of attachment theory is that that children who grow up with insensitive or inconsistent parenting or trauma internalize a view of the world as unsafe and view themselves as unworthy of love and protection. These early relational experiences lay down the foundation of one's view of oneself and expectation of others. This schema, combined with temperament and biology, inform and influence future relationships and experiences. But for Bowlby, because the internal working model is shaped by relational experience, it is continually open for revision if the environment were to change.2 As psychotherapists, we aim to facilitate that revision.


Assuntos
Poder Familiar , Adolescente , Criança , Humanos
8.
Crisis ; 40(5): 333-339, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30813828

RESUMO

Background: Adolescent suicidality is a growing public health concern. Although evidence supports a link between anxiety and suicidality, little is known about risk associated with specific anxiety disorders. Aims: This study examined the prevalence of anxiety disorders in a sample of adolescents with depression and suicidal ideation and the associations between specific anxiety disorders and suicide ideation severity and attempt history. Method: The sample consisted of 115 adolescents (Mage = 14.96 years; 55.8% African American) entering a clinical trial for suicidal ideation and depressive symptoms. Prior to treatment, adolescents completed self-report and interview measures. Results: In all, 48% of the sample met criteria for an anxiety disorder, 22% met criteria for social anxiety disorder (SAD), and 40% met criteria for major depressive disorder (MDD). SAD was uniquely associated with more severe suicidal ideation. Limitations: Findings may not generalize to all suicidal adolescents, and non-measured variables may account for the observed relationships. Conclusion: Future research should examine whether targeting social anxiety would improve treatment response for suicidal adolescents.


Assuntos
Transtornos de Ansiedade/psicologia , Depressão/psicologia , Risco , Ideação Suicida , Tentativa de Suicídio/psicologia , Adolescente , Agorafobia/epidemiologia , Agorafobia/psicologia , Transtornos de Ansiedade/epidemiologia , Ansiedade de Separação/epidemiologia , Ansiedade de Separação/psicologia , Depressão/epidemiologia , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/psicologia , Feminino , Humanos , Masculino , Transtorno de Pânico/epidemiologia , Transtorno de Pânico/psicologia , Tentativa de Suicídio/estatística & dados numéricos
9.
Child Psychiatry Hum Dev ; 50(5): 727-737, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-30847634

RESUMO

Eating disorders are a serious, life-threating condition impacting adolescents and young adults. Providers in primary care settings have an important role in identifying disordered eating (DE) symptoms. Unfortunately, symptoms go undetected in 50% of patients in medical settings. Using the behavioral health screen, this study identified DE risk profiles in a sample of 3620 female adolescents and young adults (ages 14-24), presenting in primary care. A latent class analysis with twenty psychosocial factors identified three DE risk groups. The group at highest risk for DE was characterized by endorsement of internalizing symptoms and a history of trauma. The next risk group consisted of those with externalizing symptoms, particularly substance use. The group at lowest risk for DE reported more time spent with friends compared to their peers. Primary care providers and psychiatric teams can benefit from knowing the psychosocial risk patterns affiliated with DE, and using brief, comprehensive screening tools to identify these symptoms.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/etiologia , Atenção Primária à Saúde , Transtornos Relacionados ao Uso de Substâncias/complicações , Adolescente , Feminino , Amigos , Humanos , Masculino , Programas de Rastreamento , Fatores de Risco , Adulto Jovem
10.
J Am Acad Child Adolesc Psychiatry ; 58(9): 897-906, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-30877051

RESUMO

OBJECTIVE: Although several treatments have been shown to be effective in treatment of youth suicidal thoughts and behaviors (STBs), there is a pressing need to account for the substantial variation in adolescents' response to and outcomes from these treatments. METHOD: Secondary analyses of data from a 16-week randomized trial of Attachment-Based Family Therapy (ABFT) and Family-Enhanced NonDirective Supportive Therapy (FE-NST) identified distinct classes of adolescents' treatment response. Established risk factors for STBs, along with treatment condition and sociodemographic variables, were then tested as predictors of class membership. RESULTS: Three patterns of adolescents' treatment response and outcome were identified: a) nonresponders (15.8%), b) good responders (57.5%), and c) partial responders (26.7%). After controlling for initial symptom severity, nonresponders were more likely to have higher levels of nonsuicidal self-injury and pessimism and were more likely to meet diagnostic criteria for major depressive disorder (MDD) than good or partial responders. Partial responders were more likely than good responders to meet criteria for MDD and to have higher perceived burdensomeness. CONCLUSION: Although most adolescents showed significant symptom reductions with both treatments, adolescents with higher pretreatment levels of pessimism, MDD, nonsuicidal self-injury, and perceived burdensomeness were less likely to show an optimal pattern of treatment benefit. The findings point to heterogeneity in treatment response that may require adapting treatments for adolescents with these pretreatment profiles. CLINICAL TRIAL REGISTRATION INFORMATION: Attachment-Based Family Therapy for Suicidal Adolescents; http://clinicaltrials.gov; NCT01537419.


Assuntos
Transtorno Depressivo Maior/terapia , Terapia Familiar/métodos , Apego ao Objeto , Ideação Suicida , Adolescente , Criança , Transtorno Depressivo Maior/psicologia , Feminino , Humanos , Masculino , Avaliação de Resultados em Cuidados de Saúde , Philadelphia , Escalas de Graduação Psiquiátrica
11.
J Am Acad Child Adolesc Psychiatry ; 58(7): 721-731, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30768418

RESUMO

OBJECTIVE: To evaluate the efficacy of attachment-based family therapy (ABFT) compared with a family-enhanced nondirective supportive therapy (FE-NST) for decreasing adolescents' suicide ideation and depressive symptoms. METHOD: A randomized controlled trial of 129 adolescents who are suicidal ages 12- to 18-years-old (49% were African American) were randomized to ABFT (n = 66) or FE-NST (n = 63) for 16 weeks of treatment. Assessments occurred at baseline and 4, 8, 12, and 16 weeks. Trajectory of change and clinical recovery were calculated for suicidal ideation and depressive symptoms. RESULTS: There was no significant between-group difference in the rate of change in self-reported ideation (Suicidal Ideation Questionnaire-Jr; F1,127 = 181, p = .18). Similar results were found for depressive symptoms. However, adolescents receiving ABFT showed a significant decrease in suicide ideation (t127 = 12.61, p < .0001; effect size, d = 2.24). Adolescents receiving FE-NST showed a similar significant decrease (t127 = 10.88, p < .0001; effect size, d = 1.93). Response rates (ie, ≥50% decrease in suicide ideation symptoms from baseline) at post-treatment were 69.1% for ABFT versus 62.3% for FE-NST. CONCLUSION: Contrary to expectations, ABFT did not perform better than FE-NST. The 2 treatments produced substantial decreases in suicidal ideation and depressive symptoms that were comparable to or better than those reported in other more intensive, multicomponent treatments. The equivalent outcomes could be attributed to common treatment elements, different active mechanisms, or regression to the mean. Future studies will explore long-term follow up, secondary outcomes, and potential moderators and mediators. CLINICAL TRIAL REGISTRATION INFORMATION: Attachment-Based Family Therapy for Suicidal Adolescents; http://clinicaltrials.gov; NCT01537419.


Assuntos
Terapia Familiar , Apego ao Objeto , Transtorno Reativo de Vinculação na Infância/terapia , Ideação Suicida , Tentativa de Suicídio/prevenção & controle , Adolescente , Criança , Depressão/psicologia , Depressão/terapia , Feminino , Humanos , Masculino , Pennsylvania , Transtorno Reativo de Vinculação na Infância/psicologia , Autorrelato , Tentativa de Suicídio/psicologia
12.
Child Abuse Negl ; 77: 155-167, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29353719

RESUMO

Depressive symptoms and self-harm, i.e. non-suicidal self-injury and suicidal behaviors, are highly prevalent in youngsters involved in Child Welfare System (CWS) services. Little research investigates, however, why these CWS youngsters are at risk. We explored whether trust in caregiver support and communication about experiences with primary caregivers, are associated with CWS youngsters' depressive symptoms and/or self-harm. An anonymous online survey of 271 CWS youngsters (10-21 years of age, 57.2% female) was used to assess trust and communication, and depressive symptoms/self-harm. Results showed significant negative associations between self-reported trust in maternal and paternal support, and depressive symptoms/self-harm. Communication about experiences with one's biological mother mediated the relationship between trust in maternal support and depressive symptoms/self-harm. Furthermore, the presence of an additional trustworthy caregiver buffered the impact of low trust in maternal or paternal support on depressive symptoms/self-harm. Implications for interventions targeting CWS youngsters' depressive symptoms and self-harm are discussed.


Assuntos
Depressão/psicologia , Comportamento Autodestrutivo/psicologia , Ideação Suicida , Confiança , Adolescente , Adulto , Cuidadores/psicologia , Criança , Proteção da Criança , Comunicação , Depressão/diagnóstico , Feminino , Humanos , Masculino , Relações Mãe-Filho , Fatores de Risco , Autorrelato , Inquéritos e Questionários , Adulto Jovem
13.
Suicide Life Threat Behav ; 48(4): 431-437, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-28726309

RESUMO

Despite condemnation of same-sex attraction by certain religious groups, few studies have explored the relationship between religion, same-sex attraction, and suicidality. This study examined the moderating effect of same-sex attraction on the relationship between parent/adolescent religiosity and suicide ideation/attempts in a suicidal adolescent sample (N = 129). Linear and negative binomial regressions tested the effects of a two-way dichotomous (same-sex attraction, yes/no) by continuous (religiosity) interaction on ideation and attempts, respectively. The interaction was not significant for ideation. However, high religiosity was associated with more attempts in youth reporting same-sex attraction but fewer attempts in those reporting opposite-sex attraction only.


Assuntos
Religião e Psicologia , Comportamento Sexual/psicologia , Tentativa de Suicídio , Adolescente , Feminino , Humanos , Masculino , Fatores de Risco , Ideação Suicida , Tentativa de Suicídio/prevenção & controle , Tentativa de Suicídio/psicologia , Tentativa de Suicídio/estatística & dados numéricos , Estados Unidos/epidemiologia
14.
Am J Prev Med ; 53(1): 48-54, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28410860

RESUMO

INTRODUCTION: Suicide is a major public health problem and a complex clinical challenge. Assessment and early identification could be enhanced with screening tools that look beyond depression. The purpose of this study was to identify profiles of risk behaviors and social stress associated with suicidal ideation and behavior using the Behavioral Health Screen. METHODS: The study used screening data from 2,513 primary care patients (aged 14-24 years). Data were collected between 2008 and 2012, and were analyzed in 2016. RESULTS: Latent class analysis identified a high and low risk profile. Domains of primary influence included substance use, sexual assault, same-sex behavior, and unsafe sex. The high-risk group was 11 times more likely to have made a suicide attempt, five times more likely to report a history of suicidal ideation and behavior, and three times more likely to report recent suicidal ideation and behavior. CONCLUSIONS: Risk behaviors and social stress contribute to the risk for suicide above and beyond depression and should be assessed during routine primary care visits with adolescents. The Behavioral Health Screen can screen all these domains and thus assist primary care providers in assessing for both psychiatric and social stress factors associated with youth suicide.


Assuntos
Depressão/diagnóstico , Atenção Primária à Saúde/métodos , Estresse Psicológico/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Suicídio/prevenção & controle , Adolescente , Adulto , Medicina do Comportamento/métodos , Depressão/psicologia , Feminino , Humanos , Masculino , Medição de Risco/métodos , Fatores de Risco , Comportamento Autodestrutivo , Comportamento Sexual/psicologia , Estresse Psicológico/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Suicídio/psicologia , Violência/psicologia , Adulto Jovem
15.
Attach Hum Dev ; 19(5): 447-462, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28002988

RESUMO

Insecure attachment styles have consistently been identified as risk factors for adolescent psychopathology and, more specifically, suicidal ideation. However, much less is known about the mechanisms that account for the relationship between attachment styles and severity of suicidal ideation within clinical samples. In the current study, adolescents' expectancies for caregiver availability and responsiveness were coded from transcripts of the Suicide Narrative Interview in a clinical sample of 129 depressed and suicidal adolescents. Results indicated that negative expectancies for caregiver availability in the Suicide Narrative Interview were associated both with attachment insecurity and with the intensity of adolescents' suicidal ideation. The implications of adolescents' expectancies for caregiver availability as targets for clinical intervention are discussed.


Assuntos
Cuidadores/psicologia , Apego ao Objeto , Suicídio/psicologia , Adolescente , Criança , Depressão/psicologia , Feminino , Humanos , Masculino , Fatores de Risco , Fatores Socioeconômicos , Ideação Suicida , Tentativa de Suicídio/psicologia
16.
Psychol Belg ; 57(1): 43-58, 2017 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-30479453

RESUMO

The Flemish Child Welfare System (CWS) is in great need of a shared empirically informed clinical strategy for working with depressed adolescents and their families. Many evidence-based practices (EBP) exist, but little is known as to whether they can be successfully imported in the CWS. Therefore, the current study explores the implementation of a particular EBP, Attachment-Based Family Therapy (ABFT), in home-based services of the Flemish CWS in Belgium. Specifically, the study focused on (1) the acceptability of ABFT by counselors and whether negative attitudes about EBP can be changed (n = 73 counselors), and (2) the feasibility of implementing ABFT (n = 43 adolescents, 11-17 years old, 72% female) by exploring initial effectiveness. The results suggest that (1) initial negative attitudes of counselors towards ABFT were significantly more positive after attending training and discussions about ABFT, and that (2) ABFT could be used by counselors to successfully reduce adolescent depressive symptoms. Future research should include a control group to draw stronger causal conclusions. Strengths and limitations of the study's design and implications for further dissemination are discussed.

17.
J Adolesc Health ; 59(1): 38-43, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-27053400

RESUMO

PURPOSE: Lesbian, gay, bisexual, and questioning (LGBQ) youth exhibit significantly higher rates of mental health problems, including anxiety, depression, suicidal ideation, and nonsuicidal self-injury than their heterosexual peers. Past studies tend to group LGBQ youth together; however, more recent studies suggest subtle differences in risk between sexual minority groups. This study examined differences in mental health symptoms across male and female youth who are attracted to the same sex (gay and lesbian), opposite sex (heterosexual), both sexes (bisexual), or are unsure of whom they were attracted to (questioning) in a sample of 2,513 youth (ages 14-24 years). METHODS: Data were collected using the Behavioral Health Screen-a Web-based screening tool that assesses psychiatric symptoms and risk behaviors-during routine well visits. RESULTS: Bisexual and questioning females endorsed significantly higher scores on the depression, anxiety, and traumatic distress subscales than did heterosexual females. Lesbians, bisexual females, and questioning females all exhibited significantly higher lifetime suicide scores than heterosexual females. Interestingly, bisexual females exhibited the highest current suicide scores. Gay and bisexual males endorsed significantly higher scores on the depression and traumatic distress subscales than did heterosexual males. Gay males also exhibited higher scores on the anxiety subscale than heterosexual males, with bisexual males exhibiting a nonsignificant trend toward higher scores as well. CONCLUSIONS: Findings highlight varying level of risk across subgroups of LGBQ youth and suggest the importance of considering LGBQ groups separately in the context of a behavioral health assessment, especially for females.


Assuntos
Sintomas Comportamentais/psicologia , Atenção Primária à Saúde/métodos , Minorias Sexuais e de Gênero/psicologia , Adolescente , Ansiedade , Feminino , Humanos , Internet , Masculino , Relações Médico-Paciente , Risco , Fatores Sexuais , Comportamento Sexual/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Inquéritos e Questionários , Adulto Jovem
18.
J Abnorm Child Psychol ; 43(2): 355-68, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24993312

RESUMO

The present prospective study examined the relations among stressful life events, coping, and depressive symptoms in children at varied risk for depression. Participants were 227 children between 7 and 17 years old (mean age = 12.13 years, SD = 2.31, 54.6 % female) who were part of a longitudinal study of depressed and nondepressed parents and their children. Youth completed measures assessing stressful life events and coping strategies at four time points over 22 months. Children's depressive symptoms were assessed at each time point by clinical interviews of parents and children, and children's self-report. Structural equation modeling indicated that stressful life events significantly predicted subsequent depressive symptoms. Bootstrap analyses of the indirect effects in three different models revealed that primary control engagement coping and disengagement coping strategies partially mediated the relation between stressful life events and children's depressive symptoms across time. Regarding the direction of effects, more consistent relations were found for coping as a mediator of the link from stress to depressive symptoms than from symptoms to stress. Thus, one potential mechanism by which stressful life events may contribute to depressive symptoms in children is through less use of primary control coping and greater use of disengagement coping strategies. This is consistent with the view that the adverse effects of stress may contribute to impairments in the ability to cope effectively.


Assuntos
Adaptação Psicológica , Depressão/psicologia , Estresse Psicológico/psicologia , Adolescente , Criança , Filho de Pais Incapacitados/psicologia , Feminino , Humanos , Acontecimentos que Mudam a Vida , Estudos Longitudinais , Masculino , Fatores Sexuais , Inquéritos e Questionários
19.
Clin Child Psychol Psychiatry ; 18(3): 334-50, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22930777

RESUMO

Several studies have earned Attachment Based Family Therapy (ABFT) the designation of a promising empirically supported treatment for adolescents with depression. This study evaluated the feasibility of importing ABFT into a hospital-based outpatient clinic in Norway. This article documents the challenges of initiating and conducting research in a real world clinical setting and training staff therapists. It also reports on outcomes of a pilot randomized clinical trial. Implementation barriers rapidly emerged in relation to hospital administration, infrastructure development, and therapists. Despite these barriers, 20 clinic-referred adolescents were randomly assigned to ABFT (n= 11) or to Treatment as Usual (TAU) (n= 9). Adolescents in ABFT showed significantly better symptom reduction compared to adolescents in TAU with an effect size of 1.08. While preliminary, this study suggests that Norwegian clinical staff therapists could be engaged in learning and delivering ABFT, and in producing promising treatment results. The importance of institutional support for dissemination research is highlighted.


Assuntos
Transtorno Depressivo/terapia , Terapia Familiar/métodos , Apego ao Objeto , Adolescente , Transtorno Depressivo/psicologia , Estudos de Viabilidade , Feminino , Humanos , Masculino , Noruega , Resultado do Tratamento
20.
J Pediatr ; 162(2): 302-7.e1, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22974576

RESUMO

OBJECTIVE: To determine whether prenatal diagnosis of congenital heart disease (CHD) increases maternal stress. STUDY DESIGN: Self-report instruments were administered to mothers carrying a fetus with CHD. Domains included: (1) traumatic stress (Impact of Events Scale-Revised); (2) depression (Beck Depression Index II); and (3) anxiety (State-Trait Anxiety Index). Modifiers included: (1) coping skills (COPE Inventory); (2) partner satisfaction (Dyadic Adjustment Scale); and (3) demographics. Multivariate linear regression models were used to assess relationships between stress measures and modifiers. RESULTS: Fifty-nine mothers (gestational age 27 ± 3 weeks) completed all measures. Clinically important traumatic distress was seen in 39%, depression in 22%, and state anxiety in 31%. Lower partner satisfaction was associated with higher depression (P < .01) and higher anxiety (P < .01). After controlling for partner satisfaction and income, "denial" was most associated with increased traumatic stress, anxiety, and depression (P < .01). CONCLUSIONS: Posttraumatic stress, depression, and anxiety are common after prenatal diagnosis of CHD. Healthy partner relationships and positive coping mechanisms can act as buffers.


Assuntos
Cardiopatias Congênitas/diagnóstico , Complicações na Gravidez/etiologia , Complicações na Gravidez/psicologia , Diagnóstico Pré-Natal , Estresse Psicológico/etiologia , Adulto , Estudos Transversais , Feminino , Humanos , Gravidez
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...