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1.
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
2.
J Interpers Violence ; 36(1-2): 976-986, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29294931

RESUMO

Individuals with histories of interpersonal trauma are at increased risk for posttraumatic stress disorder (PTSD). Risk of PTSD is particularly salient during critical periods of development, such as adolescence and emerging adulthood. However, little is known about the unique effects and interactions of protective factors and interpersonal trauma on PTSD symptoms in adolescents and young adults. The current study tested whether positive peer and family experiences decrease the associations between interpersonal trauma and PTSD symptoms and whether these associations differed by victim-perpetrator relationships. Participants included 3,618 adolescents and young adults (aged 14-24 years) who completed the Behavioral Health Screen-a web-based screening tool that assesses psychiatric symptoms and associated risk factors-during a routine visit across 10 primary care sites in Pennsylvania. In support of the stress buffering hypothesis, results revealed that positive peer and family experiences buffered the effects of interpersonal trauma by a romantic partner and an adult in the home. Future research should examine whether programs aimed at improving peer or family relationships improve outcomes for traumatized youth.

3.
J Interpers Violence ; 36(7-8): NP4208-NP4229, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29991306

RESUMO

Campus sexual assault (CSA) is a growing area of research and public health concern, yet little research has considered the sociocultural context in which CSA occurs or the effect of sociocultural factors on the posttraumatic stress disorder (PTSD) symptoms of CSA survivors. This study describes the results of a web-based census survey administered to students at a liberal arts college. Of the 1,611 students who completed the survey (74% female; 71.4% White, 4.3% African American, 12% Hispanic), 13.5% reported experiencing at least one type of completed or attempted CSA. Female students, participants in Greek life, and students who reported victimization prior to college were more likely to report having experienced CSA. CSA was positively correlated with PTSD symptoms, and this relationship was stronger for racial/ethnic minorities, those who reported less sense of community, and those who were more aware of campus services to address CSA. This study demonstrates multiple levels of sociocultural influence on the mental health of college students who have experienced CSA and may suggest ways for improving prevention and intervention strategies to address CSA and its consequences.

4.
Anxiety Stress Coping ; 33(2): 165-175, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32008351

RESUMO

Background and objectives: Procrastination is a common problem among college students. Negative affect associated with stress and anxiety is linked to higher levels of procrastination. Although there is a relationship between procrastination and affect, little is known about the direction of this relationship. The current study explored whether changes in daily negative affect (NA) or positive affect (PA) preceded procrastination or whether procrastination preceded changes in affect. Method and design: The current study is a secondary data analysis of a larger study. After completing an initial survey assessing students' emotional well-being, students were asked to participate in a follow-up daily diary survey. Participants in the daily diary (N = 53) completed a brief survey each weekday evening for two weeks that assessed daily affect and events. Multilevel regression tested whether NA and PA predicted next-day procrastination and vice versa. Results: Cross-lag panel analysis demonstrated that students reported more procrastination following days they experienced higher levels of NA. However, procrastination did not predict changes in NA. PA was not associated with prior day or next day procrastination experiences when controlling for NA. Conclusions: These findings demonstrate that negative emotions motivate procrastination behavior. Implications for helping students cope with and regulate NA are discussed.


Assuntos
Afeto , Inquéritos Epidemiológicos/estatística & dados numéricos , Procrastinação , Autorrelato , Estudantes/psicologia , Adulto , Feminino , Inquéritos Epidemiológicos/métodos , Humanos , Estudos Longitudinais , Masculino , Motivação , Estudantes/estatística & dados numéricos , Universidades , Adulto Jovem
5.
J Behav Med ; 42(4): 603-612, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31367926

RESUMO

Assessing firearm access among adolescents with behavioral health risk factors is important for the primary prevention of suicide and interpersonal violence. We describe self-reported firearm access and the associated behavioral risk factors and demographic characteristics in a cross-sectional study conducted in the emergency department of an urban pediatric hospital from June 2013 to June 2014. A total of 2258 adolescents received a behavioral health survey to assess access to firearms inside and outside the home, mental health symptoms, and risk behaviors. One of 6 patients in our sample (15%) endorsed access to a firearm. Male gender, lifetime alcohol use, lifetime marijuana use, and lifetime other drug use were associated with access. Participants reporting access were more likely to report clinical levels of lifetime suicidality and depression. The odds of current suicidality were highest in those with 24-h access (OR 2.77 CI 1.73-4.46), compared to those who did not endorse access.


Assuntos
Comportamento do Adolescente/psicologia , Serviço Hospitalar de Emergência , Armas de Fogo/estatística & dados numéricos , Assunção de Riscos , População Urbana/estatística & dados numéricos , Adolescente , Agressão/psicologia , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Masculino , Fatores de Risco , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Inquéritos e Questionários , Violência/estatística & dados numéricos
6.
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
7.
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
8.
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
9.
BMJ Open ; 8(6): e021448, 2018 06 11.
Artigo em Inglês | MEDLINE | ID: mdl-29895656

RESUMO

OBJECTIVES: The study aimed tocompare recurring themes in the artistic expression of military service members (SMs) with post-traumatic stress disorder (PTSD), traumatic brain injury and psychological health (PH) conditions with measurable psychiatric diagnoses. Affective symptoms and struggles related to verbally expressing information can limit communication in individuals with symptoms of PTSD and deployment-related health conditions. Visual self-expression through art therapy is an alternative way for SMs with PTSD and other PH conditions to communicate their lived experiences. This study offers the first systematic examination of the associations between visual self-expression and standardised clinical self-report measures. DESIGN: Observational study of correlations between clinical symptoms of post-traumatic stress, depression and anxiety and visual themes in mask imagery. SETTING: The National Intrepid Center of Excellence at the Walter Reed National Military Medical Center, Bethesda, Maryland, USA. PARTICIPANTS: Active-duty military SMs (n=370) with a history of traumatic brain injury, post-traumatic stress symptoms and related PH conditions. INTERVENTION: The masks used for analysis were created by the SMs during art therapy sessions in week 1 of a 4-week integrative treatment programme. PRIMARY OUTCOMES: Associations between scores on the PTSD Checklist-Military, Patient Health Questionnaire-9 and Generalized Anxiety Disorder 7-item scale on visual themes in depictions of aspects of individual identity (psychological injury, military symbols, military identity and visual metaphors). RESULTS: Visual and clinical data comparisons indicate that SMs who depicted psychological injury had higher scores for post-traumatic stress and depression. The depiction of military unit identity, nature metaphors, sociocultural metaphors, and cultural and historical characters was associated with lower post-traumatic stress, depression and anxiety scores. Colour-related symbolism and fragmented military symbols were associated with higher anxiety, depression and post-traumatic stress scores. CONCLUSIONS: Emergent patterns of resilience and risk embedded in the use of images created by the participants could provide valuable information for patients, clinicians and caregivers.


Assuntos
Ansiedade/psicologia , Terapia pela Arte , Lesões Encefálicas Traumáticas/psicologia , Depressão/psicologia , Militares/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto , Ansiedade/terapia , Lesões Encefálicas Traumáticas/terapia , Depressão/terapia , Feminino , Humanos , Masculino , Maryland , Máscaras , Escalas de Graduação Psiquiátrica , Autoimagem , Transtornos de Estresse Pós-Traumáticos/terapia
10.
J Consult Clin Psychol ; 86(7): 593-603, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29939053

RESUMO

OBJECTIVE: Little is known about the extent to which previous weeks' stressful events spill over and influence adolescents' abilities to derive insight from treatment sessions. Even less is known about factors that moderate clients' vulnerabilities to these spillover effects. The current study examined the spillover of negative interpersonal events to postsession insight and the role of difficulties in emotion regulation in this spillover effect. METHOD: Participants were 129 adolescents with moderate to severe depressive symptoms and suicidal ideation (Mage = 14.96, 83% female, 56% African American/Black) participating in a comparative efficacy trial of Attachment-Based Family Therapy (ABFT) and Family-Enhanced Nondirective Supportive Therapy (FE-NST). A within-subject mediation model tested presession negative affect as a mediator of spillover of past week's events on postsession insight. We then examined baseline difficulties in emotion regulation (DERS) as a between-subjects moderator of the mediation model. RESULTS: Negative affect partially mediated (44%) the spillover of the past week's negative events on adolescents' ratings of postsession insight (p = .03, 95% confidence interval, CI [-.09., -.002]). Baseline DERS increased adolescents' vulnerabilities to spillover effects (p = .01, 95% CI [-.28, -.03]). Negative interpersonal events from the past week influence presession negative affect and spill over to adolescents' abilities to gain insight from their treatment sessions. Adolescents who began treatment with greater DERS were particularly vulnerable to these spillover effects. Findings indicate the need for therapists to adapt sessions to individual differences in depressed and suicidal adolescents' exposure to negative interpersonal events preceding treatment and in their vulnerabilities to spillover and emotion dysregulation. (PsycINFO Database Record


Assuntos
Depressão/psicologia , Emoções/fisiologia , Terapia Familiar , Estresse Psicológico/psicologia , Ideação Suicida , Adolescente , Feminino , Humanos , Masculino , Resolução de Problemas
11.
Anxiety Stress Coping ; 31(4): 387-401, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29730941

RESUMO

BACKGROUND: Although research supports associations between anxiety and emotional reactivity in adults (Cisler, J. M., Olatunji, B. O., Feldner, M. T., & Forsyth, J. P. (2010). Emotion regulation and the anxiety disorders: an integrative review. Journal of Psychopathology and Behavioral Assessment, 32(1), 68-82.), few studies have examined emotional reactivity in anxious youth (e.g., Carthy et al., 2010; Tan, P. Z., Forbes, E. E., Dahl, R. E., Ryan, N. D., Siegle, G. J., Ladouceur, C. D., & Silk, J. S. (2012). Emotional reactivity and regulation in anxious and nonanxious youth: a cell-phone ecological momentary assessment study. Journal of Child Psychology and Psychiatry, 53(2), 197-206.). METHODS: Using daily diary methodology, this study examined both negative affect (NA) and positive affect (PA) reactivity to daily events in youth diagnosed with anxiety (N = 68; 60% female; 78% non-Hispanic White; M age = 11.18 years, SD = 3.17). We also examined whether parent-reported emotion regulation would predict emotional reactivity. RESULTS: Participants reported more NA on days they experienced more negative parent and teacher events and less PA on days that they experienced more negative peer events. Additionally, better emotion regulation was associated with less NA reactivity to negative teacher events and to both negative and positive academic events. CONCLUSIONS: Interpersonal events have a salient effect on daily affect for anxious youth. Youth anxiety therapists should target emotion regulation associated with negative events involving adults and address barriers to developing and maintaining positive peer relationships.


Assuntos
Atividades Cotidianas/psicologia , Transtornos de Ansiedade/psicologia , Nível de Alerta , Ajustamento Emocional , Adaptação Psicológica , Adolescente , Afeto , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/terapia , Criança , Feminino , Humanos , Relações Interpessoais , Masculino , Determinação da Personalidade , Psicoterapia , Tristeza/psicologia
12.
Sch Psychol Q ; 33(1): 10-20, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29629785

RESUMO

There is a need to delineate best practices for referring, assessing, and retaining students suspected of posttraumatic stress (PTS) and maladaptive grief (MG) in school-based treatment. Evidence-based risk-screening procedures should accurately include students who are appropriate for group treatment and exclude students who do not require treatment or who are better served by other forms of intervention and support. We described and evaluated the sequence of steps used to screen 7th- and 8th-grade students (N = 89) referred by school staff as candidates for an open trial of group-based Trauma and Grief Component Therapy for Adolescents (TGCTA; Saltzman et al., in press). We used t tests to compare included versus excluded students on PTS symptom and MG reaction scores (University of California at Los Angeles Posttraumatic Stress Disorder Reaction Index; Grief Screening Scale) during the group screen, individual interview, and treatment-implementation phases. Logistic regressions tested the incremental utility of including measures of both trauma exposure and related emotional and conduct problems (Strengths and Difficulties Questionnaire) in the screening battery. Results suggest that the group screen helped to detect mental health needs and that the individual interview further identified students with PTS and emotional problems. Conduct problems and trauma exposure predicted attrition among students who qualified for treatment. MG incrementally predicted students who advanced from the group screening to the individual interview, and trauma exposure incrementally predicted attrition from treatment. Findings yield implications for improving research and practice, including procedures for enhancing school-based referral, screening, assessment, and selection procedures. (PsycINFO Database Record


Assuntos
Pesar , Escalas de Graduação Psiquiátrica , Trauma Psicológico/diagnóstico , Encaminhamento e Consulta , Instituições Acadêmicas , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Estudantes/psicologia , Adolescente , Feminino , Humanos , Masculino
13.
Arch Suicide Res ; 22(1): 20-31, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-28121237

RESUMO

Latent class analysis of medical records data from 3,523 emergency department (ED) patients (ages 14-24; 31% Caucasian; 67% female) distinguished 6 groups with varying histories of suicidal ideation and behavior based on items endorsed on the Behavioral Health Screen, a web based, nurse-initiated screening tool. As expected, the more severe suicidality groups reported higher levels of depressive symptoms, traumatic distress, and substance abuse symptoms. Findings support the validity of the BHS and its utility as a medical decision tool to help ED staff evaluate the severity of patients' suicidality.


Assuntos
Comportamento do Adolescente/psicologia , Medição de Risco/métodos , Comportamento Autodestrutivo , Ideação Suicida , Tentativa de Suicídio , Adolescente , Serviços de Saúde do Adolescente/estatística & dados numéricos , Manual Diagnóstico e Estatístico de Transtornos Mentais , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Hospitais Pediátricos/estatística & dados numéricos , Humanos , Masculino , Programas de Rastreamento/métodos , Psiquiatria Preventiva/métodos , Fatores de Risco , Comportamento Autodestrutivo/diagnóstico , Comportamento Autodestrutivo/psicologia , Tentativa de Suicídio/psicologia , Tentativa de Suicídio/estatística & dados numéricos , Estados Unidos/epidemiologia
14.
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
15.
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
16.
Crisis ; 37(3): 241-6, 2016 05.
Artigo em Inglês | MEDLINE | ID: mdl-27040126

RESUMO

BACKGROUND: Suicide is a serious public health concern for US youth. Research has established an association between bullying and suicide risk. However, several questions remain regarding this relationship. AIMS: The present study examined (a) whether experiences of verbal, physical, and cyber bullying were uniquely associated with general suicide risk; (b) whether each specific form of bullying was related to suicide attempt; and (c) whether depression moderated the relationship between each type of bullying and suicide risk. METHOD: The sample included medical records of 5,429 youth screened in primary care when providers had mental health concerns. Patients were screened using the Behavioral Health Screen (BHS), which assessed a range of mental health problems and behaviors, including bullying, depression, and suicide. RESULTS: All types of bullying were associated with suicide risk, but verbal bullying was uniquely associated with suicide attempt. Depression significantly moderated the relationship between each type of bullying and suicide risk. CONCLUSION: The study's limitations include the use of cross-sectional and self-report data [corrected]. When medical providers evaluate suicide risk, bullying should be considered as a possible precipitant, especially if the patient is depressed. Verbal bullying may be particularly important in understanding severity of suicide risk.


Assuntos
Bullying , Depressão/psicologia , Suicídio/psicologia , Adolescente , Bullying/estatística & dados numéricos , Depressão/epidemiologia , Feminino , Humanos , Masculino , Pennsylvania/epidemiologia , Atenção Primária à Saúde/estatística & dados numéricos , Escalas de Graduação Psiquiátrica , Fatores de Risco , Tentativa de Suicídio/psicologia , Tentativa de Suicídio/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
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 ; 44(3): 471-81, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26084594

RESUMO

Emotional reactivity to negative interpersonal events has been consistently linked with depressive symptoms in studies with adults. However, little is known about the role that emotional reactivity plays in the maintenance of depressive symptoms during adolescence. A structured diary, administered to 132 economically disadvantaged adolescents (53% female, 76% African American) at age 14, measured adolescent daily reports of negative events involving parents, teachers, and peers and ratings of negative and positive affect. We examined the relationship between emotional reactivity (changes in negative and positive affect that correspond with negative events) and the maintenance of depressive symptoms between ages 13 and 15. We also tested unique effects of different types of emotional reactivity, depending on the type of interpersonal event. Results provided support for the emotional reactivity model for negative teacher events: heightened reactivity to negative teacher events was related to the maintenance of depressive symptoms. Findings suggest that adolescents' emotional reactivity to teachers has important implications for the continuity of depressive symptoms during early adolescence for disadvantaged youth.


Assuntos
Depressão/psicologia , Emoções/fisiologia , Relações Interpessoais , Grupo Associado , Estresse Psicológico/psicologia , Adolescente , Comportamento do Adolescente/psicologia , Feminino , Humanos , Masculino , Modelos Psicológicos , Fatores Sexuais
19.
Child Psychiatry Hum Dev ; 47(4): 539-47, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-26384978

RESUMO

This study evaluated the impact of dysregulation across cognitive, affective, and behavioral domains on acute and 7- to 19-year follow-up outcomes of cognitive-behavioral therapy (CBT) for anxiety, and explored dysregulation as a predictor of psychopathology and impairment in young adulthood among individuals who received anxiety treatment as youth. Participants (N = 64; 50 % female, 83 % non-Hispanic White) from two randomized clinical trials completed a follow-up assessment 7-19 years later. Latent profile analysis identified dysregulation based on Anxious/Depressed, Attention Problems, and Aggressive Behavior scores on the Child Behavior Checklist. Although pretreatment dysregulation was not related to acute or follow-up outcomes for anxiety diagnoses that were the focus of treatment, dysregulation predicted an array of non-targeted psychopathology at follow-up. Among youth with a principal anxiety disorder, the effects of CBT (Coping Cat) appear to be robust against broad impairments in self-regulation. However, youth with a pretreatment dysregulation profile likely need follow-up to monitor for the emergence of other disorders.


Assuntos
Transtornos de Ansiedade/terapia , Ansiedade/terapia , Terapia Cognitivo-Comportamental , Adolescente , Adulto , Afeto , Agressão/psicologia , Ansiedade/psicologia , Transtornos de Ansiedade/psicologia , Criança , Cognição , Feminino , Seguimentos , Humanos , Masculino , Resultado do Tratamento
20.
Child Psychiatry Hum Dev ; 47(4): 657-64, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26458909

RESUMO

Youth living with HIV (YLH) are at elevated risk of internalizing symptoms, although there is substantial individual variability in adjustment. We examined perceived HIV-related stigma, shame-proneness, and avoidant coping as risk factors of internalizing symptoms among YLH. Participants (N = 88; ages 12-24) completed self-report measures of these potential risk factors and three domains of internalizing symptoms (depressive, anxiety, and PTSD) during a regularly scheduled HIV clinic visit. Hierarchical regressions were conducted for each internalizing symptoms domain, examining the effects of age, gender, and maternal education (step 1), HIV-related stigma (step 2), shame- and guilt-proneness (step 3), and avoidant coping (step 4). HIV-related stigma, shame-proneness, and avoidant coping were each correlated with greater depressive, anxiety, and PTSD symptoms. Specificity was observed in that shame-proneness, but not guilt-proneness, was associated with greater internalizing symptoms. In multivariable analyses, HIV-related stigma and shame-proneness were each related to greater depressive and PTSD symptoms. Controlling for the effects of HIV-related stigma and shame-proneness, avoidant coping was associated with PTSD symptoms. The current findings highlight the potential importance of HIV-related stigma, shame, and avoidant coping on the adjustment of YLH, as interventions addressing these risk factors could lead to decreased internalizing symptoms among YLH.


Assuntos
Adaptação Psicológica , Ansiedade/psicologia , Depressão/psicologia , Infecções por HIV/psicologia , Vergonha , Estigma Social , Transtornos de Estresse Pós-Traumáticos/psicologia , Adolescente , Criança , Mecanismos de Defesa , Feminino , Culpa , Humanos , Masculino , Fatores de Risco , Autorrelato , Adulto Jovem
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