Peer support for borderline personality disorder: A critical review of its feasibility, acceptability, and alignment with concepts of recovery.

Many organizations have adopted peer support to increase service alignment with recovery-oriented principles. Yet, few studies have scrutinized borderline personality disorder (BPD)-specific concepts of "recovery" and "recovery-oriented practice," nor evaluated the extent to which existing peer support services (PSS) align with these concepts. We addressed these knowledge gaps in four phases: (a) a literature review to understand BPD-specific concepts of "recovery" and "recovery-oriented practice," (b) a literature review and open web search to describe the implementation, feasibility, or effectiveness of PSS for people with BPD, (c) a landscaping survey of program administrators regarding their BPD-PSS programs, and (d) a critical review of the extent to which current peer support for BPD aligns with "recovery" and "recovery-oriented practice." We identified 40 published sources that defined "recovery" or "recovery-oriented practice" as it pertains to BPD, and narratively summarize these results, nine sources that described PSS for people with BPD, and received survey responses from seven BPD-PSS program administrators. Our critical review highlighted the distinctive but overlapping concepts of "clinical recovery" versus "personal recovery" and underscored the alignment of BPD-PSS with personal recovery goals, including increased self-knowledge and -acceptance, hope, engagement in meaningful social roles and relationships, and self-determination. While peer support is experienced positively by service users, peer supporters, and clinicians, challenges include setting boundaries, minimizing dual roles, and ensuring adequate training, supervision, and personal support to reduce burnout. Peer support appears to be a feasible avenue for meeting the personal recovery goals of people with BPD; however, formal program evaluations are needed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Testing a diathesis-stress model during the transition to university: Associations between self-criticism, stress, and internalizing problems.

ObjectiveTo test a diathesis-stress model whereby self-criticism interacts with monthly perceived stress to predict same-month or next-month internalizing problems, including depression, anxiety, nonsuicidal self-injury (NSSI), and suicidal ideation, in students transitioning to university. Participants: 704 students (73% female, Mage = 17.97) were recruited during their first month of university in 2017 and 2018. Methods: Students completed surveys assessing self-criticism, perceived stress, and internalizing problems from September to April. Results: Self-criticism predicted higher depression and anxiety, as well as odds of NSSI and suicidal ideation, in students' first month on campus. Consistent with a diathesis-stress model, self-criticism strengthened the associations between stress and same-month depression and anxiety. Conclusions: Self-critical students are at elevated risk of internalizing problems during the transition to university, particularly when they feel more stressed than usual. These findings elucidate which students should be targeted in interventions and when interventions should be delivered to curtail internalizing problems.

Stop self-injuring, then what? Psychosocial risk associated with initiation and cessation of nonsuicidal self-injury from adolescence to early adulthood.

Nonsuicidal self-injury (NSSI) typically begins in adolescence and remits by early adulthood, but few prospective studies have investigated the long-term impact of NSSI initiation and cessation on young people's wellbeing. We examined changes in psychosocial risk associated with NSSI onset and offset in an accelerated longitudinal study of 662 adolescents (12-18 years old) who were followed biennially for 10 years. Of the 133 participants who reported NSSI, 100 had stopped engaging in NSSI by the study's end. NSSI initiation was associated with concurrent increases in depression, anxiety, externalizing symptoms, peer victimization, alcohol, tobacco and illicit substance use, and concurrent declines in physical self-concept, parent, and peer support. As NSSI persisted, youth experienced further increases in anxiety and cannabis use, and declines in physical self-concept. NSSI cessation was associated with concurrent increases in alcohol, cannabis, and tobacco use. With sustained cessation, however, youth experienced gradual improvements in depression, anxiety, externalizing symptoms, peer victimization, as well as gradual reductions in alcohol and tobacco use. By early adulthood, participants who reported ongoing NSSI worked fewer hours and were more likely to delay medical treatment for financial reasons versus those without NSSI histories, and reported less environmental mastery versus those who had discontinued NSSI. Youth who had discontinued NSSI, in turn, reported less environmental mastery and self-acceptance versus youth who never engaged in NSSI. These results contextualize NSSI cessation alongside indicators of psychological, social, and behavioral wellbeing, and underscore the persistence of psychosocial vulnerability after NSSI has resolved. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Understanding the mental health and recovery needs of Canadian youth with mental health disorders: a Strategy for Patient-Oriented Research (SPOR) collaboration protocol.

BACKGROUND: While considerable progress is being made to understand the health and self-management needs of youth with mental health disorders, little attention has focused on the mental health and recovery needs that the youth themselves identify-this despite a national priority to incorporate patient-oriented research into the development and assessment of mental health services. To address this gap, estimates of the extent to which existing patient-reported outcome measures (PROMs)-originally developed for use amongst adult populations-are clinically meaningful and psychometrically fit for use among youth are needed. In tandem, a recovery profile for youth can be constructed incorporating the youth perspective of the services provided within a community mental health setting. METHODS/DESIGN: This study will utilize a mixed methods design incorporating qualitative focus group interviews and cross-sectional survey. Our process will begin with the hiring of a youth peer research partner who will provide lived experience expertise through all phases of the study. We will advertise, recruit, and conduct four focus groups with youth who receive services from the Foundry Vancouver Granville located in British Columbia, Canada. In the first two focus groups, we will recruit youth aged 15-18 years (n = 10). In the second two focus groups, we will recruit young adults aged 19-24 years (n = 10). In parallel, we will conduct a cross-sectional survey of the recovery and mental health needs of youth, informed by ten widely used and validated PROM. Thematic analysis techniques will guide the identification of predominant thematic trends in the qualitative focus group data. We will use Classical and Rasch measurement methods to test and analyze the reliability and validity of selected PROM measures for youth populations. DISCUSSION: The proposed study has the potential to produce a preliminary conceptual and measurement model for understanding the mental health and recovery needs of youth with mental health disorders. This evidence will inform how youth mental health services can grow, support, and sustain the capacity for a collaborative, interdisciplinary and innovative patient-oriented research environment. Findings will also contribute much needed evidence to improve the standard of care for youth who experience mental health disorders in Canada and beyond.