Non-suicidal Self-Injury (NSSI): A Case for Using Emotionally Focused Family Therapy

Non-suicidal self-injury (NSSI) is defined by engaging in self destructive behaviors specifically targeted toward the body without suicidal intent. It is a mental health phenomenon increasing in occurrence. Marriage and family therapists will need to know how to treat this clinical presentation, as it is gaining recognition as a diagnostic category in the 2013 Diagnostic and Statistical Manual used to identify mental illness. This paper provides background information about NSSI, and includes an argument for testing the treatment of this disorder with Emotionally Focused Family Therapy. A clinical example is included.     

Non-Suicidal Self-Injury in Adolescents: Addressing the Function and the Family From the Perspective of Systemic Family Therapies

Non-suicidal self-injury (NSSI) in adolescence has been increasing steadily over the past several decades. Mental health professionals frequently address NSSI solely within an individual context. Behaviorally focused therapy is the norm for treating NSSI in adolescents, but existence of the behavior as a larger manifestation of structural family problems is missing from this modality of therapy. Although short-term outcomes display a reduction or cessation of NSSI, long-term efficacy is still not proven for behaviorally focused therapies. Addressing the function of NSSI in a family context will help shift the perspective of clinicians from behavioral, individual therapy to structural family therapy.     

Posttraumatic Stress Disorder Symptom Clusters and Acquired Capability for Suicide: A Reexamination Using DSM-5 Criteria

This study used the interpersonal–psychological theory of suicide to explore the relationships among DSM-5 posttraumatic stress disorder (PTSD) symptom clusters derived from the six-factor anhedonia model and facets of acquired capability for suicide (ACS). In a sample of 373 trauma-exposed undergraduates, most PTSD symptom clusters were negatively associated with facets of ACS in bivariate correlations, but the anhedonia cluster was positively associated with ACS in regression models. Structure coefficients and commonality analysis indicated that anhedonia served as a suppressor variable for the other symptom clusters. Our findings further elucidate the complex relationship between specific PTSD symptom clusters and ACS.     

Reasons for Attempting Suicide among a Community Sample of Adolescents

The motives of suicide attempts among a community sample of 99 U.S. high school students were explored. Participants completed an in‐depth computer‐assisted self interview about their most recent attempts as well as additional psychosocial measures. Results indicated that nearly 75% of the adolescents engaged in suicide attempts for reasons other than killing themselves and that depressive symptoms and premeditation prior to the attempt were significantly associated with increased risk for engaging in the attempts with death as a clear motive. Linking motive for an attempt (death, interpersonal communication, emotion regulation) and treatment approach may improve prevention of subsequent attempts and completed suicides.     

Latent structure of the Post-Traumatic Stress Disorder (PTSD) Checklist for DSM-5 (PCL-5) in South African mortuary workers

This study applied confirmatory factor analysis (CFA) to determine the dimensionality of PTSD symptoms as measured by the Post-Traumatic Stress Disorder Checklist for DSM-5 (PCL-5, Weathers et al., 2013). Participants were 150 trauma-exposed mortuary workers. Six alternative factor solutions resulted from the CFA; including Dysphoria model (four-factor), Dysphoric Arousal model (five-factor), Anhedonia model (six-factor), Externalising model (six-factor), and Hybrid model (seven-factor). Compared to the other models, the five-factor Dysphoric Arousal model had superior fit to the data. Overall, the current results provide evidence for the factorial validity and reliability of scores for the PCL-5 for research use in the South African context.     

Child Victimization and Poly-Victimization in a Community Sample of Adolescents in Northern Chile

The aim of this article is to report the prevalence of youth victimization and poly-victimization in northern Chile. Using the Juvenile Victimization Questionnaire, a sample of 706 adolescents ages 12 to 17 were surveyed. The results indicated that 89% of the participants had experienced victimization at least once in their lives and 76.8% had experienced at least 1 experience of victimization in the past year. The most frequent forms were conventional crimes (70% and 54.7%), witnessing and indirect victimization (63.2% and 45.2%), and peer and sibling victimization (50.0% and 34.6%), for the lifetime and the past year, respectively. Sexual victimization was less common for both time periods, but still relevant (15.9% lifetime and 9.9% past year). Older females and younger adolescents presented a higher risk of victimization particularly in conventional crimes and victimization by caregivers. As for poly-victimization, 21% of the adolescents presented between 4 and 6 different forms of victimization (the low poly-victimization group) and 16% reported seven or more (the high poly-victimization group) in the last year. The results showed that child and adolescent victimization is a significant problem in Chile. Percentages of victimization in Chilean adolescents were higher than those found in Europe or North America. Results from the group of poly-victims reinforces the need to evaluate the multiple forms of victimization that affect adolescents in Chile and to prioritize it in the design of the treatment of the consequences of violence, taking into account differences in gender and age.     

Relations Among Perceived Control Over Anxiety-Related Events,Worry, and Generalized Anxiety Disorder in a Sample of Adolescents

This study examined the associations among perceived control over anxiety-related events, worry, and both symptoms and diagnoses of generalized anxiety disorder (GAD). The sample was comprised of 140 adolescents (60 girls) between the ages of 10 and 17 years (M _age  = 14.6 years; SD = 2.25) recruited from the general community. Findings were consistent with hypotheses. Self-reported perceived control over anxiety-related events related negatively to worry as well as symptoms and diagnoses of GAD even after accounting for variance associated with age, gender, and negative affectivity. Results are discussed in terms of the theoretical implications that perceived control over anxiety-related events may have for understanding GAD symptomatology among youth.     

Examination of the Response Styles Theory in a Community Sample of Young Adolescents

This study examined the Response Styles Theory in a large, racially and ethnically diverse sample (N = 722) of 6th, 7th, and 8th graders. We examined the role of response styles (rumination, distraction, and problem-solving) as predictors of changes in depressive symptoms over a seven-month period. Higher levels of rumination and lower levels of problem-solving and distraction were associated with increases in depressive symptoms over time. Response style ratio scores (rumination scores divided by the sum of distraction and problem-solving scores) also predicted increases in depressive symptoms over time. Girls reported greater depressive symptoms compared to boys, and both rumination and response style ratio score statistically accounted for the gender difference in depressive symptoms. Clinical implications include the importance of problem-solving training and rumination reduction techniques in preventive interventions.     

Diagnostic Accuracy of the French Version of the Adult Attention Deficit / Hyperactivity Disorder Self-Report Screening Scale for DSM-5 (ASRS-5)

Journal of Psychopathology and Behavioral Assessment - Attention Deficit/Hyperactivity Disorder (ADHD) often persists into adulthood. However, few screening tools have been adapted to assess adult...     

Psychometric Properties of the Power of Food Scale in a Community Sample of Preadolescents and Adolescents

The Power of Food Scale (PFS) was developed to assess hedonic hunger, or how individuals think and feel about food and eating in the absence of metabolic need. The measure was originally developed and validated in two adult samples, and recent preliminary support has been provided for the validity in a sample of preadolescents. The aim of the current study was to conduct a confirmatory factor analysis (CFA) on the PFS in a community sample of preadolescents and adolescents to examine the psychometric properties in youth. Participants were 148 youth ages 11–18 (M = 12.85) from two Midwestern communities in the United States. Participants completed the PFS to assess for hedonic hunger. Structural equation modeling was used to conduct multiple CFAs to test varying factor structures of the PFS in preadolescents and adolescents. Results suggested that the scale was best represented by the previously established 15-item version of the measure with an aggregate domain and three subscales based on food proximity (i.e., food available, food present, and food tasted). Results from the CFA revealed that the measurement model had a close fit (RMSEA = 0.033, CFI = 0.985). Cronbach’s α for the total scale and the three subscales ranged from 0.86 to 0.95. Findings suggest that the previously established factor structure of the 15-item PFS best represents the factor structure of the measure in a community sample of preadolescents and adolescents.     

Executive Functioning, Temporal Discounting, and Sense of Time in Adolescents with Attention Deficit Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD)

Clinic-referred teens (ages 12–19) with ADHD and ODD (N = 101) were compared to community control (CC) teens, equated for age and sex, (N = 39) on a variety of psychological tasks assessing executive functioning (EF), temporal reward discounting, and time estimation and reproduction. A factor analysis reduced the EF measures to three dimensions, representing CPT Inattention, Working Memory, and CPT Inhibition. Results indicated that the ADHD group had significantly more CPT Inattention than the CC group. No differences were found for Working Memory or CPT Inhibition. The ADHD group displayed significantly greater temporal discounting of delayed hypothetical monetary rewards relative to immediate ones and manifested more impaired time reproduction, but not time estimation, than did the CC group. Main effects for level of IQ were found only on the Working Memory factor and largely did not interact with the group factor otherwise. The group differences in CPT Inattention, temporal discounting, and time reproduction were not a function of level of comorbid oppositional defiant disorder, delinquency, or anxiety–depression. Results are reasonably consistent with past research on EF and sense of time in children with ADHD and extend these findings to the adolescent age group. Problems with working memory and CPT inhibition found in prior studies of children with ADHD, however, were not evident here, perhaps owing to age-related improvements or insufficient task difficulty.     

The Efficacy, Safety, and Practicality of Treatments for Adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD)

Studies examining interventions for adolescents diagnosed with attention-deficit/hyperactivity disorder (ADHD) were reviewed to evaluate their efficacy. These efficacy findings were supplemented with a preliminary system for judging safety and practicality. Results suggest that the stimulant drug methylphenidate (MPH) is safe and well-established empirically, but has some problems with inconvenience and noncompliance. Preliminary research supports the efficacy, safety, and practicality of some psychotherapeutic interventions, including behavioral classroom interventions, note-taking training, and family therapy. Treatment with tricyclic antidepressants was judged to have minimal empirical support and debatable safety. Very little is known about long-term effectiveness of treatments, long-term compliance, or multimodal treatments for adolescents such as stimulants plus behavior therapy.     

Prevalence and Significant Determinants of Post-traumatic Stress Disorder in a Large Sample of Patients with Multiple Sclerosis

Chronic and life-threatening neurodegenerative diseases may be associated with post-traumatic stress disorder (PTSD). Therefore, the current study was an investigation of the prevalence of PTSD in multiple sclerosis (MS) patients, and identification of significant determinants of PTSD. Two hundred thirty-two MS patients were consecutively recruited and screened for the presence of PTSD with the Impact of Event Scale-Revised, corroborated by the Structured Clinical Interview for DSM-IV. Furthermore, participants were administered the Hospital Anxiety and Depression Scale and the Fatigue Severity Scale. Twelve patients (12/232, i.e. 5.17 %) were diagnosed as suffering from PTSD. Levels of education, anxiety and depression were significant determinants of the presence of PTSD. The role played by the levels of education, anxiety and depression in determining the presence of PTSD has been discussed. Further research on the psychological features of neurodegenerative diseases is urgently needed in order to plan appropriate treatments and improve patients’ quality of life.     

Norms for the Beck Depression Inventory (BDI-II) in a Large Dutch Community Sample

The Beck Depression Inventory (BDI-II) is a widely used instrument that provides information about the presence and severity of depressive symptoms. Although the BDI-II is a psychometrically sound instrument, relatively little is known about norm scores. This study aimed to develop reliable norms for the BDI-II in a Dutch community sample. Gender, age, and education were hypothesized to predict BDI-II scores. A total of 7,500 respondents from a community sample in The Netherlands completed the BDI-II. It was investigated by means of multiple regression analysis whether distinct norms for genders, education levels, and age group are appropriate. BDI-II scores depended on gender and education level, but not on age. BDI-II norms were computed based on the final regression model. These BDI-II norms can be used for diagnostic purposes, clinical decision making, or the evaluation of treatment effects.     

Sociodemographic Variations in Self-Reported Racism in a Community Sample of Blacks and Latino(a)s

This study investigated dimensions of socioeconomic status (SES) and self-reported racism among a convenience sample of 418 U.S.-born, Black and Latino(a) urban-dwelling adults. Predictors included indexes of individual and neighborhood SES. Self-reported racism was assessed with the Perceived Ethnic Discrimination Questionnaire–Community Version. Individuals at all levels of SES report racism, but the type of exposure varies by SES. Lower levels of SES predict higher levels of lifetime exposure to race-related stigmatization and threat/harassment, and more past-week discrimination. In contrast, higher levels of SES predict greater workplace discrimination. The findings highlight the importance of considering the complex ways in which SES and racism, 2 contributors to racial disparities in health, overlap and diverge.     

The Value of Measuring Impact Alongside Symptoms in Children and Adolescents: A Longitudinal Assessment in a Community Sample

The impact that psychiatric symptoms have on the lives of young people is central to clinical practice and classification. However, there is relatively little research on impact and its association with symptoms. This paper examines how well impact can be measured and how it relates to psychiatric outcomes. On four separate occasions over 3 years, symptoms and impact were assessed in a UK epidemiological sample (n?=?4,479; 51.5 % boys) using the Strengths and Difficulties Questionnaire (SDQ) as reported by parents, youths and teachers. Disorders were ascertained using the Development and Well-Being Assessment. An impact scale made of items about distress and impairment demonstrated considerable internal consistency, cross-informant correlations, and longitudinal stability by all reporting sources. Impact at baseline was a strong predictor of psychiatric disorder 3 years later after accounting for psychiatric disorders and symptoms measured at baseline: odds ratio OR?=?2.10, 95 % Confidence Interval (CI) [1.50, 2.94] according to parent-rated impact and OR?=?1.71, CI [1.08, 2.72] according to teacher-rated impact. Changes in impact over time were predicted, but not fully accounted for, by symptoms measured at baseline. Impact can be reliably and easily measured across time, and it may be clinically useful as an independent predictor of future symptoms and psychiatric disorders. More studies are needed to understand inter-individual variation in the impact caused by equivalent symptoms.