Suicidal Ideation and Behavior in Adolescents Aged 12–16 Years: A 17‐Year Follow‐Up

The prevalence of suicidal ideation/behavior in 1983 or 1987 and its association with future mental health in 2001 were evaluated in a provincially representative sample of Canadian adolescents (n = 1,248) aged 12 to 16 years. Approximately 13.3% (95% CI = 11.5–15.3) of adolescents self‐reported suicidal ideation/behavior. Adolescent agreement with parent (κ = .07) and teacher (κ = .05) reports at baseline was low because adults identified so few subjects. In adulthood, the associations between adolescent self‐reports of suicidal behavior/ideation and major depression and other mental health indicators were explained by respondent sex and adolescent emotional problems reported in 1983/1987. Adolescents with suicidal behavior/ideation often are not recognized by their parents and teachers and may be at risk for persistent psychiatric problems attributable to coexisting mental health problems early‐on.     

Depression and social anxiety mediate the relationship between parenting styles and risk of eating disorders: A study among Arab adolescents

In multicultural Israel, the prevalence of eating disorders (EDs), a common chronic disorder among Western adolescents (especially females), has risen for Arab adolescents, who belong to an Eastern collectivist society. The study examines family and psychological factors that may increase the risk of EDs among Muslim Arab adolescents. We expected social anxiety and depressive symptoms to mediate the association between parenting styles and risk of EDs, with possible gender differences in the mediation model. Participants were 613 Muslim adolescents (394 females and 219 males); mean age = 15.4 ± 1.6; range = 12–19. The analyses revealed that the severity of depressive symptoms and especially social anxiety mediate the relationship between authoritarian parenting style and risk of EDs. Females reported higher levels of risk of EDs, social anxiety, depression and authoritative parenting style than males; no differences appeared for authoritarian or permissive parenting styles. The research sheds new light on risk factors for EDs and the likelihood of authoritarian parenting style and social anxiety being involved in the aetiology of EDs among Arab adolescents. The outcomes meaningfully add to understanding of specific psychological processes that may be associated with the risk of EDs in this population.     

Joint Physical Custody and Adolescents’ Life Satisfaction in 37 North American and European Countries

Joint physical custody, a parental care arrangement in which a child lives with each parent about equally after separation or divorce, is an increasingly common phenomenon in many Western countries. Although attention from family scholars, practitioners, and law professionals is growing, there are hardly any numbers on the prevalence of joint physical custody (JPC). Moreover, studies using large‐scale representative data on the effects of JPC for children’s well‐being are still rare. The data for this study come from Health Behaviour in School‐Aged Children (HBSC), a representative cross‐national survey of adolescents in 37 European and North American countries that was conducted in 2002, 2006, and 2010 and included information on students at the ages of 11, 13, and 15 years (N = 92,886). First, results revealed that symmetrical JPC after family dissolution is still very rare in the majority of countries (5% or less), but reaches 10–20% in some countries. Second, adolescents’ life satisfaction in nonintact families is higher in symmetric JPC arrangements than in asymmetric care arrangements. However, after controlling for children and family characteristics, the differences disappear. Thus, it is not the symmetric JPC arrangement that induces adolescents’ higher life satisfaction, but rather the children and family characteristics that are associated with the choice of such a custody arrangement by separated or divorced parents.     

Suicidality,Self‐Harm,and Body Dissatisfaction in Transgender Adolescents and Emerging Adults with Gender Dysphoria

Prevalence of suicide attempts, self‐injurious behaviors, and associated psychosocial factors were examined in a clinical sample of transgender (TG) adolescents and emerging adults (n = 96). Twenty‐seven (30.3%) TG youth reported a history of at least one suicide attempt and 40 (41.8%) reported a history of self‐injurious behaviors. There was a higher frequency of suicide attempts in TG youth with a desire for weight change, and more female‐to‐male youth reported a history of suicide attempts and self‐harm behaviors than male‐to‐female youth. Findings indicate that this population is at a high risk for psychiatric comorbidities and life‐threatening behaviors.     

Similarities and Differences in the Functions of Nonsuicidal Self‐Injury (NSSI) and Sex as Self‐Injury (SASI)

Differences and similarities were studied in the functions of two different self‐injurious behaviors (SIB): nonsuicidal self‐injury (NSSI) and sex as self‐injury (SASI). Based on type of SIB reported, adolescents were classified in one of three groups: NSSI only (n = 910), SASI only (n = 41), and both NSSI and SASI (n = 76). There was support for functional equivalence in the two forms of SIB, with automatic functions being most commonly endorsed in all three groups. There were also functional differences, with adolescents in the SASI only group reporting more social influence functions than those with NSSI only. Adolescents reporting both NSSI and SASI endorsed the highest number of functions for both behaviors. Clinical implications are discussed, emphasizing the need for emotion regulation skills.     

Life events and functional somatic symptoms: A population study in older adolescents

The purpose of this study was to investigate the effect of negative life events on functional somatic symptoms (FSSs) in adolescents, based on data from 957 participants of the population cohort TRacking Adolescents’ Individual Lives Survey. Life events experienced between age 16 and age 19 were assessed with the Kendler's Life Stress interview. FSSs at age 19 and age 16 were measured with the Youth and Adult Self‐Report. The hypotheses were tested by the use of a latent change model. Life events predicted FSSs, even when adjusted for pre‐event levels of FSSs, symptoms of anxiety and depression, and socio‐economic status (B = 0.006, 95% CI [0.003, 0.008], β = .32). Whereas illness‐related life events did not predict FSSs independently (B = −0.003, 95% CI [−0.005, 0.09], β = .05), non‐illness‐related life events did (B = 0.007, 95% CI [0.004, 0.010], β = .31). A past‐year diagnosis of anxiety and/or depression had a significant influence on the association between life events and FSSs (B = 0.37, 95% CI [0.30, 0.46], β = .71), while female sex, exposure to childhood adversities, and family malfunctioning had not. In conclusion, our findings show that FSSs are associated with negative life events in older adolescents. We did not find evidence for stronger effects of illness‐related events.     

Network structure reveals clusters of associations between childhood adversities and development outcomes

Exposure to childhood adversity is common and associated with a host of negative developmental outcomes. The most common approach used to examine the consequences of adversity exposure is a cumulative risk model. Recently, we have proposed a novel approach, the dimensional model of adversity and psychopathology (DMAP), where different dimensions of adversity are hypothesized to impact health and well‐being through different pathways. We expect deprivation to primarily disrupt cognitive processing, whereas we expect threat to primarily alter emotional reactivity and automatic regulation. Recent hypothesis‐driven approaches provide support for these differential associations of deprivation and threat on developmental outcomes. However, it is not clear whether these patterns would emerge using data‐driven approaches. Here we use a network analytic approach to identify clusters of related adversity exposures and outcomes in an initial study (Study 1: N = 277 adolescents aged 16–17 years; 55.1% female) and a replication (Study 2: N = 262 children aged 8–16 years; 45.4% female). We statistically compare our observed clusters with our hypothesized DMAP model and a clustering we hypothesize would be the result of a cumulative stress model. In both samples we observed a network structure consistent with the DMAP model and statistically different than the hypothesized cumulative stress model. Future work seeking to identify in the pathways through which adversity impacts development should consider multiple dimensions of adversity.     

Prevalence of auditory verbal hallucinations in a general population: A group comparison study

The present study was specifically designed to investigate the prevalence of auditory verbal hallucinations (AVH) in the general population, and sought to compare similarities and differences regarding socio‐demographics, mental health and severe life events between individuals who have never experienced AVH with those who had. The study also aimed to compare those who sought professional help for their experience of AVH with those who had not sought help. Through a postal questionnaire, 2,533 participants ages 18 and over from a national survey completed the Launay‐Slade Hallucinations Scale and other measures examining AVH characteristics and other areas related to AVH. In total, 7.3% of the sample reported a life‐time prevalence of AVH. Those with AVH were more likely to be single and unemployed, reported higher levels of depression and anxiety, and experienced a higher number of severe life events compared with those without AVH. Only 16% of those who experienced AVH in the general population sought professional help for these experiences. Compared to those who did not seek professional help, participants that had were more likely to experience AVH with a negative content, experience them on a daily basis, undergo negative reactions when experiencing AVH, and resist AVH. In conclusion, the prevalence of AVH was found to be relatively high. The results also revealed higher levels of reduced mental health for individuals who sought professional help, followed by those who did not, compared with those who had never experienced AVH.     

Self‐Harm in Young Offenders

The prevalence and correlates of self‐harm and suicidal behavior in 515 young offenders (mean age 17.3 years, SD = 1.7) serving community‐based orders (CBOs; n = 242) or custodial sentences (n = 273) in Victoria, Australia, are described. Results from structured interviews showed that 83 (16.1%) participants reported self‐harming in the previous 6 months, and this was more common among those serving custodial sentences than those serving CBOs (19.4% vs. 12.4%; OR 3.10, 95% CI: 1.74–5.55). Multiple incidents were more common in females and 24% (95% CI: 19–39) of participants who had self‐harmed reported having done so with suicidal intent. Self‐harm was associated with recent bullying victimization, expulsion from school, past year violent victimization, cannabis dependence, and risk‐taking behavior in the preceding year. The epidemiological profile of self‐harm in this population appears to be distinct from that seen in the general population. Young offenders who self‐harm are a vulnerable group with high rates of psychiatric morbidity, substance misuse problems, and social risk factors. They may benefit from targeted psychological interventions designed specifically to address impulsivity, delivered both within–and during the transition from–the youth justice system.     

Lifetime Suicidal Behaviors and Career Characteristics Among U.S. Army Soldiers: Results from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)

The current report presents data on lifetime prevalence of suicide ideation and nonfatal attempts as reported by the large representative sample of U.S. Army soldiers who participated in the Consolidated All‐Army Survey of the Army Study to Assess Risk and Resilience in Servicemembers (N  =  29,982). We also examine associations of key Army career characteristics with these outcomes. Prevalence estimates for lifetime suicide ideation are 12.7% among men and 20.1% among women, and for lifetime suicide attempts are 2.5% and 5.1%, respectively. Retrospective age‐of‐onset reports suggest that 53.4%–70% of these outcomes had preenlistment onsets. Results revealed that, for both men and women, being in the Regular Army, compared with being in the National Guard or Army Reserve, and being in an enlisted rank, compared with being an officer, is associated with increased risk of suicidal behaviors and that this elevated risk is present both before and after joining the Army.     

First‐hand sensory experience plays a limited role in children's early understanding of seeing and hearing as sources of knowledge: Evidence from typically hearing and deaf children

One early‐developing component of theory of mind is an understanding of the link between sensory perception and knowledge formation. We know little about the extent to which children's first‐hand sensory experiences drive the development of this understanding, as most tasks capturing this early understanding target vision, with less attention paid to the other senses. In this study, 64 typically hearing children (M_age = 4.0 years) and 21 orally educated deaf children (M_age = 5.44 years) were asked to identify which of two informants knew the identity of a toy animal when each had differing perceptual access to the animal. In the ‘seeing’ condition, one informant saw the animal and the other did not; in the ‘hearing’ condition, one informant heard the animal and the other did not. For both hearing and deaf children, there was no difference between performance on hearing and seeing trials, but deaf children were delayed in both conditions. Further, within both the hearing and deaf groups, older children outperformed younger children on these tasks, indicating that there is a developmental progression. Taken together, the pattern of results suggests that experiences other than first‐hand sensory experiences drive children's developing understanding that sensory perception is associated with knowledge.     

Traumatic Incidents and Experiences of Racism and Sexism: Examining Associations with Components of Critical Consciousness for System‐Involved Girls of Color

Scholarship identifies critical consciousness as a key developmental asset in promoting the well‐being of adolescents experiencing multiple socio‐structural axes of oppression. Girls of color at acute risk for legal system involvement or re‐involvement are absent from this literature. They are a critical population in which to examine this construct given their experiences of oppression and the myriad benefits of critical consciousness. The current study addresses this gap by examining traumatic incidents and experiences of racism and sexism as correlates of critical reflection and action among a sample of girls (N = 220; Mean age = 14.5 years; SD = 1.3 years). Using path analysis and multigroup modeling, we examine direct associations between these three manifestations of structural oppression and critical consciousness and explore the interplay of traumatic incidents, and racism and sexism in girls’ critical consciousness development. Findings suggest that experiences of sexism and racism, uniquely and positively predict critical action, but not critical reflection. Surprisingly, girls’ experiences of traumatic incidents do not predict reflection or action. Finally, multigroup analyses show no evidence that these associations vary by the interplay of traumatic incidents, racism, and sexism. Implications for community psychology values and juvenile legal system practice and policy are discussed.     

Thoughts of Self‐Harm and Help‐Seeking Behavior among Youth in the Community

The association between thoughts of self‐harm and help‐seeking among youth with symptoms of depression was examined. Data were drawn from the Health Behavior of School‐aged Children Study (n = 15, 686), a nationally representative sample of youth in the United States. Analyses focused on comparing help‐seeking behaviors among youth with and without thoughts of deliberate self‐harm (DSH) when depressed. Depressed youth with thoughts of DSH exhibited different patterns of help‐seeking than those without. Both groups most frequently sought help from friends and parents. However, adolescents with thoughts of DSH were statistically more likely than youth without to seek help from friends (DSH: 69.9%; no DSH: 57.8%; AOR = 1.46), but less likely to seek help from parents (DSH: 53.7%; no DSH: 73.1%; AOR = 0.47). Youth with DSH were more likely to seek help from school officials (AOR = 1.05), health professionals (AOR: 1.83), or a counselor (AOR = 1.93) compared with those without thoughts of DSH who were more likely to seek help from a sibling (AOR: 0.77) or other relatives (AOR: 0.78). Results may help inform programs to improve identification of youth at risk of self‐harm in community and school settings.     

Understanding the Pathways from Depression to Suicidal Risk from the Perspective of the Interpersonal–Psychological Theory of Suicide

Suicide is a major public health concern, especially in adolescence. Identifying risk factors for suicide is important to effectively prevent such behavior. Depression is one of the most widely examined risk factors for suicidal risk. How depression and suicidal risk are related, however, is still not clear. This study tested a model with three key constructs of the interpersonal–psychological theory of suicidal behavior (IPTS)—perceived burdensomeness, thwarted belongingness, and nonsuicidal self‐injury (NSSI)—as mediators in the relationship between depression and suicidal risk among Chinese adolescents. Chinese high school students (N = 1,074; 54.2% male; M_age = 13.87 years, SD = 1.48) completed questionnaires assessing all study variables. Results suggested that perceived burdensomeness and NSSI partially mediated the relationship between depression and suicidal risk. Findings of this study emphasize the importance of the IPTS framework in understanding the possible mechanisms underlying the relationship between depression and suicidal risk, and suggest a possible avenue for suicide interventions.     

When to intervene and take a stand: Evaluating bystander roles in intergroup name-calling contexts

Children (n = 121, M = 9.86 years, SD = 0.64) and adolescents (n = 101, M = 12.84 years, SD = 0.69) evaluated proactive and passive bystander behaviour to intergroup name-calling (N = 222, 54% female). Scenarios depicted ingroup perpetrators and outgroup victims who were from a stigmatized group (ethnicity) or a non-stigmatized group (school affiliation), with bystanders depicted as being proactive (intervening to help) or passive (failing to challenge the aggression), counter to their own group's norm. Children and adolescents personally evaluated proactive bystanders more favourably than passive bystanders. However, adolescents, more than children, expected their peers to be more positive about proactive bystanders than passive bystanders in the stigmatized context. Results are discussed in terms of the complexities of bystander decisions and implications for anti-bullying interventions.     

A Prospective Examination of the Interpersonal‐Psychological Theory of Suicidal Behavior Among Psychiatric Adolescent Inpatients

The challenge of identifying suicide risk in adolescents, and particularly among high‐risk subgroups such as adolescent inpatients, calls for further study of models of suicidal behavior that could meaningfully aid in the prediction of risk. This study examined how well the Interpersonal‐Psychological Theory of Suicidal Behavior (IPTS)—with its constructs of thwarted belongingness (TB), perceived burdensomeness (PB), and an acquired capability (AC) for lethal self‐injury—predicts suicide attempts among adolescents (N = 376) 3 and 12 months after hospitalization. The three‐way interaction between PB, TB, and AC, defined as a history of multiple suicide attempts, was not significant. However, there were significant 2‐way interaction effects, which varied by sex: girls with low AC and increasing TB, and boys with high AC and increasing PB, were more likely to attempt suicide at 3 months. Only high AC predicted 12‐month attempts. Results suggest gender‐specific associations between theory components and attempts. The time‐limited effects of these associations point to TB and PB being dynamic and modifiable in high‐risk populations, whereas the effects of AC are more lasting. The study also fills an important gap in existing research by examining IPTS prospectively.     

Social Cohesion,Neighborhood Collective Efficacy,and Adolescent Subjective Well‐being in Urban and Rural Taiwan

This study investigates the association between neighborhood social cohesion, collective efficacy, and adolescent subjective well‐being in a nationally representative sample of Taiwanese youth. The study represents a first to adapt and test a developmental ecological model within a Chinese cultural context. Data came from the Taiwan Youth Project, which assessed representative samples of seventh graders (n = 2,690) and ninth graders (n = 2,851) from both urban and rural counties. The analytic sample included 4,988 adolescents (M age = 14.4, SD = 1.14; 50% female) in Taiwan. A path analysis estimated the direct and indirect effects of social cohesion on adolescent well‐being. The results suggest that neighbors can affect young people's well‐being by reinforcing their perception of safety and enhancing their self‐esteem. Comparisons between youth from urban and rural areas demonstrate a general similarity in the developmental processes, though the perception of safety is less of a concern in rural areas. Findings emphasize universal aspects of neighborhood collective efficacy and developmental–ecological models, as well as allude to culturally specific dimensions in a Chinese‐based context.     

Nonsuicidal Self‐Injury among Adolescents: A Training Priority for Primary Care Providers

Primary care providers were surveyed to determine how prepared they feel to address nonsuicidal self‐injury (NSSI) among adolescents, their interest in training on NSSI, and factors associated with routinely asking about NSSI when providing health supervision. Participants included family medicine physicians (n = 260), pediatricians (n = 127), family nurse practitioners (n = 96), and pediatric nurse practitioners (n = 54). Almost 50% felt unprepared to address NSSI, and over 70% wanted training in this area. Overall, relative to other areas of mental health care, clinicians felt least prepared to address and wanted more training on NSSI. Just 27% reported they routinely inquired about NSSI during health supervision. Factors associated with routinely asking about NSSI were identifying as female (OR = 2.37; 95% CI = 1.25–4.49), feeling better prepared to address NSSI (OR = 1.51; 95% CI = 1.04–2.20), and more frequently using a psychosocial interview to identify adolescents in distress (OR = 1.23; 95% CI = 1.02–1.48). Teaching clinicians to assess NSSI within a psychosocial interview may increase screening for and identification of the behavior among adolescents in primary care.     

Adaptive working memory training can reduce anxiety and depression vulnerability in adolescents

Adolescents can be at heightened risk for anxiety and depression, with accumulating research reporting on associations between anxiety and depression and cognitive impairments, implicating working memory and attentional control deficits. Several studies now point to the promise of adaptive working memory training to increase attentional control in depressed and anxious participants and reduce anxiety and depression symptoms, but this has not been explored in a non‐clinical adolescent population. The current study explored the effects of adaptive dual n‐back working memory training on sub‐clinical anxiety and depression symptomology in adolescents. Participants trained on either an online adaptive working memory task or non‐adaptive control task for up to 20 days. Primary outcome measures were self‐reported anxiety and depression symptomology, before and after intervention, and at 1‐month follow‐up. Self‐reported depression (p = 0.003) and anxiety (p = 0.04) decreased after training in the adaptive n‐back group relative to the non‐adaptive control group in the intention‐to‐treat sample (n = 120). These effects were sustained at follow‐up. Our findings constitute proof of principle evidence that working memory training may help reduce anxiety and depression vulnerability in a non‐clinical adolescent population. We discuss the findings’ implications for reducing risk of internalizing disorders in youth and the need for replication.     

Effectiveness of the ‘Hold me Tight’ Relationship Enhancement Program in a Self‐referred and a Clinician‐referred Sample: An Emotionally Focused Couples Therapy‐Based Approach

While evidence‐based couple therapies are available, only a minority of troubled couples seek help and they often do this too late. To reach more couples earlier, the couple relationship education (CRE) group program “Hold me Tight” (HmT) based on Emotionally Focused Couples Therapy (EFCT) was developed. This study is the first to examine the effectiveness of HmT. Using a three‐wave (waiting period, treatment, and follow‐up) within‐subject design, HmT was delivered to 79 self‐referred couples and 50 clinician‐referred couples. We applied a comprehensive outcome measure battery. Our main findings were that (1) self‐referred couples significantly improved during HmT on all measures, that is relationship satisfaction, security of partner‐bond, forgiveness, daily coordination, maintenance behavior, and psychological complaints, with a moderate‐to‐large mean effect size (d = .63), which was maintained (d = .57) during the 3.5 month follow‐up; (2) in clinician‐referred couples, who were vulnerable in terms of insecure attachment status and psychopathology, the improvement during HmT was moderate (d = .42), but this was reduced during the 3.5‐month follow‐up to a small effect (d = .22); (3) emotional functioning (typical HmT target) as well as behavioral functioning (typical Behavioral Couples Therapy‐based CRE target) improved during HmT; and (4) individual psychological complaints, although not specifically targeted, were reduced during HmT. These findings suggest that HmT is a promising intervention for enhancement of relationship functioning. Clinical implications are discussed.