创伤后应激障碍对震后青少年自杀意念的影响：安全感的调节作用

为探讨创伤后应激障碍（PTSD）及其各个症状簇对震后青少年自杀意念的影响,并检验安全感在其中的调节作用,研究采用创伤暴露程度问卷、流调中心抑郁量表儿童版、DSM-5的PTSD症状核查表、安全感量表和儿童行为问题核查表对汶川地震8.5年后的1136名中学生进行调查。结果发现：PTSD、负性认知和情绪改变症状、警觉性增高症状分别正向预测自杀意念,侵入性症状和回避性症状对自杀意念的预测作用不显著;安全感在侵入性症状、负性认知和情绪改变症状、警觉性增高症状、PTSD与自杀意念之间起负向调节作用,在回避性症状与自杀意念之间不起调节作用。这表明PTSD各症状簇对震后青少年自杀意念的预测作用不同,且安全感在其中发挥的调节作用也不同。     

Parental Monitoring and Adolescent Risk Behaviors: The Moderating Role of Adolescent Internalizing Symptoms and Gender

Parental monitoring can reduce adolescents’ engagement in risky behaviors; however, adolescents’ internalizing symptoms may alter the effectiveness of parental monitoring. The current study examines independent and interactive effects of maternal and paternal monitoring, adolescent’s internalizing symptoms, and adolescent gender on sexual behaviors and substance use with data from 659 of the 15-year-olds enrolled in the NICHD Study of Early Child Care and Youth Development. Results suggest girls who experienced less maternal monitoring and more internalizing symptoms—both independently and interactively—engaged in more risky sexual behaviors. Greater substance use was associated with less maternal and paternal monitoring for girls and boys, more internalizing symptoms for girls, and interactively with less maternal and paternal monitoring depending on girls’ levels of internalizing symptoms. The current study highlights the unique influences of mothers’ and fathers’ monitoring efforts on adolescent risky behavior based on the adolescent’s level of internalizing symptoms.     

Suicide Ideation in Adolescents Following Inpatient Hospitalization: Examination of Intensity and Lability Over 6 Months

Understanding suicide ideation (SI) in adolescents, especially during the high‐risk time following hospitalization for a suicidal event, is a crucial component of improving risk assessment. Most studies rely on single assessments of SI, despite the potential for SI to vary considerably over time. This study examined how indices of SI intensity (mean values) and lability (mean squared successive difference values) over a 6‐month period predict suicide attempts (SAs) and self‐harm, as well as how they relate to psychosocial risk factors and affective functioning, in a sample of 103 adolescents hospitalized for a SA or significant SI. Across the sample, SI intensity, but not lability, was associated with SAs and nonsuicidal self‐injury at 6‐month follow‐up. SI intensity performed similarly to single time point SI assessments, and its relations were not moderated by SI lability. SI intensity was also associated with borderline personality disorder criteria and a history of sexual abuse. In contrast, SI lability was associated with greater negative affect intensity and lability. These findings suggest that intensity of SI may confer more risk posthospitalization, and provide support for using these statistical methods to capture two distinct parameters of SI.     

Perceived Discrimination and Suicide Ideation: Moderating Roles of Anxiety Symptoms and Ethnic Identity among Asian American,African American,and Hispanic Emerging Adults

Suicide is a leading cause of death for vulnerable ethnic minority emerging adults in the United States (Web‐based injury statistics query and reporting system [WISQARS], 2015). Perceived discrimination (Journal of Youth and Adolescence, 40, 2011, 1465) and anxiety symptoms (Asian American Journal of Psychology, 1, 2010, 18) are two predictors that are theoretically and conceptually related, but have yet to be examined in a simultaneous model for suicide ideation. Existing theory and research suggest that these variables activate similar pathways (American Behavioral Scientist, 51, 2007, 551). This study sought to address this gap in the literature by examining the simultaneous relationship between perceived discrimination and anxiety symptoms as predictors of suicide ideation. The moderating effect of anxiety symptoms on the relationship between perceived discrimination and suicide ideation was examined in a multiethnic sample of emerging adults. Results indicated that anxiety symptoms moderated the perceived discrimination–suicide ideation relationship for Hispanic emerging adults, but not for their Asian American and African American counterparts. Furthermore, ethnic identity has been shown to mitigate suicide risk in the face of other stressors (Cultural Diversity and Ethnic Minority Psychology, 14, 2008, 75). Ethnic identity emerged as a protective factor for Hispanic emerging adults by further interacting with perceived discrimination and anxiety symptoms to negatively predict suicide ideation. The implications of these findings are discussed.     

The Relationship Between Posttraumatic Stress Symptoms and Suicide Ideation Among Child Survivors Following the Wenchuan Earthquake

The association between posttraumatic stress disorder (PTSD) symptoms and suicide ideation was examined in a sample of 2,298 child survivors of the Wenchuan earthquake. Results indicated that intrusion, avoidance, hyperarousal symptom clusters, and PTSD total score were significantly associated with suicide ideation. Except for intrusion, other measures of PTSD remained as statistically significant correlates of suicide ideation even after controlling for age, gender, direct exposure, indirect exposure, and depression. Furthermore, results showed that PTSD symptoms had an indirect influence on suicide ideation that was mediated by depression. The findings suggest that avoidance and hyperarousal symptom clusters of PTSD may be two important indicators of suicide ideation among child survivors of the Wenchuan earthquake. Implications of the results for intervention and prevention of suicide behavior are discussed.     

Family Functioning and Anxiety Symptoms in Adolescents: The Moderating Role of Mindfulness

Journal of Child and Family Studies - Anxiety disorders are one of the most prevalent psychiatric disorders among adolescents and can be associated with long-term adverse outcomes if untreated. Our...     

Suicidal Ideation and Eating Disorder Symptoms in Adolescents: The Role of Interoceptive Deficits

Eating disorder symptoms and suicidal ideation are relatively common, and often begin to emerge in adolescence. Interoceptive deficits, or the inability to perceive and accurately identify the physiological condition of the body, is an established risk factor for both eating disorders and suicidal thoughts and behaviors. Despite this, longitudinal research examining the temporal dynamics between these variables is scarce, especially within adolescent samples. Using a three-wave longitudinal design, the present study tested bidirectional relationships between interoceptive deficits, eating disorder symptoms, and suicidal ideation to examine whether interoceptive deficits predicted eating disorder symptoms and suicidal ideation over the course of a year among a sample of adolescents. Participants were 436 community adolescents recruited from local middle- and high-schools. Data were collected at baseline, 6-month follow-up, and 12-month follow-up. Study measures assessed current suicidal ideation, eating disorder symptom severity, and interoceptive deficits. Autoregressive cross-lagged modeling was conducted in MPlus. We found baseline eating disorder symptoms significantly predicted suicidal ideation at 6-month follow-up when controlling for baseline suicidal ideation. Baseline interoceptive deficits significantly predicted eating disorder symptoms 6-months later, while 6-month follow-up interoceptive deficits significantly predicted 12-month follow-up suicidal ideation. Our findings highlight the need for early and regular assessment of suicidal ideation and eating disorder symptoms in adolescents. Given that interoceptive deficits was a shared risk factor for both conditions within this sample, these results underscore the need for targeted interventions aimed at improving interoception.     

Trajectories of Depressive Symptoms and Externalizing Behaviors across Adolescence: Associations with Histories of Suicide Attempt and Ideation in Early Adulthood

We examined associations between adolescent problem trajectories and suicide risk outcomes in 361 community participants. Depressive symptoms (self‐report) and externalizing behaviors (parent report) were assessed six times from grades 5 to 10. Parallel process linear growth curves indicated that lifetime suicide attempt history assessed to age 25 was associated with higher intercept (grade 5) and slope (increases from grades 5 to 10) of depressive symptoms and higher slope of externalizing behaviors. Both problem intercepts predicted suicidal ideation at ages 18 to 25 years. Adolescent depressive and externalizing symptom trajectories showed independent associations with suicide risk. Preventive intervention that occurs prior to the developmental period in which suicidal thoughts and behaviors show peak prevalence is expected to prevent suicide.     

Racial/Ethnic Differences in Internalizing and Externalizing Symptoms in Adolescents

The prevalence of most adult psychiatric disorders varies across racial/ethnic groups and has important implications for prevention and intervention efforts. Research on racial/ethnic differences in the prevalence of internalizing and externalizing symptoms and disorders in adolescents has been less consistent or generally lacking. The current study examined the prevalence of these symptom groups in a large sample of sixth, seventh, and eighth graders in which the three major racial/ethnic groups in the U.S. (White, Black, and Hispanic/Latino) were well-represented. Hispanic females reported experiencing higher levels of depression, anxiety, and reputational aggression than other groups. Black males reported the highest levels of overtly aggressive behavior and also reported higher levels of physiologic anxiety and disordered eating than males from other racial/ethnic groups. Hispanic females also exhibited higher levels of comorbidity than other racial/ethnic groups.     

Internalizing Symptoms in Female Adolescents: Associations with Emotional Awareness and Emotion Regulation

The transition into adolescence involves a number of changes that for many adolescents result in increased negative affect and internalizing symptoms, especially for females. In the current study we examined the direct and indirect effects of emotional awareness on internalizing symptoms by exploring the extent to which certain emotion regulation strategies influence this relationship. Participants were 123 female adolescents aged 13–16 years (M = 14.51 years) who completed measures of emotional awareness, emotion regulation (emotional reappraisal and expressive suppression), and symptoms of depression and social anxiety. Two multiple indirect effect models were conducted including both reappraisal and suppression (one for each of the dependent variables, depression and social anxiety) via the bootstrapping method. Results found that reappraisal accounted for the effect of emotional awareness on depressive symptoms but suppression accounted for the effect of emotional awareness on social anxiety symptoms. Results suggest that emotion regulation strategies play an important role in determining depressive and social anxiety symptoms and are associated with an adolescent’s level of emotional awareness.     

青少年创伤后应激障碍症状与网络成瘾症状的关系：惩罚敏感性和孤独感的中介及性别的调节

汶川地震9.5年后,对汶川县和都江堰市767名中学生进行调查,考察惩罚敏感性和孤独感在创伤后应激障碍症状和网络成瘾症状之间的多重中介作用及性别差异。结果发现：（1）PTSD症状正向预测网络成瘾症状,并分别通过惩罚敏感性、孤独感的单独中介作用及两者的链式中介作用显著预测网络成瘾症状;（2）女性的PTSD症状显著正向预测网络成瘾症状,并分别通过惩罚敏感性和孤独感间接影响网络成瘾症状;男性的网络成瘾症状仅被PTSD症状正向预测。     

Psychometric Properties and Clinical Utility of the Scale for Suicide Ideation with Inpatient Children

The purpose of the current study was to examine the psychometric properties and clinical utility of the Scale for Suicide Ideation (SSI) for children. The SSI was administered to 100 children who were hospitalized. Data were not used from 13 subjects due to the presence of a psychotic disorder or IQ less than 70, leaving 87 participants. The SSI was examined regarding its internal consistency, concurrent validity, construct validity, and factor structure when used with children. Based on the findings, the SSI appears to have adequate psychometric properties and can be used by clinicians and researchers examining children in an inpatient setting. Recommendations for clinicians are included to help make the SSI more functional in use for children.     

Sluggish Cognitive Tempo,Processing Speed,and Internalizing Symptoms: the Moderating Effect of Age

Sluggish Cognitive Tempo (SCT) has been defined by a constellation of caregiver-reported symptoms that includes daydreaming, difficulty initiating and sustaining effort, lethargy, and physical underactivity. These symptoms have been observed in both typically developing children and in some children with Attention-Deficit/Hyperactivity Disorder (ADHD)—especially those with the predominantly inattentive presentation. Symptoms of SCT (typically identified via rating scales) appear separable from DSM inattentive ADHD symptoms, but have also been associated with internalizing symptoms. To date, however, few studies have examined associations among ratings of SCT and speeded performance-based measures. The present study examined associations among SCT, processing speed, and internalizing symptoms in a sample of 566 clinically referred children (65% male), while also considering how these associations change with age. Findings revealed small but significant age-related differences in the strength of associations between the “Daydreamy” element of SCT and processing speed (as measured by the WISC-IV Processing Speed Index—PSI), with stronger associations observed in younger children. Importantly, this difference in strength of association was not accounted for by the change in WISC-IV test forms for PSI subtests between 6–7 year-olds and 8–16 year-olds. Conversely, the association between SCT and internalizing symptoms remained generally consistent across the age range. Findings contribute to further characterization of the “slowness” of responding seen in SCT and may have implications for behavioral intervention.     

Suicide Ideation and Attempts among Low‐Income African American Adolescents

We examined the impact of risk and protective factors on the odds that African American adolescents seriously think about or attempt suicide. Data from students in grades 5–12 in a mostly urban, southeastern U.S. school district were analyzed. Findings support earlier work documenting differences in gender and grades. Risk factors were uniformly significant in understanding both ideation and attempts. Protective factors were not consistent predictors; the lowering role of religious protective factors was limited, though student's belonging to or their perception of belonging to a spiritual community was a significant factor in lowering the odds of suicide ideation.     

Parental Depression and Economic Disadvantage: The Role of Parenting in Associations with Internalizing and Externalizing Symptoms in Children and Adolescents

This study examined the effects of parental depression symptoms, economic disadvantage, and parenting behaviors in 180 children and adolescents of depressed parents (ages 9–15 years-old). Analyses revealed that while parental depression symptoms, economic disadvantage, and disrupted parenting behaviors were related to children’s internalizing and externalizing symptoms, disrupted parenting (e.g., intrusive, neglectful parenting) accounted for the association of parental depressive symptoms and economic disadvantage with children’s symptoms. This study provides evidence that disrupted parenting may be a common or shared process through which both parental depression and economic disadvantage are associated with children’s internalizing and externalizing problems.     

Three Subtypes of Internalizing and Externalizing Behaviors in Chinese Adolescents: Results of a Latent Class Analysis

Using latent class analyses (LCA), the present study aimed to test whether meaningful subtypes of internalizing and externalizing behaviors could be found among Chinese community-based adolescents. A total of 5244 adolescents, ages 11–18 years (M?=?15.11, SD?=?1.79) recruited from 16 Chinese middle schools completed the Chinese version of the Strengths and Difficulties Questionnaire (SDQ-C). We examined the data using Latent Class Analysis to identify subtypes of internalizing and externalizing behaviors among the adolescents. Multivariate Logistic regression was subsequently implemented to ascertain the relationships between latent classes and demographic covariates. Three distinct subtypes were uncovered: a high-risk group, a middle-risk group and a low-risk group; the three subtypes accounted for 19.8, 31.1, and 49.1 % of the total sample variance respectively. Youth with elevations in one behavior type were likely to have elevations in the other behavior type. Further analyses revealed that compared to the low-risk group, the adolescents from the high-risk group and middle-risk groups were female and older. Significant heterogeneity in internalizing and externalizing behaviors was revealed in this Chinese adolescent’s sample. Profiling behavior problems patterns is potentially useful as a first step in developing tailored prevention and intervention programs. Suggestions for future research, including cross-national studies, and implications for mental health professionals were discussed.