Adolescents' Comfort in Disclosing to Caregivers Predicts Suicidal Thoughts and Behaviors Directly and Indirectly Through Difficulties in Emotion Regulation.

Despite adolescents' suicidal thoughts and behaviors being major health problems, sparse literature exists on the roles of adolescents' disclosing their feelings to caregivers in their suicidal thoughts and behaviors. This study examined whether adolescents' comfort in disclosing their feelings and problems to caregivers predicts subsequent suicidal thoughts and behaviors and whether difficulties in emotion regulation mediate this association. High school students (N = 5,346 from 20 schools, 49% female-identified adolescents, and 35% 9th graders, 33% 10th graders, and 32% 11th graders) participated in the study for two years with four waves, each six months apart: fall semester in Year 1 (Wave 1), spring semester in Year 1 (Wave 2), fall semester in Year 2 (Wave 3), and spring semester in Year 2 (Wave 4). The degree to which adolescents felt comfortable disclosing their feelings and problems to caregivers at Wave 1 predicted lower suicidal thoughts and behaviors at Wave 4 directly and indirectly via higher emotional clarity at Wave 2 and feeling more able to handle negative emotions at Wave 3. Moreover, when female-identified adolescents reported feeling unable to handle negative emotions at Wave 3, they reported engaging in more suicidal thoughts and behaviors at Wave 4 than male-identified adolescents. Therefore, enhancing adolescents' comfort in disclosing their feelings and problems to caregivers and adolescent emotion regulation and taking a nuanced approach to support female-identified adolescents regarding their ability to handle negative emotions could prevent adolescents' suicidal thoughts and behaviors.

Endorsement of interpersonal strategies for dealing with hypothetical everyday arthritis problems as a function of marital status, gender, and problem severity.

We used hypothetical vignettes to examine whether older adults' endorsement of interpersonal strategies for dealing with health-related (arthritis) everyday problems varied as a function of marital status, gender, and the severity of the problem. Adults 60 years and older (N=127, M = 71.40 years, SD = 7.21) rated interpersonal (i.e., discuss with doctor, spouse, relative) and other strategies (e.g., deal with the problem alone, pray) for solving two hypothetical everyday problems (one mild and one severe arthritis problem). Women reported a greater likelihood of using interpersonal strategies. Married people rated interpersonal strategies that involved their spouse higher than other strategies. Greater severity of problems was associated with greater endorsement of interpersonal strategies. Implications of the results for understanding the conditions under which older adults endorse strategies that may initiate collaborative everyday problem solving are discussed.

The efficacy of evidence-based psychotherapies versus usual care for youths: controlling confounds in a meta-reanalysis.

In the present meta-analysis, the authors examined how several confounding moderator variables may relate to the advantage of evidence-based psychological treatments (EBTs) over usual care (UC) in the treatment of youths, including the extent to which each therapy was bona fide, supervision provided to therapists, therapist caseload, whether EBT was provided by research therapists, and whether specialized training was provided for EBT therapists. When comparing EBT with bona fide UC while controlling for each confound individually, the advantage for EBT was small and nearly always statistically nonsignificant. Additionally, an increasing total number of confounds favoring EBT was significantly predictive of a greater effect size advantage for EBT. The superior efficacy of EBTs for youths may be an artifact of confounded research designs.

Collaborative everyday problem solving among same-gender friends in early and later adulthood.

To investigate potential age-related differences in performance gains (compensation and optimization) and losses (failure to actualize potential) of collaboration with a familiar partner, the authors compared pairs of older (N = 75; 69% women) and younger (N = 75; 52% women) age-homogeneous same-gender friends who interacted or worked alone to generate strategies for solving interpersonal and instrumental problems. Two indexes of strategy fluency (total and unique number of strategies) and 2 indexes of strategy type (content of strategy repertoires and strategy selected as most effective by older and younger adults) were examined. Strategies generated by interacting pairs were compared with nominal pair scores. Nominal pair scores indexed dyadic potential and were created by pooling the performance of 2 individuals who worked alone. Age differences in strategy fluency and type were largely similar to prior research based on individual problem solvers. Interacting pairs produced fewer strategies than nominal pairs, but there were no differences in strategy type. For interpersonal problems, older adults were relatively more likely to actualize their dyadic potential.

What are the active ingredients in cognitive and behavioral psychotherapy for anxious and depressed children? A meta-analytic review.

Prior meta-analytic reviews have indicated that cognitive and behavioral treatments are efficacious in treating child and adolescent depression and anxiety. Further, a meta-analysis has suggested that behavioral treatments are superior to nonbehavioral treatments for treating anxiety and depression in youth. However, the prior meta-analysis did not examine direct comparisons between cognitive and behavioral treatments (CBT) and non-CBT treatments, leaving open the possibility that their results were artifactual. The present meta-analysis aggregated results of studies in which CBT treatments were compared with either other bona fide treatments (including other CBT therapies) or non-bona fide therapies. The heterogeneity of the distribution of differences between bona fide treatments as well as a comparison of full (e.g. CBT+Parent training) versus component treatments (e.g., CBT only) were examined. The results indicated that: (a) CBT was more efficacious than non-bona fide therapies; (b) CBT was no more efficacious than bona fide non-CBT treatments (c) the differences between bona fide treatments were homogenously distributed around zero; and (d) full CBT treatments offered no significant benefit over their components. The results strongly suggest that the theoretically purported critical ingredients of CBT are not specifically ameliorative for child and adolescent depression and anxiety.

A comparative meta-analysis of Clinical Global Impressions change in antidepressant trials.

Two scales of the Clinical Global Impressions (CGI) Scale are frequently used in antidepressant trials. No research has systematically addressed how CGI change compares to change on established measures such as the Hamilton Depression Rating Scale (HAM-D), Montgomery-Asberg Depression Rating Scale, or Beck Depression Inventory. The current meta-analysis examined 75 antidepressant trials in which the CGI was used along with at least one other popular depression measure. The CGI-Severity scale was significantly more conservative than the HAM-D in rating change in double-blind trials, but not in open trials. The Beck Depression Inventory was significantly more conservative than the CGI-Severity. The CGI-Improvement scale was significantly more liberal than the HAM-D or Montgomery-Asberg Depression Rating Scale. Rater bias or scale content may explain differences between measures. Given the often substantial differences between instruments, researchers should use a variety of measures rather than relying on any single tool in assessing treatment response.