Dating Violence Victimization, Nonsuicidal Self-Injury, and the Moderating Effect of Borderline Personality Disorder Features in Adolescent Inpatients.

The aim of the study was to examine whether Borderline Personality Disorder (BPD) features moderate the relation between dating violence victimization (DVV) experiences and nonsuicidal self-injury (NSSI) in adolescent inpatients. A total of 184 adolescent inpatients completed measures on DVV, BPD features, and NSSI at admission to treatment. Bivariate analyses revealed significant relations between DVV, BPD features, and NSSI. Hierarchical multiple regression analyses demonstrated a moderating effect of BPD features such that in the low BPD features group, more severe DVV was associated with greater NSSI frequency; adolescents in the high BPD group endorsed elevated, though stable, levels of NSSI at all levels of DVV. BPD features differentially affect the relationship between DVV and NSSI. Low BPD adolescents exposed to high DVV appear to self-injure more frequently and at rates similar to high BPD adolescents when faced with more severe DVV, while DVV appears neither necessary nor sufficient to be the cause of NSSI in high BPD adolescents. Our results indicate that DVV may be a particularly important focal point for treating adolescents who self-injure and have been victimized by a dating partner. As such, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and Dialectical Behavior Therapy (DBT) may serve as valuable clinical interventions.

Childhood Corporal Punishment and Future Perpetration of Physical Dating Violence.

OBJECTIVE: To test whether experiencing childhood corporal punishment is linked to later perpetration of dating violence. STUDY DESIGN: Young adults (n = 758; 61% female; mean age of 20 years), originally recruited for a longitudinal study as 9th- and 10th-grade Texas high school students, were asked about their childhood experiences with corporal punishment and physical abuse, as well as current experiences with dating violence. A path model was used to determine whether childhood corporal punishment was related to recent perpetration of physical dating violence, while controlling for childhood physical abuse, age, sex, ethnicity, and socioeconomic status. RESULTS: In all, 19% of participants (n = 134) reported physical dating violence perpetration and 68% reported experiencing corporal punishment as children (n = 498). Analysis showed a significant positive association between corporal punishment and physical perpetration of dating violence (OR 1.30, 95% CI 1.07-1.59). Even after controlling for sex, ethnicity, age, parental education, and child physical abuse, childhood corporal punishment was associated significantly with physical dating violence perpetration (aOR 1.29, 95% CI 1.02-1.62). CONCLUSIONS: The finding that childhood corporal punishment was associated with perpetration of young adult physical dating violence, even after controlling for several demographic variables and childhood physical abuse, adds to the growing literature demonstrating deleterious outcomes associated with corporal punishment.

Intimate Partner Violence Victimization in LGBT Young Adults: Demographic Differences and Associations with Health Behaviors.

OBJECTIVE: Intimate partner violence (IPV) is an important public health problem with high prevalence and serious costs. Although literature has largely focused on IPV among heterosexuals, studies have recently begun examining IPV in LGBT samples, with mounting evidence suggesting IPV may be more common among LGBT individuals than heterosexuals. Less research has examined the specific health consequences of IPV in this population, particularly across time and among young people, and it remains unclear whether experiences of IPV differ between subgroups within the LGBT population (e.g. race, gender identity, and sexual orientation). METHOD: An ethnically diverse sample of 172 LGBT young adults completed self-report measures of IPV, sexual behavior, mental health, and substance abuse at two time points (4- and 5-year follow-up) of an ongoing longitudinal study of LGBT youth. RESULTS: IPV was experienced non-uniformly across demographic groups. Specifically, female, male-to-female transgender, and Black/African-American young adults were at higher risk compared to those who identified as male, female-to-male transgender, and other races. Being a victim of IPV was associated with concurrent sexual risk taking and prospective mental health outcomes but was not associated with substance abuse. CONCLUSIONS: Demographic differences in IPV found in heterosexuals were replicated in this LGBT sample, though additional research is needed to clarify why traditional risk factors found in heterosexual young people may not translate to LGBT individuals. Studies examining the impact of IPV on negative outcomes and revictimization over time may guide our understanding of the immediate and delayed consequences of IPV for LGBT young people.

Exploring the clinical utility of the DSM-5 conduct disorder specifier of 'with limited prosocial emotions' in an adolescent inpatient sample.

BACKGROUND: With the recent addition of a callous-unemotional (CU) specifier to the diagnosis of conduct disorder (CD) in the DSM-5, studies are needed to evaluate the clinical utility of this specifier and the best ways to identify youth meeting criteria for this specifier in clinical samples. METHODS: To this end, the current study examined cross-sectional correlates and treatment response across four groups of inpatient adolescents (N=382, ages 12-17): those with CD without the specifier, with CD and the CU specifier, CU alone, and a group of psychiatric controls. We used two different measures to identify adolescents with high levels of CU traits: the Antisocial Process Screening Device (APSD) [1] and the Inventory of Callous-Unemotional Traits (ICU) [2]. Questionnaires and structured interviews were used to evaluate a range of outcomes including presence of baseline levels and treatment outcomes of both externalizing and internalizing problems. FINDINGS: Results indicated that the ICU, but not the APSD differentiated between conduct disordered youth with and without the specifier on externalizing behaviors in both cross-sectional relations and treatment response. CONCLUSIONS: The results of the current study caution the use of the most frequently used measure to identify the CU specifier, and make suggestions about alternatives.

Sexual Orientation and Borderline Personality Disorder Features in a Community Sample of Adolescents.

Empirical literature demonstrates that sexual minorities are at an increased risk of developing psychopathology, including borderline personality disorder (BPD). The specific link between sexual orientation and BPD has received significantly less attention in youth, and it remains unclear what drives this relation. Given that there are higher rates of psychopathology in both sexual minorities and individuals with BPD, the present study aimed to determine if sexual orientation uniquely contributes to borderline personality pathology, controlling for other psychopathology. An ethnically diverse sample of 835 adolescents completed self-report measures of borderline features, depression, anxiety, and sexual orientation. Sexual minorities scored higher on borderline features compared to heterosexual adolescents. When controlling for depression and anxiety, sexual orientation remained significantly associated with borderline features. The relation between sexual orientation and BPD cannot fully be explained by other psychopathology. Future research is necessary to understand potential mechanisms underlying this relation.

An Exploratory Study of Teen Dating Violence in Sexual Minority Youth.

Objective: Teen dating violence (TDV) represents a serious social problem in adolescence and is associated with a host of physical and emotional consequences. Despite advances in identification of risk factors, prevention efforts, and treatment, the TDV literature has overwhelmingly used samples that do not assess sexual orientation or assume heterosexuality. Although a few studies have explicitly examined dating violence among sexual minorities in adolescents, methodological issues limit the generalizability of these findings, and no study to date has examined patterns of dating violence over time in sexual minority youth. Method: An ethnically diverse sample of 782 adolescents completed self-report measures of dating violence, hostility, alcohol use, exposure to interparental violence, and sexual orientation. Results: Sexual minority adolescents reported higher rates of both TDV perpetration and victimization, and this finding persisted across 2 years for perpetration but not victimization. Findings also revealed that traditional risk factors of TDV (i.e., alcohol use, exposure to interparental violence) were not associated with TDV for sexual minority youth, although sexual orientation itself emerged as a risk factor over and above covariates when considering severe (i.e., physical and sexual) dating violence perpetration. Conclusions: Sexual minorities may be at a greater risk for TDV than their heterosexual peers. Findings are discussed within the context of a minority stress model. Future research is needed to parse out factors specifically related to sexual orientation from a stressful or invalidating environment.

Major depression in mothers predicts reduced ventral striatum activation in adolescent female offspring with and without depression.

Prior research has identified reduced reward-related brain activation as a promising endophenotype for the early identification of adolescents with major depressive disorder (MDD). However, it is unclear whether reduced reward-related brain activation constitutes a true vulnerability for MDD. One way of studying vulnerability is through a high-risk design. Therefore, the aim of the current study was to determine whether reward-related activation of the ventral striatum is reduced in nondepressed daughters of mothers with a history of MDD (high-risk) similarly to currently depressed adolescent girls, compared with healthy controls. By directly comparing groups with a shared risk profile during differing states, we aimed to shed light on the endophenotypic nature of reduced reward processing for adolescent depression. We compared reward-related neural activity through functional magnetic resonance imaging (fMRI) between three groups of female biological offspring (N = 52) of mothers with differential MDD status: (a) currently depressed daughters of mothers with a history of MDD (MDD group; n = 14), (b) age- and socioeconomic status (SES)-matched never-depressed daughters of mothers with a history of MDD (high-risk group; n = 19), and (c) age- and SES-matched control daughters of mothers with no past or current psychopathology in either the mother or the daughter (healthy control group; n = 19). For the outcome phase of the reward task, right-sided ventral striatum activation was reduced for both currently depressed and high-risk girls compared with healthy controls. This ventral striatal activity correlated significantly with maternal depression scores. These findings provide further evidence of aberrant functioning for the United States Department of Health & Human Services, National Institutes of Health, National Institute of Mental Health (NIMH) Research Domain Criteria (RDoC)-defined domain of positive valence systems as a vulnerability factor for MDD and a potential endophenotype for the development of depression.

Peer experiences of anxious and socially withdrawn youth: an integrative review of the developmental and clinical literature.

Prior research indicates that both anxious youth and socially withdrawn youth tend to experience challenges and difficulties in various aspects of their peer relationships and social functioning. While clinical psychology researchers have examined how anxiety relates to peer experiences using normative and clinically anxious samples, developmental psychologists have focused primarily on the peer experiences of shy and withdrawn children. Research from these two fields has progressed on related yet separate paths, producing similar results despite using different terminology and assessment techniques. The purpose of this review is to bring together the developmental and clinical bodies of literature on the peer experiences of anxious and socially withdrawn youth by identifying common themes and unique contributions of each discipline. Studies reviewed focus specifically on the peer constructs of acceptance, friendship, peer victimization, social skills, and social-cognitive processes. Limitations including methodological inconsistencies and insufficient examination of age-, gender-, and ethnicity-related issues are identified. Recommendations for future collaborations between developmental and clinical researchers as well as implications for interventions targeting the peer relations of anxious and withdrawn youth are discussed.