Implicit Assessment of Non-Suicidal Self-Injury: Group Differences in Temporal Stability of the Self-Injury Implicit Association Test (SI-IAT).

OBJECTIVE: We examine differences on the Self-Injury Implicit Association Test (SI-IAT) by history of non-suicidal self-injury (NSSI), in a test-retest design, to examine short-term temporal stability of SI-IAT scores. METHOD: Treatment-seeking participants (N = 113; 58% female; 89% White; Mage = 30.57) completed the SI-IAT and self-report measures at two time points (MTimeframe = 3.8 days). RESULTS: Data suggested NSSI (51% of the sample endorsed lifetime NSSI) was related to Time 1 (T1) identity and attitude, and affected stability of scores. T1 and T2 SI-IAT identity and attitude were more strongly related for participants with NSSI history. NSSI characteristics (recency; number of methods) affected stability. CONCLUSIONS: The short-term test-retest reliability of the SI-IAT is strong among those with NSSI history from T1 to T2. However, the SI-IATs use with participants without a history of NSSI was not supported beyond its established ability to differentiate between groups by NSSI history. This test may provide clinically-relevant assessment among those with a history of NSSI.

Participants with vs. without NSSI history respond differently on the SI-IATTemporal stability of SI-IAT performance is strong in a short timeframeResults supported the test-retest reliability of the SI-IAT in the target group.

An examination of theory-based suicidal ideation risk factors in college students with multiple marginalized identities.

Social marginalization increases the risk of suicidal ideation (SI) among individuals with diverse identities, yet research examining the effects of marginalization has focused on one identity. Emerging adulthood is a critical period of identity development and the age group with the highest rates of SI. Considering the challenges of living in potentially heterosexist, cissexist, racist, and sizeist environments, we tested whether possessing multiple marginalized identities was associated with severity of SI through factors proposed in the interpersonal-psychological theory (IPT) and the three-step theory (3ST) of suicide and if mediation paths were moderated by sex. A sample of 265 college students completed a cross-sectional online survey assessing SI and constructs related to IPT and 3ST. The number of marginalized identities was generated by adding minoritized sexual orientation, race/ethnicity other than non-Hispanic White, body mass index >25 kg/m2, sexual attraction to same sex but identified as heterosexual, and gender-fluid identity. In IPT multiple mediation analyses, possessing more marginalized identities was associated with SI severity through burdensomeness and hopelessness, but not belonging. Indirect paths through burdensomeness and belonging were moderated by sex. For 3ST, possessing more marginalized identities was associated with SI severity through hopelessness and psychological pain, but not social connection or meaning in life. Future research should consider intersecting social identities and test mechanisms by which multiply marginalized college students develop resilience to SI risk factors, such as support within their marginalized groups, to inform suicide assessment and intervention efforts on college campuses. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Application of the Three-Step Ideation-to-Action Theory to Passive and Active Suicidal Ideation in College Students.

Background: Few studies have tested the three-step theory of suicide (3ST), particularly in college students, who have unique developmental experiences of connectedness and high rates of suicidal ideation (SI). This study tested if factors purported in the 3ST distinguish undergraduate students with no SI, passive SI, and active SI using two conceptualizations of connectedness: social connection and meaning in life. Methods: A sample of undergraduate students aged 18-26 from an urban university completed an online survey (n=265). Results: Results showed some support for the 3ST. Greater psychological pain increased likelihood of passive SI (OR=3.74, p<.001); the model accurately identified 36% of students with passive SI. Greater pain (OR=2.74, p=.01) and hopelessness (OR=17.17, p<.05) differentiated students with active SI from those without SI in social connection models. In meaning models, greater pain relative to meaning in life differentiated students with passive SI (OR=2.29, p<.01) and active SI (OR=1.81, p<.05) relative to no SI. Each model accurately identified 68% of students with active SI. No 3ST factors differentiated students with passive SI from those with active SI. Conclusions: There was limited applicability for 3ST in differentiating college students with passive SI from those with no SI or active SI, with better differentiation of students with active SI relative to no SI. Interventions for college students with passive and active SI could target psychological pain, foster hope, and cultivate meaning.

Central Executive Network and Executive Function in Patients With Alzheimer's Disease and Healthy Individuals: Meta-Analysis of Structural and Functional MRI.

OBJECTIVE: The neural architecture of executive function is of interest given its utility as a transdiagnostic predictor of adaptive functioning. However, a gap exists in the meta-analytic literature assessing this relationship in neuropsychiatric populations, concordance between structural and functional architecture, and the relationship with neuropsychological assessment of executive function. Given the importance of the central executive network (CEN) in Alzheimer's disease, this population may be useful in understanding this relationship in Alzheimer's disease pathology. METHODS: A meta-analysis of studies (k=21) was conducted to elucidate the relationship between executive function and CEN for structural architecture (k=10; N=1,027) among patients with Alzheimer's disease (k=6; N=250) and healthy control subjects (HCs) (k=4; N=777) and for functional architecture (k=11; N=522) among patients with Alzheimer's disease (k=6; N=306) and HCs (k=5; N=216). Random-effects modeling was used to increase accuracy of conclusions about population means. RESULTS: Analyses revealed a positive brain-behavior relationship (pr=0.032, 95% CI=0.07, 0.54), although there was a lack of statistically significant heterogeneity between functional and structural neuroimaging (Q=9.89, p=0.971, I2=0.00%) and between the Alzheimer's and HC groups in functional (Q=8.18, p=0.612, I2=0.00%) and structural (Q=1.60, p=0.996, I2=0.00%) neuroimaging. Similarly, a lack of statistically significant heterogeneity was revealed between functional and structural neuroimaging among patients with Alzheimer's disease (Q=3.59, p=0.980, I2=0.00%) and HCs (Q=3.67, p=0.885, I2=0.00%). CONCLUSIONS: Structural and functional imaging in the CEN are predictive of executive function performance among patients with Alzheimer's disease and HCs. Regardless of how the CEN is affected, behavior is correlated to the degree to which the CEN is affected. Findings are significant in the context of methodological decisions in multimodal neuroimaging research.

Climate change anxiety and mental health: Environmental activism as buffer.

A growing body of research has documented the phenomenon of climate change anxiety (CCA), defined broadly as negative cognitive, emotional, and behavioral responses associated with concerns about climate change. A recently validated scale of CCA indicated two subscales: cognitive emotional impairment and functional impairment (Clayton & Karazsia, 2020). However, there are few empirical studies on CCA to date and little evidence regarding whether CCA is associated with psychiatric symptoms, including symptoms of Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD), and whether engaging in individual and collective action to address climate change could buffer such relationships. This mixed methods study draws on data collected from a sample of emerging adult students (ages 18-35) in the United States (N = 284) to address these gaps. Results indicated that both CCA subscales were significantly associated with GAD symptoms, while only the Functional Impairment subscale was associated with higher MDD symptoms. Moreover, engaging in collective action, but not individual action, significantly attenuated the association between CCA cognitive emotional impairment and MDD symptoms. Responses to open-ended questions asking about participants' worries and actions related to climate change indicated the severity of their worries and, for some, a perception of the insignificance of their actions relative to the enormity of climate change. These results further the field's understanding of CCA, both in general and specifically among emerging adults, and suggest the importance of creating opportunities for collective action to build sense of agency in addressing climate change.

The central executive network and executive function in healthy and persons with schizophrenia groups: a meta-analysis of structural and functional MRI.

This meta-analysis evaluated the extent to which executive function can be understood with structural and functional magnetic resonance imaging. Studies included structural in schizophrenia (k = 8; n = 241) and healthy controls (k = 12; n = 1660), and functional in schizophrenia (k = 4; n = 104) and healthy controls (k = 12; n = 712). Results revealed a positive association in the brain behavior relationship when pooled across schizophrenia and control samples for structural (pr = 0.27) and functional (pr = 0.29) modalities. Subgroup analyses revealed no significant difference for functional neuroimaging (pr = .43, 95%CI = -.08-.77, p = .088) but with structural neuroimaging (pr = .37, 95%CI = -.08-.69, p = .015) the association to executive functions is lower in the control group. Subgroup analyses also revealed no significant differences in the strength of the brain-behavior relationship in the schizophrenia group (pr = .59, 95%CI = .58-.61, p = .881) or the control group (pr = 0.19, 95%CI = 0.18-0.19, p = 0.920), suggesting concordance.

An exploratory mixed methods approach to implicit and explicit identification with non-suicidal self-injury.

BACKGROUND AND OBJECTIVES: Identification with non-suicidal self-injury (NSSI) is uniquely related to NSSI behavior and predicts future NSSI. This exploratory, mixed methods study used implicit and explicit approaches to further understanding of NSSI identity. METHODS: Participants included 15 treatment-seeking adults (60% female, 87% Caucasian) with lifetime NSSI. Participant age ranged from 19 to 38 years (M = 25.33, SD = 6.10). Implicit tasks were completed at two time points in a test-retest design, followed by a qualitative interview. RESULTS: Qualitative data suggest that explicit NSSI identity is relevant to some individuals with NSSI history. Mixed methods analyses indicate that individuals who explicitly identify with NSSI have stronger implicit NSSI identities than those who do not, and report more methods of NSSI on average. LIMITATIONS: Results are novel, although exploratory in nature due to the sample size, and may not be generalizable to non-clinical samples or individuals currently engaging in NSSI. CONCLUSIONS: Individuals with stronger explicit identity evidence higher implicit identity scores, suggesting a potential higher risk profile for future NSSI. This study offers further support for the value of including both implicit and explicit assessment of NSSI identity in risk assessment.

Motivation for and use of social networking sites: Comparisons among college students with and without histories of non-suicidal self-injury.

OBJECTIVE: This research examines potential differences in social network use and motivation for social network use by non-suicidal self-injury (NSSI) status. PARTICIPANTS: 367 (73% women; Mage = 20.60) college students were recruited in November-December 2011. METHODS: A random sample of 2,500 students was accessed through a university registrar to recruit students interested in an online survey assessing NSSI and various health-related behaviors. RESULTS: Social network use and motivations for social networks did not differ by NSSI status. CONCLUSIONS: Results suggest that it is not patterns of use or motivation to use social networks that could lead to concern about online behavior (i.e., behavior increasing risk of future NSSI) among those with NSSI history. Rather, future preventive and intervention efforts should address the NSSI-related content that is available online, since this is unregulated, often explicit, and commonly includes "pro-NSSI" content that may be problematic and increase risk among vulnerable individuals.

Depression with Mixed Features in Adolescent Psychiatric Patients.

Depression with mixed features is poorly understood, especially in pediatric samples. This study compares symptoms and correlates of depressed adolescent inpatients with mixed features to inpatients with bipolar disorder and major depression. 407 adolescents were administered diagnostic interviews and self-reports, and 262 were categorized as Depression with Mixed Features (MXD; n = 38), Consensus Bipolar (CB; n = 79), or Depression Only (DO; n = 145). Demographic and morbidity information were collected via chart reviews. MXD adolescents evidenced elevated mania-related symptoms compared to DO adolescents. MXD adolescents had elevated Unusually Energetic symptoms and increases for six additional category B mania-related symptoms compared to CB adolescents. MXD adolescents met criteria for more comorbid disorders and reported elevated suicidality, anger, and trauma symptoms compared to CB and DO adolescents. Overall, MXD adolescents evidenced elevated symptomatology compared to other groups, suggesting mixed depression may represent a unique constellation of symptoms meriting further investigation.

The Role of Positive Expectancies in Risk Behavior.

BACKGROUND: Alcohol use and nonsuicidal self-injury (NSSI) appear to share a conceptual overlap in functions (e.g., tension reduction). Alcohol use has been identified as a risk factor for NSSI, and higher rates of alcohol use have been documented among those with NSSI history. AIMS: This study examined whether NSSI-related alcohol expectancies affect relations between NSSI and alcohol use. METHOD: Participants were 367 college students (73% female) asked to complete an online survey about their drinking behavior and lifetime NSSI. RESULTS: NSSI and alcohol use were highly prevalent in this sample: 56% endorsed lifetime NSSI and 74% endorsed current alcohol use. Of note, 43% (n = 147) endorsed both behaviors. Positive NSSI-related alcohol expectancies showed a significant association with lifetime NSSI. In addition, positive NSSI-related alcohol expectancies were associated with more frequent drinking behavior for individuals with a history of NSSI, particularly those who had engaged in two or more methods of lifetime NSSI. CONCLUSION: Alcohol use and NSSI represent high-risk behaviors commonly employed to regulate unwanted affective states. Interventions targeting substance use and/or NSSI may consider assessing positive NSSI and substance use expectancies, as the presence of these beliefs suggests a higher risk profile.

Examining Associations of Sexual Attraction and Attitudes on Women's Disordered Eating Behavior.

OBJECTIVE: We aimed to expand the scant research on disordered eating in women identifying same-sex sexual attractions. METHOD: We used multiple linear regressions to explore potential mechanisms driving disordered eating--both explicit and implicit weight bias and heterosexism--in a cross-sectional, online-recruited community sample of women (N = 437). Participants endorsed a range of sexual attractions from exclusively opposite-sex (21.1%) to exclusively same-sex (19.5%) attraction. RESULTS: Findings revealed no associations between sexual attraction and disordered eating. Awareness of sociocultural norms valuing thinness accounted for disordered eating for all women, regardless of sexual attraction, and was influenced by attitudes regarding weight. Among women endorsing same-sex attractions, self-reported internalized heterosexism influenced disordered eating. DISCUSSION: Findings contradict long-held beliefs that same-sex attracted women are protected from disordered eating. They emphasize a universal risk, for all women, of sociocultural norms valuing thinness, as well as the risk of internalized heterosexism among same-sex attracted women.

Self-Reported Psychopathology, Trauma Symptoms, and Emotion Coping Among Child Suicide Attempters and Ideators: An Exploratory Study of Young Children.

This study examined self-reported psychopathology, trauma symptoms, and emotion coping in 7 to 12 year old children with suicidal ideation and attempts. This study compared 70 psychiatric inpatient children with current suicidal ideation to 59 psychiatric inpatient children with recent suicide attempts on measures of depression, anxiety, anger, emotional intelligence, and family/contextual factors. Results revealed greater self-reported anger as well as psychological distress associated with traumatic experiences (dissociation, anger, depression), among children who attempted suicide, in addition to increased reports of special education utilization, when compared to ideators only. These relationships were not affected by age or gender. Overall, the findings suggest self-reports of younger children who attempt suicide share similarities with older children and adolescent attempters, when compared with ideators who do not attempt. Implications for assessment and treatment are discussed.

Perceptions of the Functions of Nonsuicidal Self-Injury in a College Sample.

BACKGROUND: Rates of nonsuicidal self-injury (NSSI) are particularly high on college campuses. Commonly endorsed reasons for NSSI include interpersonal (e.g., seeking support) and intrapersonal (e.g., affect regulation) functions. AIMS: This study compared college students with and without a history of NSSI on their views of NSSI functions in order to inform gatekeeper intervention/prevention programs targeting NSSI. METHOD: The Inventory of Statements About Self-Injury, which assessed NSSI behavior and functions of NSSI, was completed by 367 college students (73% female, 95% white). RESULTS: Ninety-eight participants endorsed lifetime moderate/severe NSSI, 109 endorsed minor NSSI, and 160 denied any history of NSSI. Noninjuring participants' views of NSSI functions were compared with the views held by participants with histories of NSSI. The groups did not differ in their views of the relevance of intrapersonal functions, although noninjuring individuals appeared to stress some interpersonal factors (e.g., influence) slightly more than individuals with a history of NSSI did. CONCLUSION: These results suggest that college students generally hold similar perceptions of the functions of NSSI. Our findings suggest intervention/prevention efforts may consider broadening the selection of gatekeepers (e.g., peers with no history of NSSI) in schools and colleges to identify at-risk students and encourage help-seeking behaviors.

Sexual orientation and non-suicidal self-injury: a meta-analytic review.

The aim of this study was to conduct the first meta-analysis comparing risk for NSSI between sexual minority and heterosexual persons. Eleven published and 4 unpublished studies were reviewed, describing associations between sexual orientation and NSSI in 7,147 sexual minority and 61,701 heterosexual participants. The overall weighted effect size for the relationship between sexual orientation and NSSI using a random-effects model was OR = 3.00 (95% CI = 2.46-3.66), indicating a medium-to-large effect. Sexual minority adolescents and bisexuals were found to be at particularly high-risk. These findings highlight the need to examine mechanisms linking sexual orientation and NSSI in future research. Building on these findings can add to understanding the associations between sexual orientation, NSSI, and suicidality, as well as prevention/intervention.

Cognitive estimation and its assessment.

PURPOSE: We evaluated the internal consistency and construct and criterion validity of a 10-item revision of the Cognitive Estimation Task (CET-R) developed by Shallice and Evans to assess problem-solving hypothesis generation. METHOD: The CET-R was administered to 216 healthy adults from the Aging, Brain Imaging, and Cognition study and 57 adult outpatients with schizophrenia. RESULTS: Exploratory and confirmatory factor analysis (EFA and CFA) of the healthy sample revealed that seven of the 10 CET-R items constitute a more internally consistent scale (CET-R-7). Though EFA indicated that two CET-R-7 dimensions might be present (length and speed/time estimation, respectively), CFA confirmed that a single factor best represents the seven items. The CET-R-7 was modeled best by crystallized intelligence, adequately by fluid intelligence, and inadequately by visuospatial problem solving. Performance on the CET-R-7 correlated significantly with the neuropsychological domains of speed and fluency, but not memory or executive function. Finally, CET-R performance differed by diagnosis, sex, and education, but not age. CONCLUSIONS: This study identified an internally consistent set of items that measures the construct of cognitive estimation. This construct relates to several important dimensions of psychological functioning, including crystallized and fluid intelligence, generativity, and self-monitoring. It also is sensitive to cognitive dysfunction in adults with schizophrenia.

Dating violence victimization, dispositional aggression, and nonsuicidal self-injury among psychiatrically hospitalized male and female adolescents.

The objective of the current study was to characterize the association between dating violence victimization and dispositional aggression in predicting nonsuicidal self-injury (NSSI) among psychiatrically hospitalized male and female adolescents. One hundred fifty-five adolescents (ages 13-17) and their parents completed the Schedule for Affective Disorders and Schizophrenia for School-Age Children clinical interview to assess NSSI and child abuse; adolescents completed self-report measures of aggression and dating violence victimization (verbal, physical, and sexual). Dating violence victimization and NSSI were found to be highly prevalent among both males and females in this psychiatric inpatient sample. Two moderational models were supported, wherein dating violence was associated with NSSI in the context of elevated trait anger in males and indirect aggression in females. Findings suggest that helping victims of dating violence acquire skills to address certain forms of dispositional aggression may attenuate NSSI.

Negative cognitions as a moderator in the relationship between PTSD and substance use in a psychiatrically hospitalized adolescent sample.

Adolescents exposed to trauma are more likely to engage in alcohol and marijuana use compared to their nontrauma-exposed counterparts; however, little is known about factors that may moderate these associations. This study examined the potential moderating effect of cognitions relevant to exposure to trauma (i.e., negative view of self, world, and future) in the association between posttraumatic stress disorder (PTSD) diagnosis and substance use among a psychiatric inpatient sample of 188 adolescents. Findings were that PTSD diagnosis was not significantly associated with substance-use diagnoses, but was associated with substance-use symptoms, accounting for 2.9% and 9.6% of the variance in alcohol and marijuana symptoms, respectively. The association between PTSD diagnosis and substance use symptoms, however, was moderated by negative cognitions, with PTSD and high negative cognitions (but not low negative cognitions) being significantly positively associated with substance use symptoms. The relevant cognitions differed for alcohol symptoms and marijuana symptoms. Children and adolescents who experience trauma and PTSD may benefit from early interventions that focus on cognitive processes as one potential moderator in the development of posttrauma substance use.

Perceptions of friendship among youth with distressed friends.

This cross-sectional study examined the relationship between a friend's level of internalizing distress and the focal child's perceptions of friendship amongst 5th, 8th, and 11th grade youth. Participants completed the Youth Self-Report to assess internalizing distress and measures assessing perceptions of friendship quality, social support, and self-disclosure within reciprocal, same-sex friendship dyads. Results indicated that youth with friends experiencing low levels of internalizing distress reported poorer friendship quality and decreased levels of social support and self-disclosure within the friendship compared to youth with friends experiencing average or high internalizing distress. In a second set of analyses controlling for the focal child's own internalizing symptoms, gender, and age, friend's level of internalizing distress remained a significant, unique predictor of target participants' self-disclosure about their own problems within the friendship. The findings suggest that a mild degree of internalizing distress may enhance, rather than harm, friendships amongst youth.

Associations of Mothers' Friendship Quality with Adolescents' Friendship Quality and Emotional Adjustment.

Little research has examined the association of parents' friendships with adolescent's well-being, perhaps because the association was considered too distal. However, developmental theories suggest that contexts in which parents, but not their children, are situated may be related to child development (Bronfenbrenner, 1979; 1986). The current work examined associations between the quality of mothers' own friendships and their adolescent children's friendship quality and emotional adjustment. Fifth-, eighth-, and eleventh-graders (N = 172) whose mothers' friendships were characterized by conflict and antagonism reported having friendships that were high in negative friendship qualities as well as elevated internalizing symptoms. These associations held after controlling for mother-child relationship quality, suggesting that mothers' friendships may have a unique association with adolescents' adjustment.

The impact of social contagion on non-suicidal self-injury: a review of the literature.

In this review, we explore social contagion as an understudied risk factor for non-suicidal self-injury (NSSI) among adolescents and young adults, populations with a high prevalence of NSSI. We review empirical studies reporting data on prevalence and risk factors that, through social contagion, may influence the transmission of NSSI. Findings in this literature are consistent with social modeling/learning of NSSI increasing risk of initial engagement in NSSI among individuals with certain individual and/or psychiatric characteristics. Preliminary research suggests iatrogenic effects of social contagion of NSSI through primary prevention are not likely. Thus, social contagion factors may warrant considerable empirical attention. Intervention efforts may be enhanced, and social contagion reduced, by implementation of psychoeducation and awareness about NSSI in schools, colleges, and treatment programs.