"They don't really get heard": A qualitative study of sibling involvement across two forms of family-based treatment for adolescent anorexia nervosa.

Little is known about the involvement of siblings in family-based treatment (FBT) for anorexia nervosa (AN). To explore the experience of families, adolescents who had completed FBT, their siblings, and parents were interviewed. Siblings reported that involvement in FBT enhanced their understanding of anorexia and that they supported their family in various ways. While siblings often wished they had attended more sessions, there was no consensus among parents and patients regarding sibling attendance and many were concerned about potential negative impacts on siblings. Clinicians should discuss sibling roles and expectations early in FBT and work actively with families to address concerns.

The Application of an Etiological Model of Personality Disorders to Problem Gambling.

Problem gambling is a significant mental health problem that creates a multitude of intrapersonal, interpersonal, and social difficulties. Recent empirical evidence suggests that personality disorders, and in particular borderline personality disorder (BPD), are commonly co-morbid with problem gambling. Despite this finding there has been very little research examining overlapping factors between these two disorders. The aim of this review is to summarise the literature exploring the relationship between problem gambling and personality disorders. The co-morbidity of personality disorders, particularly BPD, is reviewed and the characteristics of problem gamblers with co-morbid personality disorders are explored. An etiological model from the more advanced BPD literature-the biosocial developmental model of BPD-is used to review the similarities between problem gambling and BPD across four domains: early parent-child interactions, emotion regulation, co-morbid psychopathology and negative outcomes. It was concluded that personality disorders, in particular BPD are commonly co-morbid among problem gamblers and the presence of a personality disorder complicates the clinical picture. Furthermore BPD and problem gambling share similarities across the biosocial developmental model of BPD. Therefore clinicians working with problem gamblers should incorporate routine screening for personality disorders and pay careful attention to the therapeutic alliance, client motivations and therapeutic boundaries. Furthermore adjustments to therapy structure, goals and outcomes may be required. Directions for future research include further research into the applicability of the biosocial developmental model of BPD to problem gambling.

Coping style and ecstasy use motives as predictors of current mood symptoms in ecstasy users.

BACKGROUND: Elevated depressive and anxiety symptoms during childhood and adolescence have been associated with greater risk of later ecstasy use. Ecstasy users have reported using ecstasy to reduce depression or worry, or to escape. While these findings suggest that some people use ecstasy as a form of self-medication, limited research has been conducted examining the relationship between affective symptoms, coping styles and drug use motives in ecstasy users. This cross-sectional study aimed to determine if coping style and/or ecstasy use motives are associated with current mood symptoms in ecstasy users. METHODS: A community sample (n=184) of 18-35 year olds who had taken ecstasy at least once in the past 12 months completed self-report measures of depression, anxiety, ecstasy use motives and coping styles. Timeline follow back methods were used to collect information on lifetime ecstasy, recent drug use and life stress. Trauma exposure was measured using the Composite International Diagnostic Interview-Trauma List. RESULTS: Coping motives for ecstasy use and an emotion-focused coping style were significantly associated with current depressive and anxiety symptoms. Emotion-focused coping mediated the relationship between a history of trauma and current anxiety symptoms and moderated the relationship between recent stressful life events and current depressive symptoms. CONCLUSIONS: These findings highlight the importance of interventions targeting motives for ecstasy use, and providing coping skills training for managing stressful life events among people with co-occurring depressive/anxiety symptoms and ecstasy use.

Subacute effects of ecstasy on mood: an exploration of associated risk factors.

Ecstasy use may result in lowered mood, anxiety or aggression in the days following use. Yet, few studies have investigated what factors increase the risk of experiencing such symptoms. Ecstasy users (at least once in the last 12 months) who subsequently took ecstasy (n=35) over the period of one week, were compared on measures of mood, sleep, stress and drug use, with those who abstained from ecstasy (n=21) that week. Measures were administered the week prior to ecstasy use and one and three days following use, or the equivalent day for abstainers. Mood symptoms were assessed using the Kessler-10 self-report psychological distress scale, a subjective mood rating (1-10), and using the depression, anxiety and hostility items from the clinician-rated Brief Psychiatric Rating Scale. Timeline Followback methods were used to collect information on drug use and life stress in the past month. Self-reported sleep quality was also assessed. Ecstasy use was not associated with subacute depressive, anxiety or aggressive symptoms. Rather, lowered mood and increased psychological distress were associated with self-reported hours and quality of sleep obtained during the three-day follow-up. These findings highlight the importance of considering sleep disruption in understanding the short-term mood effects of ecstasy use.

Mindfulness and problem gambling: a review of the literature.

This article reviews the literature with respect to mindfulness and its potential for reducing the severity of problem gambling behaviour. Interest in the role of mindfulness as a treatment for problem gambling has gained the attention of researchers across Australia, the United States, and Canada. However, the literature is limited and current studies have severe methodological limitations. Despite this issue, investigations have revealed that dispositional mindfulness is related to less severe problem gambling outcomes and that psychological distress, overconfidence and risk willingness, myopic focus on reward and ego involvement may act as mediators in this relationship. Moreover, the literature indicates that the inverse relationship between dispositional mindfulness and psychological distress may be mediated by factors such as values clarification; emotional, cognitive, and behavioural flexibility; non-attachment; emotion dysregulation/distress intolerance; thought suppression; and rumination. This article discusses the theoretical and clinical implications of these relationships with respect to mindfulness-based interventions for problem gambling. It is recommended that the approach be considered with cautious optimism.

The effect of ostracism upon mood in youth with borderline personality disorder.

The experience of rejection or abandonment in Borderline Personality Disorder (BPD) can lead to profound changes in affect. Yet, the intensity, duration, and type of mood changes that occur in response to rejection remain unclear. This study examined the effect of ostracism upon mood in 30 outpatient youth diagnosed with BPD and 22 healthy community control participants (aged 15-24). Cyberball, a virtual balltoss game, was used to simulate ostracism and 13 mood states were recorded before, immediately after, and 15 minutes after the game. The results showed that while ostracism induced changes in anger, rejection, surprise, suspicion, and joy, there were no differences in the pattern of emotional responding and regulation between the two groups. The BPD group consistently rated their mood as more intense across all 13 mood states and across time compared with the control group. These findings suggest that, compared to healthy individuals, those youth with BPD experience negative emotions as more intense and that in mild cases of interpersonal rejection, their emotional responding and regulation are similar to their healthy peers.

Impulsivity in borderline personality disorder: reward-based decision-making and its relationship to emotional distress.

Impulsivity in Borderline Personality Disorder (BPD) has been defined as rapid and unplanned action. However, a preference for immediate gratification and discounting of delayed rewards might better account for the impulsive behaviors that appear to regulate emotional distress in BPD. To investigate this, a delay discounting task was administered to 30 outpatients diagnosed with BPD and 28 healthy community controls (all aged 15-24) before and after a mood induction. Trait impulsivity was measured with the Barratt Impulsiveness Scale. The results showed that the BPD group had a greater preference for immediate gratification and higher rate of discounting the delayed reward than the control group. Although the mood induction resulted in increased feelings of rejection and anger in all participants, and the rate of delay discounting changed significantly in the control group, the rate of discounting did not change for the BPD group. There was no evidence of rapid decision-making in the BPD group as response times were similar between the two groups during both trials. Finally, greater general impulsiveness and nonplanning impulsiveness were associated with greater rates of discounting in the BPD group. Together these findings suggest that BPD is characterized by a preference for immediate gratification and tendency to discount longer-term rewards. This characteristic appears to exist independent of feelings of rejection and anger, rather than being reactive to this, and to be related to trait impulsivity.

Depressive and anxiety symptomatology in ecstasy users: the relative contribution of genes, trauma, life stress and drug use.

RATIONALE: Previous research has identified elevated rates of depressive and anxiety symptoms amongst ecstasy users; however, few studies have examined which factors increase the likelihood of experiencing such symptoms. OBJECTIVES: The current study aimed to determine the relationship between ecstasy use and depressive/anxiety symptomatology after controlling for known environmental and genetic (polymorphism of the serotonin transporter gene) risk factors for depression and anxiety disorders. METHODS: Participants consisted of a community sample of 184 18-35-year olds who had taken ecstasy at least once in the past 12 months. Participants completed an interview and questionnaires and provided a saliva sample. Mood symptoms were assessed using the Mood and Anxiety Symptom Questionnaire. Timeline methods were used to collect information on lifetime and recent ecstasy use, as well as recent other drug use and life stress. Trauma exposure was measured using the Composite International Diagnostic Interview--Trauma List. Genomic DNA was extracted from participant saliva samples. RESULTS: Neither lifetime nor recent ecstasy use was associated with the severity of current mood symptoms, either alone or in combination with genetic risk factors. Rather, lifetime trauma, recent stressful life events, the frequency of tobacco use and recent polydrug use significantly predicted the severity of depressive and anxiety symptoms. CONCLUSIONS: These results highlight the need to consider the role of environmental factors when examining the relationship between ecstasy use and mood symptoms. Whether ecstasy exacerbates such symptoms in vulnerable individuals requires further investigation using prospective designs.

An examination of emotion regulation, temperament, and parenting style as potential predictors of adolescent depression risk status: a correlational study.

Given that depression is a debilitating disorder, it is critical that we advance our understanding about the aetiology of this disorder. This study investigated both traditional (temperament and parenting) and novel (emotion regulation strategy) risk factors associated with adolescent depression. Forty-four adolescents (12-16 years; 64% females) with high scores on a self-report depressive symptomatology questionnaire were compared to a similar group of 44 adolescents with low scores, matched for age, gender, and ethnicity. Significant group differences were present on all assessed risk factors. The presence of high depressive symptomatology was found to be associated with (1) low levels of temperamentally based positive mood, flexibility, and approach behaviours, (2) a parenting style characterized by low nurturance and high overprotection, and (3) emotion regulation characterized by higher levels of expressive suppression and lower levels of cognitive reappraisal. It was concluded that, in addition to specific temperament characteristics and parenting style, use of particular emotion regulation strategies is associated with varying levels of depressive symptomatology. These findings reinforce the importance of incorporating emotion regulation into explanatory models of depression symptomatology. Further research that tests the direction of effects for these cross-sectional findings is warranted.

Are mating strategies and mating tactics independent constructs?

This study explored the constructs of mating tactics and mating strategy. These constructs are conceptually related but distinct. In current research, the measurement of one of these constructs is often viewed as being indicative of the other. Therefore, an exploration of these constructs will enhance understanding of study outcomes in this research area. Self-report measures of mating tactics and strategies were administered to 183 female participants, aged 18-45 years. The Escalating Sexual Encounters Questionnaire (ESEQ, Greer & Buss, 1994), the Derogatis' Sexual Experience Scale (Derogatis & Melisaratos, 1979), the Sexual Strategies Measure (SSM, Schmitt, 1996), the Sociosexual Orientation Inventory (Simpson & Gangestad, 1991), and two questions assessing age at menarche and total number of sexual partners were administered. Exploratory factor analysis with oblique rotation produced two distinct factors reflecting a "tactic"-based factor and a "strategy"-based factor. This finding is consistent with viewing mating tactics and mating strategies as distinct and varying independently. An important implication of this study is that measurement of mating tactics is not indicative of underlying mating strategies in women. Further, four patterns of female mating style emerged upon review of participant factor scores and are discussed within an evolutionary context.