Neural Correlates of Emotion Regulation and Adolescent Suicidal Ideation.

BACKGROUND: Research on the neural correlates associated with risk for suicidal ideation (SI) has been limited, particularly in one increasingly at-risk group-adolescents. Previous research with adolescents indicates that poor emotion regulation skills are linked with SI, but these studies have not previously examined neural activation in service of emotion regulation between those with and without SI histories. METHODS: Here we examine whether SI is associated with neural responses during an emotion regulation functional magnetic resonance imaging task in a group of adolescents (N = 49) 13 to 20 years of age (mean = 16.95). RESULTS: While there were no differences between youths with and without SI in self-reported emotional responses to negative pictures, youths with SI activated the dorsolateral prefrontal cortex more than youths without SI on trials in which they attempted to regulate their emotional responses compared with trials in which they passively viewed negative pictures. In contrast, during passive viewing of negative stimuli, youths with SI activated the dorsolateral prefrontal cortex, temporoparietal junction, and cerebellum less than same-age control subjects. CONCLUSIONS: These findings were robust to control subjects for depression and adversity exposure and are consistent with the idea that youths with SI have disrupted emotion regulation, potentially related to differences in recruitment of top-down control regions. In contrast, youths without SI activated regions implicated in emotion regulation even when not directed to effortfully control their emotional response. This is the first study to examine neural function during emotion regulation as a potential neural correlate of risk for SI in adolescents.

A Calming Cushion as a Therapeutic Wellness Tool for Youths with Disabilities and History of Trauma.

Seclusion and restraint are commonly used by residential staff to control unsafe behaviors of youths with disabilities and complex trauma histories. This pilot study examined the effect of a nonrestraining cushion as a calming device and wellness tool in a setting that prohibits supportive physical contact, to see to what extent the cushion might help these youths to better regulate their emotional distress and unwanted behaviors. Volunteers used the cushion for 15 minutes over 24 sessions. Nine students completed the study and reported reduction in anxiety and agitation, and a soothing feeling with residual effects to their daily routines. This pilot study suggests that the use of a nonrestraining, deep-pressure cushion may simulate a secure holding effect for young people with emotional dysregulation. The cushion is a safe and healing wellness tool that empowers youths and provides programs with an alternative to seclusion and restraint.

Child Abuse, Neural Structure, and Adolescent Psychopathology: A Longitudinal Study.

OBJECTIVE: Child abuse exerts a deleterious impact on a broad array of mental health outcomes. However, the neurobiological mechanisms that mediate this association remain poorly characterized. Here, we use a longitudinal design to prospectively identify neural mediators of the association between child abuse and psychiatric disorders in a community sample of adolescents. METHOD: Structural magnetic resonance imaging (MRI) data and assessments of mental health were acquired for 51 adolescents (aged 13-20; M=16.96; SD=1.51), 19 of whom were exposed to physical or sexual abuse. Participants were assessed for abuse exposure (time 1), participated in MRI scanning and a diagnostic structured interview (time 2), and 2 years later were followed-up to assess psychopathology (time 3). We examined associations between child abuse and neural structure, and identified whether abuse-related differences in neural structure prospectively predicted psychiatric symptoms. RESULTS: Abuse was associated with reduced cortical thickness in medial and lateral prefrontal and temporal lobe regions. Thickness of the left and right parahippocampal gyrus predicted antisocial behavior symptoms, and thickness of the middle temporal gyrus predicted symptoms of generalized anxiety disorder. Thickness of the left parahippocampal gyrus mediated the longitudinal association of abuse with antisocial behavior. CONCLUSION: Child abuse is associated with widespread disruptions in cortical structure, and these disruptions are selectively associated with increased vulnerability to internalizing and externalizing psychopathology. Identifying predictive biomarkers of vulnerability following childhood maltreatment may uncover neurodevelopmental mechanisms linking environmental experience with the onset of psychopathology.