Embodiment and Psychological Health in Adolescence: 1. Development and Validation of a Brief 12-item Questionnaireto Measure the Experience of Embodiment.

Our objective was to characterize adolescent health and psychosocial issues in patients with childhood-onset systemic lupus erythematosus (cSLE) and evaluate demographic and disease characteristics associated with adolescent health. We retrospectively examined adolescents aged 12 to 18 years with cSLE seen at the Hospital for Sick Children meeting the American College of Rheumatology/Systemic Lupus International Collaborating Clinics classification criteria, assessed by adolescent medicine in the cSLE clinic between 2018 and 2020. Adolescent health issues were characterized using the Home, Education/Employment, Activities, Diet/Drugs, Sexuality, Suicide/mood (HEADDSS) framework. Issues were classified as presenting and/or identified; adolescent health burden was tabulated as the number of distinct adolescent issues per patient. Multiple Poisson regression models examined associations between patient and disease characteristics (age, sex, material deprivation, disease activity, disease damage, and high-dose glucocorticoid exposure) and adolescent health issues. A total of 108 (60%) of 181 adolescents with cSLE were seen by adolescent medicine, with a median of 2 (interquartile range [IQR] 1-3) visits and a median of 2 (IQR 1-5) adolescent health issues during the study period. Common issues were mood (presenting in 21% vs identified in 50%), sleep (27% vs 2%), school and education (26% vs 1%), and nonadherence (23% vs 8%). Psychoeducation was provided by adolescent medicine to 54% of patients. High-dose glucocorticoids (risk ratio [RR] 1.82, 95% confidence interval [CI] 1.41-2.35, P < 0.001), material deprivation (RR 1.17, 95% CI 1.04-1.30, P = 0.007), and lower SLE Disease Activity Index scores (RR 0.95, 95% CI 0.92-0.98, P = 0.004) were associated with higher adolescent health burden. Adolescents with cSLE experience many adolescent issues, especially low mood. High-dose glucocorticoids and social marginalization are associated with greater adolescent health burden. This study highlights the importance of addressing adolescent health needs as part of routine care.

To assess general practitioners' (GPs') perceptions of barriers in the health care system that hinder provision of effective adolescent health care; and to assess the training needs of GPs for a future education program in adolescent health issues. Retrospective questionnaire survey. A 66-item questionnaire was mailed during May and June 1995 to a random stratified sample of 997 rural and urban Victorian GPs. A Practice Assessment Task enabling respondents to fulfil Royal Australian College of General Practitioners' quality assurance requirements was mailed on return of completed questionnaires if requested. The response rate was 72.4%. After adjusting for stratified sampling, 77% (95% confidence interval [CI], 73%-81%) of respondents favoured individual Medicare cards for adolescents from the age of 16. Thirty-eight per cent (95% CI, 34%-43%) were less willing to charge for longer consultations because they feared Health Insurance Commission (HIC) investigation. Most respondents indicated that their undergraduate training in adolescent mental health issues was inadequate and 64% (95% CI, 61%-68%) found it difficult to obtain advice about complex mental health problems. An interest in continuing medical education in adolescent health issues was expressed by 82% (95% CI, 79%-86%) of respondents. Individual Medicare cards should be automatically issued to adolescents from the age of 16 to improve their ability to access health care. Revision of the Medicare rebate system and clarification of HIC's investigative functions may improve GP's effectiveness in adolescent consultations. Undergraduate medical and GP training should include curriculum relevant to adolescent health care.

Background Non-suicidal self-injury (NSSI) is particularly common among trans young people. NSSI is most commonly used as an emotion regulation strategy, which may explain the high prevalence of the behavior among trans young people, who often experience unique stressors. In the current study we test an application of the Pantheoretical Framework of Dehumanization, in which transphobic experiences, body surveillance, body dissatisfaction, and gender dysphoria are all theorized to predict NSSI. Method 923 trans people aged 14–25 (M age = 20.17, 83.7% lifetime history of NSSI) completed an online survey including measures of NSSI history and frequency, transphobic experiences, body surveillance, body dissatisfaction, and gender dysphoria. Results All four predictor variables were positively associated with NSSI. Greater gender dysphoria and body surveillance were both associated with having a history of NSSI, while greater transphobic experiences and body dissatisfaction were both associated with more frequent NSSI. In addition, both transphobic experiences and body surveillance were associated with greater body dissatisfaction and gender dysphoria, and there was a positive relationship between body dissatisfaction and gender dysphoria themselves. We also found a number of significant indirect effects. Both transphobic experiences and body surveillance were associated with NSSI history through gender dysphoria, and with NSSI frequency through body dissatisfaction. Body dissatisfaction also mediated the relationship between body surveillance and gender dysphoria. Conclusion The results of this study provide support for our application of the Pantheoretical Framework of Dehumanization and present novel findings regarding the role of gender dysphoria in NSSI among trans young people.

Context and perspectives in adolescent health psychology.- A biopsychosocial perspective on adolescent health and disease.- Issues of diversity in adolescent health psychology: exploring sociocultural influences on adolescent health.- Socioeconomic influences on health and health behavior in adolescents.- Public health approaches to adolescent health beyond disease and illness.- Epidemiology of adolescent health.- Disease prevention in adolescence.- Determinants of health-related behaviors in adolescence.- Psychosocial stress, emotion regulation, and resilience in adolescents.- Mental literacy, mental health, and adolescents.- Advances in measurements and utilization of health-related quality of life instruments.- The Effects of physical activity on the physical and psychological health of adolescents.- Adolescent sexual assault: prevalence, risk associates, outcomes, and intervention.- Intimate partner violence in adolescent romantic relationships.- Continuity of behavior and parenting from childhood through adolescence.- School performance.- Brain development and health implications in adolescents.- Puberty: its role in adolescent maturation.- Adolescent sexuality and sexual behavior.- Intervention effectiveness research in adolescent health psychology: Methodological issues and strategies.- Training issues in adolescent health.- Reforming the behavioral health delivery system for adolescents: why is it needed and what is psychology's role?.- Confidentiality and care of the adolescent patient.- Treatment adherence in adolescents.- Smoking in adolescents.- Adolescent substance abuse.- Attention deficit/hyperactivity disorder in adolescence.- Social and biological changes during adolescence that precipitate the onset of antisocial behavior.- Personality disorders in adolescence.- Deliberate self-harm in adolescents.- Eating disorders in adolescents.- Anxiety in adolescents.- Depression and suicide-related behavior in adolescence.- Adolescents with intellectual disabilities.- Pregnancy in adolescents.- Sexually transmitted infections (STIs) and the developing adolescent: influences of and strategies to reduce STI acquisition.- HIV among adolescents in the United States.- Obesity in adolescents.- Cardiovascular complaints in adolescence: clinical considerations.- Asthma in adolescents.- Endocrine disorders in adolescents.- Musculoskeletal injuries in adolescents: a sports medicine model.- Headaches in adolescents.- Chronic pain in adolescents: physiological and psychological bases for pain.

Extensive evidence from Western societies supports the role for body dissatisfaction in the etiological models of non-suicidal self-injury (NSSI). However, research of the underlying mechanisms of this relationship has been limited, especially in China. Therefore, the aim of this study was to examine the association between body dissatisfaction and NSSI among college students in China. Possible mediating roles for psychological distress and disordered eating, as well as a moderating role for self-compassion, were also examined. College students (n = 655, Mage = 20.32years, SD = 1.02) were recruited from Henan province, China. Each participant completed questionnaires regarding body dissatisfaction, psychological distress, disordered eating, and self-compassion. A close to medium positive relationship between body dissatisfaction and NSSI was revealed with r = 0.24 (p < .001). The relationship was found to be fully mediated by psychological distress and disordered eating. The mediation role for disordered eating was found to be further moderated by self-compassion, suggesting that self-compassion acted as a buffer against the relationship between disordered eating and NSSI. These findings indicate that body dissatisfaction, psychological distress, disordered eating, and self-compassion mayplay important roles in Chinese young adults' NSSI. Researchers and practitioners need to pay closer attention to the underlying mechanisms of how body dissatisfaction links to NSSI to deepen the understanding of their linkage as well as to provide appropriate interventions. Level V, cross-sectional descriptive study.

Purpose Translate the Western Ontario Rotator Cuff (WORC) Index into Traditional Chinese (WORC-TC), validate its psychometric properties, and adapt it to rotator cuff tears (RCTs) in patients who only understand Traditional Chinese. Methods Translation and psychometric validation were performed. A total of 210 patients completed the WORC-TC, Quick Disability of the Arm, Shoulder, and Hand (QuickDASH), 12-item Short-Form Health Survey (SF-12), Numerical Pain Rating Scale (NPRS), and State Anger Scale (SAS) questionnaires. Construct validity and internal consistency were evaluated. Test–retest reliability analyses were conducted on a 30-patient sub-sample. Results The translation and linguistic validation process modified one item. Exploratory factor analysis identified a four-factor structure explaining 66.132% variance. The WORC-TC demonstrated convergent validity with QuickDASH (r = 0.834, p < 0.001), NPRS (r = 0.754, p < 0.001), and SF-12 (r = −0.702, p < 0.001), and divergent validity with the SAS (r = 0.286, p < 0.001). Known-group validity was confirmed, with significant differences between high- and low-pain groups (p < 0.001). The WORC-TC showed satisfactory internal consistency (Cronbach’s alpha: 0.94) and good test–retest reliability (intraclass correlation coefficient: 0.79). Conclusion The WORC-TC can reliably evaluate quality of life in patients with RCTs who exclusively use Traditional Chinese.

PurposeRisk factors of negative affect, body dissatisfaction, distress tolerance, and negative urgency are independently associated with bulimia symptoms and non-suicidal self-injury (NSSI). However, relationships of these risk factors within comorbid presentations are not fully understood. The current study examined specific roles of these risk factors within this relationship.MethodsAn at-risk community sample of young adults (N = 429) completed an online survey of negative affect, body dissatisfaction, distress tolerance, negative urgency, bulimia symptoms, and NSSI.ResultsA hypothesized path model was a good fit to the data. Results indicated direct paths from body dissatisfaction, negative urgency, and distress tolerance to bulimia symptoms. Negative urgency, distress tolerance, and bulimia symptoms were directly associated with NSSI. Consistent with hypotheses, distress tolerance and negative urgency acted as vulnerability factors, increasing the strength of associations between bulimia symptoms and NSSI. Distress tolerance also strengthened associations between negative urgency and NSSI. In addition to the direct effect, negative urgency was indirectly associated with NSSI via body dissatisfaction bulimia. Hypothesized indirect effects through distress tolerance were not supported.ConclusionsResults support etiological models of bulimia and NSSI, and suggest deficits in emotion regulation strengthen risk of comorbid presentations. Furthermore, individuals with greater impulsivity and difficulty tolerating distress are at increased risk of engaging in both bulimia behaviors and NSSI, providing targets for clinical intervention.Level of evidenceLevel V, cross-sectional descriptive study.

BACKGROUND:Eating disorders (EDs) are associated with a risk of premature death, as well as suicidal and self-injurious behavior. A low or high body mass index (BMI) and weight control behavior can also have an impact on self-injurious and suicidal behavior. While some studies show that interpersonal sensitivity is a risk factor for EDs, affective disorders, and self-injurious behavior, in-depth studies of these issues have not been done.AIM:The present study investigates how self-injurious and suicidal behavior relate to weight control behavior, BMI, and interpersonal sensitivity in adolescent girls from a clinical population with diagnosed EDs compared with adolescent girls from the general population.METHODS:The main group was comprised of 31 girls with a diagnosis of ED (as the main diagnosis or co-occurring with affective disorders, M=151.13 years), being treated in in the Eating Disorder Clinic of the Scientific and Practical Center for Mental Health of Children and Adolescents named after G.E. Sukhareva. The comparison group consisted of 27 adolescent girls recruited from Proton Educational Center (M=15.511.09 years). The measures included a qualitative survey that yielded data on weight control behavior, and self-injurious behavior, a Blitz questionnaire probing the suicide risk (used only in the main group), and the Interpersonal Sensitivity Measure. Height and weight data were also recorded for BMI calculation.RESULTS:The qualitative analysis of weight control behavior yielded the following results: purging behavior, restrictive behavior, and corrective behavior. Participants in the main group used purging and restrictive behavior more often, whereas participants in the comparison group used strategies associated with a healthy lifestyle. The main group and participants who practiced purging and restrictive weight control in the overall sample had the smallest BMI. Self-injurious behavior was approximately evenly distributed both amongst the main and comparison groups. Self-cutting was the most prevalent type of self-injury. In the main group, self-injury was associated with a smaller BMI, while in the comparison group it was associated with an increase in the fear of rejection and overall interpersonal sensitivity. Based on the assessment of the suicide risk, six participants in the main group were deemed high-risk; they also displayed increased fear of rejection, dependence on the assessments of others, and overall interpersonal sensitivity. All girls in the suicide risk subgroup had non-suicidal self-injuries.CONCLUSION:The results of our study broaden our understanding of the risk factors of suicidal and self-injurious behavior in adolescent girls with EDs and reveal the characteristics of the type of weight control behavior used by this group in comparison with adolescent girls in the general population. Girls with EDs who were considered at the risk of committing suicide demonstrated high interpersonal sensitivity, which provides a rationale for further studying the general interpersonal mechanisms that underlie the pathogenesis of EDs, as well as that of self-injurious and suicidal behavior.

Purpose: Sexual minority men (SMM) have been shown to be at high risk of nonsuicidal self-injury (NSSI). Internalized homophobia, body dissatisfaction, and psychological distress have been found to be related to NSSI among SMM, but few studies have focused on the mechanisms underlying these associations. Thus, the current study was conducted to examine the association between internalized homophobia and NSSI, and whether body dissatisfaction and psychological distress mediate this relationship among young SMM in China. Methods: In total, 264 young SMM (mean age, 22.00 ± 2.86 years) in Henan Province, China, participated in the study. A set of questionnaires were used to assess participants' internalized homophobia, body fat dissatisfaction, muscularity dissatisfaction, psychological distress, and NSSI. Correlation and mediation analyses were used to examine the data. Results: Internalized homophobia correlated positively with NSSI (r = 0.24, p < 0.001) among young SMM in China. This relationship was partly mediated by body fat dissatisfaction, muscularity dissatisfaction, and psychological distress. Conclusion: The study findings suggest that internalized homophobia is a risk factor for NSSI among young SMM in China, and that body fat and muscle dissatisfaction and psychological distress underlie the association between internalized homophobia and NSSI. In developing interventions targeting NSSI among SMM, the findings of the current study should be considered to improve intervention outcomes.

Adolescent mental health issues are being increasingly acknowledged, yet the bulk of adolescent psychological issues may be traced back to childhood. This literature review provides a comprehensive analysis of the association between childhood trauma and mental health disorders in adolescents. A systematic search of relevant terms including emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, non-suicidal self-injury, suicide, aggressive behavior, Internet addiction, post-traumatic stress disorder, depression, and cognition was conducted. This review meticulously catalogs and discusses psychological disorders based on their specific classifications, resulting harms, association with childhood trauma, mediating mechanisms, and coping techniques. The findings from numerous pertinent journals and literature highlight a significant correlation between childhood abuse and neglect and various aspects of adolescent behavior, mood, and cognition. By a variety of intermediary systems, this association may be indirectly related. Treatment enables intervention and prevention of adolescent mental health issues. Several articles have demonstrated that childhood trauma has negative consequences on adolescent mental health. Unfortunately, there are research in this sector, and the majority of them is cross-sectional or has restrictions. Therefore, the contribution of this paper is to inspire readers or future researchers to further explore the effects of childhood trauma on adolescent psychology.

Introduction

Nonsuicidal self-injury (NSSI) is a prevalent behavior among young people maintained by complex transdiagnostic processes. This study sought to investigate whether NSSI attentional bias—the preferential allocation of attentional resources to environmental NSSI cues—is one such transdiagnostic process experienced by young adults with histories of NSSI. Participants were 39 young adults who completed a dot probe task designed to measure attentional bias to NSSI cues and negatively-valenced cues. Participants also provided NSSI urge and affect ratings during the task. Paired samples t-tests were conducted to determine if participants exhibited a significant attentional bias to NSSI cues and negatively-valenced cues compared to neutral cues, and to test whether NSSI urge ratings following the dot probe task increased from baseline levels. Participants exhibited a significant attentional bias to NSSI cues presented for 200 ms and a significant attentional bias to negative cues presented for 200 ms. The urge to engage in NSSI was elicited by NSSI cues, but not by negative cues. These findings indicate exposure to NSSI cues elicits both attentional bias and NSSI urge, a unique process that differs from a mere generalized attentional bias to negative affective stimuli known to be exhibited by individuals with other forms of psychopathology, such as anxiety or depressive disorders. These results provide preliminary evidence for possible avenues of intervention as it relates to the role of exposure to NSSI cues in the maintenance of NSSI, including managing cue-elicited urge and tolerating changes in affective states.

Nonsuicidal self-injury (NSSI) has become a major public health issue in adolescents. This cross-sectional case-controlled study aims to assess the impact of identity diffusion, psychopathology, and mentalization on NSSI in adolescence. The study sample consisted of 153 adolescents (76.5% girls; Mage = 15.6 years). The sample included 56 clinical cases of NSSI, 45 psychiatric cases without NSSI, and 52 healthy controls, all recruited in Ankara, Türkiye, from June 1, 2022, to August 31, 2022. Mentalization was assessed by "The Movie for the Assessment of Social Cognition" (MASC) which categorizes mentalizing as "correct mentalizing" "hypermentalizing" "undermentalizing" and "no-mentalizing". All participants filled in the Self-Injurious Behavior Screening Questionnaire, Assessment of Identity Development in Adolescence (AIDA), and Youth Self Report (YSR), and Inventory of Statements About Self-injury (ISAS). The NSSI group showed lower mentalizing capacity than the healthy control group (p = .011), and more no-mentalizing errors than the other two groups (p = .014). Identity diffusion scores were higher in the NSSI group than in the other two groups (p < .001). Multivariate logistic regression analysis showed that the presence of maternal psychiatric disorder (p = .019, OR = 5.21), identity diffusion (p = .007, OR = 1.02), no mentalizing (p = .049, OR = 1.28), and total psychopathology symptoms (p = .009, OR = 1.12) had a significant impact on NSSI. Current findings suggest that transdiagnostic approaches, including mentalization and identity diffusion, may contribute to a more comprehensive understanding of NSSI and to the development of clinical interventions.

OBJECTIVES Our first aim was to examine baseline differences in body dissatisfaction, depression, and anxiety symptoms by gender, age, and Tanner (ie, pubertal) stage. Our second aim was to test for changes in youth symptoms over the first year of receiving gender-affirming hormone therapy. Our third aim was to examine potential differences in change over time by demographic and treatment characteristics. Youth experiences of suicidal ideation, suicide attempt, and nonsuicidal self-injury (NSSI) are also reported. METHODS Participants (n = 148; ages 9–18 years; mean age 14.9 years) were receiving gender-affirming hormone therapy at a multidisciplinary program in Dallas, Texas (n = 25 puberty suppression only; n = 123 feminizing or masculinizing hormone therapy). Participants completed surveys assessing body dissatisfaction (Body Image Scale), depression (Quick Inventory of Depressive Symptoms), and anxiety (Screen for Child Anxiety Related Emotional Disorders) at initial presentation to the clinic and at follow-up. Clinicians completed the Quick Inventory of Depressive Symptoms and collected information on youth experiences of suicidal ideation, suicide attempt, and NSSI. RESULTS Affirmed males reported greater depression and anxiety at baseline, but these differences were small (P &amp;lt; .01). Youth reported large improvements in body dissatisfaction (P &amp;lt; .001), small to moderate improvements in self-report of depressive symptoms (P &amp;lt; .001), and small improvements in total anxiety symptoms (P &amp;lt; .01). No demographic or treatment-related characteristics were associated with change over time. Lifetime and follow-up rates were 81% and 39% for suicidal ideation, 16% and 4% for suicide attempt, and 52% and 18% for NSSI, respectively. CONCLUSIONS Results provide further evidence of the critical role of gender-affirming hormone therapy in reducing body dissatisfaction. Modest initial improvements in mental health were also evident.

Objective Disordered eating behaviors (DEBs) and nonsuicidal self-injury (NSSI) frequently co-occur in university students, yet what underlies this co-occurrence remains unknown. Network analysis was used to identify psychosocial correlates that may link DEBs and NSSI in university students and test whether networks were similar across gender. Participants Four hundred and seventy college women and 473 college men (aged 18–25 years). Methods Participants completed online questionnaires. Networks were estimated for men, women, and a combined sample. Results The networks for men and women were invariant. The most central nodes in the combined network were difficulties in emotion regulation and body dissatisfaction. Interoception and difficulties in emotion regulation were directly associated with past-month NSSI and strongly associated with body dissatisfaction, linking DEBs and NSSI in the network. Conclusions Difficulties in emotion regulation, interoception, and body dissatisfaction may play critical roles in the comorbidity of DEBs and NSSI in university students.