Pub Date : 2020-12-21DOI: 10.2174/2210676610666200225105529
Eunice Yuen, Julie Sadhu, Cynthia Pfeffer, Barry Sarvet, R Susan Daily, Jonathan Dowben, Kamilah Jackson, John Schowalter, Theodore Shapiro, Dorothy Stubbe
Purpose: The field of psychiatry has conventionally employed a medical model in which mental health disorders are diagnosed and treated. However, the evidence is amassing that using a strengths-based approach that promotes wellness by engaging the patient's assets and interests may work in synergy with the medical model to promote recovery. This harmonizes with the patient-centered care model that has been promoted by the Institute of Medicine.
Methods: The article uses a clinical case to highlight the attributes of a strength-based model in the psychiatric treatment of adolescents.
Results: Outcome metrics from a number of studies have demonstrated enhanced youth and parent satisfaction and decreased use of hospital level of care with the implementation of strengths-based therapeutic modalities.
Implications: Incorporating strengths-based interventions into conventional psychiatric practice provides a multi-faceted treatment approach that promotes recovery in children and adolescents with psychiatric disorders.
{"title":"Accentuate the Positive: Strengths-Based Therapy for Adolescents.","authors":"Eunice Yuen, Julie Sadhu, Cynthia Pfeffer, Barry Sarvet, R Susan Daily, Jonathan Dowben, Kamilah Jackson, John Schowalter, Theodore Shapiro, Dorothy Stubbe","doi":"10.2174/2210676610666200225105529","DOIUrl":"https://doi.org/10.2174/2210676610666200225105529","url":null,"abstract":"<p><strong>Purpose: </strong>The field of psychiatry has conventionally employed a medical model in which mental health disorders are diagnosed and treated. However, the evidence is amassing that using a strengths-based approach that promotes wellness by engaging the patient's assets and interests may work in synergy with the medical model to promote recovery. This harmonizes with the patient-centered care model that has been promoted by the Institute of Medicine.</p><p><strong>Methods: </strong>The article uses a clinical case to highlight the attributes of a strength-based model in the psychiatric treatment of adolescents.</p><p><strong>Results: </strong>Outcome metrics from a number of studies have demonstrated enhanced youth and parent satisfaction and decreased use of hospital level of care with the implementation of strengths-based therapeutic modalities.</p><p><strong>Implications: </strong>Incorporating strengths-based interventions into conventional psychiatric practice provides a multi-faceted treatment approach that promotes recovery in children and adolescents with psychiatric disorders.</p>","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8046159/pdf/nihms-1666109.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38883925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-08DOI: 10.2174/2210676610999201208214837
Noga Oschry-Bernstein, N. Horesh-Reinman, Adar Avnon, Tomer Mevorach, A. Apter, S. Fennig
The separateness of anxiety disorder and depressive disorder as two distinct disorders is often questioned. The aim of the current study is to examine whether there is a different profile of life events and personality characteristics for anxiety and depression disorders in adolescents. One hundred forty-six adolescents participated in the study, 57 boys and 89 girls, ranging in age from 11-18 years (mean=15.08+1.97). The study group included 92 adolescents with a clinical diagnosis of depression or anxiety, and the comparison group included 54 teenagers with no known psychopathology. Multinomial logistic regression produced different predictive profiles for anxiety disorder and for depressive disorders. Life event variables, especially minor life events and early traumas, were found to be predictors for depression. Furthermore, interaction was found between early trauma and minor life events in the prediction of depression, such that the existence of trauma weakened the statistical correlation between minor life events and the onset of depression. In addition, contrary to the literature regarding adults, it was found that during adolescence personality variables have a unique contribution as predictive factors for vulnerability to the onset of anxiety and depression, thus reducing the significance of life events. Our findings suggest that different profile of life events and personality characteristics can be identified for the two disorders. In addition, it appears that early traumas are a dominant factor that overshadows more recent life events at the onset of depression among adolescents.
{"title":"The Relationship between Life Events and Personality Style to the Development of Depressive and Anxiety Disorders Among Adolescents","authors":"Noga Oschry-Bernstein, N. Horesh-Reinman, Adar Avnon, Tomer Mevorach, A. Apter, S. Fennig","doi":"10.2174/2210676610999201208214837","DOIUrl":"https://doi.org/10.2174/2210676610999201208214837","url":null,"abstract":"\u0000\u0000The separateness of anxiety disorder and depressive disorder as two distinct disorders is often questioned. The aim of the current study is to examine whether there is a different profile of life events and personality characteristics for anxiety and depression disorders in adolescents.\u0000\u0000\u0000\u0000One hundred forty-six adolescents participated in the study, 57 boys and 89 girls, ranging in age from 11-18 years (mean=15.08+1.97). The study group included 92 adolescents with a clinical diagnosis of depression or anxiety, and the comparison group included 54 teenagers with no known psychopathology.\u0000\u0000\u0000\u0000Multinomial logistic regression produced different predictive profiles for anxiety disorder and for depressive disorders. Life event variables, especially minor life events and early traumas, were found to be predictors for depression. Furthermore, interaction was found between early trauma and minor life events in the prediction of depression, such that the existence of trauma weakened the statistical correlation between minor life events and the onset of depression.\u0000In addition, contrary to the literature regarding adults, it was found that during adolescence personality variables have a unique contribution as predictive factors for vulnerability to the onset of anxiety and depression, thus reducing the significance of life events.\u0000\u0000\u0000\u0000Our findings suggest that different profile of life events and personality characteristics can be identified for the two disorders. In addition, it appears that early traumas are a dominant factor that overshadows more recent life events at the onset of depression among adolescents.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2020-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46909866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-02DOI: 10.2174/2210676610666200316100146
M. McDonald, J. Shatkin, Zhuorong Li, Emine Kahraman Sevgi Güngör Meltem E. Durgun, Y. Özsoy, Fatemeh Sheikholeslami-Farahani Ashraf Shahvelayati Zohreh Maryam Ghazvini, Saeid Abad, V. Tsanov, Hristo Tsanov, M. Rai, Rehan Qamar, M. Riaz, Yanqi Shi, Peng Liu, Tianyu Xie, Cheng Zhong
International data indicates that up to 20% of the world’s children and adolescents have at least one mental health disorder. In the United States, nearly 50% of teenagers meet DSM criteria for a psychiatric disorder, and over 25% suffer from a “severe disorder.” Mental health and substance use disorders remain two of the greatest contributors to the global disease burden. Typically, mental health professionals are not trained for prevention; however, over the past 50 years, the field of psychiatry has identified many practices that prevent and limit the severity of psychiatric disorders. In this overview, we first address the great degree of cognitive, emotional, and behavioral suffering that children and adolescents face world-wide. We then describe how a health promotion/disease prevention model differs from typical mental health care. Finally, we describe a series of interventions at the individual, community, and societal levels that can be utilized to prevent and lessen the burden of mental illness. Given our enhanced understanding of the prevalence of mental illness, the degree to which it interferes with healthy functioning, and the enormous global burden it causes, now is the time to engage psychiatrists and psychologists in health promotion and disease prevention. The field of psychiatry should begin to focus on designing and implementing mental health promotion and disease prevention programs, akin to those described here, to combat the onset, development, and progression of mental illness.
{"title":"Preventing Child and Adolescent Mental Illness - We Got This","authors":"M. McDonald, J. Shatkin, Zhuorong Li, Emine Kahraman Sevgi Güngör Meltem E. Durgun, Y. Özsoy, Fatemeh Sheikholeslami-Farahani Ashraf Shahvelayati Zohreh Maryam Ghazvini, Saeid Abad, V. Tsanov, Hristo Tsanov, M. Rai, Rehan Qamar, M. Riaz, Yanqi Shi, Peng Liu, Tianyu Xie, Cheng Zhong","doi":"10.2174/2210676610666200316100146","DOIUrl":"https://doi.org/10.2174/2210676610666200316100146","url":null,"abstract":"\u0000\u0000International data indicates that up to 20% of the world’s children\u0000and adolescents have at least one mental health disorder. In the United States, nearly 50% of\u0000teenagers meet DSM criteria for a psychiatric disorder, and over 25% suffer from a “severe\u0000disorder.” Mental health and substance use disorders remain two of the greatest contributors\u0000to the global disease burden. Typically, mental health professionals are not trained for prevention;\u0000however, over the past 50 years, the field of psychiatry has identified many practices\u0000that prevent and limit the severity of psychiatric disorders.\u0000\u0000\u0000\u0000 In this overview, we first address the great degree of cognitive, emotional, and\u0000behavioral suffering that children and adolescents face world-wide. We then describe how a\u0000health promotion/disease prevention model differs from typical mental health care. Finally,\u0000we describe a series of interventions at the individual, community, and societal levels that\u0000can be utilized to prevent and lessen the burden of mental illness.\u0000\u0000\u0000\u0000 Given our enhanced understanding of the prevalence of mental illness, the degree\u0000to which it interferes with healthy functioning, and the enormous global burden it\u0000causes, now is the time to engage psychiatrists and psychologists in health promotion and\u0000disease prevention. The field of psychiatry should begin to focus on designing and implementing\u0000mental health promotion and disease prevention programs, akin to those described\u0000here, to combat the onset, development, and progression of mental illness.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2020-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47219291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-02DOI: 10.2174/2210676610666200226090427
Caroline S. Clauss-Ehlers
Autobiographical narrative (i.e., the process through writing or storytelling where one recalls life experiences and their impact on identity) has been found to effectively help adolescents cope with a range of medical and psychological issues. The current study addressed the overall preliminary research question: How does implementing an autobiographical narrative approach promote resilience, psychological well- being, and ethnic identity among adolescents? A secondary study aim was to explore how central the memories evoked by each workshop were to participant identity. The study’s third goal was to promote life skill development and self-awareness through participation in the autobiographical narrative intervention. The intervention incorporated a community-based participatory research (CBPR) framework in its partnership with a community centre in Northern England. The intervention consisted of an 8-week autobiographical program with youth participants from working and lower middle-class backgrounds. Socioeconomic status was operationalized by self-report on a demographic data sheet completed by participants. Analyses indicated that participants viewed the events discussed in the 8-week program as being more central to their lives after their participation. Maladaptive coping appeared to decrease after participation in the intervention. Results suggest interventions that incorporate an autobiographical narrative approach within a CBPR framework may promote positive outcomes among adolescents with limited economic resources.
{"title":"Exploration of Psychological Well-Being, Resilience, Ethnic Identity, and Meaningful Events Among a Group of Youth in Northern England: An Autobiographical Narrative Intervention Pilot Study","authors":"Caroline S. Clauss-Ehlers","doi":"10.2174/2210676610666200226090427","DOIUrl":"https://doi.org/10.2174/2210676610666200226090427","url":null,"abstract":"\u0000\u0000Autobiographical narrative (i.e., the process through writing or storytelling\u0000where one recalls life experiences and their impact on identity) has been found to\u0000effectively help adolescents cope with a range of medical and psychological issues.\u0000\u0000\u0000\u0000The current study addressed the overall preliminary research question: How does\u0000implementing an autobiographical narrative approach promote resilience, psychological\u0000well- being, and ethnic identity among adolescents? A secondary study aim was to explore\u0000how central the memories evoked by each workshop were to participant identity. The\u0000study’s third goal was to promote life skill development and self-awareness through participation\u0000in the autobiographical narrative intervention.\u0000\u0000\u0000\u0000The intervention incorporated a community-based participatory research (CBPR)\u0000framework in its partnership with a community centre in Northern England. The intervention\u0000consisted of an 8-week autobiographical program with youth participants from working and\u0000lower middle-class backgrounds. Socioeconomic status was operationalized by self-report on\u0000a demographic data sheet completed by participants.\u0000\u0000\u0000\u0000Analyses indicated that participants viewed the events discussed in the 8-week program\u0000as being more central to their lives after their participation. Maladaptive coping appeared\u0000to decrease after participation in the intervention.\u0000\u0000\u0000\u0000Results suggest interventions that incorporate an autobiographical narrative\u0000approach within a CBPR framework may promote positive outcomes among adolescents\u0000with limited economic resources.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2020-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44005962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-02DOI: 10.2174/2210676610666200324113209
S. A. Garbacz, D. Minch, Phoebe Jordan, Kaitlyn Young, M. Weist
Partnerships with families in education settings should emphasize their roles as active and engaged co-equal partners. However, common practices in schools are to involve families at school-based events and share information with them about their child’s education in a manner that does not promote two-way interactions. The objectives of this paper are to describe relevant background on familyschool connections; approaches to promote academic performance and mental and behavioral health; and a framework to organize family partnerships that support all youth across a continuum of support intensity. A review based on the relevant family-school partnership and systems change literature was conducted. The review focused on prevention, tiered approaches that provide a continuum of support to students, and partnership-centered family engagement. Research supports family-school partnerships in a tiered prevention framework. A theory of change was developed to depict the impact of family partnerships on proximal and distal outcomes. Implications suggest a need for partnership-centered approaches to school reform in state and federal policy to support investments in school and district initiatives. Initiatives should embed culturally sensitive practices so that all children can thrive. Future directions for investigating effective approaches for family partnerships are described.
{"title":"Moving Towards Meaningful and Significant Family Partnerships in Education","authors":"S. A. Garbacz, D. Minch, Phoebe Jordan, Kaitlyn Young, M. Weist","doi":"10.2174/2210676610666200324113209","DOIUrl":"https://doi.org/10.2174/2210676610666200324113209","url":null,"abstract":"\u0000\u0000Partnerships with families in education settings should emphasize\u0000their roles as active and engaged co-equal partners. However, common practices in schools\u0000are to involve families at school-based events and share information with them about their\u0000child’s education in a manner that does not promote two-way interactions.\u0000\u0000\u0000\u0000The objectives of this paper are to describe relevant background on familyschool\u0000connections; approaches to promote academic performance and mental and behavioral\u0000health; and a framework to organize family partnerships that support all youth across a\u0000continuum of support intensity.\u0000\u0000\u0000\u0000A review based on the relevant family-school partnership and systems change literature\u0000was conducted. The review focused on prevention, tiered approaches that provide a\u0000continuum of support to students, and partnership-centered family engagement.\u0000\u0000\u0000\u0000Research supports family-school partnerships in a tiered prevention framework. A\u0000theory of change was developed to depict the impact of family partnerships on proximal and\u0000distal outcomes.\u0000\u0000\u0000\u0000 Implications suggest a need for partnership-centered approaches to school reform\u0000in state and federal policy to support investments in school and district initiatives. Initiatives\u0000should embed culturally sensitive practices so that all children can thrive. Future directions\u0000for investigating effective approaches for family partnerships are described.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2020-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47836447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-31DOI: 10.2174/221067661003201221094120
L. Flaherty
{"title":"Psychotherapy, Suicide and Depression, Body Dysmorphic Disorder, Aggression, an Unusual Case, and the Case for Harm Reduction in Treating Adolescent Substance Abuse","authors":"L. Flaherty","doi":"10.2174/221067661003201221094120","DOIUrl":"https://doi.org/10.2174/221067661003201221094120","url":null,"abstract":"<jats:sec>\u0000<jats:title />\u0000<jats:p />\u0000</jats:sec>","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2020-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41684437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-27DOI: 10.2174/2210676610999200727095605
S. Soelling, D. Koganti, I. Padilla, M. Goodman, P. Prakash, Randi N. Smith
Suicide is the second leading cause of adolescent death and suicide attempts outnumber deaths 50:1 for adolescents 15 to 19 years of age. This study examines differences in outcomes between adolescents and adults treated at an adult trauma center in an effort to guide recovery and prevention strategies following an adolescent suicide attempt. Retrospective review of patients aged ≥14 years treated at an urban, Level 1 trauma center for self-inflicted injuries between 2009 and 2018 was performed. The cohort was divided into adolescents (14-19 years) and adults (≥20 years) and into group A (economically distressed) and group B (non-distressed). Demographics, injury, outcomes, and geospatial analysis were compared. Among 723 patients, 60 (8%) were adolescents of which 92% were male, 55% black, 47% blunt injuries, and 53% penetrating. In adults, 76% were male, 41% black, 28% blunt injuries, and 72% penetrating. Mortality estimates for adolescents and adults were 35% and 24%, respectively (p=0.09). Most adolescent deaths occurred within 3 days after admission, while adult deaths occurred further into hospitalization (p<0.01). Cox regression analysis found higher mortality with self-pay compared to private insurance (HR 2.6; p<0.001), and penetrating vs. blunt/other injuries (HR 2.4; p<0.001). Psychiatric care was administered in 64% of adolescents (n=39) and 84% of adults (p< 0.01). Inpatient psychiatric care for adolescents who attempted suicide was limited at an adult trauma center. The high incidence of suicide attempts and community-level distress in adolescents require immediate attention and resources.
{"title":"Suicide Attempts and Adolescents: The Need for Specialized Resources at Adult Trauma Centers","authors":"S. Soelling, D. Koganti, I. Padilla, M. Goodman, P. Prakash, Randi N. Smith","doi":"10.2174/2210676610999200727095605","DOIUrl":"https://doi.org/10.2174/2210676610999200727095605","url":null,"abstract":"\u0000\u0000Suicide is the second leading cause of adolescent death and suicide\u0000attempts outnumber deaths 50:1 for adolescents 15 to 19 years of age. This study examines\u0000differences in outcomes between adolescents and adults treated at an adult trauma center in\u0000an effort to guide recovery and prevention strategies following an adolescent suicide attempt.\u0000\u0000\u0000\u0000 Retrospective review of patients aged ≥14 years treated at an urban, Level 1\u0000trauma center for self-inflicted injuries between 2009 and 2018 was performed. The cohort\u0000was divided into adolescents (14-19 years) and adults (≥20 years) and into group A (economically\u0000distressed) and group B (non-distressed). Demographics, injury, outcomes, and\u0000geospatial analysis were compared.\u0000\u0000\u0000\u0000Among 723 patients, 60 (8%) were adolescents of which 92% were male, 55%\u0000black, 47% blunt injuries, and 53% penetrating. In adults, 76% were male, 41% black, 28%\u0000blunt injuries, and 72% penetrating. Mortality estimates for adolescents and adults were 35%\u0000and 24%, respectively (p=0.09). Most adolescent deaths occurred within 3 days after admission,\u0000while adult deaths occurred further into hospitalization (p<0.01). Cox regression analysis\u0000found higher mortality with self-pay compared to private insurance (HR 2.6; p<0.001),\u0000and penetrating vs. blunt/other injuries (HR 2.4; p<0.001). Psychiatric care was administered\u0000in 64% of adolescents (n=39) and 84% of adults (p< 0.01).\u0000\u0000\u0000\u0000Inpatient psychiatric care for adolescents who attempted suicide was limited at\u0000an adult trauma center. The high incidence of suicide attempts and community-level distress\u0000in adolescents require immediate attention and resources.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2020-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46438393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-23DOI: 10.2174/2210676610999200623112132
E. Savilahti, M. Rytilä-Manninen, H. Haravuori, M. Marttunen
Family background, social support and psychological characteristics are known to be associated with depression in adolescence, but scientific data in complex, naturalistic settings are scarce. To investigate the characteristics of adolescent psychiatric inpatients with depressive disorders compared to peers without psychiatric disorders and to adolescent psychiatric inpatients without depression. The study population of 206 inpatients (13-17 years old) and 203 age and gendermatched non-referred adolescents was evaluated using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL) interview, and clinical interview and clinical records when available. Structured self-reports provided information on family background, defense styles, self-image and perceived social support. We compared firstly subjects with current depressive disorders (n=120) to subjects without any psychiatric disorder (n=159) and secondly within the inpatient population, those with depressive disorders (n=117) to those with any other psychiatric diagnoses (n=89). Current depressive disorders were characterized by worse self-image, less mature defenses and less perceived social support particularly from the family. Adversities in the family were more prevalent in subjects with depression compared to subjects without any psychiatric diagnosis, while among inpatients, no significant differences were observed. Psychiatric comorbidity was common in all inpatients, whereas suicidality was more prevalent among inpatients with depression. Negative self-image, less mature defense style and low perceived social support particularly from the family were characteristics of depression in adolescents.
{"title":"Adolescent Inpatients with Depression: Comparison to Inpatients without Depression and to Peers without Psychiatric Disorders","authors":"E. Savilahti, M. Rytilä-Manninen, H. Haravuori, M. Marttunen","doi":"10.2174/2210676610999200623112132","DOIUrl":"https://doi.org/10.2174/2210676610999200623112132","url":null,"abstract":"\u0000\u0000Family background, social support and psychological characteristics\u0000are known to be associated with depression in adolescence, but scientific data in complex,\u0000naturalistic settings are scarce.\u0000\u0000\u0000\u0000To investigate the characteristics of adolescent psychiatric inpatients with depressive\u0000disorders compared to peers without psychiatric disorders and to adolescent psychiatric\u0000inpatients without depression.\u0000\u0000\u0000\u0000The study population of 206 inpatients (13-17 years old) and 203 age and gendermatched\u0000non-referred adolescents was evaluated using the Schedule for Affective Disorders\u0000and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL) interview,\u0000and clinical interview and clinical records when available. Structured self-reports\u0000provided information on family background, defense styles, self-image and perceived social\u0000support. We compared firstly subjects with current depressive disorders (n=120) to subjects\u0000without any psychiatric disorder (n=159) and secondly within the inpatient population, those\u0000with depressive disorders (n=117) to those with any other psychiatric diagnoses (n=89).\u0000\u0000\u0000\u0000Current depressive disorders were characterized by worse self-image, less mature\u0000defenses and less perceived social support particularly from the family. Adversities in the\u0000family were more prevalent in subjects with depression compared to subjects without any\u0000psychiatric diagnosis, while among inpatients, no significant differences were observed.\u0000Psychiatric comorbidity was common in all inpatients, whereas suicidality was more prevalent\u0000among inpatients with depression.\u0000\u0000\u0000\u0000 Negative self-image, less mature defense style and low perceived social support\u0000particularly from the family were characteristics of depression in adolescents.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2020-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42125126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-23DOI: 10.2174/2210676610999200623114116
Marta Ruiz Cairó, S. Urben, Morgane Terren, Hélène De Rocquigny, Swen Courosse, Cecilia Bisio, Vivien Caspani, C. Legoux, Géraldine Petraglia, Boris Guignet, K. Plessen, L. Holzer
Examining the effectiveness and adequacy of adolescents’ psychiatric inpatient treatment through multiple perspectives is crucial to provide the best care. The aims of the current study were to examine the consistencies and discrepancies between patients and clinicians and to understand how each group considered the timing of improvement of symptoms and psychosocial difficulties of adolescents during a psychiatric inpatient stay. The Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA, assessing symptoms and psychosocial difficulties) was rated on a weekly basis by patients and clinicians during a psychiatric inpatient stay. Data were collected from 297 patients, 58.2% females. Both clinicians and patients reported a significant decrease of the HoNOSCA scores from admission to discharge, revealing that inpatient treatment is perceived as helping the adolescents to alleviate their symptoms and psychosocial difficulties. However, the item-by-item analyses indicated that patients and clinicians reported difficulties in different symptoms and psychosocial domains. Moreover, the week-by-week analyses revealed discrepancies in the perception of the time-course of clinical outcome- changes between clinicians and patients, as well as between males and females, and between voluntarily and involuntarily admitted patients. By integrating perspectives of patients and clinicians and their respective timelines, as well as by taking into account the mode of admission and the patient’s gender, this study provides a deeper understanding of the evolution of clinical outcome during adolescents’ hospitalizations, which allows to adapt their treatment and therewith, to help patients more efficiently.
{"title":"Evolution of Clinical Outcome During Adolescents’ Psychiatric Inpatient Care: A Prospective Multiple Informant Study","authors":"Marta Ruiz Cairó, S. Urben, Morgane Terren, Hélène De Rocquigny, Swen Courosse, Cecilia Bisio, Vivien Caspani, C. Legoux, Géraldine Petraglia, Boris Guignet, K. Plessen, L. Holzer","doi":"10.2174/2210676610999200623114116","DOIUrl":"https://doi.org/10.2174/2210676610999200623114116","url":null,"abstract":"\u0000\u0000Examining the effectiveness and adequacy of adolescents’ psychiatric\u0000inpatient treatment through multiple perspectives is crucial to provide the best care.\u0000\u0000\u0000\u0000The aims of the current study were to examine the consistencies and discrepancies\u0000between patients and clinicians and to understand how each group considered\u0000the timing of improvement of symptoms and psychosocial difficulties of adolescents\u0000during a psychiatric inpatient stay.\u0000\u0000\u0000\u0000The Health of the Nation Outcome Scales for Children and Adolescents\u0000(HoNOSCA, assessing symptoms and psychosocial difficulties) was rated on a weekly\u0000basis by patients and clinicians during a psychiatric inpatient stay. Data were collected\u0000from 297 patients, 58.2% females.\u0000\u0000\u0000\u0000Both clinicians and patients reported a significant decrease of the HoNOSCA\u0000scores from admission to discharge, revealing that inpatient treatment is perceived as\u0000helping the adolescents to alleviate their symptoms and psychosocial difficulties. However,\u0000the item-by-item analyses indicated that patients and clinicians reported difficulties\u0000in different symptoms and psychosocial domains. Moreover, the week-by-week\u0000analyses revealed discrepancies in the perception of the time-course of clinical outcome-\u0000changes between clinicians and patients, as well as between males and females,\u0000and between voluntarily and involuntarily admitted patients.\u0000\u0000\u0000\u0000By integrating perspectives of patients and clinicians and their respective\u0000timelines, as well as by taking into account the mode of admission and the patient’s\u0000gender, this study provides a deeper understanding of the evolution of clinical outcome\u0000during adolescents’ hospitalizations, which allows to adapt their treatment and therewith,\u0000to help patients more efficiently.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2020-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44309808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-23DOI: 10.2174/2210676610999200623114504
Tomos Redmond
The high prevalence of adolescent self-harm within mental health services presents considerable management concerns, exacerbated by a lack of clear evidence regarding therapeutically effective approaches. This shortfall perpetuates traditional risk-averse practice, despite likely inadequacies in mitigating self-harm through failing to address underlying psychological mechanisms. Therapeutic risk, defined as an approach whereby clinicians support individual risk-taking, may be an alternative that yields improved recovery outcomes. However, related research is adult-focused and provides limited detail on its features, practical delivery and impact on recovery. Consequently, the current study explored the experiences of professionals delivering a therapeutic risk ethos, including their conceptualisation of it and its impact on young people. Semi-structured interviews were conducted with seven mental health support workers employed by a residential healthcare provider, which promotes a therapeutic risk approach. The provider supported service users aged 15 - 20 experiencing complex psychopathology who, following inpatient discharge, presented a high risk of self-harm and suicidality. Interview data was thematically analysed. Staff participants provided their understanding of a therapeutic risk approach, suggesting risk is viewed as positive and beneficial to recovery, alongside the promotion of service user freedom and flexible therapeutic risk management. The perceived therapeutic risk incorporates both permission and support, which facilitate the exploration of underlying feelings and alternative actions. Additionally, therapeutic risk promotes positive recovery outcomes due to empowered service users having increased control over their lives. They argued this can reduce psychological distress, encouraging the development of emotional regulation and adaptive coping strategies.
{"title":"Exploring Therapeutic Risk in the Recovery Process of Adolescents at Risk of Self-harm: A Thematic Analysis of Support Staff Perceptions","authors":"Tomos Redmond","doi":"10.2174/2210676610999200623114504","DOIUrl":"https://doi.org/10.2174/2210676610999200623114504","url":null,"abstract":"\u0000\u0000The high prevalence of adolescent self-harm\u0000within mental health services presents considerable management concerns, exacerbated\u0000by a lack of clear evidence regarding therapeutically effective approaches. This shortfall\u0000perpetuates traditional risk-averse practice, despite likely inadequacies in mitigating\u0000self-harm through failing to address underlying psychological mechanisms. Therapeutic\u0000risk, defined as an approach whereby clinicians support individual risk-taking,\u0000may be an alternative that yields improved recovery outcomes. However, related research\u0000is adult-focused and provides limited detail on its features, practical delivery\u0000and impact on recovery. Consequently, the current study explored the experiences of\u0000professionals delivering a therapeutic risk ethos, including their conceptualisation of it\u0000and its impact on young people.\u0000\u0000\u0000\u0000Semi-structured interviews were conducted with seven mental health support\u0000workers employed by a residential healthcare provider, which promotes a therapeutic\u0000risk approach. The provider supported service users aged 15 - 20 experiencing complex\u0000psychopathology who, following inpatient discharge, presented a high risk of self-harm\u0000and suicidality. Interview data was thematically analysed.\u0000\u0000\u0000\u0000Staff participants provided their understanding of a therapeutic\u0000risk approach, suggesting risk is viewed as positive and beneficial to recovery,\u0000alongside the promotion of service user freedom and flexible therapeutic risk management.\u0000The perceived therapeutic risk incorporates both permission and support, which facilitate\u0000the exploration of underlying feelings and alternative actions. Additionally, therapeutic\u0000risk promotes positive recovery outcomes due to empowered service users having\u0000increased control over their lives. They argued this can reduce psychological distress, encouraging\u0000the development of emotional regulation and adaptive coping strategies.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2020-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44127835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号