Bulletin of the Menninger Clinic最新文献

There are complex cultural considerations for understanding, assessing, and treating substance use disorders (SUD) among Black men, from the initiation of substance use through SUD-related outcomes. This narrative review provides insight into some of these factors, including the individual, interpersonal, and community-level risk and protective factors (e.g., family and social roles, religiosity, racism and discrimination, exposure to trauma and adversity) underlying relative risk for substance use and disparities in SUD-related outcomes. This article also highlights the ways that public attitudes and policies related to substance use have contributed to ongoing inequities in SUD treatment access for Black men. Recommendations for clinical research and practice include increasing focus on measurement equivalence, creating pathways for access to community-based and specialty treatment, and providing services that are culturally affirming, relevant, and appropriate. Comprehensive efforts are needed to reduce SUD-related inequities and promote positive well-being among Black men and their communities.

Little is known about effective psychosocial treatments for paranoid personality disorder. This study explores the feasibility of a novel treatment, namely Evolutionary Systems Therapy, in supporting individuals diagnosed with paranoid personality disorder. Seven patients attended 10 months of individual therapy without receiving any psychopharmacological treatment. The primary outcome was the feasibility of the intervention, while the secondary outcomes were remission from the diagnosis and reliable changes in personality pathology and paranoid ideation. All recruited patients completed the intervention and did not report any adverse events. Six out of seven patients experienced remission from the diagnosis of paranoid personality disorder. All participants showed reliable changes in personality pathology and paranoid ideation, which were maintained at the 1-month follow-up. Further research is needed to confirm these encouraging results.

The Youth Risk Behavior Survey (YRBS) Data Summary & Trends Report for 2011-2021 released in February 2023 showed higher rates among female high school students relative to their male peers in endorsements of experiencing poor mental health. This review provides a developmental orientation to promote a biopsychosocial conceptualization of these recent national findings. Young women have higher rates of depressed mood, suicidal ideation, and suicidal plans relative to men, and this gender discrepancy is widening. Higher rates of endorsed school and electronic bullying, social media use, substance use, sexual victimization, and school safety concerns among young women are considered in relation to their sex-specific impact. Recommendations for clinicians are offered to improve the awareness of these important factors and to guide tailored interventions.

Eating disorders (EDs) have been traditionally viewed as a disorder affecting cisgender, heterosexual women. Yet, the prevalence of EDs among queer and trans (QnT) individuals, coupled with the lack of interventions that attend to contextual factors related to sexual orientation and gender identity, underscore a critical health disparity issue requiring urgent attention. Here, we first review factors pertaining to QnT individuals' minoritized sexual and gender identities that are important to consider in ED conceptualization for this population (e.g., minority stressors, identity-based body image standards). Next, we describe problematic assumptions present in existing ED assessment and propose more inclusive approaches. Lastly, we provide suggestions for practices that providers can implement within their treatment of EDs among QnT individuals.

Treatment assignment for patients with personality disorders (PDs) involves a complex process consisting of diagnostic assessment and deciding on the most appropriate psychotherapeutic treatment. This article describes the development of a checklist for systematic analysis of life stories to support reflective and transparent assignment of patients to either dialectical behavioral therapy (DBT) or schema-focused therapy (SFT). In a first study, an email survey, focus group, and member check were conducted among eight clinical experts to identify relevant dimensions in life stories in patients with PDs. In a second study, a checklist based on these dimensions was developed in three rounds of testing with nine clinical experts and nine psychology students. Checklist results were compared to actual assigned treatment for 20 patients. Systematic evaluation of life stories, is promising in supporting the allocation of patients with PDs to a suitable treatment approach by focusing on specific and consensual dimensions in patients' life stories.

Excessive parental psychological control may disrupt individuals' psychosocial development, thus influencing later psychological problems. The present study tests a retrospectively worded Parental Control and Disrespect Scale (PCDS) to examine factor structure and model fit as well as associations with individuation-related difficulties and negative affect. Study measures were completed by 482 adults at a single time-point. Confirmatory factor analysis suggested acceptable model fit of the retrospectively worded PCDS. PCDS scores were significantly associated with dysfunctional individuation, depressive symptoms, and generalized shame and guilt, remaining significant after controlling for age, gender, and neuroticism. Moderation analysis indicated certain associations as stronger among female participants, such that dysfunctional individuation was lower at decreased levels of parental control among women, while generalized guilt was higher at increased parental control among women. Findings support the retrospective use of the PCDS, indicating links between parental psychological control, individuation-related difficulties, and negative affect problems.

Knowledge of the long-term consequences of child sexual abuse (CSA) is crucial to further develop preventive strategies and treatment programs. The aim of this study is to investigate attachment and mentalizing ability in people who have experienced CSA. Attachment style, measured with the Experiences in Close Relationships-Relationship Structures Questionnaire (ECR-RS), and mentalization, measured with the Reflective Functioning Questionnaire (RFQ), were examined through a quantitative questionnaire survey in a sample of 49 individuals who had experienced CSA, and a control group of 612 with no history of CSA. The CSA group was, to a greater extent, identified with insecure attachment style. In addition, participants with insecure attachment were more likely to use hypomentalizing compared to individuals identified with a secure attachment. No significant association was found between attachment style and the relationship between the victim and the offender or the length of traumatic episodes.

Despite established associations between discrimination and mental health, little research has focused on gender expression discrimination and integrated individual strengths such as transgender and gender-expansive (TGE) identity pride. This study examined the roles of gender expression discrimination and pride in mental health among TGE adults across gender identity, race, and class. A national sample of TGE adults (N = 212) completed online measures assessing gender identity, race, income, gender expression-related discrimination, TGE identity pride, and depression and anxiety symptoms. Gender expression discrimination was positively associated with depressive and anxiety symptoms. Black, Indigenous, People of Color (BIPOC), higher income, transfeminine participants reported more gender expression discrimination. High TGE identity pride buffered the association between gender expression discrimination and depression-most robustly for BIPOC, lower income, transfeminine participants. TGE identity pride may buffer the effects of gender expression discrimination on depression. Intersectionality in case formulation and treatment planning with TGE individuals is vital.

The term "phubbing" is a combination of the words "phone" and "snubbing" and is explained as preferring the virtual environment to real communication by engaging with a smartphone during social interaction. Our study included 191 children aged 3-6 attending preschool education. The parents of the children were contacted via an online survey to provide information about their sociodemographic, general phubbing, digital game addiction tendencies, and social skills scale scores. The results showed a positive correlation between parental phubbing level and children's digital game addiction tendencies. Furthermore, the regression analysis revealed that parental phubbing was an increasing factor in children's tendency toward digital game addiction and a decreasing factor in children's social skill levels. In addition, we found that children's social skills may play a mediating role in the relationship between parental phubbing level and digital game addiction tendencies. Understanding the effects of parents' phubbing behaviors on children can help raise awareness and take measures to improve parent-child relationships.