Repetitive self-mutilation (RSM) has become increasingly prevalent among adolescents. Empirical research has pinpointed several correlates of this behavior, but the initiation and maintenance of RSM among adolescents are not well understood. The experiential avoidance model (EAM) proposes that self-mutilation is a behavior that allows for the avoidance or alteration of unwanted internal experiences, and that it is negatively reinforced with repetition. The current study explored the usefulness of the EAM as an explanatory theory for adolescent RSM, with the additional incorporation of issues of social context. Adolescents (N = 211) from three school-based samples completed self-report questionnaires. One-third of students reported at least one incident of purposeful, non-suicidal self-mutilation and 16% had engaged in self-mutilation repeatedly within the past 6 months. Both regression and group analyses indicated that adolescents who engage in RSM report greater psychological distress, a greater incidence of functionally equivalent behaviors, and greater exposure to self-mutilation among peers and/or in the media, when compared to their counterparts who have not engaged in RSM. Suicidal ideation/behaviors were consistently the strongest predictors of current self-mutilation behaviors. Clinical implications, limitations, and suggestions for future research are discussed.
The present study sought to build on the large body of past research into written disclosure of traumatic memories. This research has consistently found that participants who write about their traumatic experiences realize long-term physiological and psychological health benefits. More recently, it has been found that those participants who realize the most benefits are those who progressively include more elements of a good narrative, or story, in their writing about a traumatic experience over several sessions. Therefore, research has begun to examine the role of language and the structure of language in the health benefits gained from written disclosure of traumatic memories. A guided written disclosure protocol was designed for the present study, which sought to aid participants in supplying an increasing amount of narrative structure to their written disclosures of a single traumatic experience. Participants (N = 30) completed several measures of psychological and physiological health prior to and one month after completing the guided written disclosure protocol. Analyses revealed that participants who completed all four writing sessions showed statistically significant reductions in symptoms of general psychological distress, obsessive-compulsive symptoms, and intrusive and avoidant symptoms related to the traumatic experience. No significant self-reported physiological health benefits were found. The clinical and research implications of these findings are discussed.
The primary interest of this investigation concerned the self-injurious thoughts and behaviors (SITBs) of inpatient adolescents. Previous researchers have provided descriptive information regarding either automatic (or intrinsic) and social components using the Self-Injurious Thoughts and Behaviors Interview (SITBI). However, the presence and trends of these components have not firmly been established, suggesting the need to explore this area further. Eighty-two adolescent inpatients were selected and interviewed using the SITBI to evaluate the predictive ability of self-reported self-injurious behavior with regard to social and automatic, negative and positive functions. Results showed that depending on the type of thought or behavior displayed one could discern the motivation behind their actions. Automatic-Negative was seen to have the strongest relationship across all SITB behaviors while Automatic-Negative was not found to be relatively low compared to other SITB behaviors. Both Social-Positive and Social-Negative were found to be present in moderate relationships compared to Automatic in general.
The current study examined the relationships among attachment styles to parent, peer, and romantic partner, ability to regulate emotion, as well as engagement in sexual behaviors and substance use. Attachment theory and previous research suggests that an individual learns how to manage emotions through the modeling of appropriate techniques and a stable sense of self-worth. These two aspects develop through a secure attachment bond with an important figure. When an individual does not have a secure attachment bond in which to practice adaptive affect regulation strategies, he/she may attempt to manage emotions through external means, such as sexual behaviors or substance use. Overall, results supported these associations, with some notable exceptions. Across attachment sources a secure attachment style was related to lower levels of psychological distress and less engagement in substance use. In contrast to the findings from earlier studies, affect regulation did not mediate the relationship between attachment and substance use, and engagement in sexual behaviors was not significantly related to either attachment style or affect regulation.
Although the mu rhythm is traditionally defined as a normal EEG variant, recent evidence suggests that mu may have functional significance in a variety of disorders such as autism, Parkinson's disease, and multiple sclerosis. While an increasing number of articles have focused on the blocking mechanism of mu in relation to various cognitive processes and disorders, few have examined the significance of a prominent mu rhythm in the background EEG. A few studies have examined the relationship between the mu rhythm and psychological disturbance, such as attentional and affective disorders. Increasing evidence suggests that EEG and qEEG variables may be useful in classifying psychiatric disorders, presenting a neurophysiological alternative to traditional symptom-based diagnosis and classification. Thus, the intention of the present study was to examine the relationship between neuropsychological variables, gathered from multiple assessment sources, and the presence of a prominent mu rhythm in the EEG. Results did not show a statistically significant difference between individuals with and without a prominent mu rhythm on the Test of Variables of Attention (TOVA); although individuals in the mu group showed a pattern of increased impulsivity and performance decrement over time. For adults, no significant differences were observed between groups on psychological variables measured by the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). However, for children, the mu and control groups differed on several behavioral and emotional variables on the Child Behavior Checklist (CBCL). Results are examined in the context of other research and clinical implications are discussed.
Clinical research suggests that adolescent offenders often do not view their criminal behaviors as problematic and, therefore, are not motivated for treatment. Although customarily defined as a static characteristic, the transtheoretical model (TTM) proposes treatment amenability is dynamic and can be achieved through tailored interventions that motivate individuals for treatment. The current study examines the predictive validity of TTM measures for adolescent offenders at a maximum security correctional facility. In particular, the Stages of Change Scale (SOCS) and Decisional Balance for Adolescent Offenders (DBS-AO) were compared with a more traditional assessment tool utilized in evaluating treatment amenability of juvenile offenders (i.e., Risk-Sophistication-Treatment Inventory; RSTI). One hundred adolescent offenders from the Gainesville State School completed two waves of data collection with a 3-month time interval. Information was collected on offenders' treatment progress between waves. Consistent with TTM research, predictors of treatment progress included low scores on the Cons scale on the DBS-AO and on the Precontemplation scale on the SOCS. Participants in the most advanced levels of treatment also scored high on the Sophistication-Maturity scale on the RSTI and the Impression Management scale on the Paulhus Deception Scale.
The purpose of this study was to test the effectiveness of a cognitive-dissonance based intervention in reducing disordered eating attitudes and behaviors. The intervention program created dissonance through discussion, exercises, and homework aimed at addressing and countering internalized sociocultural pressures, beliefs and values about women's bodies, attractiveness, and worth in the U.S. Seventy-seven female undergraduates were randomly assigned to one of four conditions: cognitive-dissonance, combined cognitive-dissonance, healthy weight placebo control, and wait-list control To determine effectiveness of the intervention, MANCOVA procedures were used, with Time 1 scores serving as the covariate. Overall, the women who received the dissonance based interventions produced the strongest effects among measures assessing sociocultural pressures, internalization, and body dissatisfaction in comparison to the control group, and experienced significant reductions in dieting behaviors and bulimic symptoms over the course of the study, suggesting that the creation of dissonance via the intervention assisted the women in reducing eating disorder risk factors.
Both interpersonal dependency and the importance of the therapeutic alliance to successful psychotherapy outcomes have been widely studied. However, these two areas of study rarely have been viewed conjointly despite the reportedly large number of clients with dependency who present for treatment. This study elucidated the relationship between interpersonal dependency and the therapeutic alliance. Additional hypotheses explored client-therapist agreement on alliance strength in relation to client interpersonal dependency. Participants were graduate student therapists (N = 26) and their individual psychotherapy clients (N = 40) in a training clinic at a large, southwestern university. Within their first three sessions of psychotherapy, participating clients told nine Thematic Apperception Test stories and completed structured self-report measures of adult attachment, social desirability, and psychological symptoms. Interpersonal dependency was scored from the TAT stories, using the TAT Oral Dependency (TOD) scoring system developed by Masling, Rabie, and Blondheim (1967) and Huprich (2008). Three sessions following initial data collection, participating clients and their therapists completed structured self-report measures of the therapeutic alliance. Analyses revealed that interpersonal dependency was not significantly associated with client and therapist alliance ratings or the congruence between client and therapist alliance ratings. However, specific scoring categories of the TOD were associated with client alliance scores in opposing directions. In contrast to hypotheses, self-reported attachment-related dependency was significantly related to client alliance ratings and to the congruence between therapist and client alliance ratings. Clients with higher levels of self-reported attachment-related dependency rated the alliance less favorably, in agreement with their therapists, than did clients with lower levels of attachment-related dependency. Additional analyses were unsuccessful in replicating findings from previous research on interpersonal dependency. The clinical and research implications of these findings are discussed.
Burn injuries are associated with significant mortality and morbidity. Intentional burn injuries are not well understood, and warrant study to improve adjustment and outcomes. The present study examined group differences between intentional and unintentional burn injuries, comparing individuals with self-inflicted (SIB; n=109) and other-inflicted (OIB; n=109) burns to an unintentional burn (UB) group. Compared to UB, those with intentional (SIB, OIB) burn injuries were more likely to be young, female, unmarried, unemployed, abuse substances, and have positive alcohol/drug screens at hospital admission. Individuals with intentional burns report more psychological distress, lower quality of life in some areas, and lower life satisfaction. When SIB and OIB were examined individually, OIB were more likely to be African American compared to SIB and UB. OIB also had more anxiety and paranoia than UB. SIB was more likely than OIB and UB to have had medical problems or psychiatric disorders and treatment prior to the burn injury. Those with SIB were 3 times more likely than UB to die in the hospital even after controlling for age, severity of burn, and inhalation injuries. Moreover, the SIB group had high rates of suicidal ideation at discharge and follow-up. Treatment implications for burn treatment providers were discussed.
Individuals presenting with high levels of psychopathy demonstrate chronic and severe antisocial behavior and poor treatment outcomes in response to generalized rehabilitative programs. Recent research has examined the relationship between delinquency in child/adolescent populations and subsequent psychopathy. Focusing on community based/referred population of at-risk youth, this study developed and examined the effectiveness of an 18-session, psychopathy-focused, group CBT treatment program. The study incorporated treatment (n = 34) and usual-care comparison (n = 30) groups and a brief follow up period. Treatment outcomes examined measures of psychopathy, anger, impulsivity, motivation for treatment, self-reported problems, and indices of behavior. The treatment program demonstrated reductions in psychopathy on the Interpersonal (d = .55) and Affective facets (d = .24) of the PCL:YV. It also reduced overall impulsivity and improved anger suppression and treatment motivation, particularly among youth presenting with higher levels (relative to this study) of psychopathy. As a result of treatment, decreased incidents with the juvenile justice system were also observed, both during the treatment period and at six weeks follow-up. This study provides an initial empirical foundation for the ongoing development of targeted interventions for youth demonstrating psychopathic traits.
Traumatic brain injury (TBI) is the leading cause of death and disability among children and adolescents in the US. Children and adolescents who sustain moderate and severe head injuries are much more likely to evidence significant deficits in neuropsychological functioning when compared with children with mild head injuries. Information about the recovery process and functional sequelae associated with moderate and severe head injuries remains limited, despite clear indications that children who experience such injuries typically exhibit notable deficits in intellectual functioning, particularly during the acute phase of recovery. Thus, the present study was conducted to augment research on intellectual functioning in children with moderate or severe head injuries. To accomplish this, the study first examined the proposed factor model of the WISC-III in children with moderate and severe TBI. Given high prevalence rates and similar trends in cognitive impairment, particularly within the frontal lobe structures (e.g., disrupted cognitive flexibility and divided attention), the study also examined this same factor model for a group of children with attention-deficit/hyperactivity disorder (ADHD) and compared it with the model fit from the TBI group. In the second phase of the study, both the TBI and AHDH groups were evaluated to determine if distinct WISC-III index score cluster profiles could be identified. Lastly, the cluster groups for both the TBI and ADHD samples were validated using important demographic and clinical variables, as well as scores from independent neuropsychological measures of attention, executive functioning, and working memory. Parent reports of psychological and behavioral functioning were also used in an attempt to further distinguish the cluster groups. Study limitations and future research implications were also discussed.
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