Bullying victimization and psychosis : the inter-dependence and independence of risk trajectories

In the last several years a number of studies have noted an association between bullying and psychotic symptoms. Our aim here is to offer an overview on the topic, focusing especially on a developmental perspective. First, we highlight the latest studies to date regarding psychosis across the continuum and its relationship with bullying. In the second section, we summarize the three main explanatory models investigated: developmental, biological and cognitive models. In the discussion section we affirm that the sharing of numerous risk factors put people at risk of both psychosis and of being bullied, and bullying itself may further enhance the development of psychosis. Moreover, bullying is a risk factor for several mental disorders and is non-specific for psychosis, but there is some particularity in the trajectory involved between victimization and the onset of psychosis. In conclusion we recommend that the study of bullying in psychosis requires careful study of the developmental trajectories involved and research should now focus on how personal, social and biological factors interact between them

Attempting to disentangle the relationship between impulsivity and longitudinal self-harm:Epidemiological analysis of United Kingdom household survey data

Background: Impulsivity may be an important risk factor in terms of future self-harm. However, the extent of this, whether it may relate to self-harm that is new in onset and/or repetition of self-harm, and the detail of any interaction with mood instability (MI) and childhood sexual abuse (CSA) requires detailed examination. Aims: We used the 2000 Adult Psychiatry Morbidity Survey and an 18-month follow-up data to test hypotheses relating to the role of impulsivity, CSA and MI in the inception and persistence of self-harm. Methods: We assessed associations of impulsivity with (1) suicidal self-harm (SSH) and (2) non-SSH (NSSH) at baseline and follow-up, controlling for confounders including MI. Finally, we tested whether impulsivity mediated the relationship between CSA and self-harm. Results: A total of 8,580 respondents were assessed at baseline and 2,406 at follow-up as planned. Impulsivity significantly predicted emergence of new NSSH at 18-month follow-up even after adjustment for MI and other confounders. Impulsivity did not significantly predict repetition of NSSH, or repetition or new inception of SSH, even before inclusion of MI in the model. However, the absolute numbers involved were small. Cross-sectionally, impulsivity was a stronger mediator of the link between CSA and SSH (13.1%) than that between CSA and NSSH (4.8%). Conclusion: Impulsivity may increase the risk of future development of NSSH independently of MI, which is clinically important for risk assessment. The involvement of impulsivity in the repetition of self-harm generally appears less certain. However, impulsivity may have a role in SSH in the context of previous CSA

Continuity between Stressful Experiences and Delusion Content in Adolescents with Psychotic Disorders – A Pilot Study

Background: Delusions are usually considered core symptoms of schizophrenia, but they are in fact associated with a wide range of psychiatric disorders. The content of a delusion is often related to stressful life experiences that preceded the delusion. Objective: The aim of this study is to detect whether there is a link—specifically, a thematic link—between past experiences and delusion content that connects the two events via thematic analogy. Method: The sample population evaluated for this study consisted of 16 consecutive patients with delusions between the ages of 9.9 and 16.5 years. All patients were experiencing their first psychotic episodes and were not taking any medications. Data were obtained from transcribed clinical sessions. Results: The data suggested the presence of a thematic link between previous experiences and the contents of delusions for 15 patients (93%). Humiliating events, including bullying, are more likely to be linked to persecutory delusions (p = .004). Conclusions: If a thematic link between past experiences and delusion content does exist, this may provide a means of greater psychotherapeutic understanding

Psychotic-like experiences in help-seeking adolescents:Dimensional exploration and association with different forms of bullying victimization – A developmental social psychiatry perspective

Background: Psychotic-like experiences (PLEs) are common in the general population and increase the risk of psychotic disorders. Adolescents are a high-risk group of this condition. Stressful events, such as bullying, have a role in the onset of PLEs. This study has several aims: (1) to assess PLEs in adolescents seeking help from a Child and Adolescent Mental Health Service, (2) to assess the association of PLEs with specific bullying victimization and (3) to assess difference in PLEs and victimizations by sex and age. Methods: Participants were help-seeking (HS) adolescents initially screened for PLEs. They completed an assessment including characteristics of PLEs and bullying victimization. We paid particular attention to different kinds of PLEs and victimization. Results: In total, 50 PLE-positive adolescents screened from 324 HS adolescents (15.4%) constituted the sample. Paranoia and verbal bullying were the PLEs and form of victimization most represented, respectively. Verbal bullying was strongly associated with paranoia (odds ratio (OR): 4.40, confidence interval (CI): 2.8â\u88\u925.9, p <.001). Results remained significant after controlling for confounder (socio-demographic, anxiety, depression and for the latter analysis also other forms of victimization). Furthermore, social manipulation showed a strong association of paranoia and physical bullying with grandiosity. Verbal bullying was also associated with psychotic negative symptoms, but controlling for emotional symptoms and other victimization led to a reduction in the effect. Men were more involved in physical victimization and experienced grandiosity; on the contrary, late adolescents were most involved in social victimization and negative psychotic symptoms Conclusion: PLEs are relevant in HS adolescents. Bullying victimization interacts with the onset of these phenomena. In particular, verbal bullying predicted paranoia onset significantly

Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes

Background: Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage 653 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage 653 CKD in a large cohort of patients affected by T1DM. Methods: A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage 653 CKD (eGFR &lt; 60 mL/min/1.73 m2) or eGFR reduction &gt; 30% from baseline was evaluated. Results: The mean estimated GFR was 98 \ub1 17 mL/min/1.73m2 and the proportion of patients with albuminuria was 15.3% (n = 654) at baseline. About 8% (n = 337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR &lt; 90 ml/min/m2 were independent risk factors for stage 653 CKD and renal function worsening. When compared to patients with eGFR &gt; 90 ml/min/1.73m2 and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60 mL/min/1.73 m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline. Conclusions: Albuminuria and eGFR reduction represent independent risk factors for incident stage 653 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening

Psychosocial interventions in feeding and eating disorders: the experience of arts on prescription and museum visits

This review summarizes the principal aspects of psychosocial interventions in mental health problems and in detail in Feeding and Eating Disorders. Feeding and Eating Disorders represent a major public health problem and therefore it is necessary to maximize therapeutic and preventive efforts. Social prescribing, a mechanism for linking patients in primary care with non-medical sources of support within the community social factors, may represent a good strategy to cope with social factors involved in the onset and the maintenance of the disorder in order to ensure long-term effectiveness. Arts on prescribing and Museum on prescribing defined as the use of artistic activities or museum visits for therapeutic purposes seem particularly suitable interventions in patients with Feeding and Eating Disorders.L’articolo qui presentato intende fare una rassegna dei principali aspetti connessi agli interventi psicosociali nell’ambito della salute mentale, nello specifico in merito ai Disturbi Alimentari. Questi ultimi sono diventati un problema di salute pubblica e dunque si prospetta la necessità di massimizzare gli interventi preventivi e terapeutici a riguardo. La prescrizione sociale, meccanismo che permette di collegare i pazienti delle cure primarie con fonti di supporto non mediche, quali interventi in ambito sociale e comunitario, può rappresentare una buona strategia per far fronte ai fattori sociali coinvolti nell'insorgenza e nel mantenimento del disturbo al fine di garantire una lunga durata dell’efficacia dell’intervento. In particolare vengono qui descritti interventi e prescrizioni quali fruizione di attività artistiche o visite museali a fini terapeutici. Questi sembrano essere interventi particolarmente indicati nei pazienti con Disturbi dell'Alimentazione

The Relation of Callous–Unemotional Traits and Bullying in Early Adolescence Is Independent from Sex and Age and Moderated by Conduct Problems

In youths, callous–unemotional (CU) traits and conduct problems (CP) are independently associated with bullying perpetration and these effects are also observed when controlling for sex. Moreover, research indicates that the co-existence of high levels of both CU and CP further increase the risk. Although several studies have examined the relationship between CU traits and traditional bullying, few have also included a measure of cyberbullying and very few of them have focused the early adolescence. The aim of this study was to replicate and extend these findings in a large sample of Italian early adolescents considering both traditional and cyberbullying behaviors. Data were extracted from the Bullying and Youth Mental Health Naples study (BYMHNS) which included 2959 students of 10–15 years of age. CP, CU traits, traditional bullying behaviors, and cyberbullying behaviors were assessed by multi-item self-report scales. As expected, we replicated the significant and specific association between CU traits and traditional bullying, extending the findings to cyberbullying. In addition, in the latter case the effect was moderated by CP. The theoretical and clinical implications of these results were discussed