Does parental monitoring moderate the relationship between bullying and adolescent nonsuicidal self-injury and suicidal behavior? A community-based self-report study of adolescents in Germany

Background: Being a victim of bullying in school is clearly linked to various social, emotional, and behavioral problems including self-harm behavior. However, it is not known whether even occasional victimization has similar negative consequences and whether protective factors such as social support may prevent those harmful developments. The present study therefore focuses on the nonsuicidal self-injury (NSSI) and suicidal behavior (SB) in victims of bullying and the potentially moderating effect of parental monitoring. Methods: In all, a cross-sectional sample of 647 adolescents (mean age 12.8 years) were surveyed concerning bullying experiences, NSSI and SB, and parental monitoring. Results: A total of 14.4 % of respondents reported being a victim of frequent bullying in the past few months (with verbal and social bullying playing the most important role), which increased the risks of both NSSI (OR = 11.75) and SB (OR = 6.08). This relationship could also be shown for occasional victims of bullying (35.6 %), although to a lesser extent. Parental monitoring had a significant protective effect on SB in victims of occasional bullying. However, parental monitoring did not show any protective effect in victims of repetitive bullying. Conclusions: Victims of bullying show a substantial risk for engaging in self-harm behavior. Therefore, the dissemination of anti-bullying programs in schools would probably also prevent such disorders. Parental participation in school-based prevention may increase its effect; this also matches the results of the present study, showing that parental monitoring may be able to buffer the negative effects of bullying victimization, at least to a certain degree

Psychosocial functioning in adolescents with non-suicidal self-injury: the roles of childhood maltreatment, borderline personality disorder and depression

Background: There is a lack of studies examining psychosocial functioning in patients with non-suicidal self-injury (NSSI), especially in adolescents, and rates of impaired functioning in existing literature vary considerably. These variations may be attributable to further risk factors that influence psychosocial functioning. Thus, the aim of the study was to examine whether adolescent NSSI patients with childhood maltreatment (CM), a known risk factor for lower psychosocial functioning, may differ from adolescent NSSI patients without CM, and whether these differences may be explained by the severity of comorbid disorders. Specifically, we examined whether severity of borderline personality disorder (BPD), depression and posttraumatic stress disorder may explain differences in psychosocial functioning in NSSI patients with and without CM. Methods: Data of 368 adolescents with NSSI disorder from an outpatient clinic were analyzed using structural equation modeling. Clinicans' rating of the Global Assessment of Functioning Scale (GAF) was collected, in addition to clinical interviews. Results: Results indicate that GAF scores were lower among NSSI patients with CM and that the difference in psychosocial functioning between these groups was explained by BPD and depression severity. Conclusions: Psychosocial functioning in NSSI patients varies depending on whether they have experienced CM or not. Specifically, these differences seem to be attributable to higher BPD and depression severity in adolescent NSSI patients with CM. Clinicians should ensure to assess CM and focus on BPD and depression severity in this population. Treatment of BPD and depression may notably reduce psychosocial impairment in NSSI patients with CM

Effects and moderators of the Olweus bullying prevention program (OBPP) in Germany

Bullying is a common and significant risk factor for mental and physical health problems. The aim of the outlined study was to evaluate the German version of the Olweus Bullying Prevention Program (OBPP) and to investigate potential moderators of its effectiveness. 23 schools started with the implementation and all students were invited to complete the Olweus Bullying Questionnaire annually. For our analyses, the data from grades 5 to 9 were used (t0: n = 5759; t1: n = 5416; t2: n = 4894). 16 out of the 23 schools completed the 18-months implementation period. The effectiveness of the program statistically depended on its complete implementation (χ2(2) = 7.62, p = 0.022). In the group of non-completers, the prevalence of victimization did not change during the observation period of 2 years (χ2(2) = 4.64, p = 0.099). In the group of the completer schools, a significant decrease in bullying between t0 and t1 was found for victims (t0: 9.14%; t1: 6.87%; OR = 0.74; 95% CI 0.62-0.88; p = 0.001) and perpetrators (t0: 6.16%; t1: 4.42%; OR = 0.70; 95% CI 0.55-0.89; p = 0.004). After 24 months (t2), this decrease could be retained (victims: t2: 6.83%; OR = 0.73; 95%CI = 0.61-0.88; p = 0.001; perpetrators: t2: 4.63%; OR = 0.72; 95% CI 0.57-0.92; p = 0.009). Furthermore, we found the following moderators of program effectiveness in the completer schools: (1) gender (with a stronger decrease among victimized girls; p = 0.004) and (2) school grade (with a stronger decrease of victimization among grades 5-7; p = 0.028). The German version of the OBPP significantly reduced the bullying prevalence in the completer schools. Effective prevention needs time and resources: fulfilling the 18-months implementation period was the basis for positive results

Associations between depression and specific childhood experiences of abuse and neglect: a meta-analysis

Background Research documents a strong relationship between childhood maltreatment and depression. However, only few studies have examined the specific effects of various types of childhood abuse/neglect on depression. This meta-analysis estimated the associations between depression and different types of childhood maltreatment (antipathy, neglect, physical abuse, sexual abuse, and psychological abuse) assessed with the same measure, the Childhood Experience of Care and Abuse (CECA) interview. Method A systematic search in scientific databases included use of CECA interview and strict clinical assessment for major depression as criteria. Our meta-analysis utilized Cohen's d and relied on a random-effects model. Results The literature search yielded 12 primary studies (reduced from 44), with a total of 4372 participants and 34 coefficients. Separate meta-analyses for each type of maltreatment revealed that psychological abuse and neglect were most strongly associated with the outcome of depression. Sexual abuse, although significant, was less strongly related. Furthermore, the effects of specific types of childhood maltreatment differed across adult and adolescent samples. Limitations Our strict criteria for selecting the primary studies resulted in a small numbers of available studies. It restricted the analyses for various potential moderators. Conclusion This meta-analysis addressed the differential effects of type of childhood maltreatment on major depression, partially explaining between-study variance. The findings clearly highlight the potential impact of the more “silent” types of childhood maltreatment (other than physical and sexual abuse) on the development of depression

The association of self-injurious behaviour and suicide attempts with recurrent idiopathic pain in adolescents: evidence from a population-based study

Background: While several population-based studies report that pain is independently associated with higher rates of self-destructive behaviour (suicidal ideation, suicide attempts, and self-injurious behaviour) in adults, studies in adolescents are rare and limited to specific chronic pain conditions. The aim of this study was to investigate the link between self-reported idiopathic pain and the prevalence and frequency of self-injury (SI) and suicide attempts in adolescents. Methods: Data from a cross-sectional, school-based sample was derived to assess SI, suicide attempts, recurrent pain symptoms and various areas of emotional and behavioural problems via a self-report booklet including the Youth Self-Report (YSR). Adolescents were assigned to two groups (presence of pain vs. no pain) for analysis. Data from 5,504 students of 116 schools in a region of South Western Germany was available. A series of unadjusted and adjusted multinomial logistic regression models were performed to address the association of pain, SI, and suicide attempts. Results: 929 (16.88%) respondents reported recurrent pain in one of three areas of pain symptoms assessed (general pain, headache, and abdominal pain). Adolescents who reported pain also reported greater psychopathological distress on all sub-scales of the YSR. The presence of pain was significantly associated with an increased risk ratio (RR) for SI (1–3 incidences in the past year: RR: 2.96; >3 incidences: RR: 6.04) and suicide attempts (one attempt: RR: 3.63; multiple attempts: RR: 5.4) in unadjusted analysis. Similarly, increased RR was observed when adjusting for sociodemographic variables. While controlling for psychopathology attenuated this association, it remained significant (RRs: 1.4–1.8). Sub-sequent sensitivity analysis revealed different RR by location and frequency of pain symptoms. Conclusions: Adolescents with recurrent idiopathic pain are more likely to report previous incidents of SI and suicide attempts. This association is likely mediated by the presence of psychopathological distress as consequence of recurrent idiopathic pain. However, the observed variance in dependent variables is only partially explained by emotional and behavioural problems. Clinicians should be aware of these associations and interview adolescents with recurrent symptoms of pain for the presence of self-harm, past suicide attempts and current suicidal thoughts. Future studies addressing the neurobiology underpinnings of an increased likelihood for self-injurious behaviour and suicide attempts in adolescents with recurrent idiopathic pain are necessary

Unterstützung der Organisation des Behandlungsprozesses in der Kinder- und Jugendpsychiatrie - Ist- und Schwachstellenanalyse

Die enorme Ausweitung der medizinischen und technischen Diagnose- und Therapie-möglichkeiten im Gesundheitswesen führt zunehmend zu einer extremen Spezialisierung und Arbeitsteilung der am Behandlungsprozess beteiligten Berufsgruppen. Wie Behandlungsabläufe patientenorientiert und berufsgruppenübergreifend optimiert werden können und wie ein unterstützendes Informationsmanagement hierzu aussehen kann, wird am Beispiel der Kinder- und Jugendpsychiatrie des Universitätsklinikums untersucht. Zunächst wurde ein wissenschaftlich fundiertes methodisches Vorgehen entworfen, das als allgemeines Rahmenkonzept für Reorganisationsprojekte im Krankenhaus verwendet werden kann. Es wurden vier verschiedene Sichtweisen auf den Behand-lungsprozess unterschieden, die zusammen ein Gesamtbild auf die Kooperation im multiprofessionellen Behandlungsteam ergeben: Beteiligte Rollen und ihre Tätigkeitsprofile (Sicht 1), Informationsverarbeitung und informationsverarbeitende Werkzeuge (Sicht 2), arbeitsbezogene Kommunikation zwischen den Mitarbeitern (Sicht 3), organisatorische Abläufe in Form von Geschäftsprozessen (Sicht 4). Betrachtet man bisherige Abläufe und Strukturen unter dem Gesichtspunkt, welche zukünftig bewahrt werden sollten, so ergaben sich u.a. folgende Punkte: - Hoher Entscheidungsspielraum und Arbeitsmotivation der Mitarbeiter. - Versuch, die Tätigkeitsstruktur von Therapeuten, Cotherapeuten, Pflegern und Erziehern soweit wie möglich auf die Bedürfnisse von Patienten und Angehörige auszurichten. - Multidisziplinäre Behandlung. - Viel Zeit für den multidisziplinären Informationsaustausch. Umfangreiche Dokumentation. Aus den Ergebnissen wurden im Hinblick auf die Unterstützung patientenzentrierter Kooperation eine ganzes Reihe von Verbesserungspotentialen ab, welche im Bericht vorgestellt werden, z.B. Einordnung aller Tätigkeiten in den Behandlungsprozess, Optierung des Informationsmanagements, Ausrichtung der Organisationsstruktur am Prozessgedanken

A Biobehavioral Validation of the Taylor Aggression Paradigm in Female Adolescents

This research assessed the behavioral, emotional, endocrinological and autonomic reactivity to the laboratory Taylor Aggression Paradigm (TAP) in a sample of healthy female adolescents. Twenty participants were induced with the TAP to behave aggressively (aggression group) and 20 age-matched participants were not induced to behave aggressively (control group). Regression analysis revealed that the aggression group displayed significant higher levels of aggressive behavior compared to the control group (χ2 (2) = 255.50, p < 0.0001). Aggressive behavior was not related to self-reported measures of trait aggression, impulsiveness or psychopathy features. Regarding the biological responses, regression analysis on cortisol, missed the set level of significance (χ2 (1) = 3.73, p = 0.054), but showed significant effects on heart rate as a function of aggression induction (χ2 (1) = 5.81, p = 0.016). While aggression induction was associated with increased autonomic arousal (heart rate), the interpretation of the effects on cortisol warrant caution, given existing differences between groups at baseline and overly elevated cortisol attributable to the general experimental procedures and not the TAP per se. No differences were found with respect to testosterone. In summary, the present study lends preliminary support for the validity of the TAP and its use in female adolescents on a behavioral and autonomic level

Normierung der Testbatterie COGBAT bei Jugendlichen im Alter von 12 bis 15 Jahren

Das Jugendalter stellt eine wichtige Phase in der Entwicklung der Verarbeitungsgeschwindigkeit, der Aufmerksamkeit, des Gedächtnisses und der exekutiven Funktionen dar. Im Rahmen einer Normierungsstudie der kognitiven Basistestung (COGBAT) für das Jugendalter wurden Testwerte bei n = 269 Jugendlichen im Alter von 12 bis 15 Jahren erhoben und mit den Normen der Altersgruppe der 16- bis 30-Jährigen verglichen. Zusätzlich wurde überprüft, inwiefern sich diese Testergebnisse in der subjektiven Einschätzung zur Leistungsfähigkeit (FLei) und Psychopathologie (SDQ) abbilden lassen. Im Jugendalter zeigte sich ein starker Zuwachs in der kognitiven Flexibilität, der Verarbeitungs- und Reaktionsgeschwindigkeit sowie der Inhibitions- und Planungsfähigkeit. Ein bedeutsamer Geschlechtsunterschied fand sich in der Inhibition, mit stärkeren Leistungen bei Mädchen als bei Jungen. Zwischen den Testergebnissen und den subjektiven Einschätzungen zeigten sich keine Zusammenhänge

Life-time prevalence and psychosocial correlates of adolescent direct self-injurious behavior: A comparative study of findings in 11 European countries

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