Could a brief assessment of negative emotions and self-esteem identify adolescents at current and future risk of self-harm in the community? A prospective cohort analysis

Background: Self-harm is common in adolescents, but it is often unreported and undetected. Available screening tools typically ask directly about self-harm and suicidal ideation. Although in an ideal world, direct enquiry and open discussion around self-harm would be advocated, non-psychiatric professionals in community settings are often reluctant to ask about this directly and disclosure can be met with feeling of intense anxiety. Training non-specialist staff to directly ask about self-harm has limited effects suggesting that alternative approaches are required. This study investigated whether a targeted analysis of negative emotions and self-esteem could identify young adolescents at risk of self-harm in community settings. Methods: Data were collected as part of a clinical trial from young people in school years 8–11 (aged 12–16) at eight UK secondary schools (N = 4503 at baseline, N = 3263 in prospective analysis). The Short Mood and Feelings Questionnaire, Revised Child Anxiety and Depression Scale, Rosenberg Self-Esteem Scale, personal failure (Children’s Automatic Thoughts Scale), and two items on self-harm were completed at baseline, 6 and 12 months. Results: Following a process of Principal Components Analysis, item reduction, and logistic regression analysis, three internally reliable factors were identified from the original measures that were independently associated with current and future self-harm; personal failure (3 items), physical symptoms of depression/anxiety (6 items), positive self-esteem (5 items). The summed score of these 14 items had good accuracy in identifying current self-harm (AUC 0.87 girls, 0.81 boys) and at six months for girls (0.81), and fair accuracy at six months for boys (AUC 0.74) and 12 months for girls (AUC 0.77). Conclusions: A brief and targeted assessment of negative emotions and self-esteem, focusing on factors that are strongly associated with current and future self-harm, could potentially be used to help identify adolescents who are at risk in community settings. Further research should assess the psychometric properties of the items identified and test this approach in more diverse community contexts

Evolution of high βp plasmas with improved stability and confinement

Experiments to explore the long-time evolution of noninductive, high βp plasmas in the DIII-D tokamak [Plasma Physics and Controlled Nuclear Fusion Research, 1986 (International Atomic Energy Agency, Vienna, 1987), Vol. 1, p. 159], have identified a new, quiescent, high performance regime. The experiments were carried out at low current (400-800 kA) with medium power neutral beam injection (3-10 MW). This regime is characterized by high q0 (>2) and moderate li(∼1.3). It is reached by slow relaxation of the current profile, on the resistive time scale. As the profiles relax, q0 rises and li falls. When q0 goes above 2 (approximately), magnetohydrodynamic (MHD) activity disappears, and the stored energy rises. Most dramatic is the strong peaking of the central density, which increases by as much as a factor of 2. The improved central confinement appears similar to the PEP/reversed central shear/second stable core modes seen in tokamak experiments, but in this case without external intervention or transient excitation. At high current, a similar, but slower relaxation is seen. Also notable in connection with these discharges is the behavior of the edge and scrape-off layer (SOL). The edge localized modes (ELM's) as seen previously, are small and very rapid (to 1 kHz). The SOL exhibits high density (≥1 × 1019 m-3), which shows little or no falloff with radius. Also the power deposition at the divertor surface is very broad, up to four times the width usually seen. This regime is of particular interest for the development of steady-state tokamak operating scenarios, for the Tokamak Physics Experiment (TPX), and following reactors. © 1994 American Institute of Physics

Internet-based therapies for child and adolescent emotional and behavioural problems

This chapter discusses the development and evaluation of Internet-delivered cognitive behavior therapy (ICBT) in the treatment of emotional and behavior disorders in children and adolescents. Although most evaluations of ICBT to date have focused on adults, the literature regarding its use with young people is rapidly expanding. Results thus far have been strongly encouraging, with many studies showing positive outcomes in terms of reduction in symptoms associated with a broad range of psychological disorders and in enhancing emotional well-being and psychosocial functioning. However, the research is still in its early stages and it is difficult to draw firm conclusions regarding the effectiveness of ICBT with young people. The wide variation in the way that ICBT is used also makes it hard to identify the most effective formats for treatment delivery, particularly in terms of level of therapist involvement, parent participation, group online interactivity, and type of Internet material. Despite these reservations, the evidence to date provides a strong case for continued research into the development and evaluation of ICBT approaches with young people in order to determine the most effective approaches. What is clear, however, is that young people find ICBT a very appropriate method of intervention. Nevertheless, one of the big challenges is to find methods of enhancing client engagement, motivation, and compliance with the therapy content

Progress towards increased understanding and control of internal transport barriers in DIII-D

Substantial progress has been made towards both understanding and control of internal transport barriers (ITBs) on DIII-D, resulting in the discovery of a new sustained high performance operating mode termed the quiescent double barrier (QDB) regime. The QDB regime combines core transport barriers with a quiescent ELM-free H mode edge (termed QH mode), giving rise to separate (double) core and edge transport barriers. The core and edge barriers are mutually compatible and do not merge, resulting in broad core profiles with an edge pedestal. The QH mode edge is characterized by ELM-free behaviour with continuous multiharmonic MHD activity in the pedestal region and has provided density and radiated power control for longer than 3.5 s (25τE) with divertor pumping. QDB plasmas are long pulse high performance candidates, having maintained a βN H89 product of 7 for five energy confinement times (Ti ≤ 16 keV, βN ≤ 2.9, H89 ≤ 2.4 τE ≤ 150 ms, DD neutron rate Sn ≤ 4 × 1015 s-1). The QDB regime has only been obtained in counter-NBI discharges (injection antiparallel to the plasma current) with divertor pumping. Other results include successful expansion of the ITB radius using (separately) both impurity injection and counter-NBI, and the formation of ITBs in the electron thermal channel using both ECH and strong negative central shear (NCS) at high power. These results are interpreted within a theoretical framework in which turbulence suppression is the key to ITB formation and control, and a decrease in core turbulence is observed in all cases of ITB formation

Higher Fusion Power Gain with Current and Pressure Profile Control in Strongly Shaped DIII-D Tokamak Plasmas.

Fusion power has been increased by a factor of 3 in DIII-D by tailoring the pressure profile to avoid the kink instability in H-mode plasmas. The resulting plasmas are found to have neoclassical ion confinement. This reduction in transport losses in beam-heated plasmas with negative central shear is correlated with a dramatic reduction in density fluctuations. Improved magnetohydrodynamic stability is achieved by controlling the plasma pressure profile width. In deuterium plasmas the highest gain Q (the ratio of fusion power to input power), was 0.0015, corresponding to an equivalent Q of 0.32 in a deuterium-tritium plasma. © 1996 The American Physical Society

Higher fusion power gain with profile control in DIII-D tokamak plasmas

Strong shaping, favourable for stability and improved energy confinement, together with a significant expansion of the central region of improved confinement in negative central magnetic shear target plasmas, increased the maximum fusion power produced in DIII-D by a factor of 3. Using deuterium plasmas, the highest fusion power gain, the ratio of fusion power to input power, Q, was 0.0015, corresponding to an equivalent Q of 0.32 in a deuterium-tritium plasma, which is similar to values achieved in tokamaks of larger size and magnetic field. A simple transformation relating Q to the stability parameters is presented

Higher fusion power gain with profile control in DIII-D tokamak plasmas

Strong shaping, favourable for stability and improved energy confinement, together with a significant expansion of the central region of improved confinement in negative central magnetic shear target plasmas, increased the maximum fusion power produced in DIII-D by a factor of 3. Using deuterium plasmas, the highest fusion power gain, the ratio of fusion power to input power, Q, was 0.0015, corresponding to an equivalent Q of 0.32 in a deuterium-tritium plasma, which is similar to values achieved in tokamaks of larger size and magnetic field. A simple transformation relating Q to the stability parameters is presented