Coparenting Within the Family System: Review of Literature

Family systems theory which postulates that family-level processes affect children’s development over and above any individual subsystem, has changed the emphasis in research on children and families. Previous research of child devel- opment in families focused on associations with individual parent-child relationships or on connections between the marital relationships and child adjustment. In contrast, researchers have recently articulated distinctive family group dynamic, coparenting, which uniquely predicts children’s social and emotional adaptation, over and above the effects of parenting and marital processes. This article reviews the literature on recent coparenting research and studies linking this family relationship to important indicators of children’s development and adjustment. The implications for clinical practice and directions for future research are discussed

CHALLENGES OF ASSESSMENT AND TREATMENT OF ULTRA HIGH RISK FOR PSYCHOSIS IN AN ADOLESCENT

The onset of psychosis is typically preceded by a prodromal phase that is characterised by the emergence of "attenuated" psychotic symptoms. This phase is described as ultra-high risk (UHR) or at-risk mental state (ARMS) of psychosis. Criteria have been established for identifying these young people who are at clinical high risk. People at ultra-high risk (UHR) of psychosis have about 30% chance of developing the illness within two years. This category was introduced with the goal of developing treatments for prevention of psychotic disorders. Recent research suggests that early interventions appear to be effective in delaying and even preventing the onset of psychosis. These treatments include antipsychotic medication, nutritional supplements such as omega-3 fatty acids and psychological treatment. Cognitive behavioral therapy (CBT) has been tested as a potentially effective intervention in this group. Here we describe a case of a male adolescent with UHR psychotic symptoms with focus on challenges of assessing the UHR in adolescents and issues of providing effective age appropriate interventions

CHALLENGES OF ASSESSMENT AND TREATMENT OF ULTRA HIGH RISK FOR PSYCHOSIS IN AN ADOLESCENT

The onset of psychosis is typically preceded by a prodromal phase that is characterised by the emergence of "attenuated" psychotic symptoms. This phase is described as ultra-high risk (UHR) or at-risk mental state (ARMS) of psychosis. Criteria have been established for identifying these young people who are at clinical high risk. People at ultra-high risk (UHR) of psychosis have about 30% chance of developing the illness within two years. This category was introduced with the goal of developing treatments for prevention of psychotic disorders. Recent research suggests that early interventions appear to be effective in delaying and even preventing the onset of psychosis. These treatments include antipsychotic medication, nutritional supplements such as omega-3 fatty acids and psychological treatment. Cognitive behavioral therapy (CBT) has been tested as a potentially effective intervention in this group. Here we describe a case of a male adolescent with UHR psychotic symptoms with focus on challenges of assessing the UHR in adolescents and issues of providing effective age appropriate interventions

Opportunities and Challenges of Qualitative Research in the Field of Mental Health

Kvalitativna istraživanja pokazuju veliki potencijal unutar područja mentalnog zdravlja. Teme u mentalnom zdravlju iznimno su složene i multifaktorske te iziskuju uključenost miješanih metode (mixed methods) koje podrazumijevaju i kvalitativnu i kvantitativnu metodologiju. Specifičnost kvalitativne metodologije leži u mogućnosti uključivanja korisnika usluga u proces razvoja intervencija u području mentalnog zdravlja. Uporabom kvalitativne metodologije osiguravamo da su pitanja koja postavljamo pojedincima pitanja koja su za njih važna. U radu će biti prikazane neke mogućnosti uporabe kvalitativnih istraživanja u području mentalnog zdravlja, poput primjene istraživanja u razvoju i testiranju teorije, razvoju metoda s obzirom na specifičnost istraživanog područja, razvoju i testiranju intervencija i implementiranju intervencija u kliničku praksu. Prikazat ćemo i izazove s kojima se suočavaju kvalitativni istraživači koji se bave područjem mentalnog zdravlja poput pitanja koja se odnose na održavanje granica, razvijanje odnosa, razvijanje prijateljstva, refleksivnost, emocije i napuštanje uloge. Zbog svih prethodno navedenih izazova potrebno je izraditi univerzalne protokole i strategije koje bi osigurale da svi oni koji se bave kvalitativnim istraživanjima u mentalnom zdravlju imaju jednake informacije o mogućim rizicima, dostupnim resursima za pomoć i podršku i smjernicama za pojedine izazovne situacije prigodom provođenja istraživanja.Qualitative research shows great potential within the field of mental health. Mental health topics as such are extremely complex and multifactorial and require the involvement of mixed methods which include qualitative and quantitative methodology. The specificity of the qualitative methodology lies in the ability to include service users in the process of development of interventions in the field of mental health. By using a qualitative methodology, we ensure that the questions we ask the individuals represent important issues for them. In this paper we will present some of the possibilities of using qualitative research in the field of mental health, such as application of research in the development and testing of the theory, development of methods based on the specificity of the research area, development and testing of interventions and implementation of interventions in clinical practice. We will also present the challenges faced by qualitative researchers dealing with mental health issues such as issues related to maintaining boundaries, developing relationships, developing friendship, reflexivity, emotions, and abandoning the role. Due to all the above-mentioned challenges, it is necessary to develop universal protocols and strategies to ensure that all those involved in qualitative mental health research have equal information on possible risks, available help resources and guidance resources, and guidelines for particular challenging situations while conducting the research

Uporaba modernih tehnologija kao rizik za seksualno zlostavljanje i iskorištavanje djece i adolescenata putem interneta

Napredak tehnologije u zadnjih dvadesetak godina nedvojbeno je promijenio način života pa tako i način odrastanja djece i mladih, a uporaba interneta postala je sastavnim dijelom svakodnevnih životnih aktivnosti. Korištenje modernim tehnologijama, osobito u okviru rizičnih online aktivnosti, u ovom će radu biti razmotreno kao rizik u kontekstu odrastanja, a od rizičnih ponašanja razmatrat će se seksting (engl. sexting), odnosno izmjenjivanje seksualnih sadržaja, seksualna prisila i iznuda (engl. sextortion) kao iznuđivanje seksualnih sadržaja te vrbovanje ili mamljenje (engl. grooming) kao zavođenje ili namamljivanje maloljetne osobe. Svi rizici bit će detaljno analizirani u kontekstu seksualnog zlostavljanja i iskorištavanja putem interneta međusobnom povezanošću, razmatranjem posljedica kao i ulogom stručnjaka iz multikulturalne perspektive. Razvoj modernih tehnologija, kao i mogućnosti koje donosi, posebno u pandemiji, predstavljaju plodno tlo za ozbiljne prijetnje mentalnom zdravlju djece i mladih, ali i postavljaju zahtjeve pred sve one koji se bave zaštitom djece i mladih da kreiraju i razvijaju nove sustave zaštite djece

Nonsuicidal Self-Injury and Identity Development in Adolescents

Nesuicidalno samoozljeđivanje (NSSO) je značajan problem mentalnog zdravlja adolescenata. Pretpostavlja se da problemi u formiranju identiteta imaju važnu ulogu u nastanku samoozljeđujućeg ponašanja kod mladih. Ciljevi istraživanja su bili ispitati klinička obilježja u adolescenata s NSSO te istražiti razlike u razvoju identiteta između opće (školske) populacije adolescenata i adolescenata s NSSO. U istraživanju su sudjelovali adolescenti u dobi od 11 do 18 godina oba spola. Kliničku skupinu (n=31) činili su adolescenti prvi puta psihijatrijski hospitalizirani kod kojih je kliničkom procjenom utvrđena prisutnost NSSO unutar 6 mjeseci prije hospitalizacije. Školsku populaciju (n=294) činili su učenici osnovnih i srednjih škola Grada Zagreba. Svi adolescenti su popunjavali upitnik Procjena razvoja identiteta u adolescenciji (AIDA), dok su pacijenti ispunjavali i Inventar namjernog samoozljeđivanja (DSHI). U kliničkoj populaciji adolescenata utvrđena je visoka učestalost i multipli tipovi NSSO. Pacijenti s NSSO su imali značajno više rezultate difuzije identiteta u odnosu na učenike, što upućuje na veće poteškoće u razvoju identiteta kod adolescenata s NSSO. Bolje razumijevanje odnosa između oštećenja u razvoju identiteta i NSSO moglo bi unaprijediti procjenu i liječenje adolescenata s ovim značajnim psihijatrijskim problemom.Nonsuicidal self-injury (NSSI) is a significant mental health problem among adolescents. Problems in identity formation have been hypothesised to play an important role in the emergence of self-harming behaviours among adolescents. The aims of the study were to examine clinical characteristics of hospitalized adolescents with NSSI and differences in identity development between inpatients with NSSI and general (school) adolescent population. The participants were adolescents aged 11 to 18 years of both genders. The clinical sample (n=31) included inpatients hospitalized for the first time at the psychiatric ward in whom NSSI was present 6 months before referral as established by clinical assessment. The school sample (n=294) consisted of elementary and high school students from the city of Zagreb. All adolescents completed the Assessment of Identity Development in Adolescence (AIDA), while inpatients with NSSI also completed the Deliberate Self-Harm Inventory (DSHI). A high frequency and multiple types of NSSI were found in the clinical sample. Inpatient adolescents with NSSI had significantly higher scores on Identity Diffusion than students, which indicates greater difficulties in identity development in hospitalized adolescents with NSSI. A better understanding of the relationship between impairment of identity development and NSSI could improve the assessment and treatment of adolescents with this significant psychiatric problem

Predictors of Adults’ Mental Health During Initial Stage of Covid-19 Pandemic in Croatia

Besides causing serious threats to people’s physical health and lives, pandemics can lead to psychological distress. This study aimed to investigate the relationship between the COVID-19 pandemic and mental health among adults in Croatia and its association with sociodemographic factors, perceptions of pandemic, locus of control, coping with stress and perceived social support. A cross-sectional, observational study was conducted using a snowball sampling technique. The online survey collected information on sociodemographics, chronic health conditions, self-isolation measure, perception of COVID-19, mental health status, locus of control, coping with stress and perception of social support. Mental health status was assessed by the Depression, Anxiety and Stress Scale (DASS-21). A total of 1482 participants (252 males and 1230 females) completed the study. The mean age of the participants was 33.3 ± 12.2 years, 43 % of the participants had elevated levels of anxiety and 18 % suffered from severe and extremely severe anxiety, 33 % had elevated levels of depression and 12 % suffered from severe and extremely severe depression, and 55 % had elevated levels of stress with 13 % suffering from severe and extremely severe stress. The strongest predictors of mental health symptoms were coping with stress, locus of control, and perceived social support. These results highlight the necessity of implementing psychological interventions during the pandemic to improve the mental health of the adults and vulnerable groups in particular that should include identified factors associated with better mental health status such as coping with stress focused on problem, social diversion and social support

Nonsuicidal Self-Injury and Identity Development in Adolescents

Nesuicidalno samoozljeđivanje (NSSO) je značajan problem mentalnog zdravlja adolescenata. Pretpostavlja se da problemi u formiranju identiteta imaju važnu ulogu u nastanku samoozljeđujućeg ponašanja kod mladih. Ciljevi istraživanja su bili ispitati klinička obilježja u adolescenata s NSSO te istražiti razlike u razvoju identiteta između opće (školske) populacije adolescenata i adolescenata s NSSO. U istraživanju su sudjelovali adolescenti u dobi od 11 do 18 godina oba spola. Kliničku skupinu (n=31) činili su adolescenti prvi puta psihijatrijski hospitalizirani kod kojih je kliničkom procjenom utvrđena prisutnost NSSO unutar 6 mjeseci prije hospitalizacije. Školsku populaciju (n=294) činili su učenici osnovnih i srednjih škola Grada Zagreba. Svi adolescenti su popunjavali upitnik Procjena razvoja identiteta u adolescenciji (AIDA), dok su pacijenti ispunjavali i Inventar namjernog samoozljeđivanja (DSHI). U kliničkoj populaciji adolescenata utvrđena je visoka učestalost i multipli tipovi NSSO. Pacijenti s NSSO su imali značajno više rezultate difuzije identiteta u odnosu na učenike, što upućuje na veće poteškoće u razvoju identiteta kod adolescenata s NSSO. Bolje razumijevanje odnosa između oštećenja u razvoju identiteta i NSSO moglo bi unaprijediti procjenu i liječenje adolescenata s ovim značajnim psihijatrijskim problemom.Nonsuicidal self-injury (NSSI) is a significant mental health problem among adolescents. Problems in identity formation have been hypothesised to play an important role in the emergence of self-harming behaviours among adolescents. The aims of the study were to examine clinical characteristics of hospitalized adolescents with NSSI and differences in identity development between inpatients with NSSI and general (school) adolescent population. The participants were adolescents aged 11 to 18 years of both genders. The clinical sample (n=31) included inpatients hospitalized for the first time at the psychiatric ward in whom NSSI was present 6 months before referral as established by clinical assessment. The school sample (n=294) consisted of elementary and high school students from the city of Zagreb. All adolescents completed the Assessment of Identity Development in Adolescence (AIDA), while inpatients with NSSI also completed the Deliberate Self-Harm Inventory (DSHI). A high frequency and multiple types of NSSI were found in the clinical sample. Inpatient adolescents with NSSI had significantly higher scores on Identity Diffusion than students, which indicates greater difficulties in identity development in hospitalized adolescents with NSSI. A better understanding of the relationship between impairment of identity development and NSSI could improve the assessment and treatment of adolescents with this significant psychiatric problem

Nonsuicidal Self-Injury and Identity Development in Adolescents

Nesuicidalno samoozljeđivanje (NSSO) je značajan problem mentalnog zdravlja adolescenata. Pretpostavlja se da problemi u formiranju identiteta imaju važnu ulogu u nastanku samoozljeđujućeg ponašanja kod mladih. Ciljevi istraživanja su bili ispitati klinička obilježja u adolescenata s NSSO te istražiti razlike u razvoju identiteta između opće (školske) populacije adolescenata i adolescenata s NSSO. U istraživanju su sudjelovali adolescenti u dobi od 11 do 18 godina oba spola. Kliničku skupinu (n=31) činili su adolescenti prvi puta psihijatrijski hospitalizirani kod kojih je kliničkom procjenom utvrđena prisutnost NSSO unutar 6 mjeseci prije hospitalizacije. Školsku populaciju (n=294) činili su učenici osnovnih i srednjih škola Grada Zagreba. Svi adolescenti su popunjavali upitnik Procjena razvoja identiteta u adolescenciji (AIDA), dok su pacijenti ispunjavali i Inventar namjernog samoozljeđivanja (DSHI). U kliničkoj populaciji adolescenata utvrđena je visoka učestalost i multipli tipovi NSSO. Pacijenti s NSSO su imali značajno više rezultate difuzije identiteta u odnosu na učenike, što upućuje na veće poteškoće u razvoju identiteta kod adolescenata s NSSO. Bolje razumijevanje odnosa između oštećenja u razvoju identiteta i NSSO moglo bi unaprijediti procjenu i liječenje adolescenata s ovim značajnim psihijatrijskim problemom.Nonsuicidal self-injury (NSSI) is a significant mental health problem among adolescents. Problems in identity formation have been hypothesised to play an important role in the emergence of self-harming behaviours among adolescents. The aims of the study were to examine clinical characteristics of hospitalized adolescents with NSSI and differences in identity development between inpatients with NSSI and general (school) adolescent population. The participants were adolescents aged 11 to 18 years of both genders. The clinical sample (n=31) included inpatients hospitalized for the first time at the psychiatric ward in whom NSSI was present 6 months before referral as established by clinical assessment. The school sample (n=294) consisted of elementary and high school students from the city of Zagreb. All adolescents completed the Assessment of Identity Development in Adolescence (AIDA), while inpatients with NSSI also completed the Deliberate Self-Harm Inventory (DSHI). A high frequency and multiple types of NSSI were found in the clinical sample. Inpatient adolescents with NSSI had significantly higher scores on Identity Diffusion than students, which indicates greater difficulties in identity development in hospitalized adolescents with NSSI. A better understanding of the relationship between impairment of identity development and NSSI could improve the assessment and treatment of adolescents with this significant psychiatric problem