Direct and indirect aggression and victimization in adolescents - Associations with the development of psychological difficulties.

Background Previous research has established that direct and indirect forms of aggression differ in their association with gender and type of psychological difficulties. One purpose of the present study was to test if the same applies to direct and indirect victimization. A second purpose was to study these associations not only cross-sectionally (as in most previous research) but also longitudinally. A third purpose was to test the hypotheses that there are prospective bidirectional associations not only between victimization and psychological difficulties (which has been shown in previous research), but also between aggression and psychological difficulties, and that direct and indirect forms of aggression and victimization show different associations with different types of psychological difficulties. Methods The participants were a community sample of all students in two grades of regular school in a Swedish municipality who answered questionnaires as part of a two-wave longitudinal study with a one-year interval. The participants were 13-15 years old, and there were longitudinal data on 893 students, which represented 85 % of all students. The cross-sectional associations were primarily tested by semi-partial correlations, and the longitudinal associations by hierarchical multiple regression. Results The results corroborated the meaningfulness of differentiating not only between direct and indirect aggression but also between direct and indirect victimization. Boys reported being more victim to direct aggression, whereas girls reported being more victim to indirect aggression. Direct aggression predicted increased conduct problems in boys, whereas indirect aggression predicted increased conduct problems in girls, and conduct problems reciprocally predicted increased direct and indirect aggression. Indirect victimization showed prospective bidirectional associations with emotional symptoms and conduct problems, suggesting the potential development of vicious cycles of escalating problems in these areas. Conclusions The present results indicate that direct and indirect aggression, as well as direct and indirect victimization, may have different roles in the development of psychological difficulties in young adolescents. Further, the demonstration of prospective bidirectional associations points to a possible mechanism for the development of psychological difficulties, that may be described in terms of dynamical systems theory. This has potential relevance both for the prevention and the treatment of psychopathology

Depressive Symptoms and Deliberate Self-Harm in a Community Sample of Adolescents: A Prospective Study

The associations between depressive symptoms and deliberate self-harm were studied by means of a 2-wave longitudinal design in a community sample of 1052 young adolescents, with longitudinal data for 83.6% of the sample. Evidence was found for a bidirectional relationship in girls, with depressive symptoms being a risk factor for increased self-harm one year later and self-harm a risk factor for increased depressive symptoms. Cluster analysis of profiles of depressive symptoms led to the identification of two clusters with clear depressive profiles (one severe, the other mild/moderate) which were both characterized by an overrepresentation of girls and elevated levels of self-harm. Clusters with more circumscribed problems were also identified; of these, significantly increased levels of self-harm were found in a cluster characterized by negative self-image and in a cluster characterized by dysphoric relations to parents. It is suggested that self-harm serves more to regulate negative self-related feelings than sadness

Programmet Familjeband som anhörigstöd inom psykiatrin

Anhörigprogrammet Familjeband (engelska ”Family Connections”) är ett 12-15 veckors pedagogiskt program för anhöriga till patienter med borderline-personlighetsstörning och andra patienter med svårigheter att reglera sina känslor. Detta program har översatts till svenska och implementerats vid olika behandlingsenheter i landet. Denna studie beskriver en utvärdering av Familjeband såsom programmet genomförts vid fyra olika behandlingsenheter i olika delar av landet, med sammanlagt 45 kursdeltagare. En jämförelse mellan för- och eftermätning visar en signifikant minskning av psykiska symptom och upplevd börda av att ha en anhörig med psykiatrisk problematik, samt en ökad förmåga till acceptans. Jämförelsen visar också signifikanta förändringar i självrapporterade aspekter av familjefungerande: minskad benägenhet till kritiska kommentarer och emotionell överinvolvering i familjemedlemmar, samt ökade upplevelser av närhet och minskade upplevelser av kaos i familjerelationer. Effekterna var likartade vid samtliga behandlingsenheter. Totalt 67% av deltagarna uppvisade ett positivt utfall, i den bemärkelsen att de uppvisade reliabel förbättring på minst ett av sju mått utan att uppvisa reliabel försämring på något av de andra måtten. Två brister med studien är avsaknad av kontrollgrupp och uppföljning en tid efter behandlingens avslutande, vilket innebär begränsningar i de slutsatser som kan dras av resultaten

Emotional tone in young adolescents’ close relationships and its association with deliberate self-harm

Previous research has shown that a less positive emotional tone in adolescents’ relationships to parents, but not in their relationships to peers, predicts more of behaviour problems and substance use. The purpose of the present study was to replicate these findings, and to extend this research to deliberate self-harm. In a first study with a variable-oriented approach, correlations were analysed between emotional tone in close relationships and a number of behaviour problems. The main results showed that deliberate self-harm among girls, as well as conduct problems, hyperactivity, aggressive behaviour,  and the use of alcohol, were more strongly associated with poor emotional relations to their parents than with poor emotional relations to friends. In a second study, a person-oriented approach was used to investigate girls’ profiles of emotional tone in close relationships by means of cluster analysis, and to compare the clusters on measures of deliberate self-harm. The analysis led to the identification of five clusters; of these, deliberate self-harm was most frequent in a cluster of girls who reported poor emotional relations to parents in combination with good emotional relations to friends. Self-harm was also frequent in a cluster of girls characterized by poor emotional relations to both parents and friends. The results are discussed in terms of good emotional relations to friends not necessarily serving as a protective factor against emotional and behavioural problems, and the methodological value of a person-oriented approach as a complement to a traditional variable-oriented approach.Jenny Ulande

Reciprocal prospective associations between disordered eating and other psychological problems in a community sample of Swedish adolescent girls

Disordered eating and its associations with psychological difficulties and body satisfaction were prospectively studied in a community sample of 13-15 year old adolescent girls (N = 428). General psychological difficulties (including hyperactivity-inattention) and lower levels of body satisfaction at T1 were found to predict disordered eating at follow-up one year later (T2). Furthermore, reciprocal associations were found between disordered eating and psychological difficulties (but not body dissatisfaction) so that disordered eating at T1 predicted general psychological difficulties (including hyperactivity-inattention) at T2. The results support the notion of a vicious interplay between disordered eating and other subclinical psychological problems, which may represent a potential mechanism for the development of clinically significant eating disorders. It is suggested that it could be important to identify these kinds of bidirectional processes at an early stage, in order to prevent further developments of clinical forms of psychopathology

Nonsuicidal self-injury in a community sample of adolescents: Subgroups, stability, and associations with psychological difficulties

Patterns of nonsuicidal self-injury (NSSI) and their association with other psychological difficulties were studied in a community sample of young Swedish adolescents, by a 2-wave longitudinal design with a 1-year interval. Hierarchical cluster analysis at T1 identified eight NSSI subgroups in each gender, of which five were clearly replicated at T2. Among these were a subgroup with generalized high-frequent NSSI, which was associated with both internalizing and externalizing problems, and a subgroup of girls who engaged primarily in cutting and showed mainly internalizing problems. Generally, NSSI clusters among girls were more stable over time and associated with more psychological problems. The results indicate that different patterns of NSSI have different developmental and clinical implications