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Rates of suicidal ideation (SI), attempts, and death by suicide are consistently elevated among persons from sexual and gender minority groups relative to the general population. Experiences of minority stress and thwarted belongingness may contribute to elevated risk, and be most pernicious among persons with multiple marginalized identities.The present study sought to examine the relation between gender identity (cisgender vs. transgender and nonbinary individuals [TNB]) and recent SI among a convenience sample of lesbian, gay, bisexual, questioning, and queer adults.Participants (We tested a mediation model in which TNB identity was indirectly associated with SI via minority stress (Gender identity was indirectly associated with SI through minority stress and elevations in minority stress were associated with more frequent SI. The minority stress and SI association was strongest for participants reporting higher thwarted belongingness. Building and maintaining strong social support networks may be especially important for persons with intersecting gender and sexual minority identities who face minority stress.HIGHLIGHTSTNB gender identity was indirectly associated with SI via minority stressThwarted belongingness moderated the relation between minority stress and SIThe minority stress SI relation was strongest at higher thwarted belongingness.

Background. Suicide capability (fearlessness about death [FAD], preparation, and perceived capability [PC]) is presumed to be static, or to increase with exposure to provocative events. However, tests of this assumption have primarily used non-clinical samples. We examined short-term changes in capability among patients in a partial hospital program. Methods. We enrolled 296 adult patients (186 [62.7%] female; Mage=36.13, SDage=14.75) who completed diagnostic interviews and questionnaires assessing demographics, capability, and suicide ideation (SI) at intake. Capability was re-assessed twice during treatment and again at discharge, and SI was re-assessed at discharge. We used latent growth modeling (LGM) to quantify changes in capability. Results. FAD, preparation, and PC decreased from intake to discharge (ps

Dialectical behavior therapy (DBT) and motivational interviewing (MI) are two widely used and efficacious psychosocial interventions. An immense and growing number of studies examine DBT, MI, or adaptations of these approaches across diverse treatment contexts and across various clinical populations. Because DBT and MI are in high demand, it is probable that trainees and established practitioners will encounter one or both treatments over the course of their careers. Although MI and DBT initially evolved in distinct contexts for different populations, these approaches share a number of common fundamental principles. Each provides distinct and complementary strategies for enhancing clients’ motivation and ability to change. For some, an integrative or sequenced application of MI and DBT may enhance client care. The present article highlights areas of divergence, convergence, and opportunities for integration, and offers practical tips for applying DBT and MI in conjunction.

Pathological identity-related functioning is a core feature of borderline personality disorder (BPD) that is grievously underrepresented in the empirical literature. Burgeoning evidence indicates that identity pathology is multifaceted, influenced by transactions between social and endogenous processes, and associated with a wide variety of maladaptive outcomes. Although historically defined by patterns of instability (e.g. frequent and rapid changes to career goals, religious beliefs, core values, friend groups, etc.), accumulating research indicates that identity pathology also manifests as distress and functional impairment related to excessive rigidity (i.e. unrelenting negative self-evaluations; overidentification with a restricted role or group membership) and/or incongruous behavior (i.e. simultaneously holding discordant beliefs/values/attitudes, actions that are grossly contradictory with values, incoherent sense of self, etc.). Despite the complex nature of this construct, and its centrality to BPD, researchers often assess identity pathology indirectly, inadequately, or fail to measure it entirely. In this article, we briefly describe how identity pathology may fit into etiological models of BPD, highlight emerging themes from recent research, and identify important gaps in our knowledge. We also discuss limitations associated with current assessment practices, recommend alternatives, and articulate a research agenda for the future.

Leading etiological theories implicate the family environment in shaping borderline personality disorder (BPD). Although a substantive literature explores familial aggregation of this condition, most studies focus on parent influence(s) on offspring symptoms without examining youth symptom influence on the parent. The current study investigated reciprocal relations between parent and adolescent BPD symptoms over time. Participants were 498 dyads composed of urban-living girls and their parents enrolled in a longitudinal cohort study (Pittsburgh Girls Study). The authors examined BPD severity scores assessed yearly when youth were ages 15-17 years in a series of cross-lagged panel models. After controlling for autoregressive effects, a measure of parent-child conflict, and an indicator of socioeconomic status, evidence of parental influence on adolescent symptoms did not emerge. However, adolescent BPD symptoms at age 16 predicted greater parent BPD symptoms at age 17 above the influence of depression. Results highlight the importance of considering the influence of youth BPD on parental symptoms.

Little is known about pathogenic affective processes that cut across diverse mental disorders. We examine how dynamic features of positive and negative affect differ or converge across internalizing and externalizing disorders in a diagnostically diverse urban sample using bivariate dynamic structural equation modeling. One-hundred fifty-six young women completed semistructured clinical interviews and a 21-day ecological momentary assessment protocol with seven assessments of affective states per day. Internalizing and externalizing dimensions of psychopathology were modeled using confirmatory factor analysis of mental disorders. After controlling for externalizing disorders, internalizing disorders were associated with higher negative affective mean intensity, higher negative affective variability (i.e., unique innovation variance), and lower positive affective variability. Conversely, externalizing disorders were associated with less persistent positive affect (i.e., lower inertia) and more variable positive emotionality. Results suggest internalizing and externalizing disorders have distinct affective dynamic signatures, which have implications for development of tailored interventions.

Most evidence-supported treatments for psychiatric problems teach clients skills to incorporate into their daily lives. Yet little research rigorously examines the extent to which individuals absorb these strategies and can competently apply them outside of the therapeutic relationship.The current study examined the degree to which self-injuring adolescents and their mothers (n = 30 dyads) and typical control mother-daughter dyads (n = 30) were able to utilize a multicomponent interpersonal validation-oriented skill from dialectical behavior therapy, after a single teaching. We also aimed to assess whether variance in Gentle, Interested, Validate, and Easy (GIVE) skill practice was associated with a physiological index of emotion regulation (respiratory sinus arrhythmia [RSA]).An observational coding system was developed to measure skill-related behavior across four key domains (be[ing] gentle, act[ing] interested, validation, and us[ing] an easy manner; GIVE) and applied during two family conflict discussions (pre- and postskills training). Mother and adolescent RSA data were collected at rest and across discussion tasks.Behavioral indicators of skill use improved pre-to-post skills training across the entire sample, except in one GIVE domain (easy manner). Self-injuring youth and their mothers demonstrated greater improvements than control dyads with respect to being gentle. RSA reactivity scores predicted behavioral validation, such that higher RSA was associated with higher validation scores.As a field, we currently have a limited understanding of how intervention skills are used, and what factors predict effective skill application. Results suggest self-injuring adolescents and their mothers can learn and improve on most aspects of a core intervention strategy after a single teaching and that better physiological regulation during conflict is associated with more validating behaviors.

Although identity disturbance is a transdiagnostic mental health problem, modern explanatory models for its emergence are limited. To date, the social, developmental, clinical, and neuropsychological literatures exploring identity processes are also largely disconnected. Existing theories have laid the foundation for understanding important components of identity pathology, yet many overlook biological, behavioral, and interactive processes by which these difficulties may emerge. In this integrative review, we explore how broad transdiagnostic vulnerabilities for psychopathology and more specific risky behavioral processes may reciprocally interact and be refined over time into an identity disturbance profile. Our primary purpose is to review behavioral and biosocial theories and derive a testable conceptual framework for how identity disturbance emerges over the course of development. We aim to describe and integrate several disparate lines of theory and research in order to illuminate potential etiological pathways to identity pathology.

Borderline personality disorder (BPD) and antisocial personality disorder (ASPD) are among the most debilitating psychiatric conditions. Behaviors and traits associated with these disorders can have profound influences on those surrounding the affected individual. Accordingly, researchers have begun to examine effects of these symptoms on parent-child relationships. Theoretical and empirical work suggests that one mechanism linking maternal psychopathology to child symptoms is familial transmission of emotion dysregulation. The authors examined children's emotion regulation difficulties as a mediator between maternal BPD/ASPD symptoms and child behavior problems 1 year later. Analyses revealed that a composite of maternal BPD/ASPD symptoms had a direct effect on child internalizing, externalizing, and total symptoms. Associations between maternal BPD/ASPD symptoms and youth problems were partially mediated by child emotion regulation difficulties, even with maternal depression and other relevant covariates included in the models. Thus, maternal BPD/ASPD symptoms and child emotion regulation difficulties represent potential targets for prevention of psychopathology among youth.

Section III of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes an alternative model for diagnosing personality disorders (PDs). This model highlights identity impairment as a potential criterion of all PDs, which has stimulated researchers to characterize identity functioning across PD presentations. Accordingly, the present study examined associations between dimensions of identity functioning and PD symptomatology among 242 Flemish community adults (49.2% female; Mage = 42.76, SD = 14.42). Participants completed the Self-Concept and Identity Measure (Kaufman, Cundiff, & Crowell, 2015) to assess identity functioning and the Assessment of DSM-IV Personality Disorders (Schotte, De Doncker, Vankerckhoven,Vertommen, & Cosyns, 1998) to assess dimensionally measured PDs. A correlational analysis yielded negative associations between the consolidated identity subscale and all PDs, whereas scores on both disturbed identity and lack of identity scales were positively associated with PDs. A multivariate regression analysis indicated that the consolidated identity scale did not account for unique variance in PD dimensions. Disturbed identity and lack of identity scale scores positively predicted variance in all PDs, with the lack of identity scale being the stronger predictor of symptoms of paranoid, schizotypal, and borderline PDs. Study findings generally support identity impairment as a central dimension in PD symptomatology in a Flemish community sample. ispartof: Journal Of Psychopathology And Behavioral Assessment vol:43 issue:1 pages:1-10 status: Published online

OBJECTIVE The current study examined how teaching an interpersonal validation-oriented skill from dialectical behavior therapy affects behavioral and biological indices of self-inflicted injury (SII) risk among self-injuring adolescents and their mothers (n = 30 dyads), and typical control mother-daughter dyads (n = 30). METHOD Behavioral indicators of family functioning (e.g., cohesion, coercion, and invalidation) and a physiological index of emotion dysregulation (respiratory sinus arrhythmia [RSA]) were examined across two conflict tasks (pre- and postskills training). RESULTS Dyads' subjective affect and observed behavior generally improved when practicing validation. Findings indicate mother-, daughter-, and dyad-level behavior accounted for significant variance in RSA reactivity. CONCLUSIONS Results demonstrate that teaching a single skill on one occasion can have detectable effects on biosocial functioning, with important implications for the etiology and treatment of SII.

Borderline personality disorder (BPD) and alcohol use disorder frequently co-occur, yet we know relatively little about risk processes underlying this association. Previous research with nonclinical samples has highlighted how drinking motives may link personality characteristics with heavy alcohol use and problems. The present study substantively extends previous research by examining if drinkers with BPD had higher levels of alcohol use problems compared with drinkers without BPD and similar levels of alcohol use involvement. Multiple domains of impulsivity and affective instability were examined as dimensional markers of risk that may increase alcohol problems for individuals with BPD. Furthermore, multiple domains of drinking motives were examined as potential mediators accounting for the association between BPD and alcohol-related problems. Participants were 81 current drinkers (n = 39 with a current diagnosis of BPD). Results indicated that those with BPD endorsed more alcohol problems compared with non-BPD drinkers, F(1, 77) = 22.26, p < .001. These findings remained after accounting for multiple domains of impulsivity and affective instability. The indirect effects of coping and conformity-related drinking motives partially accounted for the relation between BPD and alcohol problems. Research examining differential response to alcohol for individuals with BPD is needed to directly test if acute alcohol consumption is particularly effective at reducing negative affect for adults with BPD. Offering alternative methods of managing uncomfortable or painful states and/or fitting in with others socially may represent particularly important targets for intervention efforts that decrease these reasons for drinking. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Emotional functioning can be assessed across multiple levels of analysis (e.g., subjective, physiological). The degree of concordance/discordance across such indices may mark psychopathology risk. The current study assessed associations between physiological and subjective indices of emotional responding among drinkers, with (n = 39) and without (n = 42) borderline personality disorder. Subjective changes in affect were assessed by calculating difference scores on the Positive and Negative Affective Schedule, administered before and following a lab-based stress task. Physiological dysregulation was indexed by respiratory sinus arrhythmia (RSA) reactivity. We created Discordance Index scores to examine the direction and magnitude of misalignment. More frequent alcohol use was associated with greater discordance between RSA and positive affect changes (β = -0.07, p-value = 0.009). Findings were confirmed with a response surface modeling analysis. Results highlight that individuals with greater discordance between indices of emotional responding may be at elevated risk for frequent alcohol use.

Identity distress occurs within a variety of psychiatric conditions. Reliable tools for assessing identity-related functioning among clinical populations are greatly needed. The Self- Concept and Identity Measure (SCIM) is a brief self-report scale designed to assess healthy and disturbed identity dimensions. This measure has been validated within normative but not treatment seeking samples. The present study used an a priori confirmatory approach to replicate the SCIM’s factor structure among disadvantaged women enrolled in treatment for chemical dependence (N = 216). The original three-factor structure and item loadings generally replicated within this diagnostically diverse, significantly impaired sample. Higher SCIM scores were also associated with other problems, such as emotion dysregulation and depression. Results support the SCIM’s use and scoring with clinical populations.

Leading theories and an increasingly large body of empirical work each implicate emotion dysregulation as a central contributor to the emergence and maintenance of a range of self-injurious behaviors. In fact, self-inflicted injury (SII) often serves as a maladaptive emotion regulation strategy. In this chapter, we review shared biological and contextual contributors to both conditions, and discuss mutually reinforcing influences on their development. Available evidence indicates that emotion dysregulation and SII are particularly likely to emerge when biologically vulnerable individuals are reared in specific developmental contexts. However, we cannot yet accurately predict which affective patterns mark imminent risk for SII. Although research on links between emotion dysregulation and SII has burgeoned in recent years and associations between these conditions are well established, mediating and moderating pathways require further exploration. We review recent findings, current methodological barriers, and directions for future research.

Emotion dysregulation often emerges early in development and is a core feature of many psychological conditions. The Difficulties in Emotion Regulation Scale (DERS) is a well validated and widely used self-report measure for assessing emotion regulation problems among adolescents and adults. The DERS has six subscales with five to eight items each (36 total), suggesting multiple questions may assess similar underlying constructs. In an effort to reduce respondent burden and streamline this widely-used instrument, we created a short-form version of the DERS (DERS-SF) using confirmatory factor analysis on data from three adolescent (n = 257) and two adult samples (n = 797). Scores on the DERS-SF yielded similar correlation patterns relative to the full measure, ranging from .90 to .98 and reflecting 81–96 % shared variance. This instrument maintains the excellent psychometric properties and retains the total and subscale scores of the original measure with half the items.

Background: This study examined the association between stress-related coping strategies and Internet addiction and the moderating effect of depression in a sample of Taiwanese college students. Method: A total of 500 college students (238 men and 262 women) participated in this study. Internet addiction was assessed using the Chen Internet Addiction Scale. Participants’ stress coping strategies and depressive symptoms were measured using the Coping Orientation to Problems Experienced and the Beck Depression Inventory-II, respectively. We used t and chi-square tests to examine differences in demographic characteristics, depression, and stress coping strategies between participants with and without Internet addiction. Significant variables were used in a logistic regression model to examine the association between stress coping strategies and Internet addiction and the moderating effect of depression on the association. Results: Results indicated that use of restraint coping was negatively associated with Internet addiction (odds ratio [OR] = 0.886, 95% confidence interval [CI]: 0.802–0.977), whereas denial (OR = 1.177, 95% CI: 1.029–1.346) and mental disengagement (OR = 2.673, 95% CI: 1.499–4.767) were positively associated with Internet addiction. Depression had a moderating effect on the association between denial and Internet addiction (OR = 0.701, 95% CI: 0.530–0.927). Conclusions: Stress coping strategies and depression are important factors to evaluate when developing intervention programs targeting college undergraduate students with Internet addiction.

© 2017 Elsevier Ltd Identity formation is a lifelong developmental process. Neo-Eriksonian researchers have primarily focused on normative identity exploration and commitment, while overlooking clinical identity disturbance and disorder. As a result, developmental and clinical conceptualizations of identity are largely disconnected. The Self-Concept and Identity Measure (SCIM; Kaufman, Cundiff, & Crowell, 2015) is a self-report questionnaire assessing identity consolidation, identity disturbance, and lack of identity. This instrument facilitates identifying both developmentally-appropriate and clinical-pathological identity functioning. Using three samples of Flemish individuals (totaling 1087 participants; between 18 and 67 years; 66.33% female), this study examined the factor structure and reliability of a Dutch version of the SCIM. Furthermore, associations with (1) identity dimensions of exploration and commitment, and (2) symptoms of anxiety, depression, and Borderline Personality Disorder (BPD) were investigated by means of self-report questionnaires. We replicated the three-factor structure of the SCIM in each sample. All scales showed adequate internal consistency coefficients. In line with expectations, differential associations of SCIM scales were obtained with identity dimensions and psychopathological outcomes. The present findings underscore the importance of focusing on Eriksonian notions of identity synthesis and confusion, as well as on more severe forms of identity problems, as captured by SCIM's lack of identity scale. ispartof: Personality and Individual Differences vol:123 pages:56-64 status: published

Suicide, self-injury, and predisposing vulnerabilities aggregate in families. Those at greatest risk often show deficits in two biologically-mediated domains: behavioral control and emotion regulation. This pilot study explored electroencephalographic and cardiovascular indices of self-regulation among typical and suicidal adolescents (n = 30/group) and biological family members (mothers, fathers, and siblings). We measured event-related potentials during a flanker task designed to evoke impulsive responding and respiratory sinus arrhythmia (RSA) at rest and during social rejection. Multilevel models indicate control families’ RSA was unaffected by social rejection (slope = 0.136, p = .097, d = 0.09), whereas clinical families demonstrated RSA withdrawal (slope = −0.191, p = .036, d = −0.13). Clinical families displayed weaker positive voltage (Pe) deflections following behavioral errors relative to controls (coefficient = −2.723, p = .017, d = −0.45), indicating risk for compromised cognitive control. Thus, families with suicidal adolescents showed autonomic and central nervous system differences in biological markers associated with suicide risk.

Recent changes to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders highlight the importance of identity dysfunction within several psychiatric diagnoses. Despite a long-standing tradition of identity research and theory in the developmental literature, there is limited work establishing intersections between clinical and developmental conceptualizations of identity problems. The relative lack of integration between decades of clinical and developmental work is unfortunate, and likely limits progress in both areas. In this commentary, the authors argue for greater interdisciplinary collaboration and highlight contributions from developmental and clinical theories, which, if integrated, could enhance identity scholarship. The developmental psychopathology perspective is introduced as an ideal framework to promote these goals.

Depression and social anxiety disorder (SAD) are two of the most common mental health conditions, and often occur together. Depression is usually identified as the presenting problem, which may result in SAD being overshadowed and undertreated among those with this particular comorbidity. In this case study, diagnostic overshadowing results in successful treatment of depression but delayed identification of SAD, causing an attenuated anxiety treatment response. We present recommendations on how clinicians may more thoroughly assess for comorbid Axis I diagnoses, avoid diagnostic overshadowing, and better integrate treatment approaches for SAD–major depressive disorder (MDD) comorbidity. Mechanisms underlying cognitive-behavioral treatments such as behavioral activation and exposure hold particular promise for promoting improvement in SAD and major depression simultaneously.

Biochemistry of Spinal Pain Background Context: Cytokines and neuropeptides are involved in the nervous system response and their role in pain is only beginning to be understood and incorporated into routine care. We present here a review on several cytokines and neuropeptides that might be implicated in spinal pain as well as the future directions of this field of research. Purpose: A review on the biochemistry of spinal pain. Study Design: A literature review. Methods: A literature review of pubmed using studies published in the English language and focusing on studies dealing with the cytokines and/or neuropeptides and pain. We did not restrict the years of publication. All studies were accessed through either the University of Kentucky, Albany Medical College or Emory University's system. Conclusions: Cytokines such as TNF-α, IL-1α, IL-1s, IL-6, IL-4 and IL-10 may play a role in the biochemistry of spinal pain.

Persons addicted to alcohol and drugs are at 5–10 times higher risk for suicide as compared to the general population. To address the need for improved suicide prevention strategies in this population, the Preventing Addiction Related Suicide (PARS) module was developed. Pilot testing of 78 patients demonstrated significant post-treatment changes in knowledge [ t (66)=12.07, p =.000] and attitudes [ t (75)=6.82, p =.000] toward suicide prevention issues. Significant gains were maintained at 1-month follow-up for changes in knowledge [ t (55)=6.33, p =.000] and attitudes [ t (61)=3.37, p =.0001], with changes in positive help seeking behaviors in dealing with suicidal issues in friends [ χ 2 (1) =10.49, p =.007], family [ χ 2 (1)=9.81, p =.015], and self [ χ 2 (1)=19.62, p =.008] also observed. The PARS was also highly rated by treatment staff as feasible within their standard clinical practice.

Self-inflicted injury (SII) is a continuum of intentionally self-destructive behaviors, including nonsuicidal self-injuries, suicide attempts, and death by suicide. These behaviors are among the most pressing yet perplexing clinical problems, affecting males and females of every race, ethnicity, culture, socioeconomic status, and nearly every age. The complexity of these behaviors has spurred an immense literature documenting risk and vulnerability factors ranging from individual to societal levels of analysis. However, there have been relatively few attempts to articulate a life span developmental model that integrates ontogenenic processes across these diverse systems. The objective of this review is to outline such a model with a focus on how observed patterns of comorbidity and continuity can inform developmental theories, early prevention efforts, and intervention across traditional diagnostic boundaries. Specifically, when SII is viewed through the developmental psychopathology lens, it becomes apparent that early temperamental risk factors are associated with risk for SII and a range of highly comorbid conditions, such as borderline and antisocial personality disorders. Prevention efforts focused on early-emerging biological and temperamental contributors to psychopathology have great potential to reduce risk for many presumably distinct clinical problems. Such work requires identification of early biological vulnerabilities, behaviorally conditioned social mechanisms, as well as societal inequities that contribute to self-injury and underlie intergenerational transmission of risk.

Over the past 2 decades there has been a dramatic shift in understanding of personality disorders, such as borderline personality disorder (BPD). What was historically viewed as an entrenched pattern of antagonistic, interpersonally dependent, and uncorrectable conduct is now seen as the outcome of complex-yet modifiable-developmental processes. The borderline label, which once inspired such harsh opprobrium in clinical communities that early diagnosis was considered taboo, is now increasingly applied to adolescents who are receiving effective treatment and desisting from a borderline trajectory. Research examining the developmental origins and early manifestations of BPD is increasing rapidly, making it an appropriate time to take stock of current developmental research and articulate an agenda for the future. We identify 4 challenges that continue to impede innovative research on borderline personality development: (a) inadequate attention to continuity and discontinuity across development, (b) medical and diagnostic systems that localize personality pathology within the individual, (c) the lingering belief that biological research is antithetical to contextual/interpersonal understandings of psychopathology (and vice versa), and (d) reluctance to reach across disciplinary and developmental boundaries to identify creative paradigms and foster innovative discovery. In order to overcome these challenges, we propose an approach to future research on adolescent borderline pathology that integrates developmental psychopathology, social and affective neuroscience, and personality theory perspectives. This intersection-the developmental neuroscience of personality pathology-offers theoretical and methodological advantages over disciplinary isolation and is fertile ground for generating novel hypotheses on the development and prevention of BPD. (PsycINFO Database Record

Emerging adulthood has heightened risk for substance use. College students experience unique challenges, making them prone to use of alcohol, marijuana, and nonmedical use of prescription drugs. This article reviews rates of college students' substance use, risk factors, and populations at elevated risk. Consequences include legal, academic, and mental health problems; engagement in other risky behaviors; increased rates of injury; and death. Researchers, clinicians, and university administrators must identify those at greatest risk and provide prevention and intervention programs. Despite broad evidence supporting such programs, many students fail to access appropriate treatment. Future research should elucidate treatment barriers.

Problems with identity formation are associated with a range of psychiatric disorders. Yet, the mechanisms underlying such problems and how they are refined into specific diagnostic presentations require further investigation. The present study investigated identity processes among 123 women with eating disorders (ED) and age-matched community controls via a newly developed identity model. Several clinical outcome variables were assessed. Patients with ED scored lower on committing to and identifying with identity-related choices and scored higher on maladaptive or ruminative exploration, identity diffusion and identity disorder. They also experienced less identity achievement as compared with controls. The identity disorder status was associated with the highest scores on anxiety, depression, borderline personality disorder symptoms, and non-suicidal self-injury and the lowest scores on need satisfaction. Results indicate that patients with ED experience more identity problems than community controls and those captured by an identity disorder status experience the most problematic psychosocial functioning. Copyright © 2016 John WileySons, Ltd and Eating Disorders Association.

Skin-tone preferences and colourism within Hispanic children have been largely unexamined in the psychological literature. The objectives of the current study were to investigate Hispanic children’s skin-tone preferences and the effect of assessor race and ethnicity on those preferences. To carry out the study, Clark and Clark’s colouring task was revised and administered to a sample of 52 Hispanic children aged five to seven years. The sample was divided into three conditions, varying by assessor background (Caucasian, Hispanic and African-American). A pronounced preference for lighter skin tones was found among children in the sample, although this preference was moderated by the race and ethnicity of the assessors administering the task. Hispanic children appear to be susceptible to a pro-light skin bias and influence from assessor skin colour as young as five.

In this chapter, we describe our biosocial developmental model of borderline personality disorder (BPD) with particular attention to recent empirical findings. We discuss core constructs and theories for conceptualizing BPD. Reliable biological and environmental precursors to BPD are reviewed and discussed within the greater context of the developmental psychopathology perspective. Particular attention is given to complex heterotypic trajectories have been identified and supported via recent longitudinal research. Based on existing evidence, we hypothesize that trait impulsivity and emotional sensitivity interact with family-level risk factors to increase risk for BPD. We also theorize that self-inflicted injury and other clinical features that emerge by adolescence are reliable predictors of later BPD onset for many individuals. Finally, we highlight future directions for research, intervention, and prevention of adolescent BPD traits.

Research in psychology and affective neuroscience often relies on film as a standardized and reliable method for evoking emotion. However, clip validation is not undertaken regularly. This presents a challenge for research with adolescent and young adult samples who are exposed routinely to high-definition (HD) three-dimensional (3D) stimuli and may not respond to older, validated film clips. Studies with young people inform understanding of emotional development, dysregulated affect, and psychopathology, making it critical to assess whether technological advances improve the study of emotion. In the present study, we examine whether 3D film is more evocative than 2D using a tightly controlled within-subjects design. Participants (n = 408) viewed clips during a concurrent psychophysiological assessment. Results indicate that both 2D and 3D technology are highly effective tools for emotion elicitation. However, 3D does not add incremental benefit over 2D, even when individual differences in anxiety, emotion dysregulation, and novelty seeking are considered.

The purpose was to determine factors associated with rural communities’ political readiness to enact smoke-free laws. Data from baseline assessment of a longitudinal intervention study to promote smoke-free policy in rural Kentucky communities; key informants ( n = 144) and elected officials ( n = 83) from 29 counties participated in cross-sectional telephone interviews. Controlling for population size and county-level smoking rate, the following factors predicted elected officials’ perception of the likelihood of a local smoke-free law passing in the next 12 months: (1) support from the local board of health; (2) support from local leaders; and (3) smoke-free hospitals. Communities with lower adult smoking prevalence were more ready for smoke-free laws. Rural health advocates can increase political readiness for smoke-free laws by educating and engaging Board of Health members and local leaders, promoting the voluntary adoption of smoke-free policies in rural hospitals, and investing in effective population-based approaches to evidence-based tobacco treatment in rural communities.

This study assessed barriers to metabolic care for persons with serious mental illness (SMI) by surveying experienced healthcare providers. Sixty-eight medical, mental health, and other stakeholders who care for patients with SMI attended a CME conference focused on medical management of SMI patients in 2007. They completed a 27-item survey assessing barriers to and systemic responsibility for metabolic care. The top three ranked barriers were: “separate mental health and primary care systems,” “patient's lack of resources,” and “[mental health] providers are not trained to do basic primary care.” Results indicated that ratings of CMHC responsibility for SMI metabolic care (M = 5.2, SD = 1.5) were significantly lower than ratings of public health ( M = 5.7, SD = 1.4), t(66) = 2.3, p = 0.027, and primary care providers ( M = 6.3, SD = 1.1), t(67) = 4.7, p < 0.001. Experienced providers identified a lack of integrated care and patient characteristics as important barriers to metabolic care and concluded that the primary care and public health systems are primarily responsible for metabolic treatment.

Study design Literature review of complications unrelated directly to surgical skills involved in spinal deformity surgery. Objective Highlight complications associated with perioperative issues. Summary of background data Complications can arise from mundane events that arise during the operative experience, but are not directly related to surgical skills. Methods Literature reviews that touches on the more common potential complication events that do not involve direct surgical expertise. Results The topics of positioning, nutrition, blood loss, comorbidities, OR time, and pulmonary and GI concerns are discussed as basics that could derail a surgical outcome even with an otherwise uneventful surgical technique. The need for vigilance is stressed and the nuances of understanding these are discussed. Conclusion Mundane events can derail a perfectly executed surgical undertaking. Attention to detail, team work, close monitoring, and checklist type focus will help to improve, focus, and avoid these preventable complications that have nothing to do with direct surgical skills.

Indwelling epidural catheter placement for prolonged drug delivery or is commonplace. Epidural catheter placement leading to a subsequent epidural mass is infrequently symptomatic and thus not often sought after or uncovered. Such masses can mimic lesions causing tumor, infection, and inflammation, and when found, the etiology of granuloma formation is unclear. This article describes a case of a benign epidural granuloma masquerading as an epidural tumor thought to be caused by epidural catheter placement for postoperative total hip replacement pain control. After symptoms of mechanical and radiculopathic pain arose, the patient underwent an open biopsy, spinal decompression, and intradural exploration as an MRI evaluation identified a mass in the spinal canal. Pathologic examination identified a benign fibrous granuloma. At 36-month follow-up, there was no evidence of symptom or tumor recurrence.

Indwelling epidural catheter placement for prolonged drug delivery or is commonplace. Epidural catheter placement leading to a subsequent epidural mass is infrequently symptomatic and thus not often sought after or uncovered. Such masses can mimic lesions causing tumor, infection, and inflammation, and when found, the etiology of granuloma formation is unclear. This article describes a case of a benign epidural granuloma masquerading as an epidural tumor thought to be caused by epidural catheter placement for postoperative total hip replacement pain control. After symptoms of mechanical and radiculopathic pain arose, the patient underwent an open biopsy, spinal decompression, and intradural exploration as an MRI evaluation identified a mass in the spinal canal. Pathologic examination identified a benign fibrous granuloma. At 36-month follow-up, there was no evidence of symptom or tumor recurrence.

Background Significantly more research attention has been devoted to the consistency of condom use, with far fewer studies investigating condom use errors and problems. The purpose of this review was to present the frequency of various condom use errors and problems reported worldwide. Methods: A systematic literature search was conducted for peer-reviewed articles, published in English-language journals between 1995 and 2011. Results: Fifty articles representing 14 countries met criteria for inclusion. The most common errors included not using condoms throughout sex, not leaving space at the tip, not squeezing air from the tip, putting the condom on upside down, not using water-based lubricants and incorrect withdrawal. Frequent problems included breakage, slippage, leakage, condom-associated erection problems, and difficulties with fit and feel. Prevalence estimates showed great variation across studies. Prevalence varied as a function of the population studied and the period assessed. Conclusion: Condom use errors and problems are common worldwide, occurring across a wide spectrum of populations. Although breakage and slippage were most commonly investigated, the prevalence of other condom use errors and problems found in this review were substantially higher. As a framework for understanding the role of condom errors and problems in inadequate protection, we put forward a new model: the Condom Use Experience model. This model can be used to generate testable hypotheses for future research. Addressing condom use errors and problems in research and interventions is crucial to closing the gap between the perfect use and typical use of condoms.