Implementing Attachment-Based Family Therapy for Depressed and Suicidal Adolescents and Young Adults in LGBTQ+ Services

Crisis ◽  
2021 ◽  
Author(s):  
Jody Russon ◽  
Judy Morrissey ◽  
Jamie Dellinger ◽  
Bora Jin ◽  
Guy Diamond

Abstract. Background: Suicide is a serious public health problem for LGBTQ+ adolescents and young adults. Attachment-based family therapy (ABFT) is one of the few suicide treatment models that has been tested with this population. The challenge remains in how to implement ABFT into the ecology of LGBTQ+ service settings. Aims: In this study, we tested the feasibility, acceptability, and preliminary effectiveness of ABFT in LGBTQ+ community settings. Method: Ten participants were enrolled in 16 weeks of ABFT across three LGBTQ+ organizations. Feasibility (treatment completion) and acceptability (Working Alliance Inventory [WAI]; opinions about treatment [OAT]) were measured for youth and caregivers. Depression and suicide outcomes were assessed for nine participants. Results: ABFT was demonstrated to be both feasible and acceptable. All participants completed treatment, and there were no dropouts. Adolescents/young adults and their caregivers reported high WAI and adequate OAT scores throughout treatment. There was a significant decrease in suicidal ideation (β = −12.16, t(10) = −3.14, p < .01). Decreases in depression, however, were not significant (β = −1.83, t(9.11) = −0.88, p = .40). Limitations: The small sample limits our ability to estimate treatment effectiveness. A larger effectiveness trial is warranted. Conclusion: ABFT is a promising treatment for LGBTQ+ service settings.

2021 ◽  
Author(s):  
Nancy Lau ◽  
Susannah F Colt ◽  
Shayna Waldbaum ◽  
Alison O'Daffer ◽  
Kaitlyn Fladeboe ◽  
...  

BACKGROUND Children, adolescents, and young adults with chronic conditions experience difficulties coping with disease-related stressors, comorbid mental health problems, and decreased quality of life. The COVID-19 pandemic has led to a global mental health crisis, and telemental health has necessarily displaced in-person care. However, it remains unknown whether such remote interventions are feasible or efficacious. We aimed to fill this research-practice gap. OBJECTIVE In this systematic review, we present a synthesis of studies examining the feasibility and efficacy of telemental health interventions for youth aged ≤25 years with chronic illnesses. METHODS PubMed, Embase, Web of Science, PsycInfo, and Cochrane Database of Systematic Reviews were searched from 2008 to 2020. We included experimental, quasiexperimental, and observational studies of telemental health interventions designed for children, adolescents, and young adults aged ≤25 years with chronic illnesses, in which feasibility or efficacy outcomes were measured. Only English-language publications in peer-reviewed journals were included. We excluded studies of interventions for caregivers or health care providers, mental health problems not in the context of a chronic illness, disease and medication management, and prevention programs for healthy individuals. RESULTS We screened 2154 unique study records and 109 relevant full-text articles. Twelve studies met the inclusion criteria, and they represented seven unique telemental health interventions. Five of the studies included feasibility outcomes and seven included efficacy outcomes. All but two studies were pilot studies with relatively small sample sizes. Most interventions were based on cognitive behavioral therapy and problem-solving therapy. The subset of studies examining intervention feasibility concluded that telemental health interventions were appropriate, acceptable, and satisfactory to patients and their parents. Technology did not create barriers in access to care. For the subset of efficacy studies, evidence in support of the efficacy of telemental health was mixed. Significant heterogeneity in treatment type, medical diagnoses, and outcomes precluded a meta-analysis. CONCLUSIONS The state of the science for telemental health interventions designed for youth with chronic illnesses is in a nascent stage. Early evidence supports the feasibility of telehealth-based delivery of traditional in-person interventions. Few studies have assessed efficacy, and current findings are mixed. Future research should continue to evaluate whether telemental health may serve as a sustainable alternative to in-person care after the COVID pandemic.


2020 ◽  
Vol 3 ◽  
Author(s):  
Helen Hernandez ◽  
Hanna Craven ◽  
Judith Toromo ◽  
Leslie Enane

Background: Adolescents and young adults living with HIV (AYALHIV, ages 10-24) have poorer outcomes in care compared to other age groups. The global Treat All strategy aims to extend antiretroviral therapy (ART) to all individuals living with HIV. Efforts to improve outcomes in the AYALHIV population are essential to successfully achieving viral suppression and improving the long-term health outcomes of young people, and ultimately to ending the HIV pandemic. Peer support interventions are increasingly implemented by care programs, and are broadly favored by AYALHIV. This systematic review will evaluate the current evidence for quantitative effects of peer support interventions on AYALHIV treatment outcomes.   Methods:  We searched MEDLINE, Embase, Global Health, CINAHL Complete, Cochrane, and Scopus databases for papers published between 1994 and October 2019, in all languages and regions. Studies of the effect of peer support interventions for AYALHIV on measures of adherence or retention in care were included. Solely qualitative studies and those without a comparator or control were excluded. Three researchers screened the papers independently, and those meeting criteria were included. Abstracted variables included study characteristics, participant population, peer intervention characteristics, and outcomes.   Results: The current evidence base for the effect of peer interventions for AYALHIV is very limited. Included studies were of small sample size, and primarily consisted of observational cohort studies with imperfect comparators. In initial analyses we find that studies of peer interventions have had mixed findings regarding the effect of such interventions on adherence to ART. By contrast, studies have consistently reported a favorable effect of peer interventions on increased retention in care among AYALHIV.   Conclusion/Implications: Rigorous studies of interventions to improve outcomes among AYALHIV are urgently needed. Further analyses in this review will examine differences according to study population, design, or intervention characteristics, which may underlie variable effects identified. 


PEDIATRICS ◽  
1988 ◽  
Vol 82 (3) ◽  
pp. 516-517
Author(s):  
JOE M. SANDERS

The study by Joffe et al1 presents data that suggest pediatricians have still not made a definitive commitment to providing health care for adolescents and young adults. Although this article might be subjected to criticism based upon the relatively small sample size, the demographics of the population surveyed, and the randomization techniques used in the collection of data from questionnaires, the conclusion that physicians, in general and pediatricians in particular, are failing to meet their obligations to this population is probably valid. This is particularly distressing given the priority that the American Academy of Pediatrics has placed on the delivery of health care to this age group.


2016 ◽  
Vol 06 (01) ◽  
pp. 042-044
Author(s):  
Joswin Rakesh D'SA ◽  
Seemitha Shetty ◽  
Shahina V. ◽  
Shashank Sahu ◽  
Shifali Prabhakar ◽  
...  

Abstract Introduction: Alcohol consumption is a major public health problem in most parts of the world responsible for 3.2per cent of deaths (1.8 million). Prevalence of alcohol use in India is reported to be 21.4%. The concern, is that there has been a rapid change in patterns and trends of alcohol use in India, chief among them is people are beginning to drink at ever-younger ages. Alcohol consumption of the students under the age of 18 years is markedly high which needs to be addressed. Aims and Objectives: To assess the awareness of risk factors in alcohol consumption among adolescents and young adults. Materials and Method: Materials used are -Questionnaire pertaining to the awareness of alcohol consumption. Methodology: Assessment of awareness and knowledge of alcohol consumption was done by means of answering a pretested validated questionnaire with anonymity. Results: According to the study done, 67.18% of students knew who consumed alcohol under the age of 18. It was found, 28.03% of the subjects perceived that alcohol consumption started because of the urge to try something new. Conclusion: A high majority of the students are aware of the underage drinking and risk factors associated with it.


2017 ◽  
Author(s):  
John Alexander Chalmers ◽  
Ursula Margaret Sansom-Daly ◽  
Pandora Patterson ◽  
Geoffrey McCowage ◽  
Antoinette Anazodo

BACKGROUND Adolescent and young adults with cancer are at increased risk of psychosocial difficulties relative to their healthy peers. Current models of inpatient face-to-face psychosocial care might limit the capacity for clinicians to provide timely and personalized assessment and intervention for this group. Telehealth offers a promising alternative toward increasing access to the provision of evidence-based psychosocial assessment and treatment for adolescent and young adults with cancer. OBJECTIVE This pilot study aimed to assess the feasibility and acceptability for both patients and clinicians of providing a psychosocial assessment via telehealth to adolescents and young adults currently receiving treatment for cancer, relative to face-to-face delivery. METHODS We included patients who were aged 15-25 years, currently receiving treatment, could speak English well, and medically stable. Patients were recruited from oncology clinics or wards from 5 hospitals located across Sydney and Canberra, Australia, and allocated them to receive psychosocial assessment (Adolescent and Young Adult Oncology Psychosocial Assessment Measure) with a clinical psychologist or social worker through face-to-face or telehealth modalities using a partially randomized patient preference model. Patients completed a pre- and postassessment questionnaire comprising validated and purposely designed feasibility and acceptability indices, including the impact of technical difficulties, if patients had their own devices; number of patients who were content with their group allocation; self-reported preference of modality; Treatment Credibility and Expectations Questionnaire; and Working Alliance Inventory. Clinicians also completed a postassessment questionnaire rating their impressions of the acceptability and feasibility of intervention delivery by each modality. RESULTS Of 29 patients approached, 23 consented to participate (response rate: 79%). Participants were partially randomized to either telehealth (8/23, 35%; mean age 16.50 years, range 15-23 years; females: 4/8, 50%) or face-to-face (11/23, 62%; mean age 17 years, range 15-22 years; females: 8/11, 72%) conditions. Four participants withdrew consent because of logistical or medical complications (attrition rate: 17.4%). Most participants (6/8, 75%) in the telehealth group used their computer or iPad (2 were provided with an iPad), with minor technical difficulties occurring in 3 of 8 (37.5%) assessments. Participants in both groups rated high working alliance (Working Alliance Inventory; median patient response in the telehealth group, 74, range 59-84 and face-to-face group, 63, range 51-84) and reported positive beliefs regarding the credibility and expectations of their treatment group. Postassessment preferences between face-to-face or telehealth modalities varied. Most patients in the telehealth group (5/8, 63%) reported no preference, whereas 6 of 11 (55%) in the face-to-face group reported a preference for the face-to-face modality. CONCLUSIONS Telehealth is acceptable as patient comfort was comparable across modalities, with no significant technological barriers experienced. However, patients varied in their preferred interview modality, highlighting the need to tailor the treatment to patient preference and circumstances. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12614001142628; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366609 (Archived by WebCite at http://www.webcitation.org/721889HpE)


Author(s):  
Chin Chan ◽  
Norazlina Mohamed ◽  
Soelaiman Ima-Nirwana ◽  
Kok-Yong Chin

Osteoporosis is a major public health problem affecting millions of people worldwide. Increasing knowledge, correcting health belief and promoting osteoprotective practices are effective measures for building and maintaining strong bone throughout ones’ life-span. This review aims to summarize the contemporary evidence on the knowledge, beliefs and practice of adolescents and young adults on bone health. We performed literature searches using the PubMed and Scopus databases to identify original studies from 2008 to May 2018 using the search terms “(knowledge OR beliefs OR attitude OR practice OR behaviours OR physical activity OR exercise OR diet OR nutrition) AND (young OR youth OR adolescents OR children OR young adults OR students OR teenager) AND (osteoporosis OR bone health)”. Of the 3206 articles found, 34 met the inclusion criteria. Studies showed that most adolescents and young adults had poor knowledge and expressed disinterest in osteoporosis. They believed that other diseases were more serious than osteoporosis, contributing to low perceived susceptibility and seriousness towards this disease. Popular media emerged as a platform to obtain information regarding osteoporosis. The lack of knowledge and misconceptions about osteoporosis led to poor osteoprotective practices. As a conclusion, the current evidence revealed a lack of awareness about osteoporosis among adolescents and young adults. Educational interventions may be useful to improve the awareness of osteoporosis among this population.


10.2196/30098 ◽  
2021 ◽  
Vol 8 (8) ◽  
pp. e30098
Author(s):  
Nancy Lau ◽  
Susannah F Colt ◽  
Shayna Waldbaum ◽  
Alison O'Daffer ◽  
Kaitlyn Fladeboe ◽  
...  

Background Children, adolescents, and young adults with chronic conditions experience difficulties coping with disease-related stressors, comorbid mental health problems, and decreased quality of life. The COVID-19 pandemic has led to a global mental health crisis, and telemental health has necessarily displaced in-person care. However, it remains unknown whether such remote interventions are feasible or efficacious. We aimed to fill this research-practice gap. Objective In this systematic review, we present a synthesis of studies examining the feasibility and efficacy of telemental health interventions for youth aged ≤25 years with chronic illnesses. Methods PubMed, Embase, Web of Science, PsycInfo, and Cochrane Database of Systematic Reviews were searched from 2008 to 2020. We included experimental, quasiexperimental, and observational studies of telemental health interventions designed for children, adolescents, and young adults aged ≤25 years with chronic illnesses, in which feasibility or efficacy outcomes were measured. Only English-language publications in peer-reviewed journals were included. We excluded studies of interventions for caregivers or health care providers, mental health problems not in the context of a chronic illness, disease and medication management, and prevention programs for healthy individuals. Results We screened 2154 unique study records and 109 relevant full-text articles. Twelve studies met the inclusion criteria, and they represented seven unique telemental health interventions. Five of the studies included feasibility outcomes and seven included efficacy outcomes. All but two studies were pilot studies with relatively small sample sizes. Most interventions were based on cognitive behavioral therapy and problem-solving therapy. The subset of studies examining intervention feasibility concluded that telemental health interventions were appropriate, acceptable, and satisfactory to patients and their parents. Technology did not create barriers in access to care. For the subset of efficacy studies, evidence in support of the efficacy of telemental health was mixed. Significant heterogeneity in treatment type, medical diagnoses, and outcomes precluded a meta-analysis. Conclusions The state of the science for telemental health interventions designed for youth with chronic illnesses is in a nascent stage. Early evidence supports the feasibility of telehealth-based delivery of traditional in-person interventions. Few studies have assessed efficacy, and current findings are mixed. Future research should continue to evaluate whether telemental health may serve as a sustainable alternative to in-person care after the COVID pandemic.


Author(s):  
Marc Allroggen ◽  
Peter Rehmann ◽  
Eva Schürch ◽  
Carolyn C. Morf ◽  
Michael Kölch

Abstract.Narcissism is seen as a multidimensional construct that consists of two manifestations: grandiose and vulnerable narcissism. In order to define these two manifestations, their relationship to personality factors has increasingly become of interest. However, so far no studies have considered the relationship between different phenotypes of narcissism and personality factors in adolescents. Method: In a cross-sectional study, we examine a group of adolescents (n = 98; average age 16.77 years; 23.5 % female) with regard to the relationship between Big Five personality factors and pathological narcissism using self-report instruments. This group is compared to a group of young adults (n = 38; average age 19.69 years; 25.6 % female). Results: Grandiose narcissism is primarily related to low Agreeableness and Extraversion, vulnerable narcissism to Neuroticism. We do not find differences between adolescents and young adults concerning the relationship between grandiose and vulnerable narcissism and personality traits. Discussion: Vulnerable and grandiose narcissism can be well differentiated in adolescents, and the pattern does not show substantial differences compared to young adults.


Crisis ◽  
2009 ◽  
Vol 30 (3) ◽  
pp. 115-119 ◽  
Author(s):  
Stephanie De Munck ◽  
Gwendolyn Portzky ◽  
Kees Van Heeringen

Background: Notwithstanding the epidemiological studies indicating an increased risk of attempted suicide among adolescents and young adults, there is a scarcity of international studies that examine long-term epidemiological trends in rates and characteristics of this vulnerable group. Aims: This article describes the results of a 9-year monitoring study of suicide attempts in adolescents and young adults referred to the Accident and Emergency Department of the Gent University Hospital (Belgium). Methods: Between January 1996 and December 2004, trends, sociodemographic, and methodrelated characteristics of suicide attempts were assessed by a psychiatrist on data sheets. Results: Attempted suicide rates declined from 1996 to 2001 and then rose until 2004, but did not exceed previous rates. During the 9 years of monitoring, there was a preponderance of female suicide attempters, except for 1997. Rates of attempts and of fatal suicide were negatively correlated. Significantly more males than females deliberately injured themselves. Younger attempters, especially females, significantly more often poisoned themselves with analgesics. In nearly one in five attempts, alcohol was used in combination with other methods, and alcohol intake was more commonly observed in older suicide attempters. Nearly half of the adolescents were identified as repeaters. Conclusions: The results of this study warrant further monitoring of trends and characteristics of young suicide attempters.


2017 ◽  
Vol 33 (2) ◽  
pp. 123-128 ◽  
Author(s):  
Anne van Alebeek ◽  
Paul T. van der Heijden ◽  
Christel Hessels ◽  
Melissa S.Y. Thong ◽  
Marcel van Aken

Abstract. One of the most common personality disorders among adolescents and young adults is the Borderline Personality Disorder (BPD). The objective of current study was to assess three questionnaires that can reliably screen for BPD in adolescents and young adults (N = 53): the McLean Screening Instrument for BPD (MSI-BPD; Zanarini et al., 2003 ), the Personality Diagnostic Questionnaire 4th edition – BPD scale (PDQ-4 BPD; Hyler, 1994 ), and the SCID-II Patient Questionnaire – BPD scale (SCID-II-PQ BPD). The nine criteria of BPD according to the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV; APA, 1994 ) were measured with the Structural Clinical Interview for DSM-IV Axis II disorders – BPD scale (SCID-II; First, Spitzer, Gibbon, Williams, & Benjamin, 1995 ). Correlations between the questionnaires and the SCID-II were calculated. In addition, the sensitivity and specificity of the questionnaires were tested. All instruments predicted the BPD diagnosis equally well.


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