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Help-seeking related to depression and suicidal ideations is frequent in internet forums. Forum threads concerning these topics often receive much interest through active replies but are also read by numerous passive users. Previous research indicates that such interactions may be helpful for the help-seeker, even if the underlying mechanisms are less clear. Meanwhile, some studies also suggest that online forum interactions can be less helpful or have a negative impact on the help-seeker. This study examines how online help-seeking is responded to through a qualitative thematic analysis of 72 discussion threads comprising 1,475 posts. We identify six themes that characterize different types of responses: Giving Tips, Teaching, Coaching, Consoling, Sharing One's Own Experiences, and Bullying. These response types represent different strategies in their attempts to provide help, but sometimes also appear less helpful or even malicious. The responses are heterogeneous and often contradictory, with very different tones, spanning over varied suggestions and topics, leaving the help-seeker to interpret and make sense of the messages. [ABSTRACT FROM AUTHOR]

Although Sweden is a top country for gender equality, there are disparities in domestic labor and parental leave use between men and women. The COVID-19 pandemic changed work-home life by increasing remote work. This study explored eight fathers’ work-family experiences in Sweden before, during and since the COVID-19 pandemic using interviews. Three group themes were developed using Interpretative Phenomenological Analysis: “Fatherhood as protected and restrained before and during COVID-19”, “COVID-19 as an opportunity for introspection” and “COVID-19 as an opportunity for better balance”. Fathers made meaning of the pandemic in terms of new freedom and flexibility, whilst also expressing the importance of social connection at work. The study contributes insights on fathers’ needs and the debate on post-pandemic work organization. [ABSTRACT FROM AUTHOR]

Aim: Traditional methods used when managing self‐harm in a psychiatric inpatient setting tend to infringe on the autonomy of the individuals receiving treatment and are often experienced as practically and emotionally challenging by care providers. Therefore, we examined care providers' experiences of an alternative method negotiating self‐harm abstinence agreements, which can be viewed as a form of positive risk taking. Design: A qualitative approach using semi‐structured interviews with twelve mental health professionals. Methods: Thematic analysis of the interviews. Results: Five themes emerged; "No‐harm agreements versus constant observation and coercion," "No‐harm agreements to promote independence and collaboration," "No‐harm agreements' effect on ward safety," "Ambiguity surrounding the no‐harm agreements" and "Ethical complexities of the no‐harm agreements." These indicated perceived positive effects on the therapeutic relationship, the individuals' autonomous functioning and the ward environment, but also practical and ethical difficulties. [ABSTRACT FROM AUTHOR]

Emotion regulation group therapy (ERGT) is a novel treatment specifically targeting deliberate non-suicidal self-harm (DSH) in individuals with borderline personality disorder (BPD). Identifying robust predictors of positive response to ERGT could aid clinicians in treatment selection; however, to date, only one such study has been conducted. Thus, we aimed to replicate previously identified predictors of treatment response to ERGT by investigating demographic, clinical, and diagnostic predictors in 95 women with BPD or subclinical BPD who had participated in an open-trial evaluation of ERGT. Outcomes evaluated were frequency of DSH and emotion dysregulation. Assessments were conducted at pretreatment, post-treatment, and 6-month follow-up. Multilevel mixed linear models and multilevel negative binomial generalized estimated equations were used to identify significant interactions between the predictors and outcomes. We found that greater pretreatment DSH frequency was associated with greater improvements in DSH during treatment (b = 0.998, SE = 0.00, p = 0.03) and follow-up (b = 0.997, SE = 0.00, p < 0.01) and that greater BPD severity was associated with greater improvements in DSH during treatment (b = 0.84, SE = 0.06, p = 0.02) and in emotion dysregulation at follow-up (b = −3.05, SE = 1.47, p = 0.04). Co-occurring disorders were associated with poorer treatment response during follow-up. Results were generally consistent with a previous study of the predictors of response to ERGT. The findings provide further support for the utility of this treatment across a range of BPD patients, including patients with severe DSH and BPD. [ABSTRACT FROM AUTHOR]

Background: Nonsuicidal self-injury (NSSI) is a serious health risk behavior that forms the basis of a tentative diagnosis in DSM-5, NSSI Disorder (NSSID). To date, established treatments specific to NSSI or NSSID are scarce. As a first step in evaluating the feasibility, acceptability, and utility of a novel treatment for adolescents with NSSID, we conducted an open trial of emotion regulation individual therapy for adolescents (ERITA): a 12-week, behavioral treatment aimed at directly targeting both NSSI and its proposed underlying mechanism of emotion regulation difficulties. Methods: Seventeen girls (aged 13-17; mean = 15.31) with NSSID were enrolled in a study adopting an uncontrolled open trial design with self-report and clinician-rated assessments of NSSI and other self-destructive behaviors, emotion regulation difficulties, borderline personality features, and global functioning administered at pre-treatment, post-treatment, and 6- month follow-up. Measures of NSSI and emotion regulation difficulties were also administered weekly during treatment. Results: Ratings of treatment credibility and expectancy and the treatment completion rate (88%) were satisfactory, and both therapeutic alliance and treatment attendance were strong. Intent-to-treat analyses revealed significant improvements associated with large effect sizes in past-month NSSI frequency, emotion regulation difficulties, selfdestructive behaviors, and global functioning, as well as a medium effect size in past-month NSSI versatility, from pre- to post-treatment. Further, all of these improvements were either maintained or further improved upon at 6-month followup. Finally, change in emotion regulation difficulties mediated improvements in NSSI over the course of treatment. Conclusions: Results suggest the acceptability, feasibility, and utility of this treatment for adolescents with NSSID. [ABSTRACT FROM AUTHOR]

Objective Emotion regulation group therapy (ERGT) has shown promising results in several efficacy trials. However, it has not been evaluated outside a research setting. In order to increase the availability of empirically supported treatments for individuals with borderline personality disorder and deliberate self-harm, an evaluation of ERGT in routine clinical care was conducted with therapists of different professional backgrounds who had received brief intensive training in ERGT prior to trial onset. Design Multi-site evaluation, using an uncontrolled open trial design with assessments at pretreatment, posttreatment and 6-month follow-up. Setting 14 adult outpatient psychiatric clinics across Sweden. Participants Ninety-five women (mean age=25.1 years) with borderline personality disorder (both threshold and subthreshold) and repeated self-harm were enrolled in the study. Ninety-three per cent of participants completed the post-treatment assessment and 88% completed the follow-up assessment. Primary and secondary outcome measures Primary outcome was self-harm frequency as measured with the Deliberate Self-Harm Inventory. Secondary outcomes included self-harm versatility, emotion dysregulation, other self-destructive behaviours, depression, anxiety, stress symptoms and interpersonal and vocational difficulties. Intervention ERGT is an adjunctive, 14-week, acceptance-based behavioural group treatment that directly targets both self-harm and its proposed underlying mechanism of emotion dysregulation. Results At post-treatment, intent-to-treat analyses revealed a significant improvement associated with a moderate effect size on the primary outcome of self-harm frequency (51%, reduction; Cohen's d=0.52, p<0.001) as well as significant improvements in the secondary outcomes of self-harm versatility, emotion dysregulation, other self-destructive behaviours and general psychiatric symptomatology. These results were either maintained or further improved on at 6-month follow-up. Conclusions ERGT appears to be a feasible, transportable and useful treatment for deliberate self-harm and other self-destructive behaviours, emotion dysregulation and psychiatric symptoms when delivered by clinicians in the community. [ABSTRACT FROM AUTHOR]

Lundh, L. G., Wångby-Lundh, M. & Bjärehed, J. (2011). Deliberate self-harm and psychological problems in young adolescents: Evidence of a bidirectional relationship in girls. Scandinavian Journal of Psychology 52, 476-483. The purpose of this study was to test the hypotheses that there is a bidirectional prospective relationship between mental health and deliberate self-harm, in the sense that (1) psychological problems are a risk factor for the development of self-harm; (2) self-harm is a risk factor for the development of psychological problems; and (3) the relative absence of psychological problems is a protective factor against the continued use of self-harm in adolescents who have started to harm themselves. This was studied in a community sample of 879 young adolescents by means of a 2-wave longitudinal design with a one-year interval, with self-harm measured by a nine-item version of the Deliberate Self-Harm Inventory (DSHI-9r) and psychological problems by the self-report version of the Strengths and Difficulties Questionnaire (SDQ). The hypothesis of bidirectional relationship between psychological problems and self-harm was supported among girls, but not among boys - although there was evidence of psychological problems as a risk factor of self-harm in boys, the converse was not the case. The relative absence of psychological problems was found to be a protective factor against self-harm only among boys, but not among girls. The results are discussed in terms of self-harm having a different role in the development of psychopathology among girls than among boys. [ABSTRACT FROM AUTHOR]

Nonsuicidal self-injury (NSSI) refers to the direct and deliberate destruction of one's own body tissue in the absence of lethal intent. The Inventory of Statements about Self-Injury (ISAS) is a recently developed instrument that taps both the frequency of different forms of NSSI and the self-perceived functions of the behaviour. The purpose of the present pilot study was to use the ISAS to study the functions of self-injury in a group of women with severe forms of NSSI who were treated within Swedish residential care settings and also to compare the patients' views with their therapists' views concerning these functions. Consistent with previous research, the patients reported intrapersonal functions (e.g. affect regulation and self-punishment) as more relevant than interpersonal functions (e.g. interpersonal influence and peer bonding). The therapists' ratings differed little from the patients' self-reports, although significant differences were found for some functions: The patients rated self-care and toughness as more important than the therapists did; the therapists, on the other hand, rated interpersonal influence and the marking of distress as more relevant than the patients did. Although the present study did not contain a full validation of the Swedish version of the ISAS, the results showed good internal consistency for the interpersonal and intrapersonal factors of the Swedish version. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Depressed patients have been found to generate fewer anticipated positive future events, but most previous studies have included patients who have either been severely depressed or expressed suicidal thoughts and intents or both. The aim of this study was to compare positive and negative future-directed thinking in persons with mild to moderate depression who did not express suicidal thoughts or intents (n = 20) with a matched group of nondepressed persons (n = 20). The two groups completed the Future-Thinking Task (FTT), in which they were asked to generate positive and negative anticipated future events for three upcoming time periods (1 week, 1 year, and 5-10 years). In the present version of the FTT, both quantitative and qualitative aspects were included (i.e. subjective likelihood and emotional valence). Results showed that depressed persons reported lower scores regarding anticipated future positive events but they did not differ in terms of future negative events. The results are consistent with previous research and further strengthen the notion that reduced anticipation of future positive events is a defining characteristic of depression, even in the absence of suicidal ideation. [ABSTRACT FROM AUTHOR]

The psychometric properties of the Swedish self-report version of the Strengths and Difficulties Questionnaire (SDQ-s), and the prevalence of emotional and behavioral problems as measured by the SDQ-s, were studied in 14 to 15-year-old adolescents. The psychometric properties were found to be similar to those found in other language versions, in terms of similar factor structure and acceptable test-retest stability, but low internal consistencies for some of the subscales. There was evidence of good convergent and discriminant validity. The results with regard to gender differences replicated previous findings in other countries, the girls reporting more emotional symptoms and more prosocial behavior, and the boys reporting more conduct problems and tending to report more peer problems. It is concluded that the results are in favor of using the Swedish SDQ-s as a screening instrument for adolescents, despite the low internal consistencies of some of its subscales. [ABSTRACT FROM AUTHOR]

Deliberate self-harm was studied in 14-year-old adolescents from four schools in southern Sweden with a test-retest design, using a nine-item version of the Deliberate Self-Harm Inventory. At Time 1, 40.2% of the adolescents indicated deliberate self-harm on at least one occasion compared with 36.5% at Time 2. Test-retest data showed high stability over periods of up to 2 months in duration. Cross-validation of the results from Time 1 to Time 2 showed robust correlations between deliberate self-harm and general psychopathology, a relative absence of positive feelings toward parents, and a ruminative style of emotional regulation. Further, rumination/negative thinking and a relative absence of positive feelings toward parents were predictors of self-harm independently of general psychopathology. In addition, deliberate self-harm correlated with symptoms of eating disorder and negative body esteem in girls. [ABSTRACT FROM AUTHOR]