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Virtual reality environments (VREs) are an emerging modality consisting of computer-generated worlds. Players in VREs can choose to create representative avatars. Such choices may reflect beliefs related to identity and psychological functioning. The aim of the present study was to examine associations between psychological distress, exposure to adverse childhood experiences, and choice of avatar in an immersive virtual environment. We recruited 436 participants in a VRE. Participants completed the Early Traumatic Inventory Self Report-Short Form and the Brief Symptom Inventory. We evaluated between-group differences (selection of child avatar, parent avatar, or "other" avatar, the control group) in psychological distress and traumatic childhood experiences. Individuals who selected child avatars experienced a higher degree of psychological distress and childhood trauma, especially sexual abuse, as compared to individuals who selected other avatars. Individuals who selected parent avatars were more likely to have experienced psychological distress as compared to controls. Avatar choice may reflect users' identities and psychological functioning. VREs may provide safe environments for a "do over" of adverse childhood experiences. Future research should explore VREs as venues to treat trauma and psychological distress. • Individuals who experienced childhood trauma, especially sexual abuse, were more likely to select child avatars in a virtual reality environment • Individuals who experience greater degrees of psychological distress were more likely to select child avatars in a virtual reality environment • Results suggest that avatar choice may reflect elements of psychological functioning and the influence of childhood trauma and be meaningful for the individual • Future directions could involve the development of psychological interventions to be implemented in a virtual reality environment [ABSTRACT FROM AUTHOR]

As rates of adolescent hospitalization for suicide-related crises increase, so does the urgency for improving adolescent school reintegration. Communication and collaboration are considered key mechanisms for continuity of care during times of transition; however, to date, few studies have identified critical information to share or have explored strategies for navigating challenges to information sharing during and following school reintegration. The present study explored previously hospitalized adolescent (n = 19), parent (n = 19), school professional (n = 19), and hospital professional (n = 19) views of information sharing and their perceptions of facilitators and barriers to this communication. Applied thematic analysis revealed three key themes related to the best information to share across entities, including the (a) need to consider environmental relevance to information (i.e., informing school supports and hospital treatment), (b) importance of considering information unique to each patient's circumstance (i.e., sharing information on a "case-by-case basis"), and (c) duality between families preferring to share minimal information but school professionals desiring the maximum (i.e., less is more vs. more is better). Regarding facilitators and barriers to information sharing, six key themes emerged, including (a) understanding risks and benefits of information sharing; (b) trust in hospitals and schools; (c) mental health stigma; (d) communication processes; (e) navigating individual, family, school, and community contexts; and (f) "push and pull" between privacy and need. Findings inform key considerations for collaborating with families in determining if and what information to share during school reintegration. [ABSTRACT FROM AUTHOR]

Previous research supports a link between school-related factors, such as bullying and school connectedness, and suicidal thoughts and behaviors. To deepen understanding of how school experiences may function as both protective and risk factors for youth struggling with suicidal thoughts and behaviors, this qualitative study explored multiple perspectives. Specifically, in-depth interviews were conducted with adolescents previously hospitalized for a suicidal crisis (n = 19), their parents (n = 19), and the professionals they may interact with in schools and hospitals (i.e., school professionals [ n = 19] and hospital providers [ n = 7]). Data were analyzed using applied thematic analysis revealing three main themes related to perceptions of how school experiences can positively or negatively impact mental health, including (a) school activities, (b) school social experiences, and (c) school interventions. An emergent theme related to the complexity of suicide-related risk identified the ways in which school experiences may intersect with other environmental, biological, and psychological factors. Findings underscore the need for school-based approaches to address the unique academic, social, and emotional needs of students with suicide-related risk that complement the supports and services provided in their home and community. [ABSTRACT FROM AUTHOR]