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Objectives: This study characterizes risk‐taking behaviours in a group of people with a self‐reported diagnosis of BD using fuzzy trace theory (FTT). FTT hypothesizes that risk‐taking is a 'reasoned' (but sometimes faulty) action, rather than an impulsive act associated with mood fluctuations. Design: We tested whether measures of FTT (verbatim and gist‐based thinking) were predictive of risk‐taking intentions in BD, after controlling for mood and impulsivity. We hypothesized that FTT scales would be significant predictors of risk‐taking intentions even after accounting for mood and impulsivity. Methods: Fifty‐eight participants with BD (age range 21–78, 68% female) completed a series of online questionnaires assessing risk intentions, mood, impulsivity, and FTT. Results: Fuzzy trace theory scales significantly predicted risk‐taking intentions (medium effect sizes), after controlling for mood and impulsivity consistent with FTT (part range.26 to.49). Participants with BD did not show any statistically significant tendency towards verbatim‐based thinking. Conclusions: Fuzzy trace theory gist and verbatim representations were both independent predictors of risk‐taking intentions, even after controlling for mood and impulsivity. The results offer an innovative conceptualization of the mechanisms behind risk‐taking in BD. Practitioner points: Risk‐taking behaviour in bipolar disorder is not just a consequence of impulsivity.Measures of fuzzy trace theory help to understand risk‐taking in bipolar disorder.FTT measures predict risk‐taking intentions, after controlling for mood and impulsivity. [ABSTRACT FROM AUTHOR]

Purpose: This study reviewed the evidence‐base status of mentalization‐based treatment (MBT), its quality, strengths, and limitations. The aim was to pave the way for further MBT research. Method: An electronic database and reference lists search identified MBT outcome papers, and these were systematically reviewed. The quality of the studies and the risk of bias were determined using two validated checklist tools. Results: Twenty‐three studies were included in the review. This included nine randomized controlled trials, seven uncontrolled pre‐ and post‐effectiveness studies, three retrospective cohort studies, two uncontrolled randomized trials, and two case studies. The methodological quality of almost half of the papers was assessed as fair (43%), followed by good (34%), poor (17%), and excellent (4%) ratings. Nevertheless, the review identified risk of confounding bias across the majority of studies (60%) and fidelity to treatment was poorly reported in almost half of the studies (47%). Most of the studies focused on borderline personality disorder (BPD), showing positive clinical outcomes for this population but the evidence‐base for other presentations was still developing. The treatment of adolescents who self‐harm and at‐risk mothers in substance abuse treatment showed particularly promising results, as these are client groups that have previously shown limited positive response to psychological interventions. Conclusions: Mentalization‐based treatment is a potentially effective method across a wide range of clinical presentations but further research should focus on increasing the quality and the quantity of the MBT evidence outside the treatment of BPD. Practitioner points: MBT can be a particularly effective intervention for the treatment of adults with a diagnosis of BPD and of adolescents who self‐harm and mothers enrolled in substance abuse treatments.MBT can be an effective intervention for depression and eating disorders but the evidence is currently limited.Professionals supporting mothers of children at risk may benefit from receiving training in the principles of MBT. [ABSTRACT FROM AUTHOR]

Background: The issue of violence in secure services has long been recognized both in the UK and worldwide. However, there is currently scarce literature available about violence within learning disability (LD) secure settings. Methods: Secondary data analysis was conducted on violent incidents, using information routinely collected by the staff over a 1‐year period. Results: Physical assaults were the most frequent type of incident, and the distribution in terms of days or months was homogenous and incidents were concentrated in the corridors, lounges and dining rooms of secure facilities. Antipsychotic medication was not regularly prescribed. Generalized linear modelling analyses revealed significant predictors that increased the chances of seclusion and physical restraint, such as being female or directing the violence towards staff. Conclusions: These findings can inform staff training on violence prevention and suggest that increased ward‐based supervision and enhanced use of psychological formulations may help in reducing violence within this service context. [ABSTRACT FROM AUTHOR]

Objectives Over the past two decades, there has been tremendous growth in research regarding bipolar disorder ( BD) among children and adolescents (ie, pediatric BD [ PBD]). The primary purpose of this article is to distill the extant literature, dispel myths or exaggerated assertions in the field, and disseminate clinically relevant findings. Methods An international group of experts completed a selective review of the literature, emphasizing areas of consensus, identifying limitations and gaps in the literature, and highlighting future directions to mitigate these gaps. Results Substantial, and increasingly international, research has accumulated regarding the phenomenology, differential diagnosis, course, treatment, and neurobiology of PBD. Prior division around the role of irritability and of screening tools in diagnosis has largely abated. Gold-standard pharmacologic trials inform treatment of manic/mixed episodes, whereas fewer data address bipolar depression and maintenance/continuation treatment. Adjunctive psychosocial treatment provides a forum for psychoeducation and targets primarily depressive symptoms. Numerous neurocognitive and neuroimaging studies, and increasing peripheral biomarker studies, largely converge with prior findings from adults with BD. Conclusions As data have accumulated and controversy has dissipated, the field has moved past existential questions about PBD toward defining and pursuing pressing clinical and scientific priorities that remain. The overall body of evidence supports the position that perceptions about marked international (US vs elsewhere) and developmental (pediatric vs adult) differences have been overstated, although additional research on these topics is warranted. Traction toward improved outcomes will be supported by continued emphasis on pathophysiology and novel therapeutics. [ABSTRACT FROM AUTHOR]