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We tested whether difficulties in emotion regulation mediated the association between family functioning and non-suicidal self-injury (NSSI), and whether associations between family functioning, emotion regulation, and NSSI were moderated by social support. University students (N = 846, 75.8% female, 35.5% with a history of NSSI, Mage = 20.76) completed an online questionnaire including well-validated measures of family functioning, emotion regulation, social support, and NSSI. Poor family functioning was positively associated with history of NSSI, but not past 12-month frequency of NSSI. Difficulties in emotion regulation were positively associated with both history of NSSI and frequency of NSSI in the past 12 months. Social support from friends moderated the relationship between difficulties in emotion regulation and history of NSSI; the association was stronger at higher levels of support. Poor family functioning had an indirect effect on both history of NSSI and frequency of NSSI via difficulties in emotion regulation; however, for frequency the indirect effect was only observed when social support from friends and significant others were low. Poor family functioning, difficulties in emotion regulation, and social support work together to predict NSSI engagement among university students. Findings inform potential integration of current theories and design of targeted interventions. Highlights: We investigated family functioning, difficulties in emotion regulation, social support, and NSSI among university students. Poor family functioning and emotion regulation difficulties were positively associated with NSSI. Emotion regulation difficulties mediated relationships between poor family functioning and history and frequency of NSSI. This mediated effect was only present for NSSI frequency when social support from friends and significant others were low. Early intervention may target family functioning; intervention for university students may target emotion regulation. [ABSTRACT FROM AUTHOR]

The current study tested whether emotion regulation and rumination moderated and/or mediated the relationship between accumulated adverse life experience and psychological distress in adolescence. In class, Australian high school students (n = 2637, 12–18 years, 68% female) from 41 schools completed well‐validated measures of adverse life experience, emotion regulation, rumination and psychological distress, and were followed up 1 year later (n = 1973, 75% retention rate). Adjusting for age, gender and baseline psychological distress, adverse life experience predicted psychological distress 1 year later. Expressive suppression and rumination were positively associated with psychological distress. Cognitive reappraisal was negatively associated with psychological distress and moderated the relationship between adverse life experience and psychological distress. This relationship was also partially mediated by cognitive reappraisal, expressive suppression and rumination. Promoting cognitive reappraisal and minimizing expressive suppression and rumination may be useful strategies to improve mental health for adolescents who have experienced adverse life events. Future research should examine whether adolescents who have experienced adverse life events can be trained in effective emotion regulation strategies and whether this training can prevent development of psychological maladjustment. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

A recent systematic review of studies in the developing world has critically examined linkages from familial HIV/AIDS and associated factors such as poverty and child mental health to negative child educational outcomes. In line with several recommendations in the review, the current study modelled relationships between familial HIV/AIDS, poverty, child internalising problems, gender and four educational outcomes: non-enrolment at school, non-attendance, deficits in grade progression and concentration problems. Path analyses reveal no direct associations between familial HIV/AIDS and any of the educational outcomes. Instead, HIV/AIDS-orphanhood or caregiver HIV/AIDS-sickness impacted indirectly on educational outcomes via the poverty and internalising problems that they occasioned. This has implications for evidence-based policy inferences. For instance, by addressing such intervening variables generally, rather than by seeking to target families affected by HIV/AIDS, interventions could avoid exacerbating stigmatisation, while having a more direct and stronger impact on children's educational outcomes. This analytic approach also suggests that future research should seek to identify causal paths, and may include other intervening variables related to poverty (such as child housework and caring responsibilities) or to child mental health (such as stigma and abuse), that are linked to both familial HIV/AIDS and educational outcomes. [ABSTRACT FROM PUBLISHER]

Background: Suicidal behaviors are prevalent among college students; however, students remain reluctant to seek support. We developed a predictive algorithm to identify students at risk of suicidal behavior and used telehealth to reduce subsequent risk. Methods: Data come from s everal waves of a prospective cohort study (2016–2022) of college students (n = 5454). All first-year students were invited to participate as volunteers. (Response rates range: 16.00–19.93%). A stepped-care approach was implemented: (i) all students received a comprehensive list of services; (ii) those reporting past 12-month suicidal ideation were directed to a safety planning application; (iii) those identified as high risk of suicidal behavior by the algorithm or reporting 12-month suicide attempt were contacted via telephone within 24-h of survey completion. Intervention focused on support/safety-planning, and referral to services for this high-risk group. Results: 5454 students ranging in age from 17–36 (s.d. = 5.346) participated; 65% female. The algorithm identified 77% of students reporting subsequent suicidal behavior in the top 15% of predicted probabilities (Sensitivity = 26.26 [95% CI 17.93–36.07]; Specificity = 97.46 [95% CI 96.21–98.38], PPV = 53.06 [95% CI 40.16–65.56]; AUC range: 0.895 [95% CIs 0.872–0.917] to 0.966 [95% CIs 0.939–0.994]). High-risk students in the Intervention Cohort showed a 41.7% reduction in probability of suicidal behavior at 12-month follow-up compared to high-risk students in the Control Cohort. Conclusions: Predictive risk algorithms embedded into universal screening, coupled with telehealth intervention, offer significant potential as a suicide prevention approach for students. [ABSTRACT FROM AUTHOR]

HIV stigma--both "self-stigma" toward positive individuals and "stigma by association" toward their families--is linked with adverse mental health. This study examined how stigma was associated with the mental health of parents and children in South Africa. Parent-child dyads (n = 2,477 dyads) in South Africa participated in a cross-sectional survey. For both parents and children, greater stigma was associated with their own reports of greater anxious and depressive symptoms. Parents' reports of stigma were associated with children's greater anxious and depressive symptoms. Children's reports of stigma were related to parents' greater anxious and depressive symptoms. There was a significant interaction, such that the association between parent stigma and depression was stronger when children also reported high levels of stigma. Findings provided support the effect of HIV stigma on the mental health of families and illustrate the importance of taking a family-based approach to stigma-reduction interventions to alleviate mental health problems. [ABSTRACT FROM AUTHOR]

Little is known about risk and protective factors for emotional and physical child abuse in South Africa. Existing research has focused largely on sexual abuse and relied on recollections of childhood abuse from university and high-school students or data from criminal reports. The objective of this study was to establish risk and protective factors for severe physical and emotional abuse amongst a large cross-sectional community sample of South African youth. Confidential self-report questionnaires were completed by children aged 13-19 (n = 603, 47.9% female) with local interviewers in deprived areas of South Africa. Standardised measures of abuse, hypothesised risk factors and socio-demographic variables were used. Factors associated with severe physical and emotional child abuse were experience of family conflict ( p = 0.003), unequal food distribution ( p < 0.014), inconsistent discipline ( p = 0.012), number of caregiver changes ( p = 0.022), living with a step-parent ( p = 0.034), caregiver disability ( p = 0.004), food insecurity ( p = 0.006), bullying ( p < 0.001), acquired immunodeficiency syndrome (AIDS)-related stigma ( p < 0.001), sexual abuse ( p = 0.003), school non-attendance ( p = 0.006) and non-achievement ( p = 0.015). These identified risk and protective factors at community, school, caregiver and household levels have the potential to affect the risk of abuse for children in South Africa, and may be valuable fields for future intervention efforts. Copyright © 2013 John Wiley & Sons, Ltd. Key Practitioner Messages Risk and protective factors for physical and emotional child abuse have not been thoroughly studied in South Africa., Risk and protective factors for child abuse in South Africa include poverty, AIDS-related stigma, bullying, school non-attendance and achievement, sexual abuse, caregiver disability, inconsistent discipline, family conflict and living with a step-parent., Future research should focus on longitudinal data to establish causality and to examine the relationship between child abuse and caregiver AIDS sickness. [ABSTRACT FROM AUTHOR]

Families affected by HIV/AIDS in the developing world experience higher risks of psychosocial problems than nonaffected families. Positive parenting behavior may buffer against the negative impact of child AIDS-orphanhood and caregiver AIDS-sickness on child well-being. Although there is substantial literature regarding the predictors of parenting behavior in Western populations, there is insufficient evidence on HIV/AIDS as a risk factor for poor parenting in low- and middle-income countries. This paper examines the relationship between HIV/AIDS and positive parenting by comparing HIV/AIDS-affected and nonaffected caregiver-child dyads (n=2477) from a cross-sectional survey in KwaZulu-Natal, South Africa (27.7% AIDS-ill caregivers; 7.4% child AIDS-orphanhood). Multiple mediation analyses tested an ecological model with poverty, caregiver depression, perceived social support, and child behavior problems as potential mediators of the association of HIV/AIDS with positive parenting. Results indicate that familial HIV/AIDS's association to reduced positive parenting was consistent with mediation by poverty, caregiver depression, and child behavior problems. Parenting interventions that situate positive parenting within a wider ecological framework by improving child behavior problems and caregiver depression may buffer against risks for poor child mental and physical health outcomes in families affected by HIV/AIDS and poverty. [ABSTRACT FROM PUBLISHER]

Background: By 2008, 12 million children in sub-Saharan Africa were orphaned by AIDS. Cross-sectional studies show psychological problems for AIDS-orphaned children, but until now no longitudinal study has explored enduring psychological effects of AIDS-orphanhood in the developing world. Methods: A 4-year longitudinal follow-up of AIDS-orphaned children with control groups of other-orphans and non-orphans. 1021 children ( M = 13.4 years, 50% female, 98% isiXhosa-speaking) were interviewed in 2005 and followed up in 2009 with 71% retention (49% female, M = 16.9 years), in poor urban South African settlements. Children were interviewed using sociodemographic questionnaires and well-validated standardised scales for assessing depression, anxiety, and post-traumatic stress. Data were analysed using mixed-design ANOVA and backward-stepping regression. Results: AIDS-orphaned children showed higher depression, anxiety, and post-traumatic stress disorder (PTSD) scores in both 2005 and 2009 when compared with other-orphans and non-orphans. Backward-stepping regression, controlling for baseline mental health, and sociodemographic cofactors such as age, gender, and type of bereavement, revealed that being AIDS-orphaned in 2005 was associated with depression, anxiety, and PTSD scores in 2009. This was not the case for other-orphaned or non-orphaned children. Age interacted with orphan status, such that there was a steep rise in psychological distress in the AIDS-orphaned group, but no rise with age amongst other-orphans and non-orphans. Conclusions: Negative mental health outcomes amongst AIDS-orphaned children are maintained and worsen over a 4-year period. It is important that psychosocial support programmes are sustained, and focus on youth as well as young children. [ABSTRACT FROM AUTHOR]