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Suicidal thoughts and behaviors (STBs) are common among adolescent girls and increase risk for suicide death. Emotion regulation difficulties are linked with STBs, particularly in response to targeted social rejection. However, neural correlates of this link have not been investigated and may identify novel targets for interventions. Here, we examined neural correlates of emotion regulation before and after an experimentally delivered targeted social rejection in adolescent girls with STBs and girls without STBs (i.e., control participants). Girls (N = 138; age range, 9–15 years; mean [SD] age = 11.6 [1.79] years) completed a functional neuroimaging emotion regulation task. In the middle of the task, participants were socially rejected by an unfamiliar confederate whom the participants had elected to meet. Participants also completed a multimethod STB assessment. Before rejection, girls with a history of STBs, compared with control participants, showed greater activation in the right superior frontal gyrus when passively viewing negative stimuli, and girls with suicidal behavior (SB) versus those without SB showed less activation in the right frontal pole during emotion regulation attempts. Following the rejection, girls with STBs, compared with control participants, showed greater activation in the right inferior frontal gyrus during emotion regulation. Before social rejection, girls with SB versus without SB may not activate brain regions implicated in emotion regulation, suggesting a vulnerability to poor regulation at their baseline emotional state. After social rejection, girls with any history of STBs showed altered activation in a brain region strongly associated with inhibition and emotion regulation success, possibly reflecting increased effort at inhibiting emotional responses during regulation following stress exposure. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to analyze the real‐time variability of suicidal ideation intensity and the relationship between real‐time and retrospective reports of suicidal ideation made on the Beck Scale for Suicidal Ideation (BSS), among young people with borderline personality disorder (BPD). Methods: Young people (15–25‐year olds) with BPD (N = 46), recruited from two government‐funded mental health services, rated the intensity of their suicidal ideation six times per day for 7 days before completing the BSS. Results: For 70% of participants, suicidal ideation changed in intensity approximately five times across the week, both within and between days. BSS ratings were most highly correlated with the highest real‐time ratings of suicidal ideation. However, this was not significantly different from the relationship between the BSS and both the average and most recent ratings. Median ratings of suicidal ideation intensity were higher on the BSS compared with an equivalent question asked in real time. Conclusion: Findings suggest that young people with BPD experience high levels of fluctuation in their intensity of suicidal ideation across a week and that retrospective reports of suicidal ideation might be more reflective of the most intense experience of suicidal ideation across the week. [ABSTRACT FROM AUTHOR]

Introduction: Borderline personality disorder (BPD) is a serious psychiatric condition characterized by emotional, interpersonal, and behavioral dysregulation. Significant others (SOs: family member, romantic partner, friend) of those with BPD also endorse elevated mental health concerns. The general severity of BPD symptoms, and/or severity of specific BPD dysregulation components (i.e., emotional, interpersonal, or behavioral) may uniquely influence distinct SO mental health concerns. However, which specific mental health concerns are experienced by SOs of those with BPD, and whether and how BPD influences them, remains unknown. This study therefore aimed to: (1) characterize the mental health concerns (i.e., depression, anxiety, trauma exposure and posttraumatic stress disorder, objective and subjective burden, behavioral dysregulation) of SOs of those with BPD; and (2) clarify whether and how overall BPD symptom severity, and specific BPD dysregulation components, are associated with these SO mental health concerns. Methods: SOs of those with BPD (N = 46) completed measures of mental health concerns, and informant-reports of their loved one with BPD's symptom severity at baseline, 1-, and 2-month follow-ups. Results: SOs exhibited low psychopathology across all mental health concerns, except anxiety severity, which was moderate. Higher overall BPD symptom severity, emotion dysregulation, and behavioral dysregulation, but not interpersonal dysregulation, in the person with BPD predicted worse SO mental health concerns. Discussion: Behavioral and emotional BPD symptom domains may be particularly deleterious to SO mental health, and BPD treatment providers may wish to consider referrals for SO mental healthcare in such instances. [ABSTRACT FROM AUTHOR]

Emotion dysregulation (ED), the difficulty in modulating which emotions are felt, and when and how they are expressed or experienced, has been implicated in an array of psychological disorders. Despite potentially different manifestations depending on the disorder, this symptom is emerging as a transdiagnostic construct that can and should be targeted early, given the associations with various maladaptive behaviors as early as childhood and adolescence. As such, our goal was to investigate the psychotherapeutic interventions used to address ED and gauge their effectiveness, safety, and potential mechanisms across various populations. This umbrella systematic review, pre-registered under PROSPERO (registration: CRD42023411452), consolidates evidence from systematic reviews and meta-analyses on psychotherapeutic interventions targeting ED, in accordance with PRISMA guidelines. Our synthesis of quantitative and qualitative evidence from 21 systematic reviews (including 11 meta-analyses) points—with moderate overall risk of bias—to the effectiveness of Dialectical Behavior Therapy and Cognitive Behavioral Therapy in reducing ED in a wide range of adult transdiagnostic psychiatric patients and healthy participants. Similar results have emerged in other less extensively researched methods as well. However, results on adolescents and children are sparse, highlighting the need for additional research to tailor these interventions to the unique challenges of ED in younger populations with diverse externalizing and internalizing disorders. These demonstrated transdiagnostic advantages of psychotherapy for ED underscore the potential for specifically designed interventions that address this issue directly, particularly for high-risk individuals. In these individuals, early interventions targeting transdiagnostic core dimensions may mitigate the emergence of full-blown disorders. Future research on the mediating factors, the durability of intervention effects, and the exploration of understudied interventions and populations may enhance prevention and treatment efficiency, enhancing the quality of life for those affected by varied manifestations of ED. [ABSTRACT FROM AUTHOR]

There is a pressing need for effective treatments that address the high rate of suicide observed among people with psychosis. In this scoping review we highlight two suicidogenic treatment targets that have been relatively neglected in people with psychotic disorders: emotional distress and emotion dysregulation. We review the research on these constructs in psychosis and their relationship to suicide in this population, and then make clinical recommendations based on research findings. Emotional distress and emotional dysregulation may be promising treatment targets for suicide among people with psychosis. [ABSTRACT FROM AUTHOR]

Background: Dialectical behaviour therapy (DBT) is a popular treatment that targets emotional dysregulation, a key feature associated with borderline personality disorder (BPD). The majority of available literature exploring the effectiveness of DBT is based on research concerning female samples. Therefore, the application and efficacy of DBT as a treatment intervention for men and boys remains unclear. Methods: Multiple research databases were searched using a systematic review process for articles that reported on the use of DBT with male samples across any outcome measure and included pre‐ and post‐treatment symptom scores. Results: Nineteen studies met the inclusion criteria. Studies indicated that the application of DBT to male samples varies. Vast differences were found in treatment length, use of DBT modes and population settings. Most studies identified some benefits of DBT; however, the sample sizes were small and there was large heterogeneity across the studies. Conclusions: There is preliminary evidence supporting the use of DBT for males, specifically targeting anger and violence as well as emotional dysregulation and suicidality. Despite this, the limitations and heterogeneity from the current studies preclude the current review from drawing any definitive conclusions about the overall efficacy of the treatment in this population. [ABSTRACT FROM AUTHOR]

Background: Urinary incontinence (UI) might be linked to suicidal ideation, but we do not yet have all the relevant details. This study aimed to dig deeper into the connection between UI and suicidal ideation using data from the National Health and Nutrition Examination Survey (NHANES). Methods: We examined 31,891 participants aged ≥ 20 years from NHANES 2005–2018 who provided complete information. We used standardized surveys to check for UI and signs of suicidal ideation. To better understand this relationship, we used statistical tools such as multivariable logistic regression, subgroup analysis, and sensitivity analyses. Results: Among the 31,891 participants, 28.9% reported UI and 10.7% reported suicidal ideation. Those with UI exhibited a significantly greater incidence of suicidal ideation (15.5%) than did those without UI (8.8%, P < 0.001). After adjusting for various factors, including age, sex, marital status, socioeconomic status, educational level, lifestyle factors, and chronic comorbidities, UI remained significantly associated with suicidal ideation (OR:1.54, 95% CI = 1.39–1.7, P < 0.001). Among all types of UI, MUI participants were more likely to experience suicidal ideation. Compared with no UI, higher odds of suicidal ideation suffered from MUI (OR:2.11, 95%CI:1.83–2.44, P < 0.001), SUI (OR:1.4, 95%CI:1.19–1.65, P < 0.001), UUI(OR:1.37,95%CI:1.16–1.62, P < 0.001) after full adjustment. With the exception of individuals living with a partner, the remaining subgroups exhibited a positive correlation between urinary incontinence and suicidal ideation, considering that factors such as age, sex, and prevalent comorbidities such as hypertension, depression, and diabetes did not reveal any statistically significant interactions (all P > 0.05). Sensitivity analyses, incorporating imputed missing covariates, did not substantially alter the results (OR: 1.53, 95% CI: 1.4–1.68, P < 0.001). Conclusion: Urinary incontinence may correlate with increased suicidal ideation risk, priority screening for suicidal ideation and timely intervention are essential for individuals with urinary incontinence, but prospective studies are needed to verify the results. [ABSTRACT FROM AUTHOR]

Background: Major Depressive Disorder is a long-term, recurring, and very common illness that is associated with a significant decline in functional ability. The gold-standard method of treating depression is pharmacotherapy, which involves the use of antidepressant medications either alone or in various combinations. However, approximately 30% of Major Depressive Disorder patients suffer from Treatment Resistant Depression, a more severe condition that has a profound impact on patients' lives. Our study aims to conduct the first comprehensive review and meta-analysis to assess the effectiveness and safety of adding Dialectical Behavior Therapy to antidepressant medications compared to groups using pharmacotherapy alone as an intervention for adults with Treatment Resistant Depression. Materials and methods: We will search for publications in the following databases: Cochrane Central Register of Controlled Trials, MEDLINE, Embase, Lilacs, Web of Science, and PsycINFO. We will manually review the reference lists of the included studies to identify potentially relevant studies. There will be no restrictions on the language or publication date. Quality assessment of the included studies will be performed independently according to the Cochrane Risk of Bias instrument. To assess the certainty of the findings' body of evidence, we will use the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. This study aims to determine the effectiveness and safety of Dialectical Behavior Therapy as an intervention for Treatment Resistant Depression in adults. Ethics and dissemination: Ethical approval was not required as individual patient data was not obtained. Our intention is to publish the systematic review in a medical journal that offers open access upon completion of the process. Trial registration: PROSPERO registration numberCRD42023406301. Registered on March 24, 2023. [ABSTRACT FROM AUTHOR]

Dialectical behavior therapy (DBT) is widely acknowledged as an effective treatment for individuals with borderline personality disorder (BPD). However, the optimal treatment duration within DBT remains a topic of investigation. This retrospective, naturalistic non-randomized study aimed to compare the efficacy of 8 week and 12 week DBT interventions with equivalent content, focusing on the change of BPD-specific symptomatology as the primary outcome and depressive symptoms as the secondary outcome. Overall, 175 patients who participated in DBT and received either 8 week or 12 week intervention were included in the analysis. Routine inpatient treatment was adapted from standard DBT with the modules: skill training, interpersonal skills, dealing with feelings, and mindfulness. Measurements were taken at baseline, mid-point, and endpoint. The borderline symptom list-23 (BSL-23) was used for the assessment of borderline-specific symptoms, while the Beck depression inventory-II (BDI-II) was used for the assessment of depressive symptoms. Statistical analysis was conducted using linear mixed models. Effect sizes were calculated for both measures. The results of the analysis indicated an improvement in both groups over time. Effect sizes were d = 1.29 for BSL-23 and d = 1.79 for BDI-II in the 8 week group, and d = 1.16 for BSL-23 and d = 1.58 for BDI-II in the 12 week group. However, there were no differences in the change of BPD-specific symptoms or the severity of depressive symptoms between the 8 week and 12 week treatment duration groups. Based on these findings, shorter treatment durations, like 8 weeks, could be a viable alternative, offering comparable therapeutic benefits, potential cost reduction, and improved accessibility. However, further research is needed to explore factors influencing treatment outcomes and evaluate the long-term effects of different treatment durations in DBT for BPD. Trial registration: drks.de (DRKS00030939) registered 19/12/2022. [ABSTRACT FROM AUTHOR]

Objective: Borderline personality disorder (BPD) is the most common personality disorder, affecting 1.8% of the general population, 10% of psychiatric outpatients, and 15%–25% of psychiatric inpatients. Practice guidelines recommend psychotherapies as first-line treatments. However, psychotherapies commonly used for the treatment of BPD are numerous, and little is known about the comparative effectiveness of each individual psychotherapy versus treatment as usual (TAU) or other psychotherapies. To systematically assess the comparative effectiveness of commonly used psychotherapies versus TAU or versus other psychotherapies for BPD treatment. Method: We conducted systematic literature searches in MEDLINE, EMBASE, the Cochrane Library, and APA PsycINFO up to July 14, 2022, and searched reference lists of pertinent articles and reviews. Inclusion criteria were (a) patients 13 years or older with a diagnosis of BPD, (b) treatment with commonly used psychotherapies, (c) comparison with TAU or another psychotherapy, (d) assessment of relevant BPD-related health outcomes, and (e) randomized or nonrandomized trials or controlled observational studies. Two investigators independently screened abstracts and full-text articles and graded the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach. Results: We found 25 psychotherapy studies meeting inclusion criteria with data on 2,545 participants. Seventeen studies compared nine psychotherapies with TAU and nine studies compared eight psychotherapies with another psychotherapy for the treatment of BPD. Overall, both TAU and included psychotherapies were effective in treating the severity and symptoms of BPD. Moderate certainty of evidence suggests that systems training for emotional predictability and problem solving is more effective than TAU for the treatment of BPD; low certainty of evidence suggests that dialectical behavior therapy, schema therapy, transference-focused psychotherapy, acceptance and commitment therapy, manual-assisted cognitive therapy, and cognitive behavioral therapy are more effective than TAU for treating BPD. We were unable to draw conclusions from head-to-head comparisons of psychotherapies, which were limited to single studies with very low to low certainty of evidence. Conclusions: All commonly used psychotherapies improve BPD severity, symptoms, and functioning. Our assessment found no strong evidence suggesting that any one psychotherapy is more beneficial than another. What is the public health significance of this article?: For clinicians, this work can be used to inform practice guidelines on psychotherapies to treat BPD. For funders, policymakers, and researchers, this work identifies research gaps and opportunities for future research in the area. [ABSTRACT FROM AUTHOR]

Introduction Dialectical behavior therapy (DBT) is a multimodal evidence-based suicide prevention psychotherapy with barriers to full implementation. This study qualitatively examined barriers and facilitators to the DBT skills group treatment mode, which can be implemented as a stand-alone intervention. Using data from a national mixed-methods program evaluation of DBT in the Veterans Health Administration (VHA), this is the first article to examine barriers and facilitators to DBT skills groups implemented with a DBT consultation team or as a stand-alone intervention. Materials and Methods A subset of data from semi-structured telephone interviews of six clinicians and three administrators (n  = 9 respondents) was analyzed to provide complementarity and expansion on prior quantitative findings. The data were coded using an iterative process based on content analysis and a codebook based on the Promoting Action on Research Implementation in Health Services framework. The study was approved by the institutional review board for the Palo Alto VA Health Care System. Results Barriers and facilitators were organized by Promoting Action on Research Implementation in Health Services domains of evidence, context, and facilitation. Results showed how reduced leadership support and low receptivity to providing DBT skills groups functioned as barriers and also identified a barrier not described earlier in the literature: the perception that this group could conflict with expanding access to care for more veterans. The results showed how leadership supported implementation, including by mapping clinic grids and supporting training, and also revealed how a supportive culture among providers facilitated division of labor between skills group providers, and how offering a treatment that filled a gap in services supported the group. At some sites, a provider with prior DBT experience was instrumental in starting DBT skills groups or developing ongoing training. Conclusions Qualitatively analyzed barriers and facilitators to a group-delivered suicide prevention intervention, DBT skills groups, expanded on quantitative findings on the importance of leadership support, culture, and training as facilitators. Future work implementing DBT skills group as a stand-alone treatment will need to address the barrier of receptivity and perceived barriers about access to care. [ABSTRACT FROM AUTHOR]

Background: This study investigated the effectiveness of dialectical behavior therapy (DBT) in patients with borderline personality disorder (BPD) during the COVID-19 pandemic, assessing negative affect, depression, and anxiety levels as indicators of health. Methods: A total of 287 participants were recruited, including BPD patients at different stages of treatment and the general population without a diagnosis of BPD. Questionnaires were used to assess the fear of COVID-19 and the referenced health indicators. Results: No differences were observed between groups in levels of fear of COVID-19, but there were differences in the health indicators studied. BPD patients in long-term treatment showed levels of negative affect similar to those of the general population, while those in early treatment stages exhibited significantly higher levels. However, no significant improvements were observed in levels of depression and anxiety in the long-term treatment group compared to those who underwent the initial treatment phase. Conclusions: These findings underscore the importance of effectively intervening in BPD, especially in stress-inducing situations such as the pandemic, and suggest the need to explore complementary approaches to addressing depression and anxiety in this clinical context. [ABSTRACT FROM AUTHOR]

Purpose: Adolescents are particularly vulnerable to suicide attempts, which is a major risk factor for completed suicide in this age group. However, most research on suicide prevention interventions comes from high-income countries with predominantly white participants and English protocols. This study examines interventions that have been tested in Latin America and Spain. Methods: A systematic review was conducted to include interventions aimed at reducing suicide ideation, attempts, and increasing knowledge about it in these regions. Results: Sixteen articles were selected, and Dialectical Behaviour Therapy, Problem Solving Therapy, and Trauma-Focused Cognitive Behavioural Therapy were found to be more effective than standard treatments or wait-list conditions in reducing the outcomes. Discussion: This review highlights the need for more research on preventive interventions in Latin America and Spain. While all interventions evaluated were effective, further research and replication studies are necessary to strengthen the evidence base for these interventions. [ABSTRACT FROM AUTHOR]

Posttraumatic nightmares (PTN) are a frequent symptom after a traumatic event and often play part in the psychopathology of patients with borderline personality disorder (BPD). Imagery rehearsal therapy (IRT) currently offers the best evidence for an effective treatment to reduce PTNs, although high drop‐out rates are common. Art therapy in IRT may counteract this, by its indirect, nonverbal, and often playful approach that helps to break through avoidance. This case study focusses on the perception of a patient with BPD in an art therapy based IRT treatment for patients with PTNs. It tells the story of Aurelia, a 40‐year‐old woman who, within this treatment, processes traumatic contents of her childhood like physical and sexual violence, but also current interactional problems that manifest themselves in her nightmares. Following the IR‐AT treatment for PTNs Aurelia noticed a reduction in her nightmares, was less afraid of them and felt calmer towards her trauma. She expressed herself in the art medium and by this developed more self‐efficacy. Her process resulted in an integration of the trauma and a perceived decrease in borderline symptoms. Future research can build on this basis to further explore the mechanisms and effects of IR‐AT for PTNs. [ABSTRACT FROM AUTHOR]

Background: Recent findings suggest that brief dialectical behavior therapy (DBT) for borderline personality disorder is effective for reducing self-harm, but it remains unknown which patients are likely to improve in brief v. 12 months of DBT. Research is needed to identify patient characteristics that moderate outcomes. Here, we characterized changes in cognition across brief DBT (DBT-6) v. a standard 12-month course (DBT-12) and examined whether cognition predicted self-harm outcomes in each arm. Methods: In this secondary analysis of 240 participants in the FASTER study (NCT02387736), cognitive measures were administered at pre-treatment, after 6 months, and at 12 months. Self-harm was assessed from pre-treatment to 2-year follow-up. Multilevel models characterized changes in cognition across treatment. Generalized estimating equations examined whether pre-treatment cognitive performance predicted self-harm outcomes in each arm. Results: Cognitive performance improved in both arms after 6 months of treatment, with no between-arm differences at 12-months. Pre-treatment inhibitory control was associated with different self-harm outcomes in DBT-6 v. DBT-12. For participants with average inhibitory control, self-harm outcomes were significantly better when assigned to DBT-12, relative to DBT-6, at 9–18 months after initiating treatment. In contrast, participants with poor inhibitory control showed better self-harm outcomes when assigned to brief DBT-6 v. DBT-12, at 12–24 months after initiating treatment. Conclusions: This work represents an initial step toward an improved understanding of patient profiles that are best suited to briefer v. standard 12 months of DBT, but observed effects should be replicated in a waitlist-controlled study to confirm that they were treatment-specific. [ABSTRACT FROM AUTHOR]

Suicide is prevalent among young adults, and epidemiological studies indicate that insomnia, nightmares, and depression are significantly associated with a high incidence of suicidal ideation (SI). However, the causal relationship between these factors and SI remains unclear. Therefore, the purpose of this study was to examine the association between nightmares and depression and insomnia and SI in young adults, as well as to develop a mediation model to investigate the causal relationship between insomnia, nightmare, depression, and SI. We assessed insomnia, nightmares, depression, and SI in 546 young adults using the Insomnia Severity Scale (ISI), Disturbing Dream and Nightmare Severity Scale (DDNSI), Depression Study Scale (CESD-20), and Columbia-Suicide Severity Rating Scale (C-SSRS). Using the Bootstrap method, the mediation effects of nightmares and depression between insomnia and SI were calculated. The results demonstrated that nightmares and depression fully mediated the relationship between insomnia and SI, including the chain-mediation of insomnia and SI between nightmare and depression with an effect value of 0.02, 95% CI 0.01–0.04, and depression as a mediator between insomnia and SI with an effect value of 0.22, 95% CI 0.15–0.29. This study found that depression and nightmares may be risk and predictive factors between insomnia and SI, which implies that the assessment and treatment of depression and the simple or linked effect of nightmares play crucial roles in preventing SI in young adults. [ABSTRACT FROM AUTHOR]

ObjectiveMethodResultsConclusionWe investigated whether defense mechanisms in patients with borderline personality disorder (BPD) predict treatment response of dialectical behavior therapy (DBT) and whether they moderate outcome in different treatment lengths.We analyzed a subsample of 60 outpatients with BPD, randomized into either 6 (n = 30) or 12 (n = 30) months of DBT. The average level of defensive adaptiveness, assessed with observer-rated overall defensive functioning (ODF) and “immature” (i.e., maladaptive) defenses were used as predictors and moderators of self-reported frequency of self-harm. We conducted a Generalized Linear Mixed Model (GLMM).A lower ODF at treatment onset predicted smaller reductions in self-harm, irrespective of treatment length (IRR = 0.92, 95% CI = [0.86, 0.99], p = .020). Lower order “immature” (“major image distorting”) defenses showed significantly smaller (IRR = 1.13, 95% CI = [1.06, 1.21], p < .001) and higher order “immature” (“minor image distorting”) defenses showed significantly larger (IRR = .91, 95% CI = [.85, .97], p = .006) reductions in self harm in the 6-month but not in the 12-month treatment.Even though the results have to be regarded as preliminary due to the small sample size, findings might indicate that patients with BPD and lower average defensive adaptiveness may benefit from individualized treatment plans including specific interventions targeting defense function. [ABSTRACT FROM AUTHOR]

Sleep and circadian rhythm disorders are very common in adolescents and have been linked to suicidal ideation. However, little is known about adolescent sleep before a suicide attempt (SA). The objectives of this study were to compare the sleep of adolescents aged 13 to 18 over a period of 4 weeks before a SA compared to a non-SA group, then to analyze the association between sleep, support social and well-being based on information from validated questionnaires. In 2015, 250 adolescents were included, 55 were recruited the day after a SA in French hospitals (before SA evaluations were retrospective). Logistic regression analyzes showed that during school days, bedtime was equivalent in both groups, but sleep onset latency was significantly longer in SA (86 min vs. 52 min, p = 0.016), and wake-up time was earlier (6 h 22 vs. 6 h 47, p = 0.002), resulting in a shorter total sleep time of 44 min (OR = 0.76, CI 95% [0.61–0.93]) the month preceding SA. Adolescents with longer sleep time performed better on perceived psychological well-being (p = 0.005), relationship with parents (p = 0.011) and school environment (p < 0.001). Results indicate a significant change in the quantity and quality of adolescents' subjective sleep in the 4 weeks preceding SA requiring objective measures to study the predictive properties of sleep in SA. [ABSTRACT FROM AUTHOR]

Background: Suicide is a prominent source of harm and death globally, and it is the leading cause of premature death among prisoners. Therefore, the main aim of this study was to determine the prevalence and factors associated with suicidal ideation and attempt among prisoners in Northwest Ethiopia. Methods: An institution-based cross-sectional study design was performed from May 23 to June 22, 2022. After proportional allocation to the three correctional institutions, a total of 788 study participants were randomly recruited. The World Health Organization Composite International Diagnostic Interview (CIDI) was used to evaluate suicide ideation and attempt. To determine factors associated with suicidal ideation and attempt, multivariate logistic regression analyses were conducted. At a 95% confidence interval (CI) of P-value <0.05, statistical significance was declared. Results: The prevalence of suicidal ideation and attempt among prisoners was 23.6% and 10.7%, with 95% CI (20.76, 26.70) and (8.68, 13.02), respectively. Female sex (AOR = 2.38, 95% CI: 1.12, 5.05), family history of mental illness (AOR = 3.09, 95% CI: 1.93, 4.88), depression (AOR = 2.04, 95% CI: 1.43, 2.98), poor social support (AOR = 2.76, 95% CI: 1.56, 4.85) and previous incarceration (AOR = 1.84, 95% CI: 1.18, 2.86) were significantly associated with suicidal ideation. However, being single (AOR = 2.58, 95% CI: 1.47, 4.54), family history of suicide (AOR = 2.43, 95% CI: 1.18, 5.01), depression (AOR = 2.62, 95% CI: 1.59, 4.31) and previous imprisonments (AOR = 2.11, 95% CI: 1.20, 3.69) were associated with suicidal attempt. Conclusions: The prevalence of suicidal ideation and attempt among prisoners were found to be high. Therefore, the findings of this study recommend that early detection and design of prison mental health services should be delivered to develop mental health care, prevention, and intervention programs for incarcerated people to improve suicidal behavior in prison. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodResultsConclusionsThis study examined the effectiveness of dialectical behavior therapy (DBT) in a partial hospitalization program (PHP) for adolescents and young adults.In the present study, 146 patients (mean age = 17.5) in a DBT PHP completed surveys assessing suicidality, difficulties in emotion regulation, depression, and anxiety, as well as effective coping skills on their admission and discharge from the program.After a 20-day course of intensive DBT programming, patients showed statistically significant decreases, associated with mostly medium and large effect sizes, in suicidal behaviors, depression, anxiety, stress, and emotion dysregulation. Patients also showed significant increases in the use of mindfulness and functional coping skills.These results demonstrate the significant effects of intensive-level (PHP) DBT delivered over a relatively brief period to adolescents and young adults with severe difficulties. Future studies should explore DBT impact on additional treatment targets and identify the strongest predictors of improved outcomes. [ABSTRACT FROM AUTHOR]

Background: Deliberate self-harm (DSH) and emotion dysregulation (ED) peaks in adolescence, and is associated with an increased risk of psychopathology, suicide and lower functioning in adulthood. DBT-A has been established as an effective treatment for reducing DSH, however less is known about changes in emotion dysregulation. This study aimed to identify baseline predictors of treatment response in outcome trajectories of DSH and emotion dysregulation. Methods: Response trajectories of DSH and ED were investigated using Latent Class Analysis on RCT data comparing DBT-A and EUC for 77 adolescents treated for deliberate self-harm and borderline traits. Logistic regression analysis was used to examine baseline predictors. Results: Two-class solutions were selected for both indicators, distinguishing between early and late responders in DSH, and responders and non-responders in ED. Higher levels of depression, shorter DSH histories and not receiving DBT-A predicted less favourable response in DSH, while DBT-A was the only predictor of treatment response in ED. Conclusions: DBT-A was associated with a significantly faster reduction of deliberate self-harm in the short-term and improved emotion regulation in the long-term. [ABSTRACT FROM AUTHOR]

Background: Higher education is associated with reduced depressive symptoms and requires investment without guaranteed employment. It remains unclear how sex and employment status together contribute to the association between mental health and educational attainment. This study investigated the role of sex and employment status together in the associations of 1) depressive symptoms and 2) suicidal ideation with education. Methods: Using 2005–2018 National Health and Nutrition Examination Survey data, cross-sectional analyses were conducted on individuals ≥20 years who completed the depression questionnaire and reported their employment status and highest level of education. Survey-weighted multivariable logistic regression models were used to explore how depressive symptoms and suicidal ideation are associated with educational attainment in an analysis stratified by sex and employment status. To account for multiple testing, a significance level of a < 0.01 was used. Results: Participants (n = 23,669) had a weighted mean age of 43.25 (SD = 13.97) years and 47% were female. Employed females (aOR = 0.47, 95% CI 0.32, 0.69), unemployed females (aOR = 0.47, 95% CI 0.29, 0.75), and unemployed males (aOR = 0.31, 95% CI 0.17, 0.56) with college education had reduced odds of depressive symptoms compared to those with high school education. Employed females with college education also had reduced suicidal ideation odds compared to those with high school education (aOR = 0.41, 95% CI 0.22, 0.76). Conclusions: Females demonstrated significant associations between depressive symptoms and education, regardless of employment status, whereas males demonstrated an association only if unemployed. Employed females, in particular, demonstrated a significant association between suicidal ideation and education. These findings may inform future research investigating the underlying mechanisms and etiology of these sex-employment status differences in the association between mental health and education. [ABSTRACT FROM AUTHOR]

Introduction: Borderline personality disorder (BPD) is a disorder of pervasive emotion dysregulation associated with high rates of self‐injurious thoughts and behaviors (SITB). Understanding specific emotion states in relation to SITB is important for effective intervention. Methods: The current study examined whether, and how, the specific emotion of shame contributes to suicide ideation and urges to engage in non‐suicidal self‐injury (NSSI) both directly, and indirectly via anger, among individuals with BPD. Participants (N = 100) were enrolled in a 6‐month comprehensive dialectical behavior therapy (DBT) program and provided daily ratings of shame, anger, suicide ideation, and urges for NSSI. Results: We found that higher daily ratings of shame and anger were directly associated with higher same‐day ratings of both suicidal ideation and urges for NSSI. Furthermore, anger partially mediated the relationships between shame and both suicidal ideation and urges for NSSI. Conclusion: These findings highlight shame and anger as potential antecedents of SITB among individuals with BPD. Clinical approaches, such as DBT, that include personalized, ongoing, clinical assessment of these specific affective states may be particularly important for treatment of SITB. [ABSTRACT FROM AUTHOR]

Introduction: Mentalization‐based therapy (MBT) and its adapted version for adolescents (MBT‐A) are repeatedly highlighted as promising treatments for reducing self‐harm, particularly in borderline personality disorder (BPD). Despite the availability of publications providing evidence of their efficacy in reducing self‐harm, recent meta‐analyses have yielded mixed results. To inform best‐practice clinical decision‐making, we conducted a systematic review and meta‐analysis. We aimed to disentangle findings for both adolescents and adults on the efficacy of MBT(‐A) in reducing self‐harm (primary outcome) and symptoms of BPD and depression (secondary outcomes). Methods: Web of Science, Scopus, Embase, PubMed/Medline, and Cochrane Review Database were searched for eligible studies published until September 2022. In total, 14 studies were identified, comprising 612 participants from nine MBT studies (six pre–post, three RCTs) and five MBT‐A studies (two pre–post, three RCTs). Aggregated effect sizes were estimated using random‐effects models. Meta‐regressions were conducted to assess the effect of moderator variables (treatment duration, drop‐out rates, and age) on effect sizes. Results: Overall, both MBT and MBT‐A demonstrated promising effects in reducing self‐harm (g = −0.82, 95% CI −1.15 to −0.50), borderline personality disorder (g = −1.08, 95% CI −1.38 to −0.77), and depression (g = −1.1, 95% CI −1.52 to −0.68) symptoms. However, when compared to control interventions (TAU, SCM), MBT(‐A) did not prove to be more efficacious, with the exception of MBT showing superior effects on BPD symptoms in adults (g = −0.56, 95% CI −0.88 to −0.24). Conclusion: Although the pre–post evaluations seem promising, this analysis, including RCTs, showed no superiority of MBT(‐A) to control conditions, so that prioritizing the application of MBT (‐A) for the treatment of self‐harm is not supported. Possible explanations and further implications are discussed. [ABSTRACT FROM AUTHOR]

Summary: Suicidal risk in mothers is a public health priority. Risk factors include biological, psychological and psychosocial factors. Among the biological factors, the role of sleep disturbances as potential contributors to increased suicidal risk during the peripartum period is becoming apparent. To explore this further, we conducted a systematic review following the PRISMA criteria. Currently, 10 studies have examined the role of insomnia and poor sleep quality in suicidal risk during the peripartum period and have involved 807,760 women. The data showed that disturbed sleep and poor sleep quality increase the risk of suicidal ideation in both pregnant women with and without perinatal depression. The results of the meta‐analysis indicated that insomnia and poor sleep quality increase the odds of suicidal risk in pregnant women by more than threefold (OR = 3.47; 95% CI: 2.63–4.57). Specifically, the odds ratio (OR) for poor sleep quality was 3.72 (95% CI: 2.58–5.34; p < 0.001), and for insomnia symptoms, after taking into account perinatal depression, was 4.76 (95% CI: 1.83–12.34; p < 0.001). These findings emphasise the importance of assessing and addressing sleep disturbances during the peripartum period to mitigate their adverse effects on peripartum psychopathology and suicidal risk. [ABSTRACT FROM AUTHOR]

Dance Movement Therapy is gradually becoming recognized as a treatment option in Mental Health Care. However, the working mechanisms can be difficult to comprehend without experiential knowledge of this therapy form. This article aims to offer insight into the clinical application of Dance Movement Therapy for Sanne, a woman with a history of interpersonal relationship difficulties, problems with self‐regulation, low self‐efficacy and diagnosed with Borderline Personality Disorder and co‐morbid Complex Post Traumatic Stress Disorder. This case illustration describes treatment interventions during two months of bi‐monthly Dance Movement Therapy as an additional treatment alongside weekly group therapy and bi‐monthly individual Psychotherapy. Post treatment, Sanne demonstrates improvements in self‐regulatory behavior, interpersonal relationships and self‐efficacy as well as an experience she describes as being whole. This article highlights the implications for practitioners of embodied forms of therapy as well as multidisciplinary teams who wish to better understand how the use of opposites within Dance Movement Therapy may be used as an additional intervention for people with Borderline Personality Disorder and co‐morbid complex Post Traumatic stress Disorder. [ABSTRACT FROM AUTHOR]

Objective: Complex post‐traumatic stress disorder (CPTSD) is a classification within the International Classification of Diseases, 11th Revision (ICD‐11) that, besides the DSM‐5 symptom clusters of post‐post‐traumatic stress disorder (PTSD), includes the presence of negative self‐concept, difficulties in regulating emotions and relationship skills. The purpose of the present study was to provide guidance on how to deliver Eye Movement Desensitization and Reprocessing (EMDR) therapy in the context of CPTSD, based on current clinical knowledge and the latest scientific research findings. Method: This paper describes the treatment of a 52‐year‐old woman with CPTSD and borderline personality disorder for which immediate trauma‐focused EMDR therapy was used. Results: First, a description of what EMDR therapy entails and some important treatment strategies that the therapist may employ to assist in trauma‐focused treatment of clients with CPTSD using EMDR therapy are outlined. Conclusion: The treatment results are in line with mounting evidence supporting the notion that EMDR therapy is a safe and potentially effective treatment alternative for individuals with CPTSD or personality problems. [ABSTRACT FROM AUTHOR]

This paper is concerned with the lure of redemption in contemporary academic and accounts of exhaustion, endurance, and biopolitical life. Drawing on, and contributing to recent work on negativity in cultural geography, the paper analyses how optimism and redemption find their way in to academic writing on the contemporary condition. It interrogates the optimism in these literatures, paying attention to the genealogical roots of the propensity to redeem accounts of slow and attritional violence and biopolitical subjectivity. In particular, the paper charts the implicit politics and ethics at play in the invocation of the Deleuzian 'otherwise' which haunts many accounts of the transformatory potential of exhaustion, and the remnants of dialectical historicism and Christian morality at the heart of redemption narratives in accounts of endurance. The paper ends by questioning the motives behind such hopeful readings, and asks what it might entail to refuse to redeem tales of violence with optimistic glimmers of an as-yet unspecified world. [ABSTRACT FROM AUTHOR]

Individuals with borderline personality disorder (BPD) often report chronic, severe self-hatred. It is frequently experienced as immutable, seen as a barrier to recovery, and is associated with risk for self-injury and suicide attempts. Yet self-hatred remains a poorly understood, underdiagnosed, and undertreated presentation of BPD. In this concept article and review, we describe the nature of self-hatred in BPD and related disorders, propose a theory as to the development of self-hatred in BPD, review the assessments of and interventions for self-hatred, and consider next steps in the research, assessment, and treatment of self-hatred in BPD. Through increased awareness, understanding, and measures of self-hatred in BPD, new treatment paradigms can be developed to ensure more comprehensive recovery. [ABSTRACT FROM AUTHOR]

Dialogism and dialectical knowledge making have long subtended theories of written discourse and therefore the design of rhetoric and writing curricula. As universities move toward interdisciplinary and applied disciplinary epistemologies, theories of written discourse based in the dialogical and dialectical tradition require new scrutiny. This article synthesizes scholarship from the rhetoric of science, written communication theory, and transdisciplinary theory to develop a new poly-logical and poly-lectical approach to written communication for interdisciplinary discourse. The article concludes with examples of hermeneutic and heuristic invention strategies for rhetoric and composition pedagogy that can encourage poly-logical and poly-lectical inquiry on contemporary interdisciplinary issues. [ABSTRACT FROM AUTHOR]

This paper looks at how a metaphoric vocabulary borrowed from the skazka was used to illustrate dialectical materialism in popular science writing of the early 1930s. In examining the emergence and function of this new style, which I term "dialectical skazochnost'," I offer an explanation of the animated nature trope, which appeared frequently in texts for young readers during the First Five‐Year Plan. Rather than contradicting materialism, the anthropomorphization of non‐living matter in stories about "conquering nature" arose out of an effort to illustrate how natural forces previously considered immutable could be transformed for human use. A popular conception of dialectical materialism guided this use of figurative language, which had been scorned by radical critics during the skazka debates of the late 1920s. I look primarily at two books by M. Il'in, The Story of the Great Plan (1930) and Men and Mountains (1935), which exemplify the use of dialectical skazochnost'. [ABSTRACT FROM AUTHOR]

Complex posttraumatic stress disorder (CPTSD) is a term representing the psychopathological implications of exposure to chronic, inter‐personal trauma. These include the main symptoms of PTSD, as well as changes in identity, emotion regulation, and inter‐personal relationships. Self‐harm and dissociation (i.e., disintegration of mental processes) are also quite common in CPTSD. Considering this complex and often severe clinical picture, mental health professionals often find it difficult to effectively treat CPTSD. In this paper, we present an integrative approach to the treatment of CPTSD based on a combination of techniques from several psychotherapy approaches. The case described here illustrates the need for therapeutic flexibility and eclecticism when treating individuals exposed to chronic trauma. We show the advantages of flexible therapeutic attunement, which enables the therapist to respond to the changing need of the patient, as well as her fluid clinical picture and symptom manifestation. The case also illustrates how interventions taken from psychodynamic therapy, Dialectical behavior therapy, and Eye Movement Desensitization and Reprocessing may be applicable in various stages of treatment, alleviating the patient's distress in several psychological and physical domains. [ABSTRACT FROM AUTHOR]

Student-run and student-staffed behavioral health clinics increase service capacity and access to low-cost services and are usually created by medical schools and behavioral health graduate programs. There is little information about student-staffed programs developing independently of academic institutions. As the demand for mental health services continues to grow, it is essential that successful models of community-based service provision are shared so other agencies can replicate models and increase service capacity. This article outlines the elements of a student-staffed behavioral health program model run by a nonprofit. Details on staffing, student selection, supervision, evaluation methods, supplemental training, and funding are included. [ABSTRACT FROM AUTHOR]

This article argues that Returning Souls, directed by anthropologist Hu Tai-Li, expresses cultural revitalization sensuously, sensibly, and dialectically in documenting the repatriation of ancestral souls to the indigenous Taiwanese village Tafalong. The images in Returning, through montage, offer a way of accessing and representing the dialectical tensions of myth, indigeneity, historical reality, and secularization among the indigenous Tafalong people. In examining their autonomy and vitality, Hu presents a splintered world populated with fragmented histories and constructed through humor acts and interplays among ritual-images and myth-images. Moreover, she explores the image-spectator relation structure, using images to stimulate meanings relevant to her innermost concern for the indigenous Taiwanese through sensory experiences and embodied knowledge and materiality, toward regional aesthetics. In engagingly juxtaposing and interposing images, Hu's radical cinematic deployments based on the historical enmeshment of the indigenous Taiwanese work toward ushering in new possibilities for archiving indigenous material in the future. [ABSTRACT FROM AUTHOR]

Suicidal ideation is a substantial clinical challenge in treatment-resistant depression (TRD). Recent work demonstrated promising antidepressant effects in TRD patients with no or mild suicidal ideation using a specific protocol termed intermittent theta burst stimulation (iTBS). Here, we examined the clinical effects of accelerated schedules of iTBS and continuous TBS (cTBS) in patients with moderate to severe suicidal ideation. Patients with TRD and moderate to severe suicidal ideation (n = 44) were randomly assigned to receive accelerated iTBS or cTBS treatment. Treatments were delivered in 10 daily TBS sessions (1800 pulses/session) for 5 consecutive days (total of 90,000 pulses). Neuronavigation was employed to target accelerated iTBS and cTBS to the left and right dorsolateral prefrontal cortex (DLPFC), respectively. Clinical outcomes were evaluated in a 4-week follow-up period. Accelerated cTBS was superior to iTBS in the management of suicidal ideation (p week 1 =.027) and anxiety symptoms (p week 1 =.01). Accelerated iTBS and cTBS were comparable in antidepressant effects (p <.001; accelerated cTBS: mean change at weeks 1, 3, 5 = 49.55%, 54.99%, 53.11%; accelerated iTBS: mean change at weeks 1, 3, 5 = 44.52%, 48.04%, 51.74%). No serious adverse events occurred during the trial. One patient withdrew due to hypomania. The most common adverse event was discomfort at the treatment site (22.73% in both groups). These findings provide the first evidence that accelerated schedules of left DLPFC iTBS and right DLPFC cTBS are comparably effective in managing antidepressant symptoms and indicate that right DLPFC cTBS is potentially superior in reducing suicidal ideation and anxiety symptoms. [ABSTRACT FROM AUTHOR]

Background: WHO statistics show that someone attempts suicide every three seconds and commits suicide every 40 seconds somewhere in the world. There is a scarcity of aggregate evidence in Ethiopia. The aim of this review was to assess the pooled prevalence of suicidal ideation, attempts, and associated factors among adult HIV/AIDS patients in Ethiopia to fill this gap. Methods: We extensively searched the bibliographic databases of PubMed, MEDLINE, Scopus, Google Scholar, and the Web of Science to obtain eligible studies. Further screening for a reference list of articles was also done. The Microsoft Excel Spreadsheet was used to extract data, and Stata 17 was used for analysis. To check heterogeneity, the Higgs I2 and Cochran's Q tests were employed. Sensitivity and subgroup analysis were implemented. To detect publication bias, Egger's test and funnel plots were used. Results: The pooled prevalence of suicidal ideation and attempts among adult HIV/AIDS patients in Ethiopia was 20.3 with a 95% CI (14, 26.5) and 11.1 with a 95% CI (6.6, 15.5), respectively. Living alone (AOR 4.98; 95% CI: 2.96–8.37), having comorbidity or other opportunistic infection (AOR 4.67; 95% CI: 2.57–8.48), female sex (AOR 2.86; 95% CI: 1.76, 4.62), having WHO clinical stage III of HIV (AOR 3.69; 95% CI: 2.15, 6.32), having WHO clinical stage IV of HIV (AOR 5.43; 95% CI: 2.81, 10.53), having co-morbid depression (AOR 5.25; 95% CI: 4.05, 6.80), having perceived HIV stigma (AOR 2.53; 95% CI: 1.67, 3.84), and having family history of suicidal attempt (AOR 2.79; 95% CI: 1.38, 5.66) were significantly associated with suicidal ideation. Being female (AOR 4.33; 95% CI: 2.36, 7.96), having opportunistic infections (AOR 2.73; 95% CI: 1.69, 4.41), having WHO clinical stage III of HIV (AOR 3.78; 95% CI: 2.04, 7.03), having co-morbid depression (AOR 3.47; 95% CI: 2.38, 5.05), having poor social support (AOR 3.02; 95% CI: 1.78, 5.13), and having WHO clinical stage IV (AOR 7.39; 95% CI: 3.54, 15.41) were significantly associated with suicidal attempts. Conclusion: The pooled magnitude of suicidal ideation and attempt was high, and factors like opportunistic infection, WHO clinical stage III of HIV, WHO clinical stage III of HIV, and co-morbid depression were related to both suicidal ideation and attempt. Clinicians should be geared towards this mental health problem in HIV patients during management. [ABSTRACT FROM AUTHOR]

Suicide and self-harm have significant health, economic and social costs. Group-based interventions can be an effective and advantageous treatment approach; however, there is little evidence on the application of these groups in youth community mental health settings in Australia. Using the RE-AIM framework, we explore the feasibility and implementation of two group programmes in a youth-focussed community-based mental health service: dialectical behaviour therapy-adolescent (DBT-A) and cognitive behavioural Self and Strength (S&S). Data were collected from an Australian community mental health service that implemented two group therapy treatments over 12 months. RE-AIM implementation framework outcomes included programme reach (patient flow, group uptake, treatment completion), effectiveness (youth and care clinical outcomes), adoption (staff perception), implementation (barriers), and maintenance (service commitment and acceptability). Groups were considered for all eligible clients (61% of referrals), of these 36% accepted treatment and of those who commenced, 71% completed DBT-A and 82% completed S&S. DBT-A participants reported improved suicidality, emotion dysregulation, self-harm and quality of life (QoL). S&S participants reported improved QoL. Despite small sample size, treatment was acceptable to participants, with high retention and adherence across both groups. Clinicians involved in facilitation noted positive clinical impacts. Group-based interventions have the potential to reduce emotion dysregulation difficulties for youth. Understanding barriers to uptake of group programmes in community-based mental health settings is essential to improve the reach and implementation of group programmes. What is already known about this topic: Self-harm and suicide are major public health concerns for youth, with self-harm linked to suicide completion. High rates of self-harm and emotion dysregulation occur in youth presenting to community-based mental health services. Clinicians need to be able to offer evidence-based interventions to support these individuals. Group-based interventions for emotion dysregulation present an opportunity to improve health outcomes, facilitate skill development and encourage social help-seeking behaviour. What this topic adds: Group-based interventions for emotion dysregulation have positive clinical outcomes for young people who engage in these programmes and offer potentially cost-effective solutions to addressing youth mental health; however, reach was low. Staff facilitators and group participants reported high acceptability and provided positive feedback on the group programmes. Further investigation into the barriers for group therapy is required to develop and implement strategies to increase uptake of group therapy. [ABSTRACT FROM AUTHOR]

Introduction: Epistemic trust, or trust in transmitted knowledge, has been proposed as a critical factor in psychopathology and psychotherapy. This study aimed at evaluating the psychometric properties of the Epistemic Trust, Mistrust, and Credulity Questionnaire (ETMCQ) in Iran. Method: Data were collected from 906 participants. Along with the ETMCQ, measures of mentalizing, mindfulness, perspective‐taking, attachment, emotion dysregulation, and borderline personality disorder were administered. Confirmatory factor analysis and exploratory structural equation modeling (ESEM) were used to determine factorial structure. Results: The ESEM model showed an acceptable fit and outperformed the confirmatory model. A 14‐item version of the ETMCQ was retained after examining item performance. Our findings also established criterion‐related validity for mistrust and credulity, an acceptable internal consistency for credulity, discriminant power for mistrust and credulity in detecting positive screens for borderline personality disorder, and measurement invariance across sexes. Conclusion: This study provides evidence for the cross‐cultural applicability of the ETMCQ. Nonetheless, the validity of the trust and internal consistency of the mistrust subscale require particular attention in future research. [ABSTRACT FROM AUTHOR]

Background: Research suggests that individuals with a mental health diagnosis often engage in social media to access support for their diagnosis. However, there is a lack of information on online usage in those diagnosed with borderline personality disorder (BPD). Furthermore, there is little research using qualitative interviews to examine the use of social media, such as YouTube, for psychological support. Purpose: The aim of the present study was to explore experiences of YouTube in individuals diagnosed with borderline personality disorder, including its impact on their offline lives. Methods: Six participants were recruited on social media; all those who contacted the researcher and met inclusion criteria were interviewed. Semi-structured interviews were used, lasting between 40 and 60 min. Data were transcribed verbatim and analysed using interpretive phenomenological analysis. Findings: The analysis produced two global themes: 'YouTube as a form of self-help' and 'YouTube transforming the self'. Limitations: All the participants were female, limiting transferability of the findings. Originality: This paper is the first to show that YouTube could be used in addition to regular support to initiate recovery for those with BPD. It could provide them with a way to reduce self-stigma, enhance self-awareness and learn coping techniques. [ABSTRACT FROM AUTHOR]

Modernization is the process of transformation and development from traditional agricultural society to modern industrial society and information society. A necessary path and inevitable choice for human society in its development to an advanced stage, modernization represents the direction of progress and driving force of development for human civilization. At once a reflection and critique, a dialectical sublation, and an overall transcendence of traditional society, modernization is led by an advanced class that embodies the contemporary spirit. For its promotion, modernization relies principally on the three levers of science and technology, capital, and the market, and as its goal, it posits the realization of industrialization, urbanization, and informatization. Led by the Communist Party of China (CPC), the Chinese path to modernization is socialist in its essence, and possesses not only the common properties of modernization, but also Chinese characteristics based on China's particular national conditions. Specifically, this path embodies the people-centered concept of modernization, is committed to achieving all-round human development and social progress, surpasses the object-centered model of Western modernization guided by the logic of capital, and provides a new choice and development direction for humanity in achieving modernization. [ABSTRACT FROM AUTHOR]

This document contains a collection of abstracts related to psycho-oncology research. The abstracts cover a range of topics, including the needs of cancer survivors, the experiences of caregivers, the role of self-efficacy in mental health, and the implementation of screening tools. The studies emphasize the importance of tailored interventions, cultural sensitivity, and addressing the unique challenges faced by different populations. The findings highlight the need for further research and the development of effective interventions to improve psychosocial support for cancer patients and their families. The integration of psychiatric oncology services and the use of electronic patient-reported outcomes are also discussed as potential strategies to enhance mental health care in oncology settings. [Extracted from the article]

This document is a collection of abstracts from a symposium on adolescent and young adult (AYA) psycho-oncology research and practice. The symposium focuses on the unique psychosocial challenges faced by AYAs with cancer and explores different research approaches and interventions to address these challenges. The presentations cover topics such as social genomics, artificial intelligence (AI) for distress monitoring, and computer-based cognitive-behavioral therapy. The symposium aims to highlight the importance of transdisciplinary research and its implications for future AYA cancer research, practice, and policy. Additionally, the document includes presentations on the psychosocial needs of vulnerable hematopoietic stem cell transplantation (HSCT) recipients and the disparities in psychosocial care for AYA HSCT recipients. The abstracts provide insights into ongoing research and interventions aimed at improving the psychosocial well-being of AYAs with cancer and HSCT recipients. The text discusses the need for further studies on psychosocial care for adolescent and young adult bone marrow transplant (BMT) recipients, particularly in diverse clinical settings. It highlights the barriers faced by Latin patients undergoing hematopoietic stem cell transplantation (HSCT), such as inadequate care coordination and sociopolitical factors. The importance of care coordination for patients with complex needs during HSCT is also emphasized. Additionally, the text explores the challenges and significance of saying the final goodbye to terminally ill patients, particularly in different age groups and from the perspective of trainees. [Extracted from the article]

Chronic pain affects nearly 20% of the U.S. population. It is a leading cause of disability globally and is associated with a heightened risk for suicide. The role of the central nervous system in the perception and maintenance of chronic pain has recently been accepted, but specific brain circuitries involved have yet to be mapped across pain types in a large-scale study. We used data from the UK Biobank (N = 21,968) to investigate brain structural alterations in individuals reporting chronic pain compared with pain-free control participants and their mediating effect on history of suicide attempt. Chronic pain and, more notably, chronic multisite pain was associated with, on average, lower surface area throughout the cortex after adjusting for demographic, clinical, and neuropsychiatric confounds. Only participants with abdominal pain showed lower subcortical volumes, including the amygdala and brainstem, and lower cerebellum volumes. Participants with chronic headaches showed a widespread thicker cortex compared with control participants. Mediation analyses revealed that precuneus thickness mediated the relationship of chronic multisite pain and history of suicide attempt. Mediating effects were also identified specific to localized pain, with the strongest effect being amygdala volume in individuals with chronic abdominal pain. Results support a widespread effect of chronic pain on brain structure and distinct brain structures underlying chronic musculoskeletal pain, visceral pain, and headaches. Mediation effects of regions in the extended ventromedial prefrontal cortex subsystem suggest that exacerbated negative internal states, negative self-referencing, and impairments in future planning may underlie suicidal behaviors in individuals with chronic pain. [ABSTRACT FROM AUTHOR]

This study aimed to compare dialectical behavior therapy (DBT), acceptance and commitment therapy (ACT) and mindfulness based stress reduction (MBSR) effects on irritable bowel syndrome (IBS) symptoms, quality of life (QOL), anxiety and depression among patients with IBS. Eighty three eligible patients with a Rome- IV diagnosis were randomly allocated in DBT, MBSR, ACT, and control groups (n = 22 per group). All the patients were evaluated for IBS symptoms by IBS Severity Scoring System (IBS-SSS), QOL by irritable bowel syndrome quality of life (IBS-QOL), anxiety by Beck's Anxiety Inventory (BAI) and depression by Beck Depression Inventory- II (BDI-II) on the studied groups at the time of their inclusion in the study and 8 weeks after it. Each of the intervention groups took part in 8 group sessions. Conversely, the control group were evaluated without any intervention. 54 male and 29 female in 4 groups completed the study: DBT (n = 20), MBSR (n = 19), ACT (n = 22), and control groups (n = 22). The results showed significant differences between the groups based on the variables of the IBS-SSS, IBS-QOL, BAI and BDI-II (p < 0.05). Furthermore, the ACT intervention had considerably lower levels of IBS symptoms, anxiety, and depression compared to the other groups; also, the significant impacts of the QOL variable showed the higher scores of the ACT compared to the treatment groups. The therapies could not be applied to other groups of people. Other shortcomings were the absence of a follow-up strategy. This research offers preliminary evidence that ACT is more successful than other therapy groups in reducing IBS symptoms, anxiety and sadness, and improving QOL in IBS patients. [ABSTRACT FROM AUTHOR]

Based on Uno's new insight that in the first chapter on the commodity, the value of a commodity is not yet defined as objectified abstract labor, this article first examines the problems in Marx's value form theory and presents a new understanding of the simple, the expanded, and the general value form, and reformulates the theory of the commodity into a dialectical whole composed of the world of commodities. Second, the article responds to Elena Lange's critique of Uno's value theory. Third, the article argues that fetishism of the commodity never originates from alienated abstract labor but from a specific relationship between commodity owners; therefore, the theories of value form and fetishism of the commodity address the common theme. A reformulated theory of the value form should integrate, not omit, the fetishism of the commodity within it. JEL Classification: B14, B41, D46 [ABSTRACT FROM AUTHOR]

The culture around personality disorder treatment has changed drastically in the past generation. While once perceived as effectively untreatable, there are now numerous evidence-based treatment approaches for personality disorders (especially borderline personality disorder). The questions, however, of who should be matched to which treatment approach, and when, remain largely unanswered. In other areas of psychiatry, particularly substance use disorders and eating disorders, assessing patient treatment readiness is viewed as indispensable for treatment planning. Despite this, relatively little research has been done with respect to readiness and personality disorder treatment. In this article, we propose multiple explanations for why this may be the case, relating to both the unique features of personality disorders and the current cultural landscape around their treatment. While patients with personality disorders often face cruel stigmatization, and muchmore work needs to be done to expand access to care (i.e., our system's readiness for patients), even gold-standard treatment options are unlikely to work if a patient is not ready for treatment. Further study of readiness in the context of personality disorders could help more effectively match patients to the right treatment, at the right time. Such research could also aid development of strategies to enhance patient readiness. [ABSTRACT FROM AUTHOR]

Objectives: South Africa instituted one of the world's strictest lockdowns during the COVID‐19 pandemic, which generated heightened conditions of psychosocial stress and posed widespread mental health risks. Despite the elevated burdens of suicidal behaviors and risk of psychiatric disease in the country, few studies have examined the impacts of psychosocial stress from the pandemic on suicidal ideation in South Africa. This study examined the association between psychosocial stress experienced under the COVID‐19 pandemic and adult suicidal ideation, as well as degree to which sleep quality and duration mediated this relationship. Methods: An online survey assessed experiences of COVID‐19 psychosocial stress, sleep quality and duration, and suicidal ideation in a sample of 189 South African adults during the second and third waves of the COVID‐19 pandemic. A causal inference framework for mediation analysis was used to assess the degree to which sleep quality and duration explained the association between COVID‐19 psychosocial stress and suicidal ideation. Results: Suicidal ideation was reported in 21% of adults. Adults described having moderate sleep quality and an average of 6.9 hours of sleep per night. COVID‐19 psychosocial stress significantly predicted adult suicidal ideation in fully adjusted models. Sleep quality, but not sleep duration, significantly mediated the association between COVID‐19 psychosocial stress and suicidal ideation, accounting for 25.9% of the total effect. Conclusions: Poor sleep quality may play an important role in exacerbating the alarming stress‐induced mental health effects of the COVID‐19 pandemic. Further research is necessary to understand the underlying sleep dynamics and associated psychological and neurobiological processes that perpetuate adult suicidal ideation. [ABSTRACT FROM AUTHOR]

Reflective functioning is the process of reflecting on the thoughts and feelings of oneself and others and is foundational to healthy human relationships. The 54-item Reflective Function Questionnaire (RFQ) is a self-report measure that assesses reflective functioning, initially developed while studying individuals with borderline personality disorder (BPD). The purpose of the present study was to translate the RFQ from English to Persian and evaluate its reliability and validity among Iranian prisoners. The sample of this study included 509 (455 men and 54 women) Iranian prisoners. Findings confirm the translated measure had acceptable face and content validity. A confirmatory factor analysis (CFA) confirmed two dimensions of certainty (RFQ-c) and uncertainty (RFQ-u) of reflective functioning. The correlation analysis showed positive relationships between the dimensions of the RFQ and the borderline personality symptoms questionnaire and the emotional dissatisfaction questionnaire. Correlation analysis also showed negative associations between the dimensions of the RFQ and the Toronto Basic Empathy Scale (BES) and the Kentucky Inventory of Mindfulness Skills (KIMS) questionnaire, confirming the concurrent validity of the RFQ. The Cronbach's alphas of the RFQ-c and RFQ-u subscales were.69 and.7 respectively, which demonstrated relatively acceptable internal consistency. The results of the analysis demonstrated that the translated RFQ had desirable psychometric properties for evaluating reflective function among Iranian prisoners. [ABSTRACT FROM AUTHOR]