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Trauma-exposed youth often experience impairing externalizing problems (EXTs), yet the relationship between EXTs, trauma exposure, and posttraumatic stress symptoms (PTSS) are not well understood. To examine the extent of their co-occurrence, we report the rates and correlates of youth EXTs relative to clinically elevated PTSS in a sample of youth referred to a trauma and grief specialty clinic.Self- and caregiver-report measures were obtained from 260 youth ages 7-19 years (The 4 groups were comorbid PTSS and EXTs (18%); EXTs-only group (36%); PTSS-only group (13%), and subclinical symptom group (34%). The comorbid PTSS and EXTs group had the highest scores on all other child and caregiver symptom measures. Compared to the subclinical group, youth in the PTSS-only group had increased depressive symptoms and suicidal ideation, whereas youth in the EXTs-only group had elevated levels of caregiver strain.Co-occurring PTSS and EXTs is a common presentation among trauma-exposed youth referred to treatment. These youth are also likely to suffer from other problems of clinical concern, including suicidal ideation, and their problems are associated with caregiver distress. More research is needed to examine unique risk and resiliency factors related to the development of youth EXTs in response to trauma exposure. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Ethical concerns frequently arise in suicide prevention research regarding participant safety and confidentiality. Despite a substantial literature on managing and navigating ethical concerns in suicide research, little attention has been paid to the reporting of ethical procedures. Furthermore, standard procedures for reporting ethical risk management procedures have not been developed.A review of the current literature was performed to examine the current state of reporting of ethical procedures within suicide research. Articles published in 2020 (The majority of articles reported ethical review or approval (84.7%) and reported the use of an informed consent process (77.9%). Only 28.2% included risk mitigation procedures. Of those 29.7% of those articles reported conducting risk evaluation, 66.7% reported resource dissemination, and 51.4% reported an intervention.As empirical support for brief interventions accrues, suicide prevention researchers should consider establishing standards for the reporting of procedures to ensure the safety of participants with suicidal risk.HighlightsReporting suicide safety protocols helps ensure high ethical standards in research.Fewer than 1/3 of articles reviewed reported risk mitigation procedures in 2020.Standard procedures for reporting safety protocols in suicide research are needed.

Background: Lesbian, gay, and bisexual youth face a disproportionate risk of suicidal ideation and attempt compared to heterosexual counterparts. Escalation from ideation to attempt can occur quickly, and youth who survive suicide attempts are likely to pursue subsequent, riskier attempts. This study examines the effects of bullying and sexual orientation on suicidal outcomes. Methods: Data came from the national, school-administered 2017 Youth Risk Behavior Survey (N = 14,765). Bivariate associations, binomial logistic regressions, and ordinal logistic regressions were performed. Results: Lesbian/gay, bisexual, and unsure youth reported greater odds of ideation and attempts compared to heterosexual youth. For ideation, increased effects were inconsistent across bullying types and significant interactions were found for bisexual youth who were bullied in school, and for lesbian/gay youth who were cyberbullied. Conclusion: These results underscore the need to understand bullying victimization for lesbian, gay, and bisexual youth. Awareness of increasing cyberbullying and creating school environments of no-bullying tolerance in the post-pandemic era are among the challenges ahead.

Magnetoencephalography (MEG) measures human brain function via assessment of the magnetic fields generated by electrical activity in neurons. Despite providing high-quality spatiotemporal maps of electrophysiological activity, current MEG instrumentation is limited by cumbersome field sensing technologies, resulting in major barriers to utility. Here, we review a new generation of MEG technology that is beginning to lift many of these barriers. By exploiting quantum sensors, known as optically pumped magnetometers (OPMs), 'OPM-MEG' has the potential to dramatically outperform the current state of the art, promising enhanced data quality (better sensitivity and spatial resolution), adaptability to any head size/shape (from babies to adults), motion robustness (participants can move freely during scanning), and a less complex imaging platform (without reliance on cryogenics). We discuss the current state of this emerging technique and describe its far-reaching implications for neuroscience.

The evolution of human cognitive function is reliant on complex social interactions which form the behavioural foundation of who we are. These social capacities are subject to dramatic change in disease and injury; yet their supporting neural substrates remain poorly understood. Hyperscanning employs functional neuroimaging to simultaneously assess brain activity in two individuals and offers the best means to understand the neural basis of social interaction. However, present technologies are limited, either by poor performance (low spatial/temporal precision) or an unnatural scanning environment (claustrophobic scanners, with interactions via video). Here, we describe hyperscanning using wearable magnetoencephalography (MEG) based on optically pumped magnetometers (OPMs). We demonstrate our approach by simultaneously measuring brain activity in two subjects undertaking two separate tasks—an interactive touching task and a ball game. Despite large and unpredictable subject motion, sensorimotor brain activity was delineated clearly, and the correlation of the envelope of neuronal oscillations between the two subjects was demonstrated. Our results show that unlike existing modalities, OPM-MEG combines high-fidelity data acquisition and a naturalistic setting and thus presents significant potential to investigate neural correlates of social interaction.

Magnetoencephalography with optically pumped magnetometers (OPM-MEG) offers a new way to record electrophysiological brain function, with significant advantages over conventional MEG including adaptability to head shape/size, free movement during scanning, better spatial resolution, increased signal, and no reliance on cryogenics. However, OPM-MEG remains in its infancy, with significant questions to be answered regarding optimal system design and robustness. Here, we present an open-source dataset acquired using a newly constructed OPM-MEG system with a triaxial sensor design averaging 168 channels. Using OPM-optimised magnetic shielding and active background-field control, we measure the test-retest reliability of the human connectome. We employ amplitude envelope correlation to measure whole-brain functional connectivity in 10 individuals whilst they watch a 600 s move clip. Our results show high repeatability between experimental runs at the group level, with a correlation coefficient of 0.81 in the theta, 0.93 in alpha and 0.94 in beta frequency ranges. At the individual subject level, we found marked differences between individuals, but high within-subject robustness (correlations of 0.56 ± 0.25, 0.72 ± 0.15 and 0.78 ± 0.13 in theta, alpha and beta respectively). These results compare well to previously reported findings using conventional MEG; they show that OPM-MEG is a viable way to characterise whole brain connectivity and add significant weight to a growing argument that OPMs can overtake cryogenic sensors as the fundamental building block of MEG systems.

Suicide is a leading cause of death among children and adolescents, and research has shown a significant increase in the rates of emergency department (ED) visits because of suicide ideation and attempts for children younger than 18 years. OBJECTIVE This study examined the feasibility of screening all patients entering the ED using the Columbia-Suicide Severity Rating Scale as well as examining the rates of suicide ideation and attempts endorsed by adolescents who present at the ED. METHODS This study used a sample of 12,113 patients between the ages of 11 and 19 years. RESULTS Results revealed that 13.5% of the participants endorsed passive suicide ideation in the month leading up to their ED visit and 11.3% of the participants reported active ideation in the prior month. Results also revealed that patients whose chief complaints were coded as psychiatric or medical trauma were more likely to endorse either active or passive suicidal ideation than other presenting problems. Patients with a psychiatric or medical trauma chief complaint were also more likely to report lifetime suicidal behavior and suicidal behavior 3 months before the ED visit. CONCLUSIONS In addition to findings, implications, feasibility, and lessons learned are discussed for other institutions or departments considering implementation of a widespread screening.Highlights:• Suicide screenings were implemented in a large pediatric emergency department.• One in 5 endorsed suicidal ideation or behavior regardless of presenting problem.• Feasibility and lessons learned are discussed for others hoping to implement a widespread screening.

Suicidal thoughts and behaviors (STBs) remain a pressing public health problem for transgender and gender diverse (TGD) persons. The goal of this study was to apply social-ecological and minority stress frameworks to identify individual and interpersonal-level TGD-specific STB risk and protective factors. This is a secondary analysis of the 2015 United States Transgender Health Survey, a comprehensive cross-sectional health assessment of a national sample of TGD adults (N = 27,658). Chi-square and Analysis of Variance (ANOVA) were used to identify bivariate correlates of 12-month and lifetime suicidal ideation (SI) and suicide attempt (SA). Logistic regression was employed to identify the strongest STB risk and protective factors across levels. Sexual minority identification, racial minority identification, and having a disability were lifetime STB risk factors. TGD identity, sexual minority identification, racial minority identification (SA only), lower education, lower income, military experience, having a disability, and being uninsured were 12-month STB risk factors. Psychological distress was the most robust STB risk factor. Workplace discrimination, family rejection, healthcare discrimination, and childhood bias-based victimization were lifetime STB risk factors. All forms of discrimination and victimization (with the exception of family rejection for SI) were 12-month STB risk factors. Family and coworker support were protective factors for lifetime SA (but not SI) and all 12-month STBs. Being less out about TGD identity was a protective factor for STBs (except for 12-month SI). Findings support social-ecological and minority stress STB risk frameworks. Recommendations are provided for a comprehensive approach to TGD suicide prevention.

This study describes the prevalence of suicidal ideation (SI) during acute lymphoblastic leukemia (ALL) therapy and investigates the influence of clinical factors and physical symptoms on SI.The Children's Depressive Inventory (CDI-2) was administered to ALL patients (diagnosed 2012-2017) at start of consolidation, delayed intensification (DI), maintenance cycle 1 (MC1), and maintenance cycle 2 (MC2) in a multi-site study. SI was present if patients endorsed the item "I want to kill myself." Logistic regression models evaluated associations between SI and sociodemographic factors; depressive symptoms; and below average, average, and above average symptom clusters identified using latent class analysis of pain, nausea, fatigue, and sleep.Participants (n = 175) were 51% male, 75% high-/very high-risk disease, with a median age of 11.2 years at diagnosis (range: 7-18 years). Overall, 14.9% of patients (75% under age 12 years) endorsed SI during treatment, including 4% at start of consolidation, 9% at DI, 8% at MC1, and 4% at MC2. Non-Hispanic Other patients were 10.9-times (95% CI: 2.30-53.40) more likely than non-Hispanic Whites to endorse SI (p = 0.003). The frequency of SI was higher in patients experiencing above average (53.3%) compared to below average (4.1%, p = 0.003) symptoms. Depressive symptoms were consistently associated with SI.SI during the initial year of childhood ALL was more prevalent in children under the age of 12 years, from ethnic groups not typically associated with increased risk, and who endorsed increased physical and depressive symptoms. Findings highlight the need for improved screening of mental health problems to mitigate symptoms of distress.

The Grief Facilitation Inventory (GFI) is a newly-developed measure of caregiver behaviors theorized to facilitate or hinder children's adaptive grief reactions. We examine its factor structure, reliability, and validity. An exploratory factor analysis identified four factors: Ongoing Connection, Existential Continuity/Support, Caregiver Grief Expression, and Grief Inhibition/Avoidance. Both child- and caregiver-report versions had adequate-to-good internal consistency. The child-report GFI showed evidence of criterion-referenced validity via significant correlations with measures of child maladaptive grief and other psychological symptoms. Results provide preliminary evidence of the reliability, validity, and clinical utility of the GFI as a measure of caregiver grief-facilitation behaviors.

Objective This study evaluated the factor structure, internal consistency reliability, construct and criterion validity, and measurement invariance of the Interpersonal Needs Questionnaire (INQ) among adolescents. Method Participants (N = 539) included three distinct samples of youth drawn from two outpatient psychology clinics and an inpatient psychiatric unit. The combined sample was 63.3% female and had a mean age of 14.95 years (SD = 1.31 years). All participants completed the INQ as well as measures of depressive symptoms and suicide ideation. Results Confirmatory factor analyses indicated that the removal of three items from the thwarted belongingness subscale of the INQ was needed to achieve acceptable model fit. The resulting combined 12-item scale demonstrated good factor structure, internal consistency reliability, construct validity, and criterion validity. The modified 12-item INQ also demonstrated scalar invariance across subgroups defined by sex, race, and age. Conclusions Findings support the use of this reduced 12-item version of the INQ among adolescents. Youth may have difficulty accurately responding to changes in item valence; thus, future research with youth should consider using a 12-item version of the INQ that avoids valence changes within subscales.

Objective The current study examines components of the Interpersonal Theory of Suicide as mediators of the association between attention-deficit/hyperactivity disorder (ADHD) symptoms and suicide ideation in college students with elevated depressive symptoms. Specifically, indirect effects of perceived burdensomeness and thwarted belongingness were simultaneously evaluated on the association between self-reported ADHD symptoms and suicide ideation, controlling for gender and levels of depression. Method Participants were 217 college students with elevated depressive symptoms (Mage = 20.72 years old; SD = 3.74) who participated in a larger study on mood and well-being. The sample was predominantly female (77.9% female) and Hispanic (72.7%). Results In a multivariate mediation model controlling for gender and depressive symptoms, there were significant indirect effects of perceived burdensomeness and thwarted belongingness on the association between self-reported ADHD symptoms and suicide ideation. Conclusion Perceived burdensomeness and thwarted belongingness may represent promising targets for preventing suicide ideation in individuals with elevated ADHD symptoms.

Civic engagement is thought to enhance personal well-being, yet little research has examined links between civic engagement, burdensomeness, and belongingness during periods of heightened civic act...

The current study examined how polytraumatization classes predicted mental health outcomes among a sample of treatment-seeking, traumatized, and bereaved youth. A latent class analysis identified t...

The Active Inhibition Scale (AIS; Ayers, Sandler, & Twohey, 1998) is an 11-item, self-report measure of emotional suppression among children and adolescents. Previous research with the AIS has linked emotional suppression to several clinically significant outcomes, such as posttraumatic stress symptoms (PTSS) and suicide, among trauma-exposed and bereaved youth; however, there are no published evaluations of its psychometric properties. We examined the factor structure and criterion validity of the AIS in two samples. Sample 1 included youth (M = 12.22 years, SD = 2.96, range: 6-18 years; 55.4% female) referred to an outpatient psychology clinic specializing in childhood trauma and grief. Sample 2 included youth (M = 13.18 years, SD = 2.58, range: 8-18 years; 61.8% female) referred to a community grief counseling center. Confirmatory factor analytic results supported a one-factor solution, Cronbach's α = .94. Additionally, AIS scores correlated positively with PTSS, depression, and maladaptive grief, rs = .43-.64. Evidence of factorial invariance was found across gender, race/ethnicity, and age group. Emotional suppression scores were higher among girls compared to boys, Black and Hispanic youth compared to White youth, and older compared to younger age groups. The magnitude of correlations between AIS and symptom measure scores was comparable across groups. These results support the reliability and criterion validity of the AIS with diverse youth populations and underscore the role that emotional suppression may play in explaining group differences in mental health symptoms.

Suicide safety planning is an intervention to assist individuals with suicide ideation in maintaining safety during a suicidal crisis. However, safety planning with adolescents is complicated by ad...

Suicide-related behaviors are over-represented among youth with autism spectrum disorder (ASD). A more thorough understanding of the connections between ASD and suicide-related behaviors may help t...

Our aim was to demonstrate the first use of Optically Pumped Magnetoencephalography (OP-MEG) in an epilepsy patient with unrestricted head movement. Current clinical MEG uses a traditional SQUID system for recording MEG signal, where sensors are cryogenically cooled and housed in a helmet in which the patient’s head is fixed. Here we use a different type of sensor (OPM), which operates at room temperature and can be placed directly on the patient’s scalp, permitting free head movement. We performed two 30 minute OP-MEG recording sessions in a patient with refractory focal epilepsy and compared these with clinical scalp EEG performed earlier. OP-MEG was able to identify analogous interictal activity to scalp EEG, and source localise this activity to an appropriate brain region. This is the first application of OP-MEG in human epilepsy. Future directions include simultaneous EEG/OP-MEG recording and prolonged OP-MEG telemetry.

INTRODUCTION: Existing CBT protocols for internalizing disorders target thoughts and behaviors related to anxiety and/or depression, but do not explicitly target other identified risk factors for suicide ideation, including perceived burdensomeness toward others. The aims of the current study were to (1) develop a novel, brief module (the “Give program”) targeting perceived burdensomeness toward others that can be embedded within existing CBT protocols for youth internalizing disorders, (2) evaluate the acceptability and feasibility of the module with an eye toward intervention refinement, and (3) examine reductions in perceived burdensomeness. METHODS: Participants were 18 clinic-referred youths with anxiety or depressive disorders who endorsed burdensomeness. We used a quasi-experimental interrupted time-series design to evaluate changes in burdensomeness scores following the administration of the module. RESULTS: The module was clinically feasible and well-accepted. Youth burdensomeness scores increased in the first half of the CBT protocol and decreased immediately following the administration of the Give program module. Burdensomeness scores were significantly associated with suicide ideation. CONCLUSION: The current study is the first to develop and evaluate a module targeting burdensomeness in at-risk youth in an outpatient setting, demonstrating that burdensomeness can be efficiently and effectively targeted within existing evidence-based treatment protocols for internalizing disorders in youth.

Purpose of Review The manuscript reviews the extant literature on suicide-related thoughts and behaviors among youth and young adults with pediatric diabetes. This evidence is presented within the context of current theories of the etiology of suicidal behavior to highlight how diabetes may contribute to suicide risk, and to support providers in understanding the interplay between pediatric diabetes and suicide risk. The manuscript also reviews evidence-based approaches to suicide prevention suitable for use in pediatric healthcare settings, with suggestions for their application to this unique population. Recent Findings Several recent studies identify heightened rates of suicidal ideation, suicide attempts, and suicide among youth and young adults with pediatric diabetes, as compared with their peers without diabetes. Evidence-based suicide prevention approaches frequently emphasize the importance of reducing suicidal youths’ access to potentially lethal means for suicidal behavior. This approach may require special considerations for youth with pediatric diabetes, due to their need to carry sufficient quantities of insulin and the dangers of inaccurate insulin dosing and/or overdose. Suggestions for suicide prevention for this population include risk screening as part of routine diabetes care, early prevention, education for youth and families, and provider awareness of risk factors, warning signs, and implications for diabetes care. Summary Youth and young adults with diabetes reported elevated rates of suicide-related behaviors as compared with their peers without diabetes. Existing suicide prevention approaches may require substantial adaptation for use with youth and young adults with diabetes. Further research is needed to examine how to best prevent suicidal behaviors among this population.

Magnetoencephalography (MEG) has been revolutionised by optically pumped magnetometers (OPMs). “OPM-MEG” offers higher sensitivity, better spatial resolution, and lower cost than conventional instrumentation based on superconducting quantum interference devices (SQUIDs). Moreover, because OPMs are small, lightweight, and portable they offer the possibility of lifespan compliance and (with control of background field) motion robustness, dramatically expanding the range of MEG applications. However, OPM-MEG remains nascent technology; it places stringent requirements on magnetic shielding, and whilst a number of viable systems exist, most are custom made and there have been no cross-site investigations showing the reliability of data. In this paper, we undertake the first cross-site OPM-MEG comparison, using near identical commercial systems scanning the same participant. The two sites are deliberately contrasting, with different magnetic environments: a “green field” campus university site with an OPM-optimised shielded room (low interference) and a city centre hospital site with a “standard” (non-optimised) MSR (higher interference). We show that despite a 20-fold difference in background field, and a 30-fold difference in low frequency interference, using dynamic field control and software-based suppression of interference we can generate comparable noise floors at both sites. In human data recorded during a visuo-motor task and a face processing paradigm, we were able to generate similar data, with source localisation showing that brain regions could be pinpointed with just ∼10 mm spatial discrepancy and temporal correlations of > 80%. Overall, our study demonstrates that, with appropriate field control, OPM-MEG systems can be sited even in city centre hospital locations. The methods presented pave the way for wider deployment of OPM-MEG.

Politics entails personal costs and benefits which may differ for youth from different sociocultural backgrounds. The at-stake hypothesis proposes that politically marginalized youth experience greater costs (e.g., stress, conflict) and benefits (e.g., empowerment) related to politics, whereas the at-risk hypothesis proposes that politically marginalized youth experience greater costs but lower benefits. In Study 1, we examined the factor structure of a new political costs and benefits measure among youth (N=1,056, Mage=15.91 years), and tested mental health and demographic correlates. Consistent with the at-stake hypothesis, marginalized youth experienced greater political costs and benefits than non-marginalized youth, although findings were nuanced. In Study 2, a sub-sample of participants (N=191, Mage=16.05 years) were recontacted from Study 1 to provide written explanations for why specific findings emerged. Adolescents’ reasons indicated that laws and policies disproportionately affect youth from marginalized populations, thus producing both negative and positive political experiences.