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Approximately 17% of adolescents and young adults will engage in non-suicidal self-injury (NSSI) at least once in their lifetime, leading the World Health Organization to identify self-injury as one of the top five public health concerns for adolescents. Despite the widespread prevalence of this behavior, NSSI continues to be heavily stigmatized in both medical and community settings, deterring many engaged in NSSI from seeking informal support from friends and family as well as formal psychological or psychiatric treatment. In contrast to the low rates of in-person help-seeking for NSSI, online support groups are highly utilized by those engaged in NSSI. Thus, an empirical study of responses to frequent, voluntary disclosure of NSSI on social media is needed to better understand how these communities meet the needs of those who self-injure. The current project used latent Dirichlet allocation to identify frequent and favored themes in response to self-injury content in the largest self-injury group on Reddit (over 100,000 members). Reddit, the 9th most visited website in the world, is a chat-based social media platform that has 430+ million active users and billions of site visits, with current estimates suggesting that ∼63% of the U.S. population are Reddit users. Identified themes included: (1) recovery encouragement; (2) provision of social and instrumental support; and (3) daily realities of living with NSSI. Responses that encouraged recovery received more upvotes on Reddit than any other type of comment. These results can inform evidence-based, person-centered, dimensional treatments for NSSI. Responses to NSSI that encourage recovery resonated most with members of the group. Group members provided many social and instrumental NSSI supports to each other. Results provide insight into the real-time needs of those engaged in NSSI. [ABSTRACT FROM AUTHOR]

Background: Impaired profiles of neurocognitive function have been consistently demonstrated among pediatric patients with bipolar disorder (BD), and may aid in the identification of endophenotypes across subtypes of the disorder. This study aims to determine phenotypic cognitive profiles of patients with BD Type I and II. Methods: Subjects (N = 79) consisted of BD I (n = 27) and BD II (n = 19) patients and demographic and intellectually matched healthy controls (HC; n = 33) that completed a battery of neurocognitive tasks. Results: Bipolar disorder Type I patients performed significantly more poorly compared to HC on all domains of cognitive function including attention, executive function, working memory, visual memory, and verbal learning and memory. BD I patients also performed more poorly compared to BD II patients on all domains of cognitive functioning with the exception of working memory, whereas BD II patients did poorly relative to HC only on verbal learning and memory. Conclusions: Findings from the current study indicate that BD I patients are characterized by more severe cognitive impairment relative to BD II patients who show an intermediate pattern of performance between BD I patients and HC. Verbal learning and memory may effectively differentiate pediatric BD patients and controls, regardless of the subtype of BD, and may serve as a cognitive endophenotype for the disorder. Additionally, these findings move us closer to developing effective cognitive interventions tailored to specific subtypes of pediatric BD patients.

Objective: The chronic and refractory course of pediatric bipolar disorder merits the study of adjunctive psychosocial interventions designed to facilitate long-term improvements. The objective of this study is to conduct a pilot study of a maintenance model of the child- and family-focused cognitive-behavioral therapy program (CFF-CBT), which comprises psychosocial booster sessions and optimized pharmacotherapy, and to assess whether positive effects seen after the acute phase of treatment could be sustained over time with the use of this model. Method: The study design was an open trial with the goal of assessing feasibility of such a maintenance model over time. Thirty-four patients 5 to 17 years of age who underwent CFF-CBT were delivered the maintenance model of treatment over a 3-year period and assessed for symptom changes (Children's Global Impressions Scale-Bipolar) and global functioning (Children's Global Assessment Scale). Results: Results indicated that participation in the maintenance model of CFF-CBT treatment was associated with positive effects in symptoms and functioning over the 3-year follow-up period. There were no statistically significant differences in postacute-phase treatment scores and scores at years 1, 2, or 3 on any study measures, indicating the maintenance of clinically significant improvements. Conclusions: These findings suggest that maintenance treatment models are feasible and may help facilitate the long-term management of symptoms. Controlled clinical trials that build on this model will help advance treatments for pediatric bipolar disorder toward addressing the low recovery and high relapse rates associated with the disorder. (Contains 3 tables.)