Among the protective factors associated with reduced risk for suicide, scientific inquiries into school connectedness are especially important considering that schools are ideally situated to provide interventions reaching the vast majority of youth. Although there is a wealth of research that supports the association between school connectedness and reduced self-report of adolescents having a suicidal thought or making a suicide attempt, inconsistencies in the way studies have measured and operationalized school connectedness limit synthesis across findings. This meta-analytic study investigates the literature exploring associations between school connectedness and suicidal thoughts and behaviors across general and sub-populations (high risk and sexual minority youth) using a random effects model. Eligible studies examined a measure of school connectedness explicitly referred to as “school connectedness” or “connections at school” in relation to suicidal ideation or suicide attempts among youth enrolled in school (grades 6–12). Multiple meta-regression analyses were conducted to explore the influence of school connectedness measurement variation, as well as participant characteristics. Results, including 16 samples, support that higher school connectedness is associated with reduced reports of suicidal thoughts and behaviors across general (OR = 0.536), high-risk (OR = 0.603), and sexual minority (OR = 0.608) adolescents. Findings are consistent when analyzed separately for suicidal ideation (OR = 0.529) and suicide attempts (OR = 0.589) and remain stable when accounting for measurement variability. Although limited by its cross-sectional nature, findings support recent calls to increase school connectedness and proffer important implications for screening and intervention efforts conducted in schools.
Comorbid mental health disorders are highly common in trauma-exposed individuals with posttraumatic stress disorder (PTSD), depression, and generalized anxiety disorder (GAD) among the most common co-occurring conditions. Network models of psychopathology offer a novel method to understand how this comorbidity manifests. The present study examined the presence of symptom communities (groups of highly connected symptoms) within a network of these disorders and hub symptoms (symptoms that connect such communities). Cross-sectional data were obtained from a community sample (N = 1184) of trauma exposed adults. Network analyses identified 5 communities: 1 containing all depression and GAD symptoms and 4 for PTSD. The PTSD communities corresponded to symptoms of intrusion and avoidance, hyperarousal, dysphoria, and negative affect. These communities had varying levels of connectivity to the Depression & GAD community. Symptoms of GAD (inability to relax) and PTSD (restricted or diminished positive emotion) were identified as key hub symptoms for the network. The results suggest symptoms of depression and GAD are highly interrelated and that PTSD is heterogeneous. The comorbidity among these diagnoses is thought to stem from their overlap with negative affect.
Objective: Consumption of traditional and social media markedly increased at the start of the COVID-19 pandemic as new information about the virus and safety guidelines evolved. Much of the information concerned restrictions on daily living activities and the risk posed by the virus. The term "doomscrolling" was used to describe the phenomenon of elevated negative affect after viewing pandemic-related media. The magnitude and duration of this effect, however, is unclear.Furthermore, the effect of doomscrolling likely varies based on prior vulnerabilities for psychopathology such as a history of childhood maltreatment. It was hypothesized that social and traditional media exposure were related to an increase in depression and PTSD and that this increase was moderated by childhood maltreatment severity. Method: Participants completed a baseline assessment for psychopathology and 30 days of daily assessments of depression, PTSD, and pandemic-related media use. Results: Using multilevel modeling, social media exposure was associated with increased depression and PTSD. This association was stronger for those with more severe maltreatment histories. Furthermore, those with more severe baseline psychopathology used more social media during this period. These relations were not observed for traditional media sources. Conclusions: These results suggest that regular viewing of pandemic-related social media is associated with increases in psychopathology for those with existing vulnerabilities. Those with such vulnerabilities should adopt strategies to limit social media consumption.
Interventions administered shortly after a traumatic event have the potential to prevent posttraumatic stress disorder (PTSD) and related mental health conditions. A key challenge in delivering such interventions is understanding how PTSD symptoms develop in the acute post-trauma period, defined as the first 30 days after a trauma. Mobile devices have the potential to transform the way symptoms are assessed and how treatment is delivered in that they can capture the dynamic and nuanced nature of symptom progression after trauma. Symptoms can be assessed through active strategies that require user input, such as self-report, or through passive strategies, such as location information. Adaptive mobile interventions can be tailored to target PTSD symptoms as they appear and ultimately prevent more chronic courses of illness. Considerations for how such mobile strategies should be implemented are discussed.
Objective The current study extends our understanding of postpartum suicidal ideation (SI) in the context of childhood maltreatment (CM). The study longitudinally examines the prevalence and severity of maternal SI. We further examined risk and protective factors’ associations with postpartum SI. Methods SI was assessed at 4, 6, 12, 15, and 18-months postpartum in a non-clinical sample of mothers with CM histories (N = 116). For the first aim, frequency, longitudinal percentage counts, and ANOVAs were conducted. For the second aim, logistic and linear regressions were completed to examine associations between risk and protective factors and the presence and severity of SI, respectively. Results Endorsement of SI was highest at 4-months (37%) and remained at approximately 25% for the duration of the study. While the severity of CM was not significant, our sample of women with CM histories evidenced markedly higher rates of SI than other postpartum investigations. Resilience, marital status, maltreatment-related shame, and family support were associated with suicidal ideation or severity at some assessments; however, these relationships were highly variable over time. Limitations Limitations of this study include the use of self-report measures and generalizability to mothers without CM histories. Conclusion Mothers with histories of CM are at risk for postpartum SI. Our findings elucidate the importance of understanding the interplay and variability of risk and protective factors during postpartum. These results aid clinicians in identifying women at risk for suicidal ideation during postpartum.
Background: PTSD is posited to develop in the acute posttrauma period. Few studies have examined psychopathology symptoms within this period due to the demands on individuals in the first month after a trauma. Mobile devices can overcome these barriers. The feasibility of using mobile devices for this purpose, however, is unclear. Objective: The present study evaluated the acceptability of administering PTSD symptom assessments via a mobile application throughout the acute posttrauma period. Method: Participants (N = 90) were recruited from a Level 1 Trauma Center within M = 4.88 days of experiencing a traumatic event. A mobile application was placed on their smartphone that administered a daily self-report assessment of PTSD symptoms for 30 days. Participants were compensated US$1 for each assessment completed. Results: The overall response rate was 61.1% or M = 18.33, SD = 9.12 assessments. Assessments were accessed M = 65.2 minutes after participants were notified to complete them and took M = 2.52 minutes to complete. Participants reported that the daily assessments were not bothersome and were moderately helpful. Conclusion: The present study suggests that using mobile devices to monitor mental health symptoms during the acute posttrauma period is feasible and acceptable. Strategies are needed to determine how to best take advantage of these data once collected.
Background The manner in which posttraumatic stress disorder (PTSD) develops remains largely unknown. PTSD is comprised of 20 symptoms across 4 clusters. These clusters were hypothesized to reflect a failure of recovery model in which intrusive symptoms appear first. Intrusive symptoms led to avoidance of trauma‐related stimuli, which resulted in sustained arousal. The sustained arousal ultimately led to dysphoria. Methods This hypothesized symptom progression was evaluated during the acute posttrauma period (the first 30 days postevent). Participants (N = 80) reported their PTSD symptoms for 30 days via mobile devices. Using a short‐term dynamic modeling framework, a temporal and contemporaneous model of PTSD symptoms was obtained. Results In the temporal network, a fear‐conditioning component was identified that supported the hypothesized set of relations among symptom clusters. The contemporaneous network was classified by two subnetworks. The first corresponded to a fear‐conditioning model that included symptoms of intrusions and avoidance. The second included symptoms of dysphoria and arousal. Conclusions These findings suggest that, after a trauma, there may be a fear‐conditioning process that involves intrusions, avoidance, and arousal symptoms. Dysphoric symptoms were also present but developed as a partially distinct component.
Consumption of traditional and social media markedly increased at the start of the COVID-19 pandemic as new information about the virus and safety guidelines evolved. Much of the information concerned restrictions on daily living activities and the risk posed by the virus. The term ``doomscrolling'' was used to describe the phenomenon of elevated negative affect after viewing pandemic-related media. The magnitude and duration of this effect, however, is unclear. Furthermore, the effect of doomscrolling likely varies based on prior vulnerabilities for psychopathology such as a history of childhood maltreatment. It was hypothesized that social and traditional media exposure was related to an increase in depression and PTSD and that this increase was moderated by childhood maltreatment severity. Participants completed a baseline assessment for psychopathology and 30 days of daily assessments of depression and PTSD. Using multilevel modeling on 1,117 daily observations, social media access was associated with increased depression and PTSD. This association was stronger for those with more severe maltreatment histories. Furthermore, those with more severe baseline psychopathology used more social media during this period. These results suggest that doomscrolling is associated with increases in psychopathology for those with existing vulnerabilities.
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