Adolescent Psychiatry - Volume 12, Issue 2, 2022

Purpose of Review: Trauma exposure is common, with more than half of children and adolescents experiencing at least one traumatic event prior to adulthood. Although diagnoses of eating disorders are less prevalent, the majority of adolescents report engaging in disordered eating behaviors. The association between childhood trauma exposure and disordered eating behaviors has been well documented in adults, however, less is known about this association in adolescents. This review summarizes the literature that exists on the adolescent population. Recent Findings: Multiple large-scale studies have demonstrated that adolescents who have been exposed to trauma are more likely to engage in disordered eating behaviors. This association was shown to exist in both sexes, although there appears to be a higher prevalence reported in girls. There do not appear to be significant racial or cultural factors that contribute to this association. The experience of sexual trauma, increased trauma severity, and repeat victimization confer an increased risk of engaging in disordered eating behaviors. There are multiple mediators that play a role in the development of disordered eating following a traumatic experience.

Background: In recent years, the rates of young people presenting with self-harming have increased dramatically, with self-harm being a predictor of suicide. Despite evidence suggesting that self-harm is common in young people and that hospital admissions are increasing, research exploring the reasons behind young people’s motivations is not easily accessed. Systematic reviews have explored this from a range of perspectives, but none have drawn all this literature together. Methods: A systematic review of systematic reviews was conducted in accordance with PRISMA guidelines. Seven databases were searched using a peer reviewed search strategy, with a focus on the factors of child and adolescent self-harming. All English language articles, published between 2008 and 2021, were considered, and screened against inclusion criteria. References of included articles were also searched for eligible articles. Results: Twenty-two systematic reviews were included after screening against eligibility criteria. Narrative synthesis identified eight themes for motivation or reasons for self-harming: identity and subcultures, peer influences, educational stressors, mental ill health, cognitive and neuropsychological factors, trauma and attachment, internet influences and social media. Conclusion: Reasons for self-harming in adolescents are complex and multifactorial. Many studies focus on single causes or associations with self-harm rather than open-mindedly exploring a range of factors or the interactions between them. This leaves gaps in the research where hypothetical reasons for self-harm have not been systematically explored. The themes identified here could help in the clinical assessment process and guide future research in this area, including the development of potential differentiated prevention and treatment approaches.

Background: Brooding rumination, or perseverative dwelling on negative cognitions, prolongs negative affect and is associated with heightened risk for depressive symptoms. Emerging research suggests that brooding rumination may be associated with more severe depressive symptoms when individuals brood in the form of mental imagery relative to verbal thoughts. Objective: The present study tested whether rumination was more highly associated with depressive symptom severity when adolescents ruminated in the form of mental imagery compared with verbal thoughts. Methods: Adolescents (N = 145) were recruited from the community surrounding a public university in the Northeastern United States. Of these adolescents, 136 were retained in analyses based on their reports of engaging in brooding rumination at least some of the time [age range: 13-17 years; M(SD)age = 15.40(1.24) years; 60.29% female, 32.35% male, 4.41% transgender, 2.94% other genders). In this crosssectional study, adolescents reported their trait levels of brooding rumination, whether they tend to ruminate in the form of mental imagery, verbal thought, or both, and completed a measure of depressive symptom severity. Moderated regression analyses were used to test whether the strength of the relation between brooding rumination and depressive symptom severity varied based on rumination style. Results: Imagery-based brooding rumination occurred in the majority of adolescents, and imagery-based rumination was more highly associated with depressive symptom severity than verbally-based rumination for female adolescents and those adolescents high in trait brooding rumination. Conclusion: Findings emphasize the potential utility of assessing and intervening on imagery-based rumination.

Background: History of childhood maltreatment is recognized as an important risk factor for the development of mental health and cognitive difficulties. Cognitive difficulties are associated with impairments in everyday functioning in different domains such as school or work. To date, no study has evaluated the feasibility and acceptability of cognitive remediation therapy (CRT) for teenagers with a history of childhood Objective: The objective was to assess the acceptability and feasibility of the CIRCuiTS program for teenagers in youth protection services and to explore the preliminary effect on clinical and neuropsychological outcomes. Methods: Ten participants were first assessed with clinical and neuropsychological measures. They then received a mean of 16 CRT sessions with the CIRCuiTS program adapted for teenagers. The same measures as a baseline were repeated directly after the end of treatment, as well as 3-months and 1-year post-treatment. Descriptive statistics were used to assess feasibility and acceptability, while the preliminary effect of CIRCuiTS was assessed with Reliable Change Indices (RCIs). Results: CIRCuiTS was considered acceptable by both participants and therapists for the attractiveness of the program, its easiness of use and understanding, and its cultural adaptability. However, the feasibility was limited, with only 50% of participants having completed CIRCuiTS. This was mostly explained by contextual factors. RCIs revealed significant improvements in several neuropsychological domains, as well as a decline in other domains. Conclusion: This pilot study highlights challenges that must be addressed to promote engagement with CRT for teenagers in the care of youth protection services.

Background: Premenstrual syndrome affects women’s physical, psychological, and social health negatively. Moreover, it causes behavioral disorders such as anger, crime, and aggression tendencies. However, there is a limited number of studies in the literature which examined the relationship between premenstrual syndrome and crime, aggression, or violence. Objective: The objective of this study was to identify the relationship between premenstrual syndrome and aggression tendencies. Methods: This is a descriptive study. The 774 voluntary adolescent girls studying at a state university in Turkey constituted the sample of the research. Results: The mean age of adolescent girls was 19.05 ± 1.64. The mean age of first menstruation for the participants was 13.35 ± 1.23. It was determined that 58.3% of the participants had a premenstrual syndrome. Premenstrual syndrome intensity levels were higher among adolescent girls whose menstruation interval was < 28 days, those who had “irregular” menstrual cycles, those who found their menstruation-related knowledge “inadequate”, those diagnosed with “anemia” and those who thought their anger/aggression tendencies increased in their “premenstrual period” (p<0.05). Moreover, aggression tendencies increased among adolescent girls as the intensity of premenstrual syndrome increased (p<0.05). Conclusion: Health professional's premenstural symptoms were carefully evaluated and individualized care and treatment plans were created.