Hannah J. Thomas

Psychotic experiences and psychological distress predict contemporaneous and future non-suicidal self-injury and suicide attempts in a sample of Australian school-based adolescents

BACKGROUND Recent cross-sectional studies have shown psychotic experiences (PEs) are associated with suicidal ideation and behaviours. We aimed to examine associations between psychotic experiences (including persistent PE), and contemporaneous and incident non-suicidal self-injury (NSSI) and suicide attempts. METHOD Participants were from an Australian longitudinal cohort of 1896 adolescents (12-17 years). NSSI and suicide attempts were measured using the Self-Harm Behaviour Questionnaire. Items from the Diagnostic Interview Schedule for Children were used to assess psychotic experiences, and the General Health Questionnaire-12 measured psychological distress. RESULTS Adolescents both psychologically distressed and endorsing psychotic experiences had increased odds of contemporaneous and incident NSSI and attempted suicide. Psychotic experiences alone did not predict future risk. Persistent psychotic experiences were associated with increased risk of NSSI and suicide attempts. CONCLUSIONS Psychological distress with accompanying psychotic experiences and persistent psychotic experiences are important predictors of NSSI and suicide attempts. Screening these phenotypes in adolescents will assist in discerning those adolescents most at risk, providing opportunities for targeted suicide prevention strategies.

Association of different forms of bullying victimisation with adolescents’ psychological distress and reduced emotional wellbeing

Objective: The frequency and emotional response to bullying victimisation are known to be associated with adolescent mental ill health. A potentially important under-investigated factor is the form of bullying. Four common forms of bullying behaviours are name-calling, physical threats or harm, rumour spreading and social exclusion. To more comprehensively understand bullying victimisation in adolescence, we examined the association of all three factors (frequency, emotional response, form) to psychological distress and emotional wellbeing. Method: A stratified, random sample of adolescents (n = 10, 273; mean age = 14.33 years, standard deviation = 1.68 years) completed validated measures of bullying victimisation (Gatehouse Bullying Questionnaire), psychological distress (K10) and emotional wellbeing (Mental Health Inventory) in classroom time. Associations between the form of bullying victimisation and mental health outcomes were examined. Results: Adolescents reported a high prevalence of all four forms of bullying: teased or called names (30.6%), rumour spreading (17.9%), social exclusion (14.3%) and physical threats or harm (10.7%). Victimisation was independently associated with significantly higher levels of psychological distress and reduced levels of emotional wellbeing for all forms of bullying. In particular, social exclusion had a strong association with mental ill health. Adolescents who experienced frequent bullying that was upsetting reported higher psychological distress and reduced emotional wellbeing. Conclusion: Different forms of bullying victimisation were independently associated with psychological distress and reduced emotional wellbeing. In particular, frequent and upsetting social exclusion requires a targeted and measured response by school communities and health practitioners.

Prevalence and correlates of bullying victimisation and perpetration in a nationally representative sample of Australian youth

Objective: Bullying prevalence studies are limited by varied measurement methods and a lack of representative samples. This study estimated the national prevalence of bullying victimisation, perpetration and combined victim-perpetration experiences in a representative population-based sample of Australian youth. The relationships between the three types of bullying involvement with a range of mental health symptoms and diagnoses were also examined. Methods: A randomly selected nationally representative sample aged 11–17 years (N = 2967, Mage = 14.6 years; 51.6% male) completed the youth component of the Second Australian Child and Adolescent Survey of Mental Health and Wellbeing (Young Minds Matter). Parents or carers also completed a structured face-to-face interview that asked questions about a single randomly selected child in the household. The youth survey comprised self-reported bullying victimisation and perpetration (Olweus Bully–Victim Questionnaire–adapted), psychological distress (K10), emotional and behavioural problems (Strengths and Difficulties Questionnaire), as well as self-harm, suicide attempts and substance use. Modules from the Diagnostic Interview Schedule for Children Version IV were administered to all youth and parents to assess for mental disorder diagnoses (major depressive disorder, any anxiety disorder and any externalising disorder [attention-deficit hyperactivity disorder, oppositional defiant disorder and conduct disorder]). Results: The 12-month prevalence of bullying victimisation was 13.3%, perpetration 1.6% and victim-perpetration 1.9%. Logistic regression models showed all forms of involvement in bullying were associated with increased risk of psychological distress, emotional and behavioural problems, substance use, self-harm and attempted suicide. Victimisation and victim-perpetration were associated with youth-reported major depressive disorder. There were also significant associations between bullying involvement and parent-reported diagnoses of major depressive disorder, any anxiety disorder and any externalising disorder. Conclusion: Bullying continues to be frequently experienced by Australian adolescents. The current findings showed that involvement in any bullying behaviour was associated with increased risk of concurrent mental health problems. This evidence can be used to inform decisions concerning the allocation of resources to address this important health issue.

Disentangling the cognitive components supporting Austin Maze performance in left versus right temporal lobe epilepsy.

Neuropsychological tests requiring patients to find a path through a maze can be used to assess visuospatial memory performance in temporal lobe pathology, particularly in the hippocampus. Alternatively, they have been used as a task sensitive to executive function in patients with frontal lobe damage. We measured performance on the Austin Maze in patients with unilateral left and right temporal lobe epilepsy (TLE), with and without hippocampal sclerosis, compared to healthy controls. Performance was correlated with a number of other neuropsychological tests to identify the cognitive components that may be associated with poor Austin Maze performance. Patients with right TLE were significantly impaired on the Austin Maze task relative to patients with left TLE and controls, and error scores correlated with their performance on the Block Design task. The performance of patients with left TLE was also impaired relative to controls; however, errors correlated with performance on tests of executive function and delayed recall. The presence of hippocampal sclerosis did not have an impact on maze performance. A discriminant function analysis indicated that the Austin Maze alone correctly classified 73.5% of patients as having right TLE. In summary, impaired performance on the Austin Maze task is more suggestive of right than left TLE; however, impaired performance on this visuospatial task does not necessarily involve the hippocampus. The relationship of the Austin Maze task with other neuropsychological tests suggests that differential cognitive components may underlie performance decrements in right versus left TLE.

Two sides to the story: Adolescent and parent views on harmful intention in defining school bullying

Bullying is defined as repeated negative actions involving a power differential, and intention to harm. There is limited research on harmful intention as a definitional component. This study explored the role of the perpetrators harmful intention and the targets perception of harmful intention. Some 209 students (M = 14.5 years; 66.5% female) and 447 parents (M = 46.4 years; 86.4% female) were randomly assigned in an online survey. Participants assessed the likelihood of bullying in five hypothetical scenarios (physical, verbal, rumor, exclusion, and cyber) across five intention conditions, that also involved repetition and a power differential. The five intention conditions were: 1) harm intended by perpetrator (I) and perceived as intended to harm by target (I) [II condition]; 2) harm not intended by perpetrator (N) but perceived as intended to harm by target (I) [NI condition]; 3) harm intended by perpetrator (I) but not perceived as intended to harm by target (N) [IN condition]; 4) harm not intended by perpetrator (N) and not perceived as intended to harm by target N [NN condition]; and 5) a control which did not state any actual or perceived harmful intention [C condition]. For students and parents, the perpetrators harmful intention and the targets perception of harmful intention were important when considering whether a peer interaction constituted bullying. These findings confirm the applicability of the three-part definition of bullying, and highlight the importance of assessing these two dimensions of harmful intention when determining whether a problematic peer interaction should be regarded as bullying. Aggr. Behav. 43:352-363, 2017.

Why do children and adolescents bully their peers? A critical review of key theoretical frameworks

Bullying is a significant public health problem for children and adolescents worldwide. Evidence suggests that both being bullied (bullying victimisation) and bullying others (bullying perpetration) are associated with concurrent and future mental health problems. The onset and course of bullying perpetration are influenced by individual as well as systemic factors. Identifying effective solutions to address bullying requires a fundamental understanding of why it occurs. Drawing from multi-disciplinary domains, this review provides a summary and synthesis of the key theoretical frameworks applied to understanding and intervening on the issue of bullying. A number of explanatory models have been used to elucidate the dynamics of bullying, and broadly these correspond with either system (e.g., social-ecological, family systems, peer-group socialisation) or individual-level (e.g., developmental psychopathology, genetic, resource control, social-cognitive) frameworks. Each theory adds a unique perspective; however, no single framework comprehensively explains why bullying occurs. This review demonstrates that the integration of theoretical perspectives achieves a more nuanced understanding of bullying which is necessary for strengthening evidence-based interventions. Future progress requires researchers to integrate both the systems and individual-level theoretical frameworks to further improve current interventions. More effective intervention across different systems as well as tailoring interventions to the specific needs of the individuals directly involved in bullying will reduce exposure to a key risk factor for mental health problems.

Parent-child relationship quality and adolescent alcohol use

To the EditorParents have a key role in the develop -ment of adolescent alcohol use, and this has important implications for prevention programmes and policies. In a previous edition of this journal, Ryan et al. (2010) conducted a system -atic review of longitudinal studies that examined parenting factors related to adolescent alcohol use. The authors identified key parenting strategies associated with adolescent alcohol use (age of initiation and levels of alcohol use), including parental modelling, pro-vision of alcohol, monitoring, and par-ent-child relationship quality. Their review provides a valuable analysis of parent dimensions that are univari-ately and longitudinally related to ado-lescent alcohol use. In this letter, we propose two areas for future research that build on their review.First, we propose that parenting factors may interact to predict adoles -cent alcohol use. In particular, parent-child relationship quality (e.g. strong bonds, open and clear commu -nication), may be a key context that determines the impact of alcohol- specific parenting practices (e.g. moni -toring, supervision) on adolescent alcohol use. While research on the interaction of family factors has begun to emerge since the review by Ryan et al. (2010), most prior research has continued to treat family factors as constructs independent of each other. Yet, family factors may interact in important ways. For example, in the context of an emotionally close and happy relationship, parental rules about alcohol use may reduce alco-hol-related risks. In the context of a distant and unhappy relationship, parental rules about alcohol use may have undesirable outcomes. If both these processes occur, the net impact of family conflict may be weak, and potentially important and more com-plex processes may be obscured.Our second suggestion for further research relates to the theoretical mechanisms linking family/parenting factors with adolescent alcohol use. Family and parenting factors vary in the extent to which they are alcohol-spe-cific (e.g. family conflict and emotional closeness versus rules about alcohol use). Much research on how non- alcohol-specific parenting factors are related to adolescent alcohol use does not explore the mechanisms that link these two factors. Several studies now indicate that poor family relationship quality may have consequences, such as adolescent depression (Chan et al., 2013) and engagement with high-risk peer groups (Kelly et al., 2011), that have a more tangible theoretical link with adolescent alcohol use (e.g. drink-ing to reduce negative affect, peer-group socialization). Therefore, research that examines the direct links between non-alcohol-specific parenting factors and adolescent alcohol use may miss important indirect links between these constructs. Notably, we recently found that family conflict did not directly predict adolescent alcohol use, but predicted depressed mood in girls, which subsequently predicted alcohol misuse (Chan et al., 2013).The review by Ryan et al. (2010) captures well the evidence on how parenting factors may influence ado-lescent alcohol use. Further research on examining interactive models and the potential indirect effects of family processes is needed, and this may provide more specific guidance in the delivery of family- oriented prevention programmes.