Sonya K. Sterba

Revealing the Form and Function of Self-Injurious Thoughts and Behaviors: A Real-Time Ecological Assessment Study among Adolescents and Young Adults

Self-injurious behaviors are among the leading causes of death worldwide. However, the basic nature of self-injurious thoughts and behaviors (SITBs) is not well understood because prior studies have relied on long-term, retrospective, aggregate, self-report assessment methods. The authors used ecological momentary assessment methods to measure suicidal and nonsuicidal SITBs as they naturally occur in real time. Participants were 30 adolescents and young adults with a recent history of self-injury who completed signal- and event-contingent assessments on handheld computers over a 14-day period, resulting in the collection of data on 1,262 thought and behavior episodes. Participants reported an average of 5.0 thoughts of nonsuicidal self-injury (NSSI) per week, most often of moderate intensity and short duration (1-30 min), and 1.6 episodes of NSSI per week. Suicidal thoughts occurred less frequently (1.1 per week), were of longer duration, and led to self-injurious behavior (i.e., suicide attempts) less often. Details are reported about the contexts in which SITBs most often occur (e.g., what participants were doing, who they were with, and what they were feeling before and after each episode). This study provides a first glimpse of how SITBs are experienced in everyday life and has significant implications for scientific and clinical work on self-injurious behaviors.

Randomized controlled trial of a family cognitive-behavioral preventive intervention for children of depressed parents.

A family cognitive-behavioral preventive intervention for parents with a history of depression and their 9-15-year-old children was compared with a self-study written information condition in a randomized clinical trial (n = 111 families). Outcomes were assessed at postintervention (2 months), after completion of 4 monthly booster sessions (6 months), and at 12-month follow-up. Children were assessed by child reports on depressive symptoms, internalizing problems, and externalizing problems; by parent reports on internalizing and externalizing problems; and by child and parent reports on a standardized diagnostic interview. Parent depressive symptoms and parent episodes of major depression also were assessed. Evidence emerged for significant differences favoring the family group intervention on both child and parent outcomes; strongest effects for child outcomes were found at the 12-month assessment with medium effect sizes on most measures. Implications for the prevention of adverse outcomes in children of depressed parents are highlighted.

Matching method with theory in person-oriented developmental psychopathology research.

The person-oriented approach seeks to match theories and methods that portray development as a holistic, highly interactional, and individualized process. Over the past decade, this approach has gained popularity in developmental psychopathology research, particularly as model-based varieties of person-oriented methods have emerged. Although these methods allow some principles of person-oriented theory to be tested, little attention has been paid to the fact that these methods cannot test other principles, and may actually be inconsistent with certain principles. Lacking clarification regarding which aspects of person-oriented theory are testable under which person-oriented methods, assumptions of the methods have sometimes been presented as testable hypotheses or interpreted as affirming the theory. This general blurring of the line between person-oriented theory and method has even led to the occasional perception that the method is the theory and vice versa. We review assumptions, strengths, and limitations of model-based person-oriented methods, clarifying which theoretical principles they can test and the compromises and trade-offs required to do so.

Evaluating Group-Based Interventions When Control Participants Are Ungrouped

Individually randomized treatments are often administered within a group setting. As a consequence, outcomes for treated individuals may be correlated due to provider effects, common experiences within the group, and/or informal processes of socialization. In contrast, it is often reasonable to regard outcomes for control participants as independent, given that these individuals are not placed into groups. Although this kind of design is common in intervention research, the statistical models applied to evaluate the treatment effects are usually inconsistent with the resulting data structure, potentially leading to biased inferences. This article presents an alternative model that explicitly accounts for the fact that only treated participants are grouped. In addition to providing a useful test of the overall treatment effect, this approach also permits one to formally determine the extent to which treatment effects vary over treatment groups and whether there is evidence that individuals within treatment groups become similar to one another. This strategy is demonstrated with data from the Reconnecting Youth program for high school students at risk of school failure and behavioral disorders.

Fitting Multilevel Models with Ordinal Outcomes: Performance of Alternative Specifications and Methods of Estimation.

Previous research has compared methods of estimation for fitting multilevel models to binary data, but there are reasons to believe that the results will not always generalize to the ordinal case. This article thus evaluates (a) whether and when fitting multilevel linear models to ordinal outcome data is justified and (b) which estimator to employ when instead fitting multilevel cumulative logit models to ordinal data, maximum likelihood (ML), or penalized quasi-likelihood (PQL). ML and PQL are compared across variations in sample size, magnitude of variance components, number of outcome categories, and distribution shape. Fitting a multilevel linear model to ordinal outcomes is shown to be inferior in virtually all circumstances. PQL performance improves markedly with the number of ordinal categories, regardless of distribution shape. In contrast to binary data, PQL often performs as well as ML when used with ordinal data. Further, the performance of PQL is typically superior to ML when the data include a small to moderate number of clusters (i.e., ≤ 50 clusters).

Variability in Parameter Estimates and Model Fit Across Repeated Allocations of Items to Parcels.

Different random or purposive allocations of items to parcels within a single sample are thought not to alter structural parameter estimates as long as items are unidimensional and congeneric. If, additionally, numbers of items per parcel and parcels per factor are held fixed across allocations, different allocations of items to parcels within a single sample are thought not to meaningfully alter model fit—at least when items are normally distributed. We show analytically that, although these statements hold in the population, they do not necessarily hold in the sample. We show via a simulation that, even under these conservative conditions, the magnitude of within-sample item-to-parcel-allocation variability in structural parameter estimates and model fit can alter substantive conclusions when sampling error is high (e.g., low N, low item communalities, few items per few parcels). We supply a software tool that facilitates reporting and ameliorating the consequences of item-to-parcel-allocation variability. The tools utility is demonstrated on an empirical example involving the Neuroticism-Extroversion-Openness (NEO) Personality Inventory and the Computer Assisted Panel Study data set.

Alternative Model-Based and Design-Based Frameworks for Inference from Samples to Populations: From Polarization to Integration.

A model-based framework, due originally to R. A. Fisher, and a design-based framework, due originally to J. Neyman, offer alternative mechanisms for inference from samples to populations. We show how these frameworks can utilize different types of samples (nonrandom or random vs. only random) and allow different kinds of inference (descriptive vs. analytic) to different kinds of populations (finite vs. infinite). We describe the extent of each frameworks implementation in observational psychology research. After clarifying some important limitations of each framework, we describe how these limitations are overcome by a newer hybrid model/design-based inferential framework. This hybrid framework allows both kinds of inference to both kinds of populations, given a random sample. We illustrate implementation of the hybrid framework using the High School and Beyond data set.

Longitudinal Dimensionality of Adolescent Psychopathology: Testing the Differentiation Hypothesis.

BACKGROUND The differentiation hypothesis posits that the underlying liability distribution for psychopathology is of low dimensionality in young children, inflating diagnostic comorbidity rates, but increases in dimensionality with age as latent syndromes become less correlated. This hypothesis has not been adequately tested with longitudinal psychiatric symptom data. METHODS Confirmatory factor analyses of DSM-IV symptoms from seven common Axis I syndromes--major depression, generalized anxiety, separation anxiety, social anxiety, attention deficient hyperactivity, conduct, and oppositional defiant disorders--were conducted longitudinally, from ages 9 to 16, using the general-population Great Smoky Mountains Study sample. RESULTS An eight-syndrome model fit well at all ages, and in both genders. It included social anxiety, separation anxiety, oppositional defiant, and conduct syndromes, along with a multidimensional attention deficit-hyperactivity syndrome (i.e., inattention, hyperactivity, and impulsivity) and a unidimensional major depression/generalized anxiety syndrome. A high degree of measurement invariance across age was found for all syndromes, except for major depression/generalized anxiety. Major depression and generalized anxiety syndromes slightly diverged at age 14-16, when they also began to explain more symptom variance. Additionally, correlations between some emotional and disruptive syndromes showed slight differentiation. CONCLUSIONS Marked developmental differentiation of psychopathology, as implied by the orthogenetic principle, is not a prominent cause of preadolescent and adolescent psychiatric comorbidity.

Understanding Linkages Among Mixture Models

The methodological literature on mixture modeling has rapidly expanded in the past 15 years, and mixture models are increasingly applied in practice. Nonetheless, this literature has historically been diffuse, with different notations, motivations, and parameterizations making mixture models appear disconnected. This pedagogical review facilitates an integrative understanding of mixture models. First, 5 prototypic mixture models are presented in a unified format with incremental complexity while highlighting their mutual reliance on familiar probability laws, common assumptions, and shared aspects of interpretation. Second, 2 recent extensions—hybrid mixtures and parallel-process mixtures—are discussed. Both relax a key assumption of classic mixture models but do so in different ways. Similarities in construction and interpretation among hybrid mixtures and among parallel-process mixtures are emphasized. Third, the combination of both extensions is motivated and illustrated by means of an example on oppositional defiant and depressive symptoms. By clarifying how existing mixture models relate and can be combined, this article bridges past and current developments and provides a foundation for understanding new developments.

Revealing the form and function of self-injurious thoughts and behaviors: A real-time ecological assessment study among adolescents and young adults

Self-injurious behaviors are among the leading causes of death worldwide. However, the basic nature of self-injurious thoughts and behaviors (SITBs) is not well-understood because prior studies have relied on long-term, retrospective, aggregate, self-report assessment methods. We used ecological momentary assessment methods to measure suicidal and non-suicidal SITBs as they naturally occur in real-time. Participants were 30 adolescents and young adults with a recent history of self-injury who completed signaland event-contingent assessments on handheld computers over a 14-day period, resulting in the collection of data on 1262 thought and behavior episodes. Participants reported an average of 5.0 thoughts of nonsuicidal self-injury (NSSI) per week, most often of moderate intensity and short duration (1–30 minutes), and 1.6 episodes of NSSI per week. Suicidal thoughts occurred less frequently (1.1 per week), were of longer duration, and led to self-injurious behavior (i.e., suicide attempts) less often. Details are reported about the contexts in which SITBs most often occur (e.g., what participants were doing, who they were with, and what they were feeling before and after each episode). This study provides a first glimpse of how SITBs are experienced in everyday life and has significant implications for scientific and clinical work on self-injurious behaviors. Self-injurious behaviors are among the leading causes of death and injury worldwide (Nock, Borges et al., 2008; WHO, 2008), and represent one of the most perplexing problems facing psychological scientists. Philosophers have speculated about the nature of suicidal selfinjury for centuries (e.g., Kant, Camus, Rousseau, Satre, Hobbes, Locke, Hume)(see Minois, 1999), and over the past 50 years scientists have used systematic research methods to study self-injurious thoughts and behaviors (SITBs). SITBs include both suicidal behaviors (e.g., Correspondence to: Matthew K. Nock, Ph.D., 33 Kirkland Street, 1280, Cambridge, MA 02138, nock@wjh.harvard.edu. Publishers Disclaimer: The following manuscript is the final accepted manuscript. It has not been subjected to the final copyediting, fact-checking, and proofreading required for formal publication. It is not the definitive, publisher-authenticated version. The American Psychological Association and its Council of Editors disclaim any responsibility or liabilities for errors or omissions of this manuscript version, any version derived from this manuscript by NIH, or other third parties. The published version is available at www.apa.org/ pubs/journals/abn. HHS Public Access Author manuscript J Abnorm Psychol. Author manuscript; available in PMC 2017 January 23. Published in final edited form as: J Abnorm Psychol. 2009 November ; 118(4): 816–827. doi:10.1037/a0016948. A uhor M anscript