Trajectories of parent criticism across treatment for youth self-harm.

IF 6.5 1区 医学 Q1 PSYCHIATRY
Madison Aitken, Florence Perquier, Bomi Park, Daniela Carvalho, Alexandra Wright-Hughes, David Cottrell, Peter Szatmari
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引用次数: 0

Abstract

Background: Criticism from parents is a risk factor for poor youth mental health, including self-harm and limited response to psychosocial interventions. We identified trajectories of change in parent criticism across treatment for youth self-harm (suicide attempts and non-suicidal self-injury) and compared these trajectories on treatment outcomes.

Methods: This is a preregistered secondary analysis of data from the Self-harm Intervention: Family Therapy trial. Participants (N = 831, 11-17 years; 89% girls, 11% boys; 84% White) were clinically referred for self-harm and randomly assigned to family therapy or usual care. A growth mixture model identified trajectories of parent self-reported criticism across baseline, 3, and 6 months. Trajectories were compared on youth self-harm, suicidal ideation, depression, and hopelessness, and parent mental distress (baseline, and change from baseline to 12 and 12-18 months).

Results: Four trajectories of parent criticism were identified: High and remaining elevated despite a small decrease (51.6%); sharply decreasing (7.6%); low/stable (37.2%); and increasing (3.6%). Youth with parents in the high with small decrease class had more severe baseline suicidal behavior. Treatment type was not related to criticism trajectory. Parent mental distress increased in the increasing criticism class. Youth with parents in the increasing class showed less improvement in suicidal ideation at 12-month follow-up compared to the high with small decrease and sharply decreasing classes.

Conclusions: Current treatments for youth self-harm may not reduce parent criticism to subclinical levels. Increasing parent criticism may forecast poorer response to a range of treatments for youth self-harm and be indicative of increases in parent mental distress.

青少年自残治疗中父母批评的轨迹。
背景:父母的批评是青少年心理健康状况不佳的一个风险因素,包括自残和对社会心理干预的反应有限。我们确定了青少年自我伤害(自杀未遂和非自杀性自伤)治疗过程中父母批评的变化轨迹,并比较了这些轨迹对治疗结果的影响。方法:这是一项预注册的对自我伤害干预:家庭治疗试验数据的二次分析。参与者(N = 831, 11-17岁;89%女生,11%男生;84%白人)因自残而被临床转诊,并随机分配到家庭治疗或常规护理组。一个成长混合模型确定了父母自我报告的批评在基线、3个月和6个月的轨迹。比较青少年自我伤害、自杀意念、抑郁、绝望和父母精神困扰的轨迹(基线,从基线到12个月和12-18个月的变化)。结果:发现了4种父母批评轨迹:高批评和保持高批评,但有小幅下降(51.6%);急剧下降(7.6%);低/稳定(37.2%);而且还在增长(3.6%)。父母在高与小减少班级的青少年有更严重的基线自杀行为。治疗方式与批评轨迹无关。父母的精神压力在越来越多的批评阶层中增加。在12个月的随访中,父母在增加班级的青少年自杀意念改善较少,而父母在增加班级的青少年自杀意念改善较少,父母在增加班级的青少年自杀意念改善较少,父母在增加班级的青少年自杀意念改善较少,父母在增加班级的青少年自杀意念改善较少。结论:目前青少年自残的治疗方法可能无法将父母的批评降低到亚临床水平。越来越多的父母批评可能预示着对一系列青少年自残治疗的不良反应,并表明父母精神压力的增加。
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来源期刊
CiteScore
13.80
自引率
5.30%
发文量
169
审稿时长
1 months
期刊介绍: The Journal of Child Psychology and Psychiatry (JCPP) is a highly regarded international publication that focuses on the fields of child and adolescent psychology and psychiatry. It is recognized for publishing top-tier, clinically relevant research across various disciplines related to these areas. JCPP has a broad global readership and covers a diverse range of topics, including: Epidemiology: Studies on the prevalence and distribution of mental health issues in children and adolescents. Diagnosis: Research on the identification and classification of childhood disorders. Treatments: Psychotherapeutic and psychopharmacological interventions for child and adolescent mental health. Behavior and Cognition: Studies on the behavioral and cognitive aspects of childhood disorders. Neuroscience and Neurobiology: Research on the neural and biological underpinnings of child mental health. Genetics: Genetic factors contributing to the development of childhood disorders. JCPP serves as a platform for integrating empirical research, clinical studies, and high-quality reviews from diverse perspectives, theoretical viewpoints, and disciplines. This interdisciplinary approach is a key feature of the journal, as it fosters a comprehensive understanding of child and adolescent mental health. The Journal of Child Psychology and Psychiatry is published 12 times a year and is affiliated with the Association for Child and Adolescent Mental Health (ACAMH), which supports the journal's mission to advance knowledge and practice in the field of child and adolescent mental health.
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