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Houston, TX, United States

Lamis D.A.,University of South Carolina | Malone P.S.,University of South Carolina | Langhinrichsen-Rohling J.,University of South Alabama | Ellis T.E.,Menninger Clinic
Crisis | Year: 2010

Background: Individuals who are less invested in their bodies, experiencing symptoms of depression, and consuming alcohol are at increased risk for engaging in suicidal behaviors. Aims: This study examined the relationships among three risk factors - body investment, depression, and alcohol use - and suicide proneness as measured by the Life Attitudes Schedule - Short Form (LAS-SF) in college students (N = 318). Methods: Path analysis was used to construct a causal model of suicide proneness. The Body Investment Scale (BIS) subscales were assumed to be causally prior to depression, which was in turn modeled as occurring prior to alcohol use, which was in turn modeled as prior to suicide proneness. Results: As expected, suicide proneness was positively predicted by alcohol use, alcohol use was positively predicted by depression, and depression was negatively predicted by the body image component of the BIS. Additionally, the body image-suicide proneness link was significantly mediated by depression and its direct effect on suicide proneness as well as by the two-mediator path of body image on depression on drinking on suicide proneness. Conclusions: Implications are offered for the improved identification and treatment of young adults at risk for suicidal and health-diminishing behaviors. © 2010 Hogrefe Publishing.

Ha C.,University of Houston | Balderas J.C.,University of Houston | Zanarini M.C.,Harvard University | Oldham J.,Menninger Clinic | Sharp C.,University of Houston
Journal of Clinical Psychiatry | Year: 2014

Objective: The goal of this study was to carry out the first comprehensive assessment of psychiatric comorbidity in adolescents (aged 12-17 years) with DSM-IV criteria for borderline personality disorder (BPD) compared to a psychiatric comparison group without BPD. Complex comorbidity (a hallmark feature of adult BPD and defined as having any mood or anxiety disorder plus a disorder of impulsivity) was also examined as a distinguishing feature of adolescent BPD. Method: Consecutively admitted patients (October 2008 to October 2012) to an inpatient psychiatric hospital received parental consent and gave assent for participation in the study (N =418), with the final sample after exclusions consisting of 335 adolescent inpatients. A comprehensive, multimethod approach to determining psychiatric comorbidity was used, including both an interview-based (categorical) and a questionnaire-based (dimensional) assessment as well as both parent and adolescent self-report. Measures included the Diagnostic Interview Schedule for Children (NIMH-DISC-IV), Child Behavior Checklist (CBCL), Youth Self-Report (YSR), Car, Relax Alone, Forget, Friends,Trouble (CRAFFT), and the Childhood Interview for DSM-IV Borderline Personality Disorder (CI-BPD). Results: Thirty-three percent of the final sample met criteria for BPD. Adolescent inpatients with BPD showed significantly higher rates of psychiatric comorbidity compared to non-BPD psychiatric subjects for both internalizing (X1 2 =27.40, P<.001) and externalizing (X1 2 = 19.02, P< .001) diagnosis. Similarly, using dimensional scores for self-reported symptoms, adolescent inpatients with BPD had significantly higher rates of psychiatric comorbidity compared to non-BPD subjects for internalizing (t329 = -6.63, P < .001) and externalizing (t329=-7.14, P < .001) problems. Parent-reported symptoms were significantly higher in the BPD group only when using a dimensional approach (internalizing: t321 =-3.42, P<. 001; externalizing: t321 =-3.32, P<.001). Furthermore, significantly higher rates of complex comorbidity were found for adolescents with BPD (X 1 2 =26.60, P<.001). Moreover, externalizing and internalizing problems interacted in association with borderline traits (6=.25; P<.001). Conclusions: Similar to findings in adult studies of BPD, adolescents with BPD demonstrate significantly more complex comorbidity compared to psychiatric subjects without BPD. © Copyright 2014 Physicians Postgraduate Press, Inc.

Venta A.,University of Houston | Hart J.,Menninger Clinic | Sharp C.,University of Houston
Clinical Child Psychology and Psychiatry | Year: 2013

Recently, efforts have been made to better understand constructs that are associated with difficulties in emotion regulation in hopes of identifying underlying mechanisms that may be valuable targets for intervention. Against this background, the present study had two aims. Firstly, we wanted to explore the relation between emotion regulation, experiential avoidance and alexithymia by determining whether adolescents with elevated scores on a measure of alexithymia would report deficits in emotion regulation and experiential avoidance. Secondly, we sought to evaluate the role of experiential avoidance as a mediator in the relation between alexithymia and emotion regulation. The sample (N = 64) consisted of adolescents recruited from an inpatient facility of which approximately 30% were classified as having alexithymia. The results of this study indicate that adolescents with alexithymia report deficits in emotion regulation and elevated experiential avoidance. Experiential avoidance mediated the relation between alexithymia and emotion regulation, indicating that while the inability to effectively use language to identify and describe emotional states is strongly correlated with difficulties in regulating one's emotions, this relation is mediated by the unwillingness to tolerate aversive private experiences. Limitations and strengths of the present study are also noted. © The Author(s) 2012.

Coffey M.J.,Menninger Clinic
Journal of Clinical Outcomes Management | Year: 2015

Objective: To summarize the Perfect Depression Care initiative and describe recent work to spread this quality improvement initiative. Methods: We summarize the background and methodology of the Perfect Depression Care initiative within the specialty behavioral health care setting and then describe the application of this methodology to 2 examples of spreading Perfect Depression Care to general medical settings: primary care and general hospitals. Results: In the primary care setting, Perfect Depression Care spread successfully in association with the development and implementation of a practice guideline for managing the potentially suicidal patient. In the general hospital setting, Perfect Depression Care is spreading successfully in association with the development and implementation of a simple and efficient tool to screen not for suicide risk specifically, but for common psychiatric conditions associated with increased risk of suicide. Conclusion: Both examples of spreading Perfect Depression Care to general medical settings illustrate the social traction of "zero suicides," the audacious and transformative goal of the Perfect Depression Care Initiative. Copyright © 2015 by Turner White Communications Inc., Wayne, PA. All rights reserved.

Hart J.,Menninger Clinic | Bjorgvinsson T.,Houston OCD Program | Bjorgvinsson T.,Harvard University
Bulletin of the Menninger Clinic | Year: 2010

Health anxiety and hypochondriasis are serious and debilitating conditions that are poorly understood by health care providers and general public. This is so partly because of the derogatory use of the term hypochondriasis by the general public. There has been a push by mental health professionals in recent years to use the term health anxiety and to use hypochondriasis only for its extreme form. The Internet has become a popular medium, through Web sites and chat rooms, for patients to seek information, reassurance, and exchange of medical information, sometimes of limited veracity. The term cyberchondria has even been coined to describe this phenomenon. The authors review the research literature related to health anxiety and discuss the beneficial treatments of CBT and pharmacology. The utilization of intensive cognitive-behavioral therapy is highlighted with a case illustration. Copyright © 2010 The Menninger Foundation.

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