ABSTRACT
The period after psychiatric hospitalization is an extraordinarily high‐risk period for suicidal thoughts and behaviours (STBs). Affective–cognitive constructs (ACCs) are salient risk ...factors for STBs, and intensive longitudinal metrics of these constructs may improve personalized risk detection and intervention. However, limited research has examined how within‐person daily levels and between‐person dynamic metrics of ACCs relate to STBs after hospital discharge. Adult psychiatric inpatients (N = 95) completed a 65‐day ecological momentary assessment protocol after discharge as part of a 6‐month follow‐up period. Using dynamic structural equation models, we examined both within‐person daily levels and between‐person dynamic metrics (intensity, variability and inertia) of positive and negative affect, rumination, distress intolerance and emotion dysregulation as risk factors for STBs. Within‐person lower daily levels of positive affect and higher daily levels of negative affect, rumination, distress intolerance and emotion dysregulation were risk factors for next‐day suicidal ideation (SI). Same‐day within‐person higher rumination and negative affect were also risk factors for same‐day SI. At the between‐person level, higher overall positive affect was protective against active SI and suicidal behaviour over the 6‐month follow‐up, while greater variability of rumination and distress intolerance increased risk for active SI, suicidal behaviour and suicide attempt. The present study provides the most comprehensive examination to date of intensive longitudinal metrics of ACCs as risk factors for STBs. Results support the continued use of intensive longitudinal methods to improve STB risk detection. Interventions focusing on rumination and distress intolerance may specifically help to prevent suicidal crises during critical transitions in care.
Heavy episodic drinking (HED) is a major public health concern, and youth who engage in HED are at increased risk for alcohol-related problems that continue into adulthood. Importantly, there is ...heterogeneity in the onset and course of adolescent HED, as youth exhibit different trajectories of initiation and progression into heavy drinking. Much of what is known about the etiology of adolescent HED and alcohol-related problems that persist into adulthood comes from studies of predominantly White, middle-class youth. Because alcohol use and related problems vary by race/ethnicity and socioeconomic status, it is unclear whether previous findings are relevant for understanding developmental antecedents and distal consequences of adolescent HED for minoritized individuals. In the current study, we utilize a developmental psychopathology perspective to fill this gap in the literature. Using a racially and economically diverse cohort followed from adolescence well into adulthood, we apply group-based trajectory modeling (GBTM) to identify patterns of involvement in HED from age 14 to 17 years. We then investigate developmental antecedents of GBTM class membership, and alcohol-related distal outcomes in adulthood (∼ age 31 years) associated with GBTM class membership. Results highlight the importance of adolescent alcohol use in predicting future alcohol use in adulthood.
Extreme sport participation and injury rates have increased in recent decades. This study aimed to investigate sub-dimensions of impulsivity and sensation seeking that contribute to participation and ...injury risk in extreme sports.
Data included cross-sectional survey responses from 7,109 college students (Mage = 19.68, SD = 2.31).
This study utilized path analysis to investigate sub-dimensions of sensation seeking and impulsivity as predictors of extreme sport participation and injury across 3 models.
Results of the final model identify risk seeking and lack of perseverance as the two strongest predictors of extreme sports injury, risk seeking, experience seeking, and lack of premeditation as the strongest positive predictors of extreme sports participation, and lack of perseverance as the strongest negative predictor of extreme sports participation.
These results will contribute to targeted prevention and intervention efforts for extreme sports injury among young adults based on identified individual personality factors.
Health-risk behaviors have an unclear etiology and college students have elevated risk for engagement. Emotion dysregulation and several personality dimensions have been implicated in health-risk ...behaviors, but these constructs have rarely been studied together. Further, it is unknown if different types of health-risk behaviors have distinct etiologies.
2077 college students completed a cross-sectional survey.
Latent profile analysis discerned classes of participants from emotion dysregulation and personality dimensions. Differential engagement in self-injury, suicidality, disordered eating, substance misuse, and unprotected sex was evaluated across classes.
Three classes were identified, which were primarily distinguished by emotion dysregulation, urgency, and neuroticism. Health-risk behaviors generally increased across classes with increasing emotion-related constructs. Self-injury and suicidality demonstrated different patterns than other health-risk behaviors.
Results elucidate heterogeneity in health-risk behavior engagement. Focusing on emotional difficulties may be more important for reducing self-injury and suicidality than disordered eating, substance misuse, and risky sex.
College students have an elevated risk for self‐injurious thoughts and behaviours (SITBs), and there are robust differences in prevalence rates for SITBs across gender identities. Although numerous ...constructs have been implicated as risk factors, researchers have not significantly improved at predicting SITBs, possibly owing to constraints of confirmatory analyses. Classification trees are exploratory, person‐centred analyses that enable joint examination of numerous correlates and their interactions. Thus, classification trees may discern previously unstudied risk factors and identify distinct subpopulations with elevated risk for SITBs. We tested classification trees that evaluated 298 potential correlates of nonsuicidal self‐injury and suicidal ideation across self‐identified women and men. Data came from 5,131 college students who completed the National College Health Assessment, which assesses a wide range of health‐related constructs. Models produced parsimonious decision trees that accounted for a substantial amount of outcome variability (38.3–51.5%). Psychopathology, poorer psychological well‐being, and other SITBs emerged as important correlates for all participants. Trauma, disordered eating, and heavy alcohol use were salient among women, whereas alcohol use norms were important correlates among men. Importantly, models identified several constructs that may be amenable to intervention. Results support the use of exploratory analyses to explicate heterogeneity among individuals who engage in SITBs and suggest that gender identity is an important moderator for certain risk factors.
Background: Young adults have elevated risk for negative marijuana use-related outcomes, and there is heterogeneity among users. Identifying risk factors for marijuana user status will improve ...understanding of different populations of users, which may inform prediction of individuals most likely to experience negative outcomes. Objectives: To identify predictors of marijuana use initiation in young adults. We simultaneously examined a broad range of potential predictors and all their possible interactions, including constructs that have not been previously studied in substance use initiation research. Methods: Data were repeated cross-sectional survey responses from college students in Colorado (N = 4052, 77% White, 61% female, mean age = 22.77). Measures came from the National College Health Assessment, which assesses numerous health and behavioral constructs. We used recursive partitioning and random forest models to identify predictors of ever having used marijuana out of 206 variables. Results: Classification trees identified engagement in increased alcohol use and sexual behavior as salient correlates of marijuana use initiation. Parsimonious recursive partitioning trees explained a substantial amount of variability in marijuana user status (39% in the full model and 24% when alcohol variables were excluded). Random forest models predicted user status with 74.11% and 66.91% accuracy in the full model and when alcohol variables were excluded, respectively. Conclusions: Results support the use of exploratory analyses to explain heterogeneity among marijuana users and non-users. Since engagement in other health-risk behaviors were salient predictors of use initiation, prevention efforts to reduce harm from marijuana use may benefit from targeting risk factors for health-risk behaviors in general.
Previous research indicates that sensation seeking, emotion dysregulation, and impulsivity are predictive of non-suicidal self-injury (NSSI). A body of research supports that meaning in life predicts ...improved mental health and well-being, including fewer suicidal thoughts and attempts, yet no research has examined the moderating effects of meaning in life on the relations between personality and temperament and NSSI. Given the growing incidence rates of NSSI among adolescents and the potential lifelong consequences of NSSI, it is imperative to better understand the factors that reduce the rates at which adolescents in a clinical sample engage in NSSI. The present study investigates if the protective factors of meaning in life moderate the relation between personality and temperament variables and NSSI among 126 adolescents (71% female,
Mage
= 16.1,
SD
= 1.1, range 13–18, 80% White) residing in an inpatient psychiatric hospital who endorsed NSSI in the last 12 months. Results from hurdle modeling indicate that two subtypes of meaning in life, presence of meaning in life and search for meaning of life, may serve as robust protective factors against engagement in NSSI among a clinical sample of adolescents. Additionally, results suggest that search for meaning, but not presence of meaning in life, variables moderate the relations between personality and temperament and NSSI. Results provide evidence that meaning in life is an understudied variable of importance in understanding how to prevent or treat NSSI. It also underscores the need to develop, refine, and test meaning-making interventions.
Cognitive emotion regulation strategies (ERSs) are salient predictors of numerous mental health outcomes. Individuals rely on combinations of strategies and these are often context-dependent, so it ...is advantageous to evaluate several cognitive ERSs in studies on relations between emotion regulation and mental health. However, it is not always practical to examine several ERSs as separate predictors in statistical models (e.g., due to small sample size), especially when evaluating multiple factors that impact mental health. We aimed to evaluate a parsimonious underlying factor structure for overall reliance on different domains of cognitive ERSs. Using data from 2,077 young adults, we used Exploratory Structural Equation Modeling (ESEM) to evaluate underlying factor structures for nine ERSs as measured by the Cognitive Emotion Regulation Questionnaire. A three-factor solution was identified, including factors termed Positive ERSs, Internally-Oriented Negative ERSs, and Externally-Oriented Negative ERSs. The Positive ERS factor was a protective factor and the Internally-Oriented Negative ERS factor was a risk factor for several health-risk behaviors and mental health diagnoses, and effects were larger for Internally-Oriented Negative ERSs. Relations between the Externally-Oriented Negative ERSs factor and mental health outcomes were generally null. Results extend previous literature indicating that maladaptive ERSs have larger impacts on mental health concerns than adaptive strategies, and highlight that ERSs involving negative cognitions about oneself and one’s internal experiences are a salient, transdiagnostic feature of psychopathology and health-risk behaviors. This parsimonious three-factor modeling approach for cognitive ERSs may be useful in etiological models for mental health concerns.
Increasing understanding of the risk and protective factors for adolescent nonmedical use of prescription drugs (NMUPD) could inform prevention efforts. Several correlates have been identified, ...including parental factors, perceptions about use and accessibility, social norms, and age. However, these constructs have rarely been simultaneously examined using paired data from parents and adolescents. We aimed to examine the relative influence of these correlates among dyads (N = 349) of mothers and adolescent daughters. Using multiple logistic regression, daughters' past NMUPD and inclination for future NMUPD were regressed onto descriptive norms for friend use, perceived drug accessibility and risk of harm from use, daughter age, mothers' disapproval about use, mothers' past NMUPD and inclination for future NMUPD, and the mother-daughter relationship quality. Akaike weights and lasso regressions were also estimated to evaluate the relative importance of each correlate. Higher descriptive norms for friend use, older age, and mothers' inclination for NMUPD were risk factors for daughters' NMUPD, while a closer mother-daughter relationship and mothers' disapproving attitudes towards NMUPD were protective factors. The three analysis approaches were corroborative. Results suggest friend descriptive norms, mother-daughter relationship quality, and mothers' attitudes about NMUPD are important prevention targets.
COVID-19 containment behaviors (CCBs) remain important methods for reducing contagion. Theoretical frameworks to understand engagement in health-risk behaviors among young people may help identify ...individuals with elevated risk for non-adherence to CCBs. We aimed to elucidate individual differences in CCBs by evaluating if CCBs fit into an established health-risk behavior framework. Using a cross-sectional sample of 1374 young adults, we examined CCBs’ associations with personality antecedents to health-risk behaviors and to actual engagement in other health-risk behaviors. Results identified risk seeking, negative urgency, lack of premeditation, and extraversion as risk factors for less CCB adherence, while agreeableness and neuroticism were protective factors. Less CCB adherence was positively associated with binge drinking, more sexual partners, and risky driving, while negatively associated with purging and self-injury. Results suggest CCBs may be understood as a type of health-risk behavior and can contribute to the development of strategies for increasing public health guideline adherence.
