OBJECTIVE:Racial and ethnic disparities in exposure to COVID-19-related stressors, pandemic-related distress, and adverse mental health outcomes were assessed among health care workers in the Bronx, New York, during the first wave of the pandemic. METHODS:The authors analyzed survey data from 992 health care workers using adjusted logistic regression models to assess differential prevalence of outcomes by race/ethnicity and their interactions. RESULTS:Compared with their White colleagues, Latinx, Black, Asian, and multiracial/other health care workers reported significantly higher exposure to multiple COVID-19-related stressors: redeployment, fear of being sick, lack of autonomy at work, and inadequate access to personal protective equipment. Endorsing a greater number of COVID-19-related stressors was associated with pandemic-related distress in all groups and with adverse mental health outcomes in some groups; it was not related to hazardous alcohol use in any of the groups. These associations were not significantly different between racial and ethnic groups. Latinx health care workers had significantly higher probabilities of pandemic-related distress and posttraumatic stress than White colleagues. Despite greater exposure to COVID-19-related stressors, Black, Asian, and multiracial/other health care workers had the same, if not lower, prevalence of adverse mental health outcomes. Conversely, White health care workers had a higher adjusted prevalence of moderate to severe anxiety compared with Asian colleagues and greater hazardous alcohol use compared with all other groups. CONCLUSIONS:Health care workers from racial and ethnic minority groups reported increased exposure to COVID-19-related stressors, suggestive of structural racism in the health care workforce. These results underscore the need for increased support for health care workers and interventions aimed at mitigating disparities in vocational exposure to risk and stress.

Background: People engage in nonsuicidal self-injury (NSSI) to reduce negative affect, but it is not clear why they engage in this harmful type of behavior instead of using healthier strategies. The primary goal of this study was to evaluate whether people choose NSSI to reduce negative affect because they perceive it to be less cognitively costly than other available strategies.Method: In experiment one, 43 adults completed a novel, relief-based effort discounting task designed to index preferences about exerting cognitive effort to achieve relief. In experiment two, 149 adults, 52 % with a history of NSSI, completed our effort discounting task.Results: Our main results suggest that people will accept less relief from an aversive experience if doing so re-quires expending less effort, i.e. they demonstrate effort discounting in the context of decisions about relief. We also found and that effort discounting is stronger among those with a history of NSSI, but this association became nonsignificant when simultaneously accounting for other conditions associated with aberrant effort tradeoffs. Limitations: The use of a control group without NSSI or other potentially harmful relief-seeking behaviors limits our ability to draw specific conclusions about NSSI. The ecological validity of our task was limited by a modestly effective affect manipulation, and because participants made hypothetical choices.Conclusions: This study demonstrates that preferences about exerting cognitive effort may be a barrier to using healthier affect regulation strategies. Further, the preference not to exert cognitive effort, though present in NSSI, is likely not unique to NSSI. Instead, effort discounting may be a transdiagnostic mechanism promoting an array of harmful relief-seeking behaviors.

Hospitalizations among people living with HIV (PLWH) are frequent and costly. This study examined the association between psychiatric, HIV-related, and demographic factors and hospitalization rates among PLWH using data from the Einstein–Rockefeller-City University of New York Center for AIDS Research Clinical Cohort Database. Of the 10,215 PLWH included in the sample, 45

OBJECTIVE:Suicide is a major public health concern in the United States, but few effective and scalable interventions exist to help those with suicidal thoughts. We hypothesized that reading first-person narratives about working through suicidal thoughts would reduce the desire to die among adults and that this effect would be mediated by increased perceived shared experience and optimism.METHOD:Using a randomized waitlist-controlled trial, we tested the effect of digital narrative-based bibliotherapy among 528 adults visiting a social media platform dedicated to providing mental health support. Participants were randomized to either a treatment condition (n = 266), in which they read one suicide narrative per day for 14 days or to a waitlist control condition (n = 262). The primary outcome was a measure of desire to die assessed daily for the 14-day trial period and at 2-week follow-up.RESULTS:Participants in the treatment condition reported lower desire to die than participants in the control condition during the 14-day trial period (β = -0.26, p = .001) and at 2-week follow-up (t = -2.82, p = .005). Increased perceived shared experience (indirect effect b = -0.55, p < .001) and optimism (indirect effect b = -0.85, p < .001) mediated the effect of treatment on desire to die.CONCLUSIONS:Digital narrative-based bibliotherapy may be an effective intervention for those at risk for suicide, and may work in part by increasing feelings of perceived shared experience and optimism. Future research is needed to test the generalizability of these results to other platforms, groups, and conditions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

OBJECTIVE:The purpose of this study was to examine implicit affect toward suicide (i.e., how good/bad suicide is perceived). Some people might be more likely to think about/choose suicide because they perceive it as a good option (to gain relief) relative to available alternatives.METHOD:Implicit affect toward suicide among adults (N = 72) and adolescents (N = 174) with and without suicidal thoughts was examined using first-person (FP) perspective suicide pictures in the affect misattribution procedure (AMP).RESULTS:Suicidal adults' implicit positive affect toward suicide was associated with STB variables, such as explicit valence (r = 0.34) and arousal (r = 0.44) ratings of suicide pictures, and implicit affect differentiated groups above and beyond explicit valence ratings. Contrary to our hypothesis, suicidal participants did not display higher implicit positive affect toward suicide than nonsuicidal participants. However, suicidal participants displayed consistent implicit affect toward different suicide pictures, whereas nonsuicidal participants evaluated some pictures as more pleasant than others (ORs = 1.92-2.27).CONCLUSIONS:Implicit affect toward suicide may relate to STB, but stimuli characteristics (e.g., color) likely influence the accuracy of assessment with the AMP and should be a focus of future research involving this and other implicit measures.

Stressful life events are a common antecedent of suicidal thoughts. However, not all stressful events lead to increased suicidal thinking, even among those who frequently have suicidal thoughts. In this study, we examined whether the ways that individuals regulate their emotions moderates the association between stressful events and suicidal thinking. Building on prior research we hypothesized that cognitive reappraisal is associated with a weaker relationship between stress and same-day suicidal thoughts, and that expressive suppression is associated with a stronger relationship between stress and suicidal thoughts. We used a daily diary method to collect self-reports of stressful events and suicidal thoughts over a 28-day period. At baseline, we assessed participants’ tendency to use cognitive reappraisal and expressive suppression. Consistent with our first hypothesis, we found that at higher levels of reappraisal, there was a weaker relationship between stress and suicidal thoughts. Contrary to our second hypothesis, we found that at higher levels of expressive suppression there was also a weaker relationship between stress and suicidal thoughts. In contrast to laboratory-based findings suggesting that expressive suppression has negative psychological effects, these preliminary daily diary results suggest that expressive suppression could be an effective short-term emotion regulation strategy among individuals considering suicide.

The authors regret that the following error was present in the above-mentioned article. On p. 70, P23's age was incorrectly stated as 23. The correct age for P23 is 14-years-old. The authors would like to apologise for any inconvenience caused.

Relief from aversive states/contexts is among the most common motivators of behavior. Relative to reward-seeking behavior, however, relief-seeking behavior has received little scientific attention, and basic questions about the motivating properties of relief remain unanswered. Prior research has demonstrated that people prefer smaller rewards if they require less effort and less delay (i.e., wait time) than larger rewards, a tendency known as discounting. Here we asked whether effort and delay similarly influence choices about relief. To answer this question, we recruited 43 adults to complete two novel behavioral tasks designed to index tradeoffs between the cost of effort or delay, and the benefit of relief. We then compared the fit of a series of mathematical discount functions to participants’ choices in each task to identify how increased effort or delay leads to a discounted value of relief. Results suggest that the value of relief is discounted as a function of increasing effort and increasing delay. We further found that, similar to prior research on rewards, a parabolic discount model best accounted for the tradeoff between effort and relief. However, unlike previous findings on reward, a linear discount model best accounted for the tradeoff between delay and relief. Our results demonstrate that effort and delay are costs that influence choices about relief and also identify best-fitting discount models that can be used by future studies of relief-based decisions.

ABSTRACT (248 WORDS)IntroductionThere is public concern about potential associations between adolescent social media/smartphone use and risk for suicide. However, no prior studies leverage qualitative methods to explore the experiences of adolescents currently at‐risk for suicide.MethodsThis study examined social technology use from the perspectives of adolescents (n = 30; Mage = 16.1 years) currently hospitalized for a recent suicide attempt or severe ideation. We conducted in‐depth interviews and coded transcripts using thematic analysis. We had three research questions: What (1) negative and (2) positive experiences do suicidal adolescents report related to their use of social media/smartphones? (3) How do adolescents describe their disconnection from these technologies use during inpatient hospitalization and views on a subsequent return to digital connectivity after discharge?Results and conclusionsResults reveal both positive and negative social technology uses, with most participants reporting mixed (positive and negative) experiences. Negatives/risks included trouble regulating use, stress related to social media metrics, encounters with “triggering” content, hostility and meanness, self‐denigrating comparisons, and burdensome friendship expectations. Positives/benefits included social connection, social support, affect‐enhancing content, shared interests, and resources for mental health and coping. Overall, the documented risks and benefits of social technology use correspond with established (offline) risk and protective factors for suicidal thoughts and behaviors. Participants generally valued the break from social technologies during hospitalization, and also viewed them as integral to social re‐entry and identified related concerns. Future studies should test well‐being focused ‘digital hygiene’ interventions for maximizing potential benefits and minimizing potential harms of social technologies for at‐risk adolescents.

Objective Self-injurious thoughts and behaviors (SITBs) are a complex and enduring public health concern. Increasingly, teenagers use digital platforms to communicate about a range of mental health topics. These discussions may provide valuable information that can lead to insights about complex issues like SITBs. However, the field of clinical psychology currently lacks an easy-to-implement toolkit that can quickly gather information about SITBs from online sources. In the present study, we applied topic modeling, a natural language processing technique, to identify SITBs and related themes online, and we validated this approach using human coders. Method We separately used topic modeling software and human coders to identify themes present in text from a popular online Internet support forum for teenagers. We then determined the degree to which results from the software's topic model aligned with themes identified by human coders. Results We found that topic modeling detected SITBs and related themes in online discussions in a way that accurately distinguishes between relevant and irrelevant human-coded themes. Conclusions This approach has the potential to drastically increase our understanding of SITBs and related issues discussed on digital platforms, as well as our ability to identify those at risk for such outcomes.

In the United States over one-third of the population, including children and adolescents, are overweight or obese. Despite the prevalence of obesity, few studies have examined how food cravings and the ability to regulate them change throughout development. Here, we addressed this gap in knowledge by examining structural brain and behavioral changes associated with regulation of craving across development. In a longitudinal design, individuals ages 6-26 completed two structural scans as well as a behavioral task where they used a cognitive regulatory strategy to decrease the appetitive value of foods. Behaviorally, we found that the ability to regulate craving improved with age. Neurally, improvements in regulatory ability were associated with cortical thinning in medial and lateral prefrontal cortex. We also found that models with cortical thickness measurements and age chosen by a lasso-based variable selection method could predict an individual's regulation behavior better than age and other behavioral factors alone. Additionally, when controlling for age, smaller ventral striatal volumes were associated with higher body mass index and predicted greater increases in weight two years later. Taken together, these results demonstrate a role for structural brain changes in supporting the ability to resist cravings for appetitive foods across development.

Other people can profoundly affect one's opinions and decisions. In the current study, we compared the effects of peer influence on responses to a primary reward-food-in both young adolescents and adults. Food is critical for survival, and in addition to its rewarding properties, habits and practices surrounding eating are heavily influenced by social and cultural norms. To address the impact of peer influence on food valuations, young adolescents ages 10-14 and young adults ages 18-22 rated the desirability of foods before and after seeing peer opinions about those foods. We then compared the degree to which participants changed their ratings of food desirability as a function of the type of social information received (e.g., peers liking a food more or less than did the participant). We found that all participants' ratings conformed to the peer ratings and that adolescents had less stable valuations across all conditions over time. These results provide evidence for the effectiveness of peer influence in shifting valuations of appetitive stimuli and can inform interventions aimed at improving healthy eating choices. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Non-suicidal self-injury (NSSI) is a significant international mental health concern, with consequences for not only youth who self-injure, but for their entire family system. Helping caregivers respond productively to their child’s self-injury is a vital part of effectively addressing NSSI. This paper will assist school-based mental health practitioners and other personnel support caregivers of youth who self-injure by reviewing current literature, highlighting common challenges faced by school-based professionals, and providing evidenced-informed recommendations for supporting caregivers of youth who self-injure. We posit that schools can best support caregivers by having clear and well-articulated self-injury protocols and by engaging caregivers early. Once engaged, helping caregivers to navigate first conversations, keep doors open, know what to expect, seek support for themselves and understand and address safety concerns will ultimately benefit youth who self-injure and the school systems that support them. We also review recommendations for working with youth whose caretakers are unwilling or unable to be engaged.

Background: Theoretical work and clinical observation suggest that many patients experience relief from negative affect after thinking about suicide, which may increase the likelihood of future suicidal thoughts. Accordingly, our objective was to examine whether the occurrence of suicidal thinking was followed by decreased negative affect and increased positive affect. Methods: Participants were 43 adults who attempted suicide at least once in the past year (78% female, 78% White, M age = 23.28 years, SD age = 4.38 years) who completed 28 days of smartphone-based real-time monitoring, where they were signaled four times/day to report on current affect and whether they were having suicidal thoughts. Participants could initiate a survey whenever they had a suicidal thought. Results: First, we examined changes in affect that occurred when suicidal thinking at the current time (T) but not at T + 1 (approximately 4-8 h later). Negative affect decreased and positive affect increased when participants went from a period when they were experiencing suicidal thoughts to a period where they were not. Second, to assess the time course of changes in affect, we examined changes in affect before and after participant-initiated reports of suicidal thinking. Positive affect increased and sadness decreased. Limitations: Given its preliminary nature, the study has some limitations including insufficient power to expand beyond a 4-8 h timespan. Conclusions: Findings provide preliminary evidence that suicidal thinking leads to shifts in affect. These shifts in affect may be reinforcing, helping to explain (in part) why suicidal thinking is so persistent for some patients.

BACKGROUND:Suicide is a leading cause of death and a complex clinical outcome. Here, we summarize the current state of research pertaining to suicidal thoughts and behaviors in youth. We review their definitions/measurement and phenomenology, epidemiology, potential etiological mechanisms, and psychological treatment and prevention efforts.RESULTS:We identify key patterns and gaps in knowledge that should guide future work. Regarding epidemiology, the prevalence of suicidal thoughts and behaviors among youth varies across countries and sociodemographic populations. Despite this, studies are rarely conducted cross-nationally and do not uniformly account for high-risk populations. Regarding etiology, the majority of risk factors have been identified within the realm of environmental and psychological factors (notably negative affect-related processes), and most frequently using self-report measures. Little research has spanned across additional units of analyses including behavior, physiology, molecules, cells, and genes. Finally, there has been growing evidence in support of select psychotherapeutic treatment and prevention strategies, and preliminary evidence for technology-based interventions.CONCLUSIONS:There is much work to be done to better understand suicidal thoughts and behaviors among youth. We strongly encourage future research to: (1) continue improving the conceptualization and operationalization of suicidal thoughts and behaviors; (2) improve etiological understanding by focusing on individual (preferably malleable) mechanisms; (3) improve etiological understanding also by integrating findings across multiple units of analyses and developing short-term prediction models; (4) demonstrate greater developmental sensitivity overall; and (5) account for diverse high-risk populations via sampling and reporting of sample characteristics. These serve as initial steps to improve the scientific approach, knowledge base, and ultimately prevention of suicidal thoughts and behaviors among youth.

Understanding how and why affective responses change with age is central to characterizing typical and atypical emotional development. Prior work has emphasized the role of the amygdala and prefrontal cortex (PFC), which show age-related changes in function and connectivity. However, developmental neuroimaging research has only recently begun to unpack whether age effects in the amygdala and PFC are specific to affective stimuli or may be found for neutral stimuli as well, a possibility that would support a general, rather than affect-specific, account of amygdala-PFC development. To examine this, 112 individuals ranging from 6 to 23 years of age viewed aversive and neutral images while undergoing fMRI scanning. Across age, participants reported more negative affect and showed greater amygdala responses for aversive than neutral stimuli. However, children were generally more sensitive to both neutral and aversive stimuli, as indexed by affective reports and amygdala responses. At the same time, the transition from childhood to adolescence was marked by a ventral-to-dorsal shift in medial prefrontal responses to aversive, but not neutral, stimuli. Given the role that dmPFC plays in executive control and higher-level representations of emotion, these results suggest that adolescence is characterized by a shift towards representing emotional events in increasingly cognitive terms.

Emotion regulation is a critical life skill that develops throughout childhood and adolescence. Despite this development in emotional processes, little is known about how the underlying brain systems develop with age. This study examined emotion regulation in 112 individuals (aged 6-23 years) as they viewed aversive and neutral images using a reappraisal task. On "reappraisal" trials, participants were instructed to view the images as distant, a strategy that has been previously shown to reduce negative affect. On "reactivity" trials, participants were instructed to view the images without regulating emotions to assess baseline emotional responding. During reappraisal, age predicted less negative affect, reduced amygdala responses and inverse coupling between the ventromedial prefrontal cortex (vmPFC) and amygdala. Moreover, left ventrolateral prefrontal (vlPFC) recruitment mediated the relationship between increasing age and diminishing amygdala responses. This negative vlPFC-amygdala association was stronger for individuals with inverse coupling between the amygdala and vmPFC. These data provide evidence that vmPFC-amygdala connectivity facilitates vlPFC-related amygdala modulation across development.

Although one third of children and adolescents are overweight or obese, developmental changes in food craving and the ability to regulate craving remain poorly understood. We addressed this knowledge gap by examining behavioral and neural responses to images of appetizing unhealthy foods in individuals ages 6 through 23 years. On close trials (assessing unregulated craving), participants focused on a pictured food's appetitive features. On far trials (assessing effortful regulation), participants focused on a food's visual features and imagined that it was farther away. Across conditions, older age predicted less craving, less striatal recruitment, greater prefrontal activity, and stronger frontostriatal coupling. When effortfully regulating their responses to the images, all participants reported less craving and exhibited greater recruitment of lateral prefrontal cortex and less recruitment of ventromedial prefrontal cortex. Greater body mass predicted less regulation-related prefrontal activity, particularly among children. These results suggest that children experience stronger craving than adults but can also effectively regulate craving. Moreover, the mechanisms underlying regulation may differ for heavy and lean children.