Adolescent Psychiatry - Volume 8, Issue 1, 2018

Background: Reflective Functioning (RF) is considered to play a central role in risk and resilience for psychological difficulties such as borderline personality disorder (BPD) and has become an important treatment target of transdiagnostic psychosocial interventions like Mentalization Based Therapy. However, a lack of measures to assess RF in adolescents has hampered research that can further elucidate the role of RF in different types of psychopathology. Objective: The objective of the present study was to examine the validity of the Reflective Functioning Questionnaire for Youth (RFQ-Y), examine the factor structure of the french RFQ-Y, the relationship between RFQ-Y and social cognition, psychological difficulties, BPD and narcissistic personality disorders. Method: A total of 533 adolescents and young adults (age 12 - 21) from the community completed the RFQ-Y, the Child Behaviour Checklist, the Borderline Personality Features Scale and the Pathological Narcissism Inventory. A subsample of 150 participants completed the Movie for the Assessment of Social Cognition (MASC). Results: Three factors were identified. Uncertainty/confusion was strongly positively correlated with psychological difficulties, especially symptoms of borderline personality disorder. Interest/curiosity was negatively correlated with psychopathology and Excessive Certainty was positively correlated with grandiose narcissism. RFQ-Y factors correlated more strongly with psychopathology than the MASC scales. Conclusion: This study demonstrates the validity of self-report measures like the RFQ-Y and its utility for identifying problematic styles of mentalizing associated with increased risk of psychopathology in general, as well as difficulties like narcissism in particular.

Background: Hippocampal volume is reduced in Major Depressive Disorder (MDD), but the extent to which hippocampal function is altered in the context of MDD, particularly in young adults, is not well established. The hippocampus is important in recollection memory, a cognitive domain that is often impaired in depressed adults. Objective: This pilot functional Magnetic Resonance Imaging (fMRI) study aimed to assess hippocampal activity during a verbal memory task in unmedicated young adults with MDD (18-24 years of age) relative to healthy age-matched Controls. Method: Brain activity was measured in hippocampal regions during verbal encoding and retrieval, and compared between groups (N=11 in each group); exploratory whole-brain assessments were also carried out. Results: Greater right hippocampal activity during verbal memory encoding (vs. retrieval) was apparent in Controls. Further, in the MDD group, left hippocampal activity during encoding (vs. retrieval) was positively related to depression symptom severity and number of previous depressive episodes. Conclusion: This pilot study is a stepping stone in examining the effect of depression on hippocampal function in young adults.

Background: Helicopter parenting, a form of over-parenting involving the use of developmentally inappropriate strategies on the offspring, has been associated with depressive symptoms in university students. However, little research has examined the underlying mechanisms of this relationship. Resilience as the process of successful adaptation to adverse circumstances is proposed as a potential mediating factor. Objectives: This study aimed to determine: (1) if helicopter parenting would predict depressive symptoms in Irish students; (2) if this relationship between helicopter parenting and severity of depressive symptoms was mediated by resilience; and (3) which aspects of resilience were significantly contributing to this mediation. Method: Data from 208 Irish university students who completed online measures of helicopter parenting, resilience and current depressive symptoms' severity were analysed. Results: Perceived helicopter parenting, including perception of over-protection and perception of intrusiveness and control, predicted severity of depressive symptoms. The relationship between perceived helicopter parenting and depressive symptoms was mediated via decreased resilience. Social resources, perception of the self, and perception of the future were the resilience components contributing the most significantly to this relationship mediation. Conclusion: Future research in emerging adults needs to investigate helicopter parenting as a potential intervention target in the context of growing depression rates in both university students and the population in general. Longitudinal studies that follow children into adolescence and adulthood should seek to comprehensively assess the relationship between helicopter parenting, resilience development and depression.

Background: The hospitalization of a child on an inpatient psychiatric unit is traumatic for the entire family, but few services address the needs of their siblings and caregivers. Objective: This pilot study aimed to demonstrate the feasibility and potential benefits of implementing psycho-educational and support groups for caregivers and siblings of children and adolescents admitted to psychiatric units. The primary aim of this intervention was to increase sibling resiliency and reduce trauma experienced by families. Method: A total of 145 siblings and 196 caregivers participated in the intervention. Siblings participated in a structured support group that enabled them to share their stories and learn coping skills. Caregivers were provided with a psycho-education curriculum in a group facilitated by a parent mentor. At the end of each session, participants completed surveys which included questions on demographics, satisfaction, knowledge learned, and anticipated changes in behavior as the result of participating in the intervention. Results: Feasibility was demonstrated through successful recruitment, high rates of survey completion, and overall participant satisfaction. Caregivers reported gaining useful parenting strategies to better support the siblings, an increased understanding of the impact of mental illness on siblings, a reduction in feelings of isolation, and improved access to resources. Siblings reported feeling relieved and better understood, learning new coping skills, and finding validation and support through sharing their experiences in a group setting. Conclusion: This study supports the feasibility and importance of providing sibling and caregiver support and psycho-education to enhance resiliency and reduce trauma among family members of psychiatrically hospitalized children and adolescents.

Background/Objectives: Antisocial behavior is common during adolescence and incurs significant costs both for society and for the young people themselves. While most adolescents will not continue on a trajectory of antisocial behavior as they age, they may still be affected years later in terms of educational and employment opportunities. Despite stated goals of rehabilitation, there is a tendency for society to focus on harsh sentencing and punitive approaches, which have not been demonstrated to work. This paper presents an overview of theory and research on antisocial behavior and describes an approach that incorporates a developmental understanding of delinquent youth with a psychoanalytically informed perspective on treatment. Method: This method has been employed successfully over the past 20 years in combination with a comprehensive approach in the context of a juvenile justice system that allows for young offenders to be given provisional sentences and to have their criminal charges dismissed if they successfully complete the program. Results: Developmental psychotherapy is a viable and feasible approach for young offenders. It has the promise of more long-lasting effects than approaches that depend primarily on containment or punishment.