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  • North Dartmouth, Massachusetts, United States
Smoking among young adults is a significant public health problem. Despite the negative health effects, many young women smoke for weight and body image reasons. Understanding the factors that prompt young women to initiate and continue... more
Smoking among young adults is a significant public health problem. Despite the negative health effects, many young women smoke for weight and body image reasons. Understanding the factors that prompt young women to initiate and continue smoking is important for designing smoking cessation interventions. The aim of the current article is to outline a potential pathway for smoking behavior among young women, specifically applying a cognitive bias framework previously used to describe disordered eating behaviors. This article provides the rationale for using two different treatments targeting body image schema among female smokers. The authors describe the development, feasibility, and acceptability of these two treatment approaches among a sample of female college smokers (N = 24). Preliminary pilot data are presented as well as the significance and implications for future clinical interventions.
Background:Experiencing racial microaggressions has clear effects on physical and psychological health, including obsessive-compulsive disorder symptoms (OCS). More research is needed to examine this link. Psychological flexibility is an... more
Background:Experiencing racial microaggressions has clear effects on physical and psychological health, including obsessive-compulsive disorder symptoms (OCS). More research is needed to examine this link. Psychological flexibility is an important process to examine in this work.Aims:This study aimed to examine if, while controlling for depression and anxiety, experiences of microaggressions and psychological flexibility helped explain OCD symptoms within a university-affiliated sample (undergraduate, graduate and law students). This was a pilot exploration of the relationships across themes.Method:Initial baseline data from a longitudinal study of psychological flexibility, OCD symptoms, depression, anxiety and experience of microaggressions was utilized. Correlations and regressions were utilized to examine which OCD symptom dimensions were associated with experiencing racial microaggressions in addition to anxiety and depression, and the added role of psychological flexibility wa...
CHAPteR Functions of Adolescent Nonsuicidal Self-Injury ELIZABETH E. LLOYD-RICHARDSON, MATTHEW K. NOCK, AND MITCHELL J. PRINSTEIN In this chapter, the practitioner will gain an understanding of: The array of possible functions of NSSI for... more
CHAPteR Functions of Adolescent Nonsuicidal Self-Injury ELIZABETH E. LLOYD-RICHARDSON, MATTHEW K. NOCK, AND MITCHELL J. PRINSTEIN In this chapter, the practitioner will gain an understanding of: The array of possible functions of NSSI for ...
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... more
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 sc...
SummaryMedia coverage of non-suicidal self-injury (NSSI) ranges from providing helpful education to displaying graphic images. We offer the first research-informed, consensus-based guidelines for the responsible reporting and depicting of... more
SummaryMedia coverage of non-suicidal self-injury (NSSI) ranges from providing helpful education to displaying graphic images. We offer the first research-informed, consensus-based guidelines for the responsible reporting and depicting of NSSI in the media, while also advising on ideas for dissemination and collaboration between media professionals and healthcare experts.
Nonsuicidal self-injury (NSSI) is defined as the deliberate, self-inflicted damage of body tissue without suicidal intent and for purposes not socially or culturally sanctioned. School nurses are often a first point of contact for young... more
Nonsuicidal self-injury (NSSI) is defined as the deliberate, self-inflicted damage of body tissue without suicidal intent and for purposes not socially or culturally sanctioned. School nurses are often a first point of contact for young people experiencing mental health challenges, and yet they often report they lack knowledge and training to provide care for persons who engage in NSSI. In the first of two parts, this article provides school nurses with a better understanding of NSSI and the distinctions between NSSI and suicidal behaviors, discusses the role of nurses’ knowledge and attitudes on their ability to care for their patients’ mental health needs, and discusses approaches for developing a respectful, empathic manner for working with and supporting youth who engage in self-injury. Part 2 will offer a strategy for brief assessment of NSSI and reflect on two case studies and their implications for school nursing practice.
This study aims to deepen understanding of the effects on parents of having a self-injuring child by (a) analyzing differences in dimensions of caregiver strain between caregivers of youth with nonsuicidal self-injury (NSSI+) and parents... more
This study aims to deepen understanding of the effects on parents of having a self-injuring child by (a) analyzing differences in dimensions of caregiver strain between caregivers of youth with nonsuicidal self-injury (NSSI+) and parents of youth with no known mental health history (MH-); (b) identifying factors that contribute to caregiver strain; and (c) examining parent outcome expectancies. Participants were 196 NSSI+ parents and 57 MH- parents. Quantitative measures of psychosocial variables, parent mental health and support variables, and child self-injury characteristics were assessed in relation to caregiver strain, and NSSI+ parental expectancies were assessed via mixed methods. Parents with a NSSI+ youth were more likely to exhibit all forms of objective and subjective strain than parents of youth with no mental health challenges. Despite this, many parents expressed beliefs that their child would experience personal growth as a result of their NSSI experience. Findings re...
Parent and friend influences may differentially promote or deter adolescent smoking at discrete stages. Drawing from national (Add Health) data, a partial proportional odds ordinal regression model was utilized to examine the multivariate... more
Parent and friend influences may differentially promote or deter adolescent smoking at discrete stages. Drawing from national (Add Health) data, a partial proportional odds ordinal regression model was utilized to examine the multivariate influence of parent and friend variables and their interactions on transitions across smoking stages (Never Smokers, Experimenters, Intermittent, Regular/Established) separately for mother-child pairs (N = 15,983) and father-child pairs (N = 1,142). Friend smoking status was by far the strongest predictor across smoking stages. Gender differences indicated males with one or more daily smoking friends are at higher risk for regular smoking relative to females. Fathers' smoking status had a direct effect on teen smoking across all stages, whereas mothers' smoking was significant in influencing which stage of smoking teens exhibited. Moreover, maternal smoking status had an indirect effect by moderating the association between teen smoking and...
In the present research, we offer a novel method for informing consumers about the sugar content in sugar-sweetened beverages (SSBs). With a series of experiments, we present evidence that this method curbs preference for SSBs and leads... more
In the present research, we offer a novel method for informing consumers about the sugar content in sugar-sweetened beverages (SSBs). With a series of experiments, we present evidence that this method curbs preference for SSBs and leads to more negative attitudes toward SSBs. We propose that people view SSBs more negatively and show less preference for SSBs when they are able to concretely visualize the quantity of sugar in SSBs. For example, we suggest that people might have more negative views toward the idea of consuming 28 sugar cubes (concrete information), compared to consuming "70g" of sugar (abstract information). Indeed, we found that, without any intervention, people struggle to convert sugar grams into a concrete, physical sugar representation (Experiment 1). But, when people are provided ways to convert abstract sugar-nutrition information into a concrete representation, they find SSBs less attractive (Experiment 2) and are less likely to select SSBs in favor o...
A database is emerging that examines the relative contributions of genes and the environment to the etiology of smoking in adolescence. We present analyses derived from a genetically informative subsample of sibling pairs (monozygotic and... more
A database is emerging that examines the relative contributions of genes and the environment to the etiology of smoking in adolescence. We present analyses derived from a genetically informative subsample of sibling pairs (monozygotic and dizygotic twins, full siblings, and half-siblings) participating in two waves of the National Longitudinal Study of Adolescent Health to estimate these parameters on both individual differences in smoking and extreme levels of smoking. Evidence indicated both genetic and shared environmental influences on high levels of smoking frequency, as well as on individual differences in smoking. No notable gender differences in these parameters emerged. Shared environmental effects were especially notable for high levels of smoking frequency and significantly greater than those found for individual differences. These findings were compatible with prior studies of both adolescent and adult smoking and reinforce the importance of familial influences on high levels of smoking frequency in adolescence.
Prior research on sibling contagion for substance use has not attended to individual differences in the sibling relationship that may be influenced by genetic similarity. The authors utilizing data on a sample of twin and nontwin siblings... more
Prior research on sibling contagion for substance use has not attended to individual differences in the sibling relationship that may be influenced by genetic similarity. The authors utilizing data on a sample of twin and nontwin siblings participating in the National Longitudinal Study of Adolescent Health (Add Health). Although monozygotic twins had the highest levels of sibling contact and mutual friendships, the pattern of results for other sibling types were not consistent with genetic models, and biometric analysis indicated that shared environmental factors influenced these sibling relationship features. Application of DeFries-Fulker regression models provided evidence that sibling contact and mutual friendships represent a source of social contagion for adolescent smoking and drinking independent of genetic relatedness. The results are interpreted using a social contagion framework and contrasted with other competing models such as those focused on the equal environments assumption and niche selection.
To our knowledge, no prior twin studies have examined genetic and environmental contributions to the association of depressive symptoms and cigarette smoking in adolescence. Genetic and environmental contributions to the covariation of... more
To our knowledge, no prior twin studies have examined genetic and environmental contributions to the association of depressive symptoms and cigarette smoking in adolescence. Genetic and environmental contributions to the covariation of depressive symptoms and cigarette smoking were estimated among 287 monozygotic and 441 dizygotic adolescent twin pairs from the National Longitudinal Study of Adolescent Health. Depressive symptoms were measured using an 18-item modified version of the Center for Epidemiologic Studies-Depression Scale (CES-D; Radloff, 1977). Smoking involvement was defined using an ordinal scale based on smoking recency and frequency. Depressive symptoms and smoking were significantly correlated in both males and females. Twin modeling indicated that, in females, the correlation was attributable in part to common genetic factors and in part to environmental factors not shared among twins, or nonshared environment. In males, the correlation between depressive symptoms and smoking was solely attributable to nonshared environment. Nonshared environmental correlations in males and females lend support to a direct causal relationship between depressive symptoms and smoking in adolescence. However, the additional common genetic vulnerability in females suggested that common genetic factors also contribute, particularly among adolescent females.
Smoking among young adults is a significant public health problem. Despite the negative health effects, many young women smoke for weight and body image reasons. Understanding the factors that prompt young women to initiate and continue... more
Smoking among young adults is a significant public health problem. Despite the negative health effects, many young women smoke for weight and body image reasons. Understanding the factors that prompt young women to initiate and continue smoking is important for designing smoking cessation interventions. The aim of the current article is to outline a potential pathway for smoking behavior among young women, specifically applying a cognitive bias framework previously used to describe disordered eating behaviors. This article provides the rationale for using two different treatments targeting body image schema among female smokers. The authors describe the development, feasibility, and acceptability of these two treatment approaches among a sample of female college smokers (N = 24). Preliminary pilot data are presented as well as the significance and implications for future clinical interventions.
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We examined baseline differences in dysfunctional attitudes and coping associated with a history of major depressive disorder (MDD) among 435 smokers participating in a smoking cessation trial. Consistent with expectations, MDD history... more
We examined baseline differences in dysfunctional attitudes and coping associated with a history of major depressive disorder (MDD) among 435 smokers participating in a smoking cessation trial. Consistent with expectations, MDD history was associated with greater dysfunctional attitudes, greater use of maladaptive coping, less use of adaptive coping, and greater dysphoria and negative mood. The effects of MDD history on cognition and coping were independent from the effects of a history of alcohol dependence (AD), indicating that MDD history is a unique risk factor for variables associated with vulnerability to depression. Finally, regression analyses showed that the effects of MDD history on depressive symptoms and negative mood were mediated by dysfunctional attitudes and by both adaptive and maladaptive coping. Results indicate that smokers with an MDD history seeking cessation treatment possess characteristics that may be targets for cognitive-behavioral treatments (CBT) aimed at addressing vulnerability to depression and negative moods during smoking cessation.
Adolescent weight control interventions demonstrate variable findings, with inconsistent data regarding the appropriate role for parents. The current study examined the efficacy of a standard adolescent behavioral weight control (BWC)... more
Adolescent weight control interventions demonstrate variable findings, with inconsistent data regarding the appropriate role for parents. The current study examined the efficacy of a standard adolescent behavioral weight control (BWC) intervention that also targeted parent-adolescent communication and parental modeling of healthy behaviors (Standard Behavioral Treatment + Enhanced Parenting; SBT + EP) compared with a standard BWC intervention (SBT).   49 obese adolescents (M age = 15.10; SD = 1.33; 76% female; 67.3% non-Hispanic White) and a caregiver were randomly assigned to SBT or SBT + EP. Adolescent and caregiver weight and height, parental modeling, and weight-related communication were obtained at baseline and end of the 16-week intervention.   Significant decreases in adolescent weight and increases in parental self-monitoring were observed across both conditions. Analyses of covariance revealed a trend for greater reduction in weight and negative maternal commentary among S...
To examine longitudinal bidirectional associations between changes in adolescents' weight status and psychosocial constructs. 118 obese adolescents aged 13-16 years participated in a behavioral weight control intervention. Percent... more
To examine longitudinal bidirectional associations between changes in adolescents' weight status and psychosocial constructs. 118 obese adolescents aged 13-16 years participated in a behavioral weight control intervention. Percent overweight (OW), fear of negative evaluation (FNE), and frequency of weight-related teasing (WRT) were collected at baseline, end of intervention, and 12 and 24 months post-randomization. 3 multivariate latent change score models were estimated to examine longitudinal cross-lagged associations between: (1) OW and FNE; (2) OW and WRT; and (3) FNE and WRT. Decreases in OW were prospectively associated with subsequent decreases in both FNE and WRT; however, changes in FNE and WRT were not prospectively associated with subsequent change in OW. Decreases in FNE were prospectively associated with subsequent decreases in WRT. Moderate weight loss in the context of a behavioral weight control intervention has positive long-term implications for obese adolescen...
OBJECTIVE: This study examined the 24-month outcomes of a randomized controlled trial of a group-based behavioral weight control (BWC) program combined with either activity-based peer intervention or aerobic exercise. METHODS: At... more
OBJECTIVE: This study examined the 24-month outcomes of a randomized controlled trial of a group-based behavioral weight control (BWC) program combined with either activity-based peer intervention or aerobic exercise. METHODS: At baseline, 118 obese adolescents (68% female; BMI = 31.41 ± 3.33) ages 13 to 16 years (mean = 14.33; SD = 1.02) were randomized to receive 1 of 2 weight loss interventions. Both interventions received the same 16-week group-based cognitive-behavioral treatment, combined with either aerobic exercise or peer-based adventure therapy. Eighty-nine adolescents (75% of original sample) completed the 24-month follow-up. Anthropometric and psychosocial measures were obtained at baseline, at the end of the 16-week intervention, and at 12 and 24 months following randomization. RESULTS: An intent-to-treat mixed factor analysis of variance indicated a significant effect for time on both percent over 50th percentile BMI for age and gender and standardized BMI score, with ...
Objective: To evaluate demographic and psychosocial predictors of attrition and weight loss in a behaviorally based adolescent weight control trial.Methods and Procedures: Adolescents (N = 76) aged 13–16 years and 20–80% overweight (M =... more
Objective: To evaluate demographic and psychosocial predictors of attrition and weight loss in a behaviorally based adolescent weight control trial.Methods and Procedures: Adolescents (N = 76) aged 13–16 years and 20–80% overweight (M = 60.56%, s.d. = 15.17%) received standard group‐based behavioral treatment as part of a randomized trial comparing different activity interventions for overweight adolescents. Anthropometric and psychosocial measures were obtained at baseline and after the 16‐week intervention.Results: Higher parent (P < 0.01) and adolescent BMI (P < 0.05) at baseline, as well as ethnic minority status (P < 0.05) were significantly associated with attrition in univariate analyses. Parent BMI remained the only significant predictor of attrition in multivariate analyses. BMI change for completers (N = 62) was highly variable, ranging from −6.09 to +1.62 BMI units. Male gender (P < 0.01) was a significant predictor of reduction in BMI, whereas not being from ...
ABSTRACTBackgroundFew studies have investigated non-suicidal self-injury (NSSI), or the deliberate, direct destruction of body tissue without conscious suicidal intent, and the motivations for engaging in NSSI among adolescents. This... more
ABSTRACTBackgroundFew studies have investigated non-suicidal self-injury (NSSI), or the deliberate, direct destruction of body tissue without conscious suicidal intent, and the motivations for engaging in NSSI among adolescents. This study assessed the prevalence, associated clinical characteristics, and functions of NSSI in a community sample of adolescents.MethodA total of 633 adolescents completed anonymous surveys. NSSI was assessed with the Functional Assessment of Self-Mutilation (FASM).ResultsSome form of NSSI was endorsed by 46·5% (n=293) of the adolescents within the past year, most frequently biting self, cutting/carving skin, hitting self on purpose, and burning skin. Sixty per cent of these, or 28% of the overall sample, endorsed moderate/severe forms of NSSI. Self-injurers reported an average of 12·9 (s.d.=29·4) incidents in the past 12 months, with an average of 2·4 (s.d.=1·7) types of NSSI used. Moderate/severe self-injurers were more likely than minor self-injurers, ...
OBJECTIVE. Adolescence is an important period of risk for the development of lifelong smoking behaviors. Compelling, although inconsistent, evidence suggests a relationship between parental smoking and the risk of smoking initiation... more
OBJECTIVE. Adolescence is an important period of risk for the development of lifelong smoking behaviors. Compelling, although inconsistent, evidence suggests a relationship between parental smoking and the risk of smoking initiation during adolescence. This study investigates unresolved issues concerning the strength and nature of the association between parent smoking and offspring smoking initiation. METHODS. We enrolled 564 adolescents aged 12 to 17, along with 1 of their parents, into the New England Family Study between 2001 and 2004. Lifetime smoking histories were obtained from parents and their adolescent offspring. Discrete-time survival analysis was used to investigate the influence of parental smoking histories on the risk of adolescent smoking initiation. RESULTS. Parental smoking was associated with a significantly higher risk of smoking initiation in adolescent offspring. In addition, the likelihood of offspring smoking initiation increased with the number of smoking p...
This study examined rates, correlates and an interpersonal model of nonsuicidal self-injury (NSSI) among a sample of 508 sixth, seventh, and eighth graders. Questionnaires assessing NSSI, related health-risk behaviors, and relationships... more
This study examined rates, correlates and an interpersonal model of nonsuicidal self-injury (NSSI) among a sample of 508 sixth, seventh, and eighth graders. Questionnaires assessing NSSI, related health-risk behaviors, and relationships with parents were administered two times over an 11-month period. Overall, 7.5% reported engaging in NSSI within the past year with no significant differences across genders, ethnicities, or grade. Those engaging in NSSI were more likely to report having smoked cigarettes, taken drugs, and engaged in maladaptive eating behaviors. Consistent with an interpersonal model, those engaging in NSSI reported significant increases in the quality of their relationships with fathers over time. Clinical implications include considering the role of family members in efforts to prevent and treat NSSI.
Ethnographic research, including interviews, focus groups, and observations were conducted to explore gendered dimensions of smoking among low level smokers, including the acceptability of smoking in different contexts; reasons for... more
Ethnographic research, including interviews, focus groups, and observations were conducted to explore gendered dimensions of smoking among low level smokers, including the acceptability of smoking in different contexts; reasons for smoking; the monitoring of self and friends’ smoking; and shared smoking as a means of communicating concern and empathy. Important gendered dimensions of smoking were documented. Although males who smoked were described as looking manly, relaxed, and in control, among females, smoking was considered a behavior that made one look slutty and out of control. Young women were found to monitor their own and their friends’ smoking carefully and tended to smoke in groups to mitigate negative perceptions of smoking. Gender-specific tobacco cessation programs are warranted on college campuses.

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