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Background: Identifying risk factors for suicide-related thoughts and behaviors (SRTB) is essential among adolescents in whom SRTB remain a leading cause of death. Although many risk factors have already been identified, influential theories now suggest that the domain of interpersonal relationships may play a critical role in the emergence of SRTB. Because attachment has long been seen as the foundation of interpersonal functioning, we suggest that attachment insecurity warrants attention as a risk factor for SRTB. Aims: This study sought to explore relations between attachment organization and suicidal ideation, suicide attempts, and self-harm in an inpatient adolescent sample, controlling for demographic and psychopathological covariates. Method: We recruited 194 adolescents from an inpatient unit and assigned them to one of four attachment groups (secure, preoccupied, dismissing, or disorganized attachment). Interview and self-report measures were used to create four variables reflecting the presence or absence of suicidal ideation in the last year, single lifetime suicide attempt, multiple lifetime suicide attempts, and lifetime self-harm. Results: Chi-square and regression analyses did not reveal significant relations between attachment organization and SRTB, although findings did confirm previously established relations between psychopathology and SRTB, such that internalizing disorder was associated with increased self-harm, suicide ideation, and suicide attempt and externalizing disorder was associated with increased self-harm. Conclusion: The severity of this sample and methodological differences from previous studies may explain the nonsignificant findings. Nonsignificant findings may indicate that the relation between attachment organization and SRTB is moderated by other factors that should be explored in future research.

AbstractRecent studies of the relationship between parenting and child development have included a focus on the parent's capacity to treat the child as a psychological agent. Several constructs have been developed to refer to this capacity, for example maternal mind‐mindedness, reflective functioning, and parental mentalizing. In this review article, we compare and contrast different constructs from diverse theoretical backgrounds that have been developed to operationalize parental mentalizing. We examine the empirical evidence to date in support of each of the constructs and review the relevant measures associated with each construct. Next, we discuss the possibility that these apparently diverse constructs may tap into the same underlying neurobiological socio‐cognitive system. We conclude by proposing a testable model for describing the links between parental mentalization, the development of mentalizing in children, and child psychopathology.

BACKGROUND: Interpersonal trust is an important target for the conceptualization, identification, and treatment of psychiatric disorders marked by interpersonal difficulties. A core feature of adolescent externalising disorders is interpersonal impairment. However, research investigating trust is scarce. A relatively novel approach for studying trust in psychopathology is through examination of social decision making using behavioural economic games. OBJECTIVE: To employ a modified trust game in order to determine whether externalising adolescents exhibit perturbed decision making in social and/or nonsocial contexts. METHODS: Externalising inpatient adolescents (n = 141) and non-externalising psychiatric controls (n = 122) completed self-report measures of psychopathology and invested in an iterative trust game played under two conditions: social (trust) and nonsocial (lottery condition), each consisting of five consecutive trials. RESULTS: Externalising adolescents showed a limited increase in trust investments, compared to a significant increase in lottery investments, across early game trials relative to psychiatric controls. This significant three-way interaction between experimental group, game condition, and trials became most evident at the second trial of games. Between-group differences on trust investments were non-significant. However, externalising adolescents invested significantly less in the trust relative to lottery condition, an effect unobserved in psychiatric controls. CONCLUSIONS: This study tentatively suggests that adolescent externalising disorders may be associated with an insensitivity to normative social exchange which may arise, in part, from a lack of anticipated co-player reciprocity. It is not the level of trust that may distinguish externalising adolescents but perhaps the form of which the trust exchange takes shape. Conclusions are tempered by the fact that the employed trust game did not include feedback in the form of co-player repayments.

AbstractA new approach to the measurement of mentalizing is introduced. Instead of measuring the presence or absence of mentalizing capacity, the current study aimed at developing a mentalizing task that focuses on investigating biases in mentalizing through the use of ambiguous peer‐related social scenarios. The response consistency of 659 children was investigated in a community sample of children aged seven to 11. Confirmatory latent class analysis allocated children to three groups on the basis of their responses: an overly positive style (OP), a rational/neutral style (R) or an overly negative style (ON). Children classed as OP showed a greater likelihood of being above cut‐off on a population screen for externalizing disorder. Over a two‐year follow‐up period, the children who were classified as R were most likely to remain so whereas the OP and ON children were found to change group. The results are discussed in the context of social‐cognitive research in this age group. Further studies should examine the external validity of the mentalizing task because the results reported here concern only internal construct validity.

Is there such a thing as addiction? -- Gambling in scientific focus -- Picoeconomics, impulsive consumption, and disordered gambling -- Behavioral and psychological investigations of disordered gambling -- The neuroeconomics of addiction -- Addictive gambling as the basic form of addiction -- Clinical evidence and implications -- The microexplanation of disordered gambling

Community-based care is receiving increasing global attention as a way to support children who are orphaned or vulnerable due to the HIV/AIDS pandemic. Using both qualitative and quantitative methodology, this study assesses community-based responses to the well-being of orphans and vulnerable children (OVC) and compares these responses with the actual mental health of OVC in order to evaluate the South African government's approach of funding community-based organisations (CBOs) that support and care for OVC. The study results show that the activities of CBOs mainly extend government services and address poverty. Although this should not be seen as insignificant, the paper argues that CBOs give very little attention to the mental health of OVC.

IntroductionThere is a remarkable dearth of evidence on mental illness in adolescents living with HIV/AIDS, particularly in the African setting. Furthermore, there are few studies in sub‐Saharan Africa validating the psychometric properties of diagnostic and screening tools for depression amongst adolescents. The primary aim of this cross‐sectional study was to estimate the prevalence of depression amongst a sample of HIV‐positive adolescents in Malawi. The secondary aim was to develop culturally adapted Chichewa versions of the Beck Depression Inventory‐II (BDI‐II) and Children's Depression Inventory‐II‐Short (CDI‐II‐S) and conduct a psychometric evaluation of these measures by evaluating their performance against a structured depression assessment using the Children's Rating Scale, Revised (CDRS‐R).Study designCross‐sectional study.MethodsWe enrolled 562 adolescents, 12–18 years of age from two large public HIV clinics in central and southern Malawi. Participants completed two self‐reports, the BDI‐II and CDI‐II‐S, followed by administration of the CDRS‐R by trained clinicians. Sensitivity, specificity and positive and negative predictive values for various BDI‐II and CDI‐II‐S cut‐off scores were calculated with receiver operating characteristics analysis. The area under the curve (AUC) was also calculated. Internal consistency was measured by standardized Cronbach's alpha coefficient, and correlation between self‐reports and CDRS‐R by Spearman's correlation.ResultsPrevalence of depression as measured by the CDRS‐R was 18.9%. Suicidal ideation was expressed by 7.1% (40) using the BDI‐II. The AUC for the BDI‐II was 0.82 (95% CI 0.78–0.89) and for the CDI‐II‐S was 0.75 (95% CI 0.70–0.80). A score of ≥13 in BDI‐II achieved sensitivity of >80%, and a score of ≥17 had a specificity of >80%. The Cronbach's alpha was 0.80 (BDI‐II) and 0.66 (CDI‐II‐S). The correlation between the BDI‐II and CDRS‐R was 0.42 (p<0.001) and between the CDI‐II‐S and CDRS‐R was 0.37 (p<0.001).ConclusionsThis study demonstrates that the BDI‐II has sound psychometric properties in an outpatient setting among HIV‐positive adolescents in Malawi. The high prevalence of depression amongst HIV‐positive Malawian adolescents noted in this study underscores the need for the development of comprehensive services for HIV‐positive adolescents.