A comparison between pro-anorexia and non-suicidal self-injury blogs: From symptom-based identity to sharing of emotions

Virtual social interaction and loneliness among emerging adults amid the COVID-19 pandemic

Many social activities moved online during the global COVID-19 pandemic, yet research investigating whether virtual social interactions facilitate social connectedness has been inconclusive. In this study, participants completed online questionnaires assessing objective social isolation, loneliness, mental health, and virtual social interactions. There was clear evidence for worsening mental health among emerging adults during the COVID-19 pandemic characterized by large increases in depressive symptoms (mean increase = 8.35, 95% CI [6.97, 9.73], t(118) = 118, p < .001), and large decrements in happiness (mean decrease = -0.71, 95% CI [-0.84, -0.57], t(118) = 10.09, p < .001) and social satisfaction (mean decrease = -0.81, 95% CI [-1.00,-0.62], t(115) = 8.28, p < .001) post-pandemic onset. In line with expectations, those living in larger households amid the pandemic reported lower levels of loneliness and higher levels of happiness. A negative association was found between household size (an index of objective social isolation) and loneliness, b = -3.01, t(79) = 2.60, p = .011, 95% CI [-5.32, -0.71], and a positive association was found between household size and happiness, b = 22.86, t(75) = 3.30, p = .001, 95% CI [9.06, 36.65]. However, contrary to expectations, there was no association between loneliness and frequency of virtual social interactions. There was also no association between frequency of virtual social interactions and either happiness or depression. More research investigating social connectedness in the context of virtual social interactions is warranted.

Self-harm and suicidal content online, harmful or helpful? A systematic review of the recent evidence

Purpose

There are calls for greater regulation of online content related to self-harm and suicide, particularly that which is user-generated. However, the online space is a source of support and advice, including an important sharing of experiences. This study aims to explore what it is about such online content, and how people interact with it, that may confer harm or offer benefit.

Design/methodology/approach

The authors undertook a systematic review of the published evidence, using customised searches up to February 2021 in seven databases. The authors included empirical research on the internet or online use and self-harm or suicide content that had been indexed since 2015. The authors undertook a theoretically driven narrative synthesis.

Findings

From 4,493 unique records, 87 met our inclusion criteria. The literature is rapidly expanding and not all the evidence is high quality, with very few longitudinal or intervention studies so little evidence to understand possible causal links. Very little content online is classifiable as explicitly harmful or definitively helpful, with responses varying by the individual and immediate context. The authors present a framework that seeks to represent the interplay in online use between the person, the medium, the content and the outcome.

Originality/value

This review highlights that content should not be considered separately to the person accessing it, so online safety means thinking about all users. Blanket removal or unthinking regulation may be more harmful than helpful. A focus on safe browsing is important and tools that limit time and diversify content would support this.

Reflective functioning and personal recovery process of users with borderline personality disorder on Instagram: an explorative study using computerized and thematic analysis

Although recent literature has stated that mentalizing (or reflective functioning; RF) promoted the clinical recovery (symptomatic remission; CR) of individuals with borderline personality disorder (BPD), to our knowledge, there have been no studies that analyzed the relationship between RF and a process more complex than CR, namely personal recovery (PR) - a deep and unique process of change in one's attitudes, values, feelings, goals and/or roles. Furthermore, while there have been a few studies concerning PR of BPD individuals, but to date none analyzed PR of BPD individuals through online narratives shared on social media platforms. This study investigates the relationship between RF and PR of 14 Instagram users with a selfreported diagnosis of BPD. Two groups of users were distinguished on the basis of hashtags, #bpd and #bpdrecovery. Seventy randomized text posts (5 from each user) were extracted from users' profiles: 35 from the #bpd group and 35 from #bpdrecovery. Two methods of analysis were applied: i) a thematic analysis, by using the theoretical framework CHIME, which identifies five dimensions of PR; and ii) a stylistic analysis of RF utilizing computerized reflective functioning (CRF), which identifies RF lexical markers. Results indicate that the #bpdrecovery group presented more dimensions of PR, and that its posts showed a significantly higher RF than the #bpd group. These findings suggest that RF could be involved in the PR of BPD individuals, thus mentalization-based treatment could be effective in supporting PR processes and enhancing the impaired RF in BPD users even in the online context.

Mental Health Through the COVID-19 Quarantine: A Growth Curve Analysis on Italian Young Adults

INTRODUCTION

Health emergencies, such as epidemics, have detrimental and long-lasting consequences on people's mental health, which are higher during the implementation of strict lockdown measures. Despite several recent psychological researches on the coronavirus disease 2019 (COVID-19) pandemic highlighting that young adults represent a high risk category, no studies specifically focused on young adults' mental health status have been carried out yet. This study aimed to assess and monitor Italian young adults' mental health status during the first 4 weeks of lockdown through the use of a longitudinal panel design.

METHODS

Participants (n = 97) provided self-reports in four time intervals (1-week intervals) in 1 month. The Syndromic Scales of Adult Self-Report 18-59 were used to assess the internalizing problems (anxiety/depression, withdrawn, and somatic complaints), externalizing problems (aggressive, rule-breaking, and intrusive behavior), and personal strengths. To determine the time-varying effects of prolonged quarantine, a growth curve modeling will be performed.

RESULTS

The results showed an increase in anxiety/depression, withdrawal, somatic complaints, aggressive behavior, rule-breaking behavior, and internalizing and externalizing problems and a decrease in intrusive behavior and personal strengths from T1 to T4.

CONCLUSIONS

The results contributed to the ongoing debate concerning the psychological impact of the COVID-19 emergency, helping to plan and develop efficient intervention projects able to take care of young adults' mental health in the long term.

Narratives of Self-Harm at School: Identifying Trajectories of Intervention in Educational Contexts

Recent studies have shown that self-harming behaviour is increasingly widespread among adolescents, in particular at school. However, educational institutions perceive themselves unable to cope with the phenomenon, searching for protocols and guidelines to improve its management. Considering schools as useful contexts for intercepting the young malaise, this study aims at exploring the main meanings of self-harming behaviours made within the educational cultural contexts starting from the student’s narrations, in order to understand the possible trajectories of practice. In two high schools we have collected 96 narratives of self-harm written by adolescents (mean age 14; 74% females), who have been engaged in non-suicidal self-injury once in their life. The analysis of the narratives, produced with the help of a software for the automatic qualitative analysis of texts, has allowed to identify four prevalent themes organized into three sense vectors. The findings highlighted significant gender differences in the representation of the experience of self-harm between males and females, as well as the importance of meaningful relationships developed in familiar and educational contexts, which may allow the help seeking process. The emerging of culturally-shared meanings among adolescents within the investigated contexts may allow to think about possible protocols of preventive and clinical practices in schools.

Experts by Experience: Qualitative Evaluation of Adolescent Participation in the Development of a Technological Intervention to Prevent Youth Suicide in Chile

Adolescent suicide is a pressing problem in Chile that has not yet been sufficiently addressed, as suicide rates have stagnated in recent years. One possible explanation could be linked to the adult-centered paradigm that continues to prevail in relation to adolescent health initiatives. In light of this, programs that seek to promote youth mental health should consider incorporating adolescents in the design process using participatory methodologies, to ensure that these initiatives are well-suited for the population. In line with this recommendation, a group of seven adolescents, 13 to 20 years of age, were incorporated into a research team to actively guide the design, development, and validation of a technology-based intervention, known as Project Clan, which was piloted to reduce adolescent suicide in schools in Chile. This group was known as the "Group of Experts," in acknowledgment of their role as experts by experience on adolescence. A qualitative case study was conducted to explore their lived experiences, through semistructured individual in-depth interviews with six members of the group. Results showed that the adolescents had a high level of interest in mental health and had experienced problems of their own or accompanied friends who were struggling, which motivated their participation in the study. They had a critical view of the previous interventions they had received through educational institutions and valued their role in the promotion of their peers' mental health through the Group of Experts. They also highlighted the importance of creating tools that complement their daily lives and provide an alternative to existing social networks, by respecting their anonymity, providing a secure place for divulgation and self-expression, and facilitating access to professional support. We conclude that programs that address issues that affect adolescents should incorporate adolescents in the decision-making and design processes to ensure the acceptability and effectivity of their interventions.

Longitudinal effect of emotional processing on psychological symptoms in women under 50 with breast cancer

Breast cancer is a potential traumatic event associated with psychological symptoms, but few studies have analysed its impact in under-50 women. Emotional processing is a successful function in integrating traumatic experiences. This work analysed the relationship between emotional processing and psychological symptoms during three phases of treatment (before hospitalization, counselling after surgery and adjuvant therapy) in 50 women under the age of 50 with breast cancer. Mixed-effects models tested statistical differences among phases. There were significant differences in symptoms during the treatments: the levels of anxiety decrease from T1 to T3 (0.046), while those of hostility increase (<0.001). Emotional processing is a strong predictor of all symptoms. Clinical implications are discussed.

Underfifty Women and Breast Cancer: Narrative Markers of Meaning-Making in Traumatic Experience

A diagnosis of breast cancer is considered a potential traumatic event associated with physical and psychological effects. In literature, an exploration of breast cancer experience in young women is lacking, able to shed light on the narrative processes of meaning-making of the experience in specific phases of treatment, as may be the initial impact with the onset of the cancer. Meaning-making processes are determinant aspects when dealing with traumatic events. The research took place at National Cancer Institute Pascale of Naples. We collected 50 ad hoc narrative interviews to explore the different domains of the experience with under-fifty women at the first phase of the hospitalization. The Narrative Interviews were analyzed through a qualitative methodology constructed ad hoc. Starting from the functions of meaning-making that the narrative mediate we have highlight the different modes to articulate the narrative functions: The Organization of Temporality: chronicled (38%), actualized (26%), suspended (18%), interrupted (16%), and confused (2%). The Search for Meaning: internalized (42%); generalized (24%); externalized (18%); suspended (16%). The Emotional Regulation: disconnected (44%), splitted (28%), pervasive (26%), and connected (2%). The Organization of self-other Relationship: supportive (46%), avoidant (22%), overturned (16%), and sacrificial (16%). The Finding Benefit: revaluating (38%), flattened (34%), and postponed (28%). The Orientation to Action: combative (38%), blocked (36%), and suspended (26%). Findings capture the impact with the onset of the cancer, identifying both risk and resource aspects. The study allows to identify a specific use of narrative device by under-fifty women who impacted with the experience of breast cancer. The ways in which meaning-making functions are articulated highlight the specificity of the first phase of the treatment of the cancer. From a clinical psychology point of view, our findings can be used as clinical narrative markers to grasp, in a diachronic way, the process of meaning-making, integration, and coping during the first phase of breast cancer experience in young women. We consider it valuable to increase longitudinal studies with young women to highlight trajectories of meaning-making during the different phases of the treatment to think about personalized intervention practices diachronically to the experience.