Background: Given the widespread nature and clinical consequences of self-harm and suicidal ideation among adolescents, establishing the efficacy of developmentally appropriate treatments that reduce both self-harm and suicidal ideation in the context of broader adolescent psychopathology is critical.Methods: We conducted a systematic review and meta-analysis of the Dialectical Behaviour Therapy for Adolescents (DBT-A) literature on treating self-injury in adolescents (12–19 years). We searched for eligible trials and treatment evaluations published prior to July 2020 in MEDLINE/PubMed, Scopus, Google Scholar, EMBASE, and the Cochrane Library databases for clinical trials. Twenty-one studies were identified [five randomized-controlled trials (RCTs), three controlled clinical trials (CCTs), and 13 pre-post evaluations]. We extracted data for predefined primary (self-harm, suicidal ideation) and secondary outcomes (borderline personality symptoms; BPD) and calculated treatment effects for RCTs/CCTs and pre-post evaluations. This meta-analysis was pre-registered with OSF: osf.io/v83e7.Results: Overall, the studies comprised 1673 adolescents. Compared to control groups, DBT-A showed small to moderate effects for reducing self-harm (g= −0.44; 95% CI −0.81 to −0.07) and suicidal ideation (g= −0.31, 95% CI −0.52 to −0.09). Pre-post evaluations suggested large effects for all outcomes (self-harm:g= −0.98, 95% CI −1.15 to −0.81; suicidal ideation:g= −1.16, 95% CI −1.51 to −0.80; BPD symptoms:g= −0.97, 95% CI −1.31 to −0.63).Conclusions: DBT-A appears to be a valuable treatment in reducing both adolescent self-harm and suicidal ideation. However, evidence that DBT-A reduces BPD symptoms was only found in pre-post evaluations.
Summary Background The percentage of smartphone users—especially among minors—is growing, and so is the body of literature hinting at increasing rates of problematic smartphone use in children and adolescents. However, comprehensive reviews regarding this issue are still scarce. Objective The main aim of this review was to provide an overview of studies focusing on specific risk factors predicting problematic smartphone use in children and adolescents. Methods A literature search was conducted in Google Scholar and PubMed. Results The search yielded 38 articles that met the criteria for inclusion in this review. Research regarding influencing factors such as gender, age, and social, family, and personality factors, as well as duration of use and use patterns, could be found. Results seem to cautiously suggest that using a smartphone for gaming and social networking might be risk factors, whereas having good friendships might constitute a protective factor. Also, female adolescents seem to be prone to a higher smartphone addiction risk than male adolescents. For family, school, and personality factors, results are still scarce, and more research is needed. Nevertheless, strict parenting, low self-control, and low self-esteem seem to increase risks for problematic use, whereas academic motivation and school success might decrease this risk. Conclusion A concise theoretical conceptualization of problematic smartphone use and corresponding standardized measures are needed to increase comparability of future studies and to thereby add to a clearer understanding of this contested concept.
19 August 2019 in European Journal of Psychotraumatology
Contrary to specific phobias, for which Virtual Reality Exposure Therapy (VRET) constitutes an effective treatment, uncertainty still exists regarding the usefulness of VRET for posttraumatic stress disorder (PTSD). Therefore, this meta-analysis investigated the efficacy of VRET for PTSD as compared to waitlist and active comparators. A literature search yielded nine controlled studies encompassing 296 participants (124 VRET, 172 controls). The differences between conditions regarding the primary outcome of PTSD symptom severity and the secondary outcome of depressive and anxiety symptoms post-treatment were calculated using Hedges’ g. Compared to waitlist controls, VRET showed a significantly better outcome for PTSD symptoms (g = 0.62, p = .017) and depressive symptoms (g = 0.50, p = .008). There was no significant difference between VRET and active comparators regarding PTSD symptoms (g = 0.25, p = .356) and depressive symptoms (g = 0.24, p = .340) post-treatment. No significant effects emerged for anxiety symptoms. These findings suggest that VRET may be as effective as active comparators for PTSD patients. However, the results must be interpreted with caution due to the limited number of trials and the substantial number of – predominantly male – military service members studied. Additional controlled trials, considering a wider range of trauma types and balanced gender, are required to strengthen the evidence.