Richard T Liu

Richard T Liu
Harvard Medical School | HMS · Department of Psychiatry

Ph.D.

About

110
Publications
48,576
Reads
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4,966
Citations
Citations since 2017
62 Research Items
4062 Citations
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201720182019202020212022202302004006008001,000
201720182019202020212022202302004006008001,000
Additional affiliations
July 2020 - present
Massachusetts General Hospital
Position
  • Associate Professor
July 2019 - June 2020
Brown University
Position
  • Professor (Associate)
March 2014 - June 2019
Brown University
Position
  • Professor (Assistant)
Education
June 2011
University of Illinois at Chicago
Field of study
  • Clinical Psychology
May 2011 - May 2011
Temple University
Field of study
  • Clinical Psychology
June 2002 - June 2002
Cornell University
Field of study
  • Anthropology and Psychology

Publications

Publications (110)
Article
Importance: Considerably less is known about self-injurious thoughts and behaviors (SITBs) in preadolescence than older age groups, owing partly to the common view that young children are incapable of suicidal thoughts. Yet, preadolescent suicide has increased in recent years and is now the fifth leading cause of death in this age group, leading t...
Article
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S Background Suicide is among the leading cause of death in children and adolescents. There are well-known risk factors of suicide, including childhood abuse, family conflicts, social adversity, and psychopathology. While suicide risk is also known to be heritable, few studies have investigated genetic risk in younger individuals. Methods Using p...
Article
Background Although the prevalence rates of preadolescent eating disorders (EDs) are on the rise, considerably less is known about the correlates and treatment of EDs in this age group. Clarifying the epidemiology of EDs in preadolescent children is a necessary first step to understand the nature and scope of this problem in this age group. Method...
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The present study evaluated sociodemographic and diagnostic predictors of suicidal ideation and attempts in a nationally representative sample of preadolescent youth enrolled in the Adolescent Brain Cognitive Development Study. Rates and predictors of psychiatric treatment utilization among suicidal youth also were examined. Eleven thousand eight h...
Article
Background Although the clinical importance of non-suicidal self-injury (NSSI) has received increasing recognition, relatively little is known about its epidemiology. The objective of this study was to estimate the lifetime prevalence of NSSI in adults and its association with sociodemographic characteristics, psychiatric disorders, and lifetime tr...
Article
Importance: Suicide rates have been increasing among youth in the US. While the heritability of suicide risk is well established, there is limited understanding of how genetic risk is associated with suicidal thoughts and behaviors in young children. Objective: To examine whether genetic susceptibility to suicide attempts (SAs) is associated wit...
Article
Study Objectives The objectives of this study were to examine the relationships between sleep regularity and nonsuicidal self-injury (NSSI), including lifetime NSSI history and daily NSSI urges. Methods Undergraduate students (N=119; 18-26 years), approximately half of whom endorsed a lifetime history of repetitive NSSI, completed a 10-day actigra...
Article
Objective Interpersonal negative life events (NLEs) have been linked to risk for suicidal thoughts and behaviors. However, little is known about how this risk is conferred over the short term and the mechanisms linking interpersonal NLEs to suicide risk, particularly in adolescents. This study used an intensive longitudinal design to examine thwart...
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Objective Although theoretical conceptualizations of suicide hold that passive and active suicidal ideation are etiologically distinct, existing research observing this distinction is modest, with most prior studies focusing exclusively on active ideation. Understanding processes associated with passive ideation is clinically important insofar as p...
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Objective: To evaluate whether a history of depression or self-injurious thoughts and behaviors predict elevated BMI and elevated waist-to-height ratio in pre-adolescents. Methods: Baseline data were evaluated from a large, nationally representative cohort study of 9- and 10-year-old children (unweighted n = 11,875), the Adolescent Brain and Cog...
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The ability to regulate emotions in response to stress is central to healthy development. Whereas early research in emotion regulation predominantly employed static, self-report measurement, the past decade has seen a shift in focus toward understanding the dynamic nature of regulation processes. This is reflected in recent refinements in the defin...
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Objective: Depressive disorders are common among adults with alcohol use disorder and with suicidality; however, demographic differences in comorbid alcohol use disorder, binge drinking, and suicidality are understudied. The objective of this study was to determine the extent to which comorbid suicidality and alcohol use disorders and comorbid sui...
Article
Background The COVID-19 pandemic has spurred the implementation of several public safety measures to contain virus spread, most notably socially distancing policies. Prior research has linked similar public safety measures (i.e., quarantine) with suicide risk, in addition to supporting the role of social connection in suicidal thoughts and behavior...
Article
A correction to this paper has been published: https://doi.org/10.1007/s10802-021-00827-8
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Despite considerable public and scholarly debate about the role of social media in self-injurious thoughts and behaviors (SITBs), no comprehensive, quantitative synthesis of this literature has previously been undertaken. The current systematic review and meta-analysis examines associations between social media use and SITBs, including suicidal ide...
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The current study investigated whether impaired emotional response inhibition to self-harm stimuli is a risk factor for real-time nonsuicidal self-injury (NSSI) urges. Participants were 60 university students with a history of repetitive NSSI. At baseline, participants completed an emotional stop-signal task assessing response inhibition to self-ha...
Article
Although most lesbian, gay, bisexual, transgender, and questioning youths are quite resilient and emerge from adolescence as healthy adults, the effects of stigma and heterosexism can contribute to health disparities. Part 2 of this first-of-its-kind 3-part series can help pediatric primary care providers become stronger allies for TGD patients and...
Article
Suicide is the second leading cause of death in adolescents and suicide rates in this population have increased in recent years. A critical step in preventing suicide is improving the accuracy of suicide risk assessment. Measurement of suicidal cognitions typically emphasizes assessment of verbal thoughts about suicide. Recent research suggests, ho...
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Introduction Given increasing concern in suicide in preadolescent children, this study aimed to characterize and identify potential indicators of risk for suicidal ideation (SI) and suicide attempts (SAs) in this population. Methods Data were drawn from two population‐based samples of preadolescents: the 2007 and 2010 Minnesota Student Survey and...
Chapter
The current chapter provides a review of the current theoretical and empirical literature on the development of cognitive vulnerability to depression in youth. First, cognitive formulations of risk for depression are introduced, with a particular focus on the developmental antecedents of cognitive vulnerability. The potential role of childhood emot...
Preprint
Full-text available
Despite considerable public and scholarly debate about the role of social media in self-injurious thoughts and behaviors (SITBs), no comprehensive, quantitative synthesis of this literature has previously been undertaken. The current systematic review and meta-analysis examines associations between social media use and SITBs, including suicidal ide...
Article
Full-text available
Background: The relationship between life stress and depression and anxiety is well characterized in adolescents and adults. Further, research has shown that adolescents and adults with a history of childhood maltreatment are more likely to develop depression and anxiety after being exposed to stress than those without this history. However, the p...
Article
Background The family environment is an important context for the development and maintenance of depressive symptoms within families. In this study, we evaluated whether parent and adolescent self-reports of emotion regulation constructs are linked with their own (actor effects) and each other's (partner effects) depressive symptoms. Methods Parti...
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Self-injurious thoughts and behaviors (SITBs) remain a common clinical problem in youth. This article reviews the state of knowledge regarding psychosocial treatments for SITBs in youth. Broadly speaking, psychosocial treatments that incorporate parents/family and that emphasize skills development (including emotion regulation and interpersonal ski...
Article
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The current review provides a quantitative synthesis of the empirical literature on sleep disturbance as a risk factor for suicidal thoughts and behaviors (STBs). A systematic search of PsycINFO, MEDLINE, and the references of prior reviews resulted in 41 eligible studies included in this meta-analysis. Sleep disturbance, including insomnia, prospe...
Article
Objective Rates of self-injurious thoughts and behaviors have increased in adolescents over the past two decades. Sexual and gender minority (SGM) youth report elevated rates of self-injurious thoughts and behaviors compared to heterosexual and cisgender youth. Studies of factors influencing suicide risk in SGM youth remain limited, however, and ha...
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We assessed the gut microbiota of 90 American young adults, comparing 43 participants with major depressive disorder (MDD) and 47 healthy controls, and found that the MDD subjects had significantly different gut microbiota compared to the healthy controls at multiple taxonomic levels. At the phylum level, participants with MDD had lower levels of F...
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Objectives: In this study, we determined trends in prevalence of suicidal thoughts and behaviors among lesbian, gay, bisexual, and heterosexual youth from 1995 to 2017 using population-based surveillance data. Methods: Data were drawn from the Massachusetts Youth Risk Behavior Survey from 1995 to 2017 (unweighted N = 41 636). The annual percent...
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Background Compared to active ideation, passive ideation remains relatively understudied and its clinical importance poorly defined. The weight that should be accorded passive ideation in clinical risk assessment is therefore unclear. Methods We conducted a systematic review and meta-analysis of the prevalence of passive ideation, its psychiatric...
Article
Self-injurious thoughts and behaviors in childhood have received increasing recognition as an important clinical concern. Self-injurious thoughts and behaviors in childhood have been reported to be associated with concurrent psychiatric impairment, particularly externalizing disorders,¹ and to be predictors associated with negative outcomes, includ...
Article
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The current review presents a meta-analysis of the existing empirical literature on the prevalence of non-suicidal self-injury (NSSI) among lesbian, gay, bisexual, and transgender (LGBT) individuals, as well as on correlates of NSSI within sexual and gender minority populations. Eligible publications (n=51) were identified through a systematic sear...
Article
Depression in adolescence is highly prevalent and associated with negative long-term outcomes.¹ Despite decades of research on treatment for adolescent depression, sexual minority youths remain a particularly at-risk group.² Temporal trends inform progress in addressing the need to eliminate health disparities among sexual minority populations.³ To...
Article
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Recent advances in real-time monitoring technology make this an exciting time to study risk for suicidal thoughts and behaviors among youth. Although there is good reason to be excited about these methods, there is also reason for caution in adopting them without first understanding their limitations. In this article, we present several broad futur...
Article
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Despite research indicating that stressful life events are associated with subsequent suicidal ideation (SI) and behavior, there is a lack of clarity regarding whether specific types of life events are differentially related to SI and attempts. The current prospective study examines whether social rejection related life events are proximally relate...
Article
Background: Suicide is the second leading cause of death among adolescents. The purpose of this study was to test a family-focused outpatient cognitive behavioral treatment (F-CBT) protocol for depressed adolescents following psychiatric hospitalization for a suicide attempt or suicidal ideation, and who had a co-occurring risk factor (suicidal be...
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Purpose: The aim of the article was to assess temporal changes in adolescent treatment utilization for disordered eating. Methods: Data were drawn from adolescents (unweighted N = 236,752), aged 12-17 years, in the National Survey on Drug Use and Health for 2004-2017. Joinpoint regression assessed temporal trends in overall treatment utilization fo...
Article
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Nonsuicidal self-injury (NSSI) has received increasing attention in recent years as a clinically important phenomenon; it has been included in the DSM-5 as a syndrome warranting further investigation. Sexual minority youth are particularly at risk for NSSI.¹ An important step toward addressing this issue is to characterize the prevalence of NSSI am...
Article
Background: Over the past several years there has been considerable interest in the relation between emotion dysregulation and non-suicidal self-injury (NSSI), particularly given that rates of NSSI have been increasing and NSSI is a critical risk factor for suicidal behavior. To date, however, no synthesis of empirical findings exists. Methods:...
Article
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Both childhood maltreatment and impulsivity have been implicated in a broad array of negative public health outcomes and have been much studied in relation to each other. Characterizing this relationship, and the processes underlying it, are important for informing intervention efforts targeting this association and its psychopathological sequelae....
Article
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Not only is suicidal behavior strongly predicted by its past occurrence, but the risk for recurrence appears to increase with each subsequent attempt. The current paper discusses a potential explanation for this phenomenon, that suicide attempts may leave a residual psychological scar that heightens risk for future attempts. This possibility is eva...
Article
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Stress generation has potential to account for recurrent suicidal behavior. The current study represents a first step toward evaluating this possibility in a sample of adolescent psychiatric inpatients (n = 99; 79.80% female) followed over six months. At index admission, participants completed baseline measures of depressive symptom severity, suici...
Article
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Child maltreatment and sleep disturbances are particularly prevalent among individuals with a history of depression. However, the precise relation between child maltreatment and sleep within this population is unclear. The present study evaluated childhood maltreatment and trauma as a predictor of sleep duration and insomnia symptoms among young ad...
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Whether cognitive vulnerability to depression exists along a continuum of severity or as a qualitatively discrete phenomenological entity has direct bearing on theoretical formulations of risk for depression and clinical risk assessment. This question is of particular relevance to adolescence, given that cognitive vulnerability appears to coalesce...
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Suicide rates have increased over the past several decades. Prior research has evaluated risk factors for suicidal behavior, but much of this work does not adequately differentiate between risk factors for suicidal ideation (SI) and suicide attempts, nor does it differentiate between first-onset SI and recurrent ideation. This study seeks to identi...
Article
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This study aimed to: (1) examine rates of readmission among young children with oppositional defiant disorder (ODD) following discharge from a psychiatric partial hospital treatment program, and (2) examine child factors (i.e., age, sex, co-occurring diagnoses, suicidality) and family factors (i.e., parental depression, stress) as prospective predi...
Article
Objectives: This study evaluated the feasibility and initial efficacy of an empirically informed psychosocial intervention on an adolescent psychiatric inpatient unit. Methods: Data were obtained for 463 adolescents 12-16 years of age on a psychiatric inpatient unit. Information collected included demographics, psychiatric diagnoses, length of i...
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Background: Non-suicidal self-injury is being increasingly recognised as a prominent public health concern. Identification of early and modifiable risk factors is necessary to advance the screening and intervention efforts, particularly early detection of at-risk individuals. We aimed to examine childhood maltreatment, including its specific subty...
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Background: We addressed two unanswered questions from prior research, demonstrating a prospective association between frequent religious service attendance and decreased risk for suicide. First, we assessed whether religious service attendance conferred protection from suicide even after accounting for strength of religious affiliation. Second, we...
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Behavioral Approach System (BAS) sensitivity has been implicated in the development of a variety of different psychiatric disorders. Prominent among these in the empirical literature are bipolar spectrum disorders (BSDs). Given that adolescence represents a critical developmental stage of risk for the onset of BSDs, it is important to clarify the l...
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At the intersection between neuroscience, microbiology, and psychiatry, the enteric microbiome has potential to become a novel paradigm for studying the psychobiological underpinnings of mental illness. Several studies provide support for the view that the enteric microbiome influences behavior through the microbiota-gut-brain axis. Moreover, recen...
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We conducted a meta-analysis of neurobehavioral and neurocognitive indices of impulsivity in relation to suicidal thoughts and behaviors, as well as non-suicidal self-injury (NSSI). In our systematic review, 34 studies were identified and submitted to a random-effects meta-analysis. A small pooled effect size was observed for the association betwee...
Article
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Non-suicidal self-injury (NSSI) has received increasing recognition as a clinically significant phenomenon. Although in most individuals who engage in NSSI, this behavior is short-lived, for a significant proportion of these individuals, NSSI follows a chronic course. There is a need for research advancing our understanding of the mechanisms of ris...
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Suicidal ideation (SI) is a common presenting problem for psychiatric hospitalizations in adolescents and often persists following discharge. This study examines whether distinct trajectories of SI could be delineated following hospitalization and the risk factors most strongly related to these trajectories. Adolescents (N?=?104; 76 females; 28 mal...
Article
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Considerable support exists establishing a relationship between childhood adversities and adult depression. Consistent evidence has emerged linking early life adversities with a more chronic course for depression, as well as to poorer treatment outcomes. What remain decidedly less clear, however, are the moderators and mediating mechanisms underlyi...
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Depression has been linked with long-term risk for a variety of physical health ailments, including coronary heart disease (CHD). Little is known about resilience factors that may attenuate this relationship. The current study assessed whether social support moderates the long-term risk for CHD associated with this disorder. Data were drawn from th...
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A longstanding nosological question in the clinical literature is whether substance use disorders (SUDs) are best conceptualized as categorical or dimensional phenomena. Taxometric analysis is a statistical approach uniquely developed to address this issue. To date, no taxometric studies have been conducted with SUDs in adolescents. The current tax...
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Although considerable empirical work has been devoted to identifying risk factors for suicide attempts, most longitudinal research has studied recurrent attempts rather than first lifetime attempts. The present study sought to examine prospective predictors of first lifetime suicide attempts among adults receiving treatment for substance use. Data...
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Stress generation in depression (i.e. the tendency for depression-prone individuals to experience more life stress that is in part influenced by the individual) has been well established. However, more research is necessary to clarify the role of specific types of life stress in this effect. The current study extends the stress generation hypothesi...
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Background: This study examined racial/ethnic differences in mental health treatment utilization for suicidal ideation and behavior in a nationally representative sample of adolescents. Method: Data were drawn from the National Survey on Drug Use and Health. Participants included 4176 depressed adolescents with suicidal ideation and behavior in...
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Recent years have seen a considerable growth of interest in the study of life stress and non-suicidal self-injury (NSSI). The current article presents a systematic review of the empirical literature on this association. In addition to providing a comprehensive meta-analysis, the current article includes a qualitative review of the findings for whic...
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Little is known about why adolescents attempt suicide. The current study examined the endorsement, structure, and clinical correlates of adolescents' suicide attempt motivations as measured by the Inventory of Motivations for Suicide Attempts (IMSA). Suicidal adolescents (n = 52) in a psychiatric unit were administered the IMSA and interviewed abou...
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Purpose: A popular way to attempt to discern causality in clinical psychology is through mediation analysis. However, mediation analysis is sometimes applied to research questions in clinical psychology when inferring causality is impossible. This practice may soon increase with new, readily available, and easy-to-use statistical advances. Thus, w...
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Background: A basic phenomenological question of much theoretical and empirical interest is whether the latent structure of depression is dimensional or categorical in nature. Prior taxometric studies of youth depression have yielded mixed findings. In a step towards resolving these contradictory findings, the current taxometric investigation is t...
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Despite the strong association between suicidal ideation and suicidal behavior, a relative minority of ideators transition to attempting suicide. Clarifying the latent structure of suicidal ideation has direct implications for theory, as well as suicidal risk assessment and prevention efforts. Taxometric analysis is a statistical technique specific...
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Optimism has been conceptualised variously as positive expectations (PE) for the future , optimistic attributions , illusion of control , and self-enhancing biases. Relatively little research has examined these multiple dimensions of optimism in relation to psychological and physical health. The current study assessed the multi-dimensional nature o...
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Since the formulation of the hopelessness theory of depression (Psychological Review, 96, 1989, 358) a quarter-century ago, it has garnered considerable interest. The current article presents a systematic review of this theory, including its subsequent elaborations (Rose and Abramson's [Rochester Symposium of Developmental Psychopathology, 1992, Un...
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Background: Although several risk factors for suicidal ideation (SI) have been identified in the research literature, there is a pressing need for studies evaluating markers of risk differentiating ideators from people who have attempted. According to the interpersonal theory of suicide, habituation to painful or provocative experiences increases...
Article
Objective: Identifying trans-diagnostic risk factors for suicidality may improve assessment and treatment. This study examined the degree to which clinician ratings of adolescent irritability, based on adolescent versus parent report, were associated with adolescent suicidal ideation beyond established risk factors (i.e., female gender, depressive...
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Although the majority of research in the field has focused on childhood stressors as a risk factor for psychopathology, a burgeoning body of literature has focused on the possible steeling effect of moderate types of stressful events. The current study investigated the effects of proximal life stressors on prospective changes in depressive symptoms...
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The purpose of this study is to assess the potential unique and relative mediating effects of three interpersonal risk factors (i.e., excessive reassurance-seeking [ERS], negative feedback seeking [NFS], and rejection sensitivity [RS]) in the relationship between childhood emotional abuse (CEA) and depressive symptoms. One hundred eighty-five under...
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A common tenet of several prominent theories of stress and psychopathology (e.g., stress exposure) is that experiencing high rates of life stressors is associated with greater risk for negative mental health outcomes. Although there has been substantial empirical support for this position, another possibility that has received considerably less att...
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Research consistently has linked hopelessness to a range of negative outcomes, including depression, during adolescence. Although interpersonal stressors such as familial and peer emotional victimization have been found to contribute to hopelessness, less research has examined whether adolescents with a greater tendency to think about and plan for...
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Adolescents with a history of suicidal behavior are especially vulnerable for future suicide attempts, particularly following discharge from an inpatient psychiatric admission. This study is the first to test whether adolescents׳ tendency to generate stress, or report more dependent events to which they contributed, was predictive of prospective su...