Cheryl A King

University of Michigan, Ann Arbor, Michigan, United States

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Publications (76)296.68 Total impact

  • Ewa K Czyz · Johnny Berona · Cheryl A King
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    ABSTRACT: Objective: Psychiatric hospitalization is essential in the clinical management of suicidal adolescents, and a considerable number of hospitalized adolescents are rehospitalized, yet little is known about how this experience may influence postdischarge outcomes. This study examined the association between rehospitalization within three months of index hospitalization and subsequent suicide attempts and suicidal ideation among adolescents. Methods: Participants were 373 youths (13-17 years old) hospitalized because of suicide risk, and they were followed for one year. Using Cox regression, the investigators examined rehospitalization within three months of index hospitalization as a predictor of time to suicide attempt during the subsequent nine months. Using latent-class growth modeling, they also examined whether rehospitalization predicted a change in the nine-month course of three suicidal ideation trajectories (subclinical, elevated but fast declining, and chronically elevated). Results: Rehospitalization was associated with greater risk of suicide attempts, above the effects of key covariates. Rehospitalization also predicted distinct changes in suicidal ideation trajectories: Within the elevated-fast declining and chronically elevated groups, rehospitalization predicted increases in ideation during the follow-up, with larger magnitude for the chronic group. In contrast, rehospitalization was associated with a decrease in follow-up suicidal ideation in the subclinical group. Conclusions: Rehospitalization predicted a more severe course of suicide ideation for most of the adolescents, but it was protective for only a smaller subgroup with subclinical levels of ideation at index hospitalization. Our findings also suggest that rehospitalization is a strong indicator of future risk of suicide attempt. These findings have important implications for intervening with rehospitalized adolescents.
    No preview · Article · Jan 2016 · Psychiatric services (Washington, D.C.)
  • Kiel Opperman · Ewa K Czyz · Polly Y Gipson · Cheryl A King
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    ABSTRACT: Objective- The interpersonal theory of suicidal behavior emphasizes the constructs of perceived burdensomeness, thwarted belongingness, and acquired capacity, which warrant investigation in adolescents at-risk for suicide due to interpersonal stressors. Methods- This study examined one component of the interpersonal theory of suicidal behavior, "suicidal desire" (suicidal ideation), in 129 adolescents (12-15 years) recruited from a general medical emergency department who screened positive for bully victimization, bully perpetration, or low interpersonal connectedness. Results- Greater perceived burdensomeness combined with low family connectedness was a significant predictor of suicidal ideation. Conclusion- This suggests the importance of addressing connectedness and perceptions of burdensomeness in prevention and early intervention efforts with at-risk adolescents.
    No preview · Article · Mar 2015 · Archives of suicide research: official journal of the International Academy for Suicide Research
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    ABSTRACT: Objective: The feasibility and concurrent validity of adolescent suicide risk screening in medical emergency departments (EDs) has been documented. The objectives of this short-term prospective study of adolescents who screened positive for suicide risk in the ED were: 1) to examine adolescents' rate of suicidal behavior during the 2 months following their ED visits and compare it with reported rates for psychiatric samples; and 2) to identify possible predictors of acute risk for suicidal behavior in this at-risk sample. Method: Participants were 81 adolescents, ages 14-19 years, seeking services for psychiatric and nonpsychiatric chief complaints, who screened positive for suicide risk because of recent suicidal ideation, a suicide attempt, and/or depression plus alcohol or substance misuse. A comprehensive assessment of suicidal behavior, using the Columbia-Suicide Severity Rating Scale, was conducted at baseline and 2 month follow-up. Results: Six adolescents (7.4%) reported a suicide attempt and 15 (18.5%) engaged in some type of suicidal behavior (actual, aborted, or interrupted suicide attempt; preparatory behavior) during the 2 months following their ED visit. These rates suggest that this screen identified a high-risk sample. Furthermore, adolescents who screened positive for suicidal ideation and/or attempt plus depression and alcohol/substance misuse were most likely to engage in future suicidal behavior (38.9%). Conclusions: In this study, use of a higher screen threshold (multiple suicide risk factors) showed promise for identifying highly elevated acute risk for suicidal behavior.
    Full-text · Article · Mar 2015 · Journal of Child and Adolescent Psychopharmacology
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    ABSTRACT: Objective: This pilot randomized controlled trial examined the effect of an online intervention for college students at risk for suicide, Electronic Bridge to Mental Health Services (eBridge), which included personalized feedback and optional online counseling delivered in accordance with motivational interviewing principles. Primary outcomes were readiness to seek information or talk with family and friends about mental health treatment, readiness to seek mental health treatment, and actual treatment linkage. Method: Participants were 76 college students (45 women, 31 men; mean age = 22.9 years, SD = 5.0 years) at a large public university who screened positive for suicide risk, defined by at least 2 of the following: suicidal thoughts, history of suicide attempt, depression, and alcohol abuse. Racial/ethnic self-identifications were primarily Caucasian (n = 54) and Asian (n = 21). Students were randomized to eBridge or the control condition (personalized feedback only, offered in plain report format). Outcomes were measured at 2-month follow-up. Results: Despite relatively modest engagement in online counseling (29% of students posted ≥1 message), students assigned to eBridge reported significantly higher readiness for help-seeking scores, especially readiness to talk to family, talk to friends, and see a mental health professional. Students assigned to eBridge also reported lower stigma levels and were more likely to link to mental health treatment. Conclusions: Findings suggest that offering students personalized feedback and the option of online counseling, using motivational interviewing principles, has a positive impact on students' readiness to consider and engage in mental health treatment. Further research is warranted to determine the robustness of this effect, the mechanism by which improved readiness and treatment linkage occurs, and the longer term impact on student mental health outcomes.
    No preview · Article · Feb 2015 · Journal of Consulting and Clinical Psychology
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    ABSTRACT: Objective: Previous research has documented the feasibility of screening in emergency departments for adolescent suicide risk. This randomized trial examined the effectiveness of Teen Options for Change (TOC), an intervention for adolescents seeking general medical emergency services who screen positive for suicide risk. Methods: Participants were 49 youths, ages 14 to 19, seeking services for nonpsychiatric emergencies. They screened positive for suicide risk because of recent suicidal ideation, suicide attempt, or depression plus substance abuse. Youths were randomly assigned to the TOC intervention or to enhanced treatment as usual. Depression, hopelessness, and suicidal ideation were assessed at baseline and two months later. Results: Adolescents assigned to TOC showed greater reductions in depression than adolescents assigned to the comparison group (Cohen's d=1.07, a large effect size). Hopelessness, suicidal ideation, and substance abuse outcomes trended positively (nonsignificantly), with small to moderate effect sizes. Conclusions: TOC may be a promising, brief intervention for adolescents seeking emergency services and at risk of suicide.
    No preview · Article · Oct 2014 · Psychiatric services (Washington, D.C.)
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    ABSTRACT: Objective: Despite the high prevalence of psychiatric emergency (PE) visits for attempted suicide and nonsuicidal self-injury (NSSI) among adolescents, we have limited information about assessment tools that are helpful in predicting subsequent risk for suicide attempts among adolescents in PE settings. This study examined the predictive validity of a highly promising instrument, the Columbia-Suicide Severity Rating Scale (C-SSRS). Method: Participants were 178 adolescents (44.4% male; ages 13-17 years) seeking PE services. The C-SSRS interview and selected medical chart data were collected for the index visit and subsequent visits during a 1-year follow-up. Results: A suicide risk concern was the most common chief complaint (50.6%) in this sample, and nearly one third of the adolescents (30.4%) reported a lifetime history of suicide attempt at index visit. Sixty-two adolescents (34.8%) had at least one return PE visit during follow-up. Lifetime history of NSSI predicted both return PE visits and a suicide attempt at return visit. The C-SSRS intensity scale score was a significant predictor of a suicide attempt at return visit for both the full sample of adolescents and the subsample who reported suicidal ideation at their index visit. In this subsample, one specific item on the intensity scale, duration, was also a significant predictor of both a return PE visit and a suicide attempt at return visit. Conclusions: The C-SSRS intensity scale and NSSI had predictive validity for suicide attempts at return visit. Results also suggest that duration of adolescents' suicidal thoughts may be particularly important to risk for suicidal behavior, warranting further study.
    No preview · Article · Oct 2014 · Pediatric Emergency Care
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    Ewa K. Czyz · Johnny Berona · Cheryl A. King
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    ABSTRACT: The challenge of identifying suicide risk in adolescents, and particularly among high-risk subgroups such as adolescent inpatients, calls for further study of models of suicidal behavior that could meaningfully aid in the prediction of risk. This study examined how well the Interpersonal-Psychological Theory of Suicidal Behavior (IPTS)—with its constructs of thwarted belongingness (TB), perceived burdensomeness (PB), and an acquired capability (AC) for lethal self-injury—predicts suicide attempts among adolescents (N = 376) 3 and 12 months after hospitalization. The three-way interaction between PB, TB, and AC, defined as a history of multiple suicide attempts, was not significant. However, there were significant 2-way interaction effects, which varied by sex: girls with low AC and increasing TB, and boys with high AC and increasing PB, were more likely to attempt suicide at 3 months. Only high AC predicted 12-month attempts. Results suggest gender-specific associations between theory components and attempts. The time-limited effects of these associations point to TB and PB being dynamic and modifiable in high-risk populations, whereas the effects of AC are more lasting. The study also fills an important gap in existing research by examining IPTS prospectively.
    Full-text · Article · Sep 2014 · Suicide and Life-Threatening Behavior
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    Adam G Horwitz · Ewa K Czyz · Cheryl A King
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    ABSTRACT: The purpose of this study was to longitudinally examine specific characteristics of suicidal ideation in combination with histories of suicide attempts and non-suicidal self-injury (NSSI) to best evaluate risk for a future attempt among high-risk adolescents and emerging adults. Participants in this retrospective medical record review study were 473 (53% female; 69% Caucasian) consecutive patients, ages 15 to 24 years (M = 19.4 years) who presented for psychiatric emergency services during a 9-month period. These patients' medical records, including a clinician-administered Columbia-Suicide Severity Rating Scale, were coded at the index visit and at future visits occurring within the next 18 months. Logistic regression models were used to predict suicide attempts during this period. Socioeconomic status, suicidal ideation severity (i.e., intent, method), suicidal ideation intensity (i.e., frequency, controllability), a lifetime history of suicide attempt, and a lifetime history of NSSI were significant independent predictors of a future suicide attempt. Suicidal ideation added incremental validity to the prediction of future suicide attempts above and beyond the influence of a past suicide attempt, whereas a lifetime history of NSSI did not. Sex moderated the relationship between the duration of suicidal thoughts and future attempts (predictive for male patients but not female). Results suggest value in incorporating both past behaviors and current thoughts into suicide risk formulation. Furthermore, suicidal ideation duration warrants additional examination as a potential critical factor for screening assessments evaluating suicide risk among high-risk samples, particularly for male patients.
    Preview · Article · May 2014 · Journal of Clinical Child & Adolescent Psychology
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    ABSTRACT: Individuals with substance use disorders (SUDs) are at high risk of suicidal behaviors, highlighting the need for an improved understanding of potentially influential factors. One such domain is self-efficacy to manage suicidal thoughts and impulses. Psychometric data about the Self-Efficacy to Avoid Suicidal Action (SEASA) Scale within a sample of adults seeking SUD treatment (N = 464) is provided. Exploratory factor analysis supported a single self-efficacy construct. Lower SEASA scores, or lower self-efficacy, were reported in those with more severe suicidal ideation and those with more suicide attempts, providing evidence for convergent validity. Implications of measuring self-efficacy in the context of suicide risk assessment are discussed.
    No preview · Article · May 2014 · Suicide and Life-Threatening Behavior
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    ABSTRACT: Abstract Objectives: This study sought to describe self-reported barriers to professional help seeking among college students who are at elevated suicide risk and determine if these barriers vary by demographic and clinical characteristics. Participants: Participants were 165 non-treatment seekers recruited as part of a Web-based treatment linkage intervention for college students at elevated suicide risk (from September 2010 through December 2011). Methods: Data were collected using Web-based questionnaires. Two coders coded students' responses to an open-ended question about reasons for not seeking professional help. Results: The most commonly reported barriers included perception that treatment is not needed (66%), lack of time (26.8%), and preference for self-management (18%). Stigma was mentioned by only 12% of students. There were notable differences based on gender, race, and severity of depression and alcohol abuse. Conclusions: Efforts aimed at reaching students at elevated risk for suicidal behavior should be particularly sensitive to these commonly described barriers.
    No preview · Article · Oct 2013 · Journal of American College Health
  • Ewa K Czyz · Cheryl A King
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    ABSTRACT: A period of particularly high risk for suicide attempts among adolescent inpatients is within 12 months after discharge. However, little is known about longitudinal trajectories of suicidal ideation in this high-risk group and how these relate to posthospitalization suicide attempts and rehospitalizations. Our objectives were to identify these trajectories and examine their relationships with posthospitalization psychiatric crises. We also examined predictors of trajectory group membership. Participants (N = 376; ages 13-17; 72% female) were assessed at hospitalization and 3, 6, and 12 months later. Trajectory groups, and their predictors, were identified with latent class growth modeling. We used logistic regression to examine associations between trajectory groups and likelihood of suicide attempts and rehospitalization, controlling for attempt history. Three trajectory groups were identified: (a) subclinical ideators (31.6%), (b) elevated ideators with rapidly declining ideation (57.4%), and (c) chronically elevated ideators (10.9%). Adolescents in the chronically elevated ideation group had 2.29, confidence interval (CI) [1.08, 4.85], p = .03, and 4.15, CI [1.65, 10.44], p < .01, greater odds of attempting suicide and 3.23, CI [1.37, 7.69], p = .01, and 11.20, CI [4.33, 29.01], p < .001, greater odds of rehospitalization relative to rapidly declining and subclinical groups, respectively. Higher baseline hopelessness was associated with persisting suicidal ideation. Results suggest that suicidal ideation severity at hospitalization may not be an adequate marker for subsequent suicidal crises. It is important to identify adolescents vulnerable to persisting suicidal ideation, as they are at highest risk of psychiatric crises. Addressing hopelessness may facilitate faster declines in ideation after hospitalization. Results also highlight a need for consistent monitoring of these adolescents' suicidal ideation after discharge.
    No preview · Article · Sep 2013 · Journal of Clinical Child & Adolescent Psychology
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    Cheryl A King · Qingmei Jiang · Ewa K Czyz · David C R Kerr
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    ABSTRACT: Clinicians commonly incorporate adolescents' self-reported suicidal ideation into formulations regarding adolescents' risk for suicide. Data are limited, however, regarding the extent to which adolescent boys' and girls' reports of suicidal ideation have clinically significant predictive validity in terms of subsequent suicidal behavior. This study examined psychiatrically hospitalized adolescent boys' and girls' self-reported suicidal ideation as a predictor of suicide attempts during the first year following hospitalization. A total of 354 adolescents (97 boys; 257 girls; ages 13-17 years) hospitalized for acute suicide risk were evaluated at the time of hospitalization as well as 3, 6, and 12 months later. Study measures included the Suicidal Ideation Questionnaire-Junior, Multidimensional Anxiety Scale for Children, Children's Depression Rating Scale-Revised, Beck Hopelessness Scale, Youth Self-Report, and Personal Experiences Screen Questionnaire. The main study outcome was presence and number of suicide attempt(s) in the year after hospitalization, measured by the Diagnostic Interview Schedule for Children. Results indicated a significant interaction between suicidal ideation, assessed during first week of hospitalization, and gender for the prediction of subsequent suicide attempts. Suicidal ideation was a significant predictor of subsequent suicide attempts for girls, but not boys. Baseline history of multiple suicide attempts was a significant predictor of subsequent suicide attempts across genders. Results support the importance of empirically validating suicide risk assessment strategies separately for adolescent boys and girls. Among adolescent boys who have been hospitalized due to acute suicide risk, low levels of self-reported suicidal ideation may not be indicative of low risk for suicidal behavior following hospitalization.
    Full-text · Article · Aug 2013 · Journal of Abnormal Child Psychology
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    Cheryl A King · Adam Horwitz · Johnny Berona · Qingmei Jiang
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    ABSTRACT: Prospective longitudinal research is needed to examine associations between bullying behaviors and trajectories of suicidal ideation and behavior and overall functional impairment. The specific aims of the present study are to: (1) characterize differences in baseline functioning between acutely suicidal adolescents who are classified into bullying perpetrator and non-bully groups and (2) examine the 1-year trajectories of these two groups of adolescents. Participants were 433 psychiatrically hospitalized suicidal adolescents (72% female), ages 13 to 17 years. Participants reported suicidal ideation, depression, anxiety, substance use, adaptive functioning, and bullying behavior. Six items from the Youth Self-Report were used to classify adolescents into bullying perpetrator (n = 54) and non-bully (n = 379) groups. Follow-up assessments were conducted at 6 weeks, 3 months, 6 months, and 12 months. At hospitalization, adolescents in the bully group reported significantly higher levels of suicidal ideation, substance use, and functional impairment. Suicidal ideation differences remitted at six weeks. The elevated functional impairment of the bullying perpetrator group persisted across the 12-month period. Adolescents who met bullying perpetrator group criteria were characterized by more severe suicidal ideation and higher levels of proximal risk factors for suicide. Bullying behavior was not stable over time but was associated with elevated suicide risk when present. These findings highlight the importance of specifically assessing for and targeting bullying behavior at multiple time points when treating suicidal adolescents.
    Full-text · Article · Jul 2013 · Journal of Adolescent Health
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    ABSTRACT: Suicidal ideation substantially increases the odds of future suicide attempts, and suicide is the second leading cause of death among adolescents. A history of adverse life events has been linked with future suicidal ideation and attempts, although studies examining potential mediating variables have been scarce. One probable mediating mechanism is how the individual copes with adverse life events. For example, certain coping strategies appear to be more problematic than others in increasing future psychopathology, and emotional suppression in particular has been associated with poor mental health outcomes in adults and children. However, no studies to date have examined the potential mediating role of emotional suppression in the relation between adverse life events and suicidal thoughts/behavior in adolescence. The goal of the current study was to examine emotional suppression as a mediator in the relation between childhood adversity and future suicidal thoughts/behaviors in youth. A total of 625 participants, aged 14-19 years, seeking ER services were administered measures assessing adverse life events, coping strategies, suicidal ideation in the last 2 weeks, and suicide attempts in the last month. The results suggest that emotional suppression mediates the relation between adversity and both (1) suicidal thoughts and (2) suicide attempts above and beyond demographic variables and depressive symptoms. This study has important implications for interventions aimed at preventing suicidal thoughts and behavior in adolescents with histories of adversity.
    Full-text · Article · Feb 2013 · Prevention Science
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    ABSTRACT: Dysregulation of the HPA axis and the dysfunction of the central serotonin (5HT) system are the most replicated biomarkers of depression and suicidal ideation and behavior. However, few studies have examined the two systems simultaneously. In this study, cortisol response was measured in depressed adolescents, following the administration of a central serotonin receptor agonist, meta-chlorphenylpiprazine (mCPP). Adolescents with major depression (MDD; n = 44; males = 15, females = 29; mean age ± SD = 15.5 ± 1.5) were divided into two groups: non-suicidal or those who reported passive suicidal ideation (n = 21), and those who had either threatened suicide or engaged in suicidal acts (n = 23). Sequential infusions of normal saline and mCPP were administered, and serial blood samples were collected for cortisol response. A differential time by group pattern of cortisol response following mCPP was found in the entire group (F6,242 = 2.6, p = 0.018). However, this was mostly attributed to males (F6,73 = 2.3, p = 0.043) who had threatened or engaged in suicidal acts and displayed a higher cortisol response at 10 and 25 min after the infusion of mCPP, which was not affected by the severity of depression. This differential pattern of cortisol secretion in response to a serotonergic agonist may be a biomarker for more severe forms of suicidal ideation and behavior in adolescent males.
    No preview · Article · Jan 2013 · Asian Journal of Psychiatry
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    ABSTRACT: The objective of this study was to investigate adolescent and parent attitudes toward screening adolescents for suicide risk and other mental health problems in the emergency department (ED). Two hundred ninety-four adolescents and 300 parents completed questionnaires about the importance of screening for suicide risk and other mental health problems in the ED, what would be helpful if the screen was positive, their concerns about screening in the ED, whether they believe screening should be a routine part of an ED visit, and whether they would complete a screening during the current visit if offered the opportunity. Overall, parents and adolescents reported positive attitudes toward screening for suicide risk and other mental health problems in the ED, with the majority responding that it should be a routine part of ED care. Suicide risk and drug and alcohol misuse were rated as more important to screen for than any of the other mental health problems by both parents and adolescents. Adolescent females and mothers were more supportive of screening for suicide risk and mental health problems in the ED than male adolescents and fathers. Descriptive data regarding screening concerns and follow-up preferences are reported. Study results suggest overall positive support for screening for suicide risk and other mental health problems in the ED, with some important preferences, concerns, and parent versus adolescent and male versus female differences.
    No preview · Article · Jun 2012 · Pediatric emergency care
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    ABSTRACT: This experimental study examined the effect of communication about type of screening follow-up (in-person follow-up vs. no in-person follow-up) on adolescents' responses to a self-report suicide risk screen. Participants were 245 adolescents (131 girls, 114 boys; ages 13-17; 80% White, 21.6% Black, 9.8% American Indian, 2.9% Asian) seeking medical emergency services. They were randomized to a screening follow-up condition. Screening measures assessed primary risk factors for suicidal behavior, including suicidal thoughts, depressive symptoms, alcohol use, and aggressive/delinquent behavior. There was no main effect of follow-up condition on adolescents' screening scores; however, significant interactions between follow-up condition and public assistance status were evident. Adolescents whose families received public assistance were less likely to report aggressive-delinquent behavior if assigned to in-person follow-up. Adolescents whose families did not receive public assistance reported significantly higher levels of suicidal ideation if assigned to in-person follow-up. Findings suggest that response biases impact some adolescents' responses to suicide risk screenings. Because national policy strongly recommends suicide risk screening in emergency settings, and because screening scores are used to make critical decisions regarding risk management and treatment recommendations, findings indicate the importance of improving the reliability and validity of suicide risk screening for adolescents.
    No preview · Article · Apr 2012 · Journal of Clinical Child & Adolescent Psychology
  • Ewa K Czyz · Zhuqing Liu · Cheryl A King
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    ABSTRACT: This study examined the extent to which posthospitalization change in connectedness with family, peers, and nonfamily adults predicted suicide attempts, severity of suicidal ideation, and depressive symptoms across a 12-month follow-up period among inpatient suicidal adolescents. Participants were 338 inpatient suicidal adolescents, ages 13 to 17, who were assessed at 3, 6, and 12 months posthospitalization. General liner models were fitted for depressive symptoms and suicidal ideation outcomes, and logistic regression was used for the dichotomous suicide attempt outcome. The moderating effects of gender and multiple attempt history were examined. Adolescents who reported greater improvements in peer connectedness were half as likely to attempt suicide during the 12-month period. Improved peer connectedness was also associated with less severe depressive symptoms for all adolescents and with less severe suicidal ideation for female individuals, but only at the 3-month assessment time point. Improved family connectedness was related to less severe depressive symptoms and suicidal ideation across the entire year; for suicidal ideation, this protective effect was limited to nonmultiple suicide attempters. Change in connectedness with nonfamily adults was not a significant predictor of any outcome when changes in family and peer connectedness were taken into account. These results pointing to improved posthospitalization connectedness being linked to improved outcomes following hospitalization have important treatment and prevention implications given inpatient suicidal adolescents' vulnerability to suicidal behavior.
    No preview · Article · Mar 2012 · Journal of Clinical Child & Adolescent Psychology
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    ABSTRACT: Careers in academic health centers (AHCs) come with a unique set of challenges and rewards. Building a stable and rewarding career as a psychologist in an AHC requires the efforts of a whole team of players and coaches. This paper outlines the characteristics of AHCs and the general skills psychologists need to thrive in this type of setting. Advice specific to each stage of career development (early, mid, and late) is offered, highlighting the themes of coaching and teamwork that are critical to success in an AHC.
    No preview · Article · Dec 2010 · Journal of Clinical Psychology in Medical Settings
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    Adam G Horwitz · Ryan M Hill · Cheryl A King
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    ABSTRACT: The coping strategies used by adolescents to deal with stress may have implications for the development of depression and suicidal ideation. This study examined coping categories and specific coping behaviors used by adolescents to assess the relation of coping to depression and suicidal ideation. In hierarchical regression models, the specific coping behaviors of behavioral disengagement and self-blame were predictive of higher levels of depression; depression and using emotional support were predictive of suicidal ideation. Results suggest that specific behaviors within the broad coping categories of emotion-focused coping (e.g., self-blame) and avoidant coping (e.g., behavioral disengagement) account for these categories' associations with depression and suicidal ideation. Specific problem-focused coping strategies did not independently predict lower levels of depression or suicidal ideation. It may be beneficial for interventions to focus on eliminating maladaptive coping behaviors in addition to introducing or enhancing positive coping behaviors.
    Preview · Article · Nov 2010 · Journal of Adolescence

Publication Stats

3k Citations
296.68 Total Impact Points


  • 1990-2015
    • University of Michigan
      • • Department of Psychiatry
      • • Department of Psychology
      • • Department of Electrical Engineering and Computer Science (EECS)
      Ann Arbor, Michigan, United States
    • Indiana University Bloomington
      Bloomington, Indiana, United States
  • 1995-2005
    • Concordia University–Ann Arbor
      Ann Arbor, Michigan, United States
  • 1994
    • Northwestern University
      Evanston, Illinois, United States