1. Influences on and prevention of self-harm behavior among the most at-risk adolescents : study protocol for the SH-MARA prospective longitudinal cohort studyLana Sernec Podnar, Petra Tomažič, Anja Tomašević Kramer, Barbara Plemeniti Tololeski, Gorjan Tasevski, Žiga Rosenstein, Simona Klemenčič, Tadej Battelino, Blaž Vrhovšek, Tadej Lahovnik, Jernej Kovač, Carla Sharp, Barbara Jenko Bizjan, Sašo Karakatič, Maja Drobnič Radobuljac, 2025, original scientific article Abstract: Background Both suicidal and non-suicidal self-injuring behaviors (NSSI) are common during adolescence In Slovenia, adolescent suicide rates are high, making suicide the leading cause of death in the year 2022 in this age group. These behaviors are influenced by a complex interplay of environmental, psychological, and genetic factors. Previous research has identified risk and protective factors mainly for suicidal behavior in adults, a notable gap in understanding these factors in adolescents remains, especially for NSSI. Notably there is an important lack of effective clinical tools or psychometric assessment methods to reliably assess the risk for either suicidal or NSSI behaviors in acutely hospitalized adolescents. Methods and analysis The proposed study uses a mixed-method observational design consisting of a prospective longitudinal cohort component involving adolescents hospitalized for high risk of DSH, and a cross-sectional comparison with a control group of healthy adolescents recruited from primary care settings. It is aimed at identifying genetic, psychosocial, and clinical factors associated with suicidal behaviors and NSSI in adolescents. The study group is recruited from adolescents aged 12–19, admitted to the Intensive Child and Adolescent Psychiatry Unit in Ljubljana due to severe self-harm risk. Exclusion criteria include involuntary treatment, acute psychotic disorders, intellectual disability, severe physical or central nervous system illnesses and acute intoxication. The control group comprises adolescents of comparable age, recruited through regular scheduled health check-ups in Slovenia. Exclusion criteria include suicidality, severe mental disorder, a history of self-harm behavior in a first-degree relative, intellectual disability, severe physical or central nervous system illnesses and acute intoxication. Enrollment runs from February 1, 2023, to December 31, 2025. Participation is voluntary, requiring parental or guardian consent for those 14 or younger
Keywords: adolescents, deliberate self-harm, non-suicidal self-injury, suicidal behavior, intensive psychiatry, personality disorder, traumatic experience, genetics, epigenetics
Published in DKUM: 17.10.2025; Views: 0; Downloads: 2
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2. Attachment in close relationships and glycemic outcomes in children with type 1 diabetesSimona Klemenčič, Jasna Klara Lipovšek, Anja Turin, Klemen Dovč, Nataša Bratina, Yael Shmueli-Goetz, Katarina Trebušak Podkrajšek, Barbka Repič-Lampret, Barbara Jenko Bizjan, Sašo Karakatič, Tadej Battelino, Maja Drobnič Radobuljac, 2023, original scientific article Abstract: Background: Our aim was to determine whether child attachment to parents, parent attachment style, and morning cortisol levels were related to diabetes outcomes measured by average glycated hemoglobin (HbA1c), HbA1c variability over 4 years and time in range (TIR) in children with type 1 diabetes (T1D). Research design and methods: 101 children with T1D and one of their parents were assessed at baseline for child attachment (Child Attachment Interview; CAI) and parent attachment (Relationship Structures Questionnaire; ECR-RS). Serum samples were collected for cortisol measurements before the interviews. HbA1c levels were measured during a 4-year follow-up period at regular 3-monthly visits, and data for TIR were exported from blood glucose measuring devices. Multivariate linear regression models were constructed to identify independent predictors of glycemic outcomes. Results: More girls than boys exhibited secure attachment to their mothers. The results of the regression models showed that securely attached girls (CAI) had higher average HbA1c than did insecurely attached girls (B = -0.64, p = 0.03). In boys, the more insecure the parent's attachment style, the worse the child's glycemic outcome: the higher the average Hb1Ac (B = 0.51, p = 0.005), the higher the HbA1c variability (B = 0.017, p = 0.011), and the lower the TIR (B = -8.543, p = 0.002). Conclusions: Attachment in close relationships is associated with glycemic outcomes in children with T1D, and we observed significant differences between sexes. A sex- and attachment-specific approach is recommended when treating children with less favorable glycemic outcomes. Special attention and tailored support should be offered to securely attached girls in transferring responsibility for diabetes care and at least to male children of insecurely attached parents to prevent suboptimal glycemic control. Further studies in larger samples and more daily cortisol measurements may help us better understand the links between stress response, attachment and T1D.
Keywords: attachment, childhood and adolescence, cortisol, diabetes control, time in range
Published in DKUM: 21.05.2024; Views: 152; Downloads: 16
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