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Autism spectrum disorder (ASD) and borderline personality disorder (BPD) are complex disorders characterized by pervasive symptoms of rigidity, emotion dysregulation and social cognitive difficulties. Comorbid ASD and BPD are recognized emerging clinical problem that may be challenging to treat.

The authors present a case study of a young person in the authors’ assessment clinic diagnosed with BPD and ASD who had received standard dialectical behavior therapy (DBT) with modest effects. The authors provide ASD-informed recommendations for continued DBT treatment.

The de-identified patient described in this case report met full criteria for ASD and BPD. The patient’s cognitive, behavioral, social and personality functioning are described in detail.

Other practitioners seeking to treat this complex comorbidity may make use of the authors’ treatment recommendations for their patients. The authors underscore the importance of individualized treatment planning and hope the authors’ exemplar will be useful to others.

Several evidence-based treatments exist for ASD and BPD symptom reduction. However, to the best of the authors’ knowledge, no current treatments exist for comorbid ASD and BPD to target emotion dysregulation in individuals with restricted and repetitive interests and behaviors and disturbances in social and communication domains.

This chapter covers two behaviors that greatly affect college students’ mental health and wellbeing: eating and sleeping. The chapter begins with a definition of eating disorders and distinguishes clinically disordered eating from other forms of problematic eating. The chapter describes common eating disorders among college students: anorexia nervosa, bulimia nervosa, avoidant restrictive food intake disorder (ARFID) and binge eating disorder. The chapter then discusses measures of problematic eating among college students, including the SCOFF, the Eating Disorder Inventory and the Eating Concerns subscale of the Counseling Center Assessment of Psychological Symptoms (CCAPS). Next, the chapter discusses the prevalence of problematic eating among college students. Cultural considerations are described, with particular attention paid to gender, sexual orientation and ethnicity. Causes of problematic eating among college students are discussed, and the consequences of problematic eating are explored, from shame to medical complications to death. Treatment options are detailed, as are barriers to seeking professional help. The chapter follows a similar structure in covering healthy and problematic sleep behaviors among college students. In particular, the chapter explores measures of sleep quality, the prevalence of problematic sleep among college students, their causes and consequences, as well as strategies for correcting poor sleep and interventions for promoting healthy sleep habits.

Clinically, it is often observed that autistic people may have a heightened need for rules and may find rule violations very distressing. It is clinically plausible that autistic individuals may be prone to hyper-morality and greater reactivity and adverse experiences arising from moral threats and violations. Such adverse experiences may, in some instances, lead to moral distress (MD) or in more extreme cases moral injury. Thus, this study aims to examine how MD can operate in the context of autism.

The authors explore clinical hypotheses on how MD can intersect with different features of autism by drawing on clinical and research knowledge of autism spectrum disorder and how it contextualises experiences of morality.

Based on a review of the literature and theory, the authors hypothesise that autistic individuals may be more prone to MD where they have a lower threshold for MD. As a result of this lower threshold, they may have more frequent exposure to MD, experience more immediate and intense subjective reactions to moral transgressions, for more protracted periods. Also, they may find it more difficult to over-ride and neutralise moral outrage. As a result, they may be more susceptible to mental health sequelae and impaired social and occupational functioning. Practical recommendations are made for clinicians supporting people with autism with a propensity for MD or moral injury, to improve their quality of life.

Practical recommendations are made for clinicians supporting people with autism with a propensity for MD or moral injury, to improve their quality of life.

Understanding MD in an autistic context is important for detecting and treating the adverse impacts of MD on autistic individuals. Importantly, erroneous preconceptions about moral reasoning in autism need to be mitigated to fully understand the moral experiences and harness the many strengths of people with autism.

This paper aims to explore using the children’s accelerated trauma technique (CATT) in an adult intellectual disability population, with the aim of reducing symptoms of post-traumatic stress disorder (PTSD).

A service evaluation was completed to investigate differences between pre- and post-CATT trauma scores.

Scores on a measure of PTSD decreased significantly following CATT.

The findings support continued use of CATT in adults with intellectual disabilities, and they highlight the need to evaluate effectiveness in a larger sample.

This paper evaluates the novel application of a trauma treatment – developed for use with children – in an adult intellectual disability population and adds to the existing evidence base.

Auditory hallucinations (“hearing voices”) are a relatively common experience, which is often highly distressing and debilitating. As mental health services are under increasing pressures, services have witnessed a transformative shift with the integration of technology into psychological care. This study aims to narratively synthesise evidence of technology-enhanced psychological assessment and treatment of distressing voices (PROSPERO 393831).

This review was carried out according to the preferred reporting items for systematic reviews and meta-analyses. Embase, MEDLINE, PsycINFO and Web of Science were searched until 30th May 2023. The Effective Public Health Practice Project (EPHPP) tool assessed methodological quality of studies.

Searching identified 9,254 titles. Fourteen studies (two assessment studies, twelve treatment studies, published 2010–2022, n = 1,578) were included in the review. Most studies were conducted in the UK, the USA or Canada. Technologies included avatar therapy, mobile apps, virtual reality, a computerised Web-based programme and a mobile-assisted treatment. Overall, technology-enhanced psychological assessments and treatments appear feasible, acceptable and effective, with avatar therapy the most used intervention. EPHPP ratings were “strong” (n = 8), “moderate” (n = 5) and “weak” (n = 1).

To the best of the authors’ knowledge, this is the first systematic review to investigate these technologies, specifically for distressing voices. Despite the relatively small number of studies, findings offer promising evidence for the clinical benefits of these technologies for enhancing mental health care for individuals with distressing voices. More high-quality research on a wider range of technologies is warranted.

The risk factors related to the mental health issues of adolescents diagnosed with mild to moderate intellectual difficulties (MMID) are not consistently recognised in South Africa. This paper aims to address the scarcity of literature by examining the risk factors linked to the mental health issues of adolescents with MMID.

Four hundred and fourteen participants were sampled from adolescent learners attending three special educational needs schools in Gauteng, South Africa. The selected sample included 275 male and 139 female participants with a median age of 16.5 years. The three schools represented Grade 8 with 177 learners and Grade 9 with 237 learners. Data were collected through a biographical questionnaire and an Adverse Child Experiences Questionnaire. A quantitative approach was used to identify the risk factors impacting the mental health of adolescents with MMID. The findings were used to propose intervention programmes for the support of adolescents diagnosed with MMID.

The findings suggest that risk factors for mental health difficulties issues among adolescents with MMID include family dysfunction, along with experiences of physical, sexual and verbal abuse as well as emotional and physical neglect. The recommendations stemming from the findings advocate empowering teachers, parents and caregivers to provide support for the mental health of learners with MMID.

The study makes a valuable contribution to reducing the existing gap in the literature regarding risk factors impacting the mental health of adolescents with MMID in South Africa. The study served as a platform for adolescents diagnosed with MMID to articulate their challenges. This cohort is occasionally marginalised and this research acts as an active contribution to research that focuses on their experiences. Their insights are crucial for enhancing intervention programmes and promoting their overall well-being.

This chapter presents a mediation model that aims to disentangle the indirect from the direct effects of retirement on health, considering the mediating role of lifestyles. The model is applied to the risk of depression, and physical inactivity is assumed to potentially mediate the effect of retirement. The results indicate that there is a significant indirect effect via the mediator, albeit relatively small in comparison to the direct effect. The analysis highlights the importance of further exploring the influence of lifestyle factors in the relationship between retirement and health, in order to gain a better understanding of the potential pathways through which retirement impacts health.

This review identifies low self-concept clarity (SCC) as a source of consumer vulnerabilities and explains how the uncertainty associated with low SCC leads to processes that result in materialistic behaviors and overspending, product dissatisfaction, and potential self-harm. Processes include uncertainty reduction efforts through symbolic self-completion and social comparison, responses to everyday self-concept threats that result in feelings of deficiency and reduced consumption constraints, and susceptibility to interpersonal and marketer influences. In addition, the negative association between SCC and materialism is explained, risk factors for low SCC are described, and the need for research to help low SCC consumers deal with their vulnerabilities is explored.