We examined the relation between child maltreatment and non-suicidal self-injury (NSSI). Participants were 86 adolescents who completed measures of child maltreatment, self-criticism, perceived criticism, depression, and NSSI. Analyses revealed significant, small-to-medium associations between specific forms of child maltreatment (physical neglect, emotional abuse, and sexual abuse) and the presence of a recent history of NSSI. Emotional and sexual abuse had the strongest relations with NSSI, and the data supported a theoretical model in which self-criticism mediates the relation between emotional abuse and engagement in NSSI. Specificity for the mediating role of self-criticism was demonstrated by ruling out alternative mediation models. Taken together, these results indicate that several different forms of childhood maltreatment are associated with NSSI and illuminate one mechanism through which maltreatment may be associated with NSSI. Future research is needed to test the temporal relation between maltreatment and NSSI and should aim to identify additional pathways to engagement in NSSI. r

Rosen served as lead for writing -original draft and writingreview and editing. Leslie A. Morland contributed equally to writing -review and editing and served in a supporting role for writing -original draft. Lisa H. Glassman served as lead for writing -review and editing and served in a supporting role for writing -original draft. Brian P. Marx served in a supporting role for conceptualization and writing -review and editing. Kendra Weaver served in a supporting role for conceptualization, data curation, and writing -review and editing. Clifford A. Smith served as lead for data curation and served in a supporting role for conceptualization and writing -review and editing. Stacey Pollack served in a supporting role for writing -review and editing. Paula P. Schnurr served in a supporting role for conceptualization and writing -review and editing. Craig S. Rosen, Leslie A. Morland, and Lisa H. Glassman contributed to conceptualization equally. Craig S. Rosen and Clifford A. Smith contributed to formal analysis equally. Craig S. Rosen and Leslie A. Morland contributed to project administration equally. The views expressed are those of the authors and do not necessarily reflect the position of the U.S. Veterans Health Administration or the government of the United States.

Objective This study examined clinical and retention outcomes following variable length prolonged exposure (PE) for posttraumatic stress disorder (PTSD) delivered by one of three treatment modalities (i.e., home‐based telehealth [HBT], office‐based telehealth [OBT], or in‐home‐in‐person [IHIP]). Method A randomized clinical trial design was used to compare variable‐length PE delivered through HBT, OBT, or IHIP. Treatment duration (i.e., number of sessions) was determined by either achievement of a criterion score on the PTSD Checklist for Diagnostic and Statistical Manual‐5 (DSM‐5; PTSD Checklist for DSM‐5) for two consecutive sessions or completion of 15 sessions. Participants received PE via HBT (n = 58), OBT (n = 59) or IHIP (n = 58). Data were collected between 2012 and 2018, and PTSD was diagnosed using the Clinician‐Administered PTSD Scale for DSM‐5 (CAPS‐5), administered at baseline, posttreatment, and 6 months following treatment completion. The primary clinical outcome was CAPS‐5 PTSD severity. Secondary outcomes included self‐reported PTSD and depression symptoms, as well as treatment dropout. Results The clinical effectiveness of PE did not differ by treatment modality across any time point; however, there was a significant difference in treatment dropout. Veterans in the HBT (odds ratio [OR] = 2.67; 95% confidence interval [CI] = 1.10, 6.52; p = .031) and OBT (OR = 5.08; 95% CI = 2.10; 12.26; p < .001) conditions were significantly more likely than veterans in IHIP to drop out of treatment. Conclusions Providers can effectively deliver PE through telehealth and in‐home, in‐person modalities although the rate of treatment completion was higher in IHIP care.

The coronavirus disease 2019 outbreak poses unique challenges for psychotherapists and other mental health professionals. The widespread fear, helplessness, illness and death, economic hardship, and disruption of social support caused by the pandemic will create a global need for both supportive crisis counseling and formal mental health treatment. As physical distancing aimed at reducing contagion sharply limits in-person contact, psychotherapists have suddenly been forced to adopt new technologies and learn to provide telepsychotherapy. At this same time, psychotherapists must contend with their own stressors as part of the pandemic-exposed population. We integrate several different literatures to outline how telepsychotherapy can help psychotherapists address patient needs during this pandemic. We review epidemiological literature on the mental health impact of pandemics, crisis counseling approaches developed from prior disasters, and clinical research on telepsychotherapy treatment of posttraumatic stress disorder. Based on this research, we provide a roadmap for ways that clinicians can use telepsychotherapy technologies for 2 levels of intervention: (1) providing strengths-based preventive interventions to help people cope with distress during a period of disruption, life-threat, and loss, and (2) delivering effective treatments to people who develop chronic conditions in response to traumatic stress.

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