Promoting resilience in children and youth: preventive interventions and their interface with neuroscience

Social-emotional competence and early adolescents' peer acceptance in school: Examining the role of afternoon cortisol

The present study investigated the role of afternoon cortisol in social-emotional competence and peer acceptance in early adolescence. To date, research on basal cortisol activity and social development in childhood and adolescence has predominately focused on understanding maladjustment and dysfunction in development. The degree to which basal cortisol is also involved in positive adjustment and social functioning remains largely unexplored. A total of 154 early adolescents (46% female; Mean age = 11.26; SD = .65) from diverse ethnic backgrounds provided self-reports of perspective taking, peer reports of acceptance by classmates, peer reports of prosocial behaviors, and saliva samples to assess basal cortisol. As expected and in alignment with previous research, afternoon cortisol, perspective taking, prosocial behaviors, and peer acceptance were all positively correlated. Path analyses followed by bootstrapping analyses revealed that the direct path from higher afternoon cortisol to higher levels of prosocial behavior was fully mediated by perspective taking skills. The direct path from higher afternoon cortisol to peer acceptance was fully mediated by perspective taking skills and prosocial behavior. The findings are discussed within the broader context of previous research on cortisol and social adjustment in childhood and early adolescence. The practical relevance of the findings is considered.

Early Adolescents' Emotional Well-Being in the Classroom: The Role of Personal and Contextual Assets

BACKGROUND

The objective was to predict early adolescents' emotional well-being from personal and contextual assets in the classroom. Emotional well-being is a key indicator of health. Aligned with the positive youth development (PYD) framework, a supportive classroom environment and positive relationships with teachers and peers were contextual assets in the present study; positive self-concept was a personal asset.

METHODS

The sample was 406 grade 4 to 7 public elementary school students from diverse backgrounds (mean = 11.27 years; SD = 0.89; 50% female). Data were self-, teacher-, and peer-reported. Structural equation modeling (SEM) analyses were used to evaluate model fit and identify significant pathways.

RESULTS

SEM indicated a good model fit. Overall, 68% of variability in early adolescents' emotional well-being was explained. Positive self-concept directly predicted emotional well-being. Supportive classroom environment predicted emotional well-being directly and indirectly through increases in positive social relationships and self-concept. Positive social relationships predicted well-being only indirectly through positive self-concept.

CONCLUSIONS

Contextual and personal assets are central for early adolescents' emotional well-being. The interrelation among assets needs to be considered when understanding, and ultimately promoting students' emotional well-being. The present findings extend previous research and inform school-based intervention and prevention programming and teacher professional development.

The benefits of yoga in children

The number of children suffering from stress and anxiety in Malaysia is on the rise. Evidence shows that mind-body therapies such as mindfulness therapy, meditation and yoga have been practiced in many other countries to reduce and/or manage the psychological effects of stress and anxiety. This review article looks at the intervention of yoga as a meditative movement practice in helping school children manage stress and anxiety. Articles were retrieved using a combination of databases including PubMed/MEDLINE, and PsycINFO. Not only peer-reviewed articles, but also those written in English language were included in this review. All studies reviewed had incorporated some form of meditative movement exercise. The intervention encompassed asanas (postures), pranayama (expansion of life force), dharana (concentration) and dhyana (meditation), which are the different paths in yoga. A total of eight articles met the inclusion criteria and were reviewed. The findings of this review reveal that the practice of yoga has brought about, among other things, improvement in managing and reducing stress and anxiety. Despite the limitations in most, if not all of the studies reviewed, in terms of heterogeneity and sample size, yoga appears to be an effective modality for helping children cope with stress and anxiety. It appears that if schools in Malaysia can incorporate yoga as part of the physical education curriculum, it will definitely benefit the students.

Personalizing and Optimizing Preventive Intervention Models via a Translational Neuroscience Framework

A new generation of research, building upon developmental psychopathology (Luthar et al. 1997; Luthar et al. (Child Development, 71, 543-562, 2000)), provides evidence that individual differences in risk for behavioral health problems result from intrapersonal and environmental modulation of neurophysiologic and genetic substrates. This transdisciplinary model suggests that, in any given individual, the number of genetic variants implicated in high-risk behavior and the way in which they are assorted and ultimately suppressed or activated in the brain by experiential and contextual factors help to explain behavioral orientations. Implications are that behavioral health problems can be amplified or reduced based on characteristics of an individual and socio-contextual influences on those characteristics. This emerging research has extraordinary implications for the design of prevention programs that more precisely target the malleable mechanisms that underlie behavioral health problems and, hence, more effectively prevent behavioral problems and promote resilience. A detailed, theory-driven examination of all evidence-based interventions is called for to identify the active ingredients that specifically impact these underlying mechanisms. Such an approach will enhance the ability of preventive interventions to achieve effect sizes indicative of beneficial impacts for a greater number of recipients. This paper presents the significant implications of this collective knowledge base for the next generation of precision-based, prevention-focused personalized interventions.

Preschool Intervention Can Promote Sustained Growth in the Executive-Function Skills of Children Exhibiting Early Deficits

This study examined the effects of the Head Start Research-Based, Developmentally Informed (REDI) preschool intervention on growth in children's executive-function (EF) skills from preschool through third grade. Across 25 Head Start centers, each of 44 classrooms was randomly assigned either to an intervention group, which received enhanced social-emotional and language-literacy components, or to a "usual-practice" control group. Four-year-old children ( N = 356; 25% African American, 17% Latino, 58% European American; 54% girls) were followed for 5 years, and EF skills were assessed annually. Latent-class growth analysis identified high, moderate, and low developmental EF trajectories. For children with low EF trajectories, the intervention improved EF scores in third grade significantly more ( d = 0.58) than in the control group. Children who received the intervention also demonstrated better academic outcomes in third grade than children who did not. Poverty often delays EF development; enriching the Head Start program with an evidence-based curriculum and teaching strategies can reduce early deficits and thereby facilitate school success.

Systematic Review of Universal Resilience-Focused Interventions Targeting Child and Adolescent Mental Health in the School Setting

OBJECTIVE

To examine the effect of universal, school-based, resilience-focused interventions on mental health problems in children and adolescents.

METHOD

Eligible studies were randomized controlled trials (RCTs) of universal, school-based interventions that included strategies to strengthen a minimum of 3 internal resilience protective factors, and included an outcome measure of mental health problems in children and adolescents aged 5 to 18 years. Six databases were searched from 1995 to 2015. Results were pooled in meta-analyses by mental health outcome (anxiety symptoms, depressive symptoms, hyperactivity, conduct problems, internalizing problems, externalizing problems, and general psychological distress), for all trials (5-18 years). Subgroup analyses were conducted by age (child: 5-10 years; adolescent: 11-18 years), length of follow-up (short: post-≤12 months; long: >12 months), and gender (narrative).

RESULTS

A total of 57 included trials were identified from 5,984 records, with 49 contributing to meta-analyses. For all trials, resilience-focused interventions were effective relative to a control in reducing 4 of 7 outcomes: depressive symptoms, internalizing problems, externalizing problems, and general psychological distress. For child trials (meta-analyses for 6 outcomes), interventions were effective for anxiety symptoms and general psychological distress. For adolescent trials (meta-analyses for 5 outcomes), interventions were effective for internalizing problems. For short-term follow-up, interventions were effective for 2 of 7 outcomes: depressive symptoms and anxiety symptoms. For long-term follow-up (meta-analyses for 5 outcomes), interventions were effective for internalizing problems.

CONCLUSION

The findings may suggest most promise for using universal resilience-focused interventions at least for short-term reductions in depressive and anxiety symptoms for children and adolescents, particularly if a cognitive-behavioral therapy-based approach is used. The limited number of trials providing data amenable for meta-analysis for some outcomes and subgroups, the variability of interventions, study quality, and bias mean that it is not possible to draw more specific conclusions. Identifying what intervention qualities (such as number and type of protective factor) achieve the greatest positive effect per mental health problem outcome remains an important area for future research.

SYSTEMATIC REVIEW PROTOCOL AND REGISTRATION

Systematic Review of Universal Resilience Interventions Targeting Child and Adolescent Mental Health in the School Setting; http://dx.doi.org/10.1186/s13643-015-0172-6; PROSPERO CRD42015025908.

Dramatic pretend play games uniquely improve emotional control in young children

Pretense is a naturally occurring, apparently universal activity for typically developing children. Yet its function and effects remain unclear. One theorized possibility is that pretense activities, such as dramatic pretend play games, are a possible causal path to improve children's emotional development. Social and emotional skills, particularly emotional control, are critically important for social development, as well as academic performance and later life success. However, the study of such approaches has been criticized for potential bias and lack of rigor, precluding the ability to make strong causal claims. We conducted a randomized, component control (dismantling) trial of dramatic pretend play games with a low-SES group of 4-year-old children (N = 97) to test whether such practice yields generalized improvements in multiple social and emotional outcomes. We found specific effects of dramatic play games only on emotional self-control. Results suggest that dramatic pretend play games involving physicalizing emotional states and traits, pretending to be animals and human characters, and engaging in pretend scenarios in a small group may improve children's emotional control. These findings have implications for the function of pretense and design of interventions to improve emotional control in typical and atypical populations. Further, they provide support for the unique role of dramatic pretend play games for young children, particularly those from low-income backgrounds. A video abstract of this article can be viewed at: https://youtu.be/2GVNcWKRHPk.

Systematic review of universal school-based 'resilience' interventions targeting adolescent tobacco, alcohol or illicit substance use: A meta-analysis

Universal school-based interventions that address adolescent 'resilience' may represent a means of reducing adolescent substance use, however previous systematic reviews have not examined the effectiveness of such an intervention approach. A systematic review was undertaken to 1) assess whether universal school-based 'resilience' interventions are effective in reducing the prevalence of tobacco, alcohol or illicit substance use by adolescents, and 2) describe such effectiveness per intervention characteristic subgroups. Eligible studies were peer-reviewed reports (1994-2015) of randomised controlled trials including participants aged 5-18years that reported adolescent tobacco, alcohol or illicit substance use, and implemented a universal school-based 'resilience' intervention (i.e. those addressing both individual (e.g. self-esteem) and environmental (e.g. school connectedness) protective factors of resilience). Trial effects for binary outcomes were synthesised via meta-analyses and effect sizes reported as odds ratios. Subgroup (by intervention type, prevention approach, setting, intervention duration, follow-up length) and sensitivity analyses (excluding studies at high risk of bias) were conducted. Nineteen eligible studies were identified from 16,619 records (tobacco: n=15, alcohol: n=17, illicit: n=11). An overall intervention effect was found for binary measures of illicit substance use (n=10; OR: 0.78, 95%CI: 0.6-0.93, p=0.007,Tau²=0.0, I²=0%), but not tobacco or alcohol use. A similar result was found when studies assessed as high risk of bias were excluded. Overall intervention effects were evident for illicit substance use within multiple intervention characteristic subgroups, but not tobacco and alcohol. Such results support the implementation of universal school-based interventions that address 'resilience' protective factors to reduce adolescent illicit substance use, however suggest alternate approaches are required for tobacco and alcohol use. PROSPERO registration: CRD42014004906.

Task utility and norms for the Preschool Executive Task Assessment (PETA)

Earlier identification of executive deficits in preschool children using an ecological approach would give more scope for intervention. The Preschool Executive Task Assessment (PETA) was developed to resemble an everyday age-appropriate task in order to examine the self-direction and integration of executive functions during a multistep task. It was designed so that performance can be evaluated in a microanalytic way and so individualized feedback and support can be easily communicated. The utility of the PETA was assessed with 166 three-to five-year olds. Results showed improved performance with increasing age and verbal intellectual quotient as well as good task reliability and utility. Evidence for influence of socioeconomic status, gender, and use of self-talk was also observed. Clinical applications and future directions of this novel measure are discussed.

Resilience

Every child is a unique individual. This individuality is evident in children exposed to psychosocial trauma or adverse childhood experiences. There exists wide variation in the way children respond to toxic stressors in their lives. Some children appear to be relatively unaffected, while others develop a variety of psychological, behavioral, and physical consequences. What is the explanation for this phenomenon? Resiliency has been suggested to explain this variation in pathology expressions in trauma-exposed children. It is vital for pediatric nurse practitioners to understand the concept of resilience. This continuing education offering will define concepts of resilience and stress, explore the neurobiology of resilience, and examine interventions that promote resilience in children.

A systematic review of pragmatic language interventions for children with autism spectrum disorder

There is a need for evidence based interventions for children with autism spectrum disorder (ASD) to limit the life-long, psychosocial impact of pragmatic language impairments. This systematic review identified 22 studies reporting on 20 pragmatic language interventions for children with ASD aged 0-18 years. The characteristics of each study, components of the interventions, and the methodological quality of each study were reviewed. Meta-analysis was conducted to assess the effectiveness of 15 interventions. Results revealed some promising approaches, indicating that active inclusion of the child and parent in the intervention was a significant mediator of intervention effect. Participant age, therapy setting or modality were not significant mediators between the interventions and measures of pragmatic language. The long-term effects of these interventions and the generalisation of learning to new contexts is largely unknown. Implications for clinical practice and directions for future research are discussed.

Clinical Hypnosis, an Effective Mind-Body Modality for Adolescents with Behavioral and Physical Complaints

Mind-body medicine is a system of health practices that includes meditation/relaxation training, guided imagery, hypnosis, biofeedback, yoga, art/music therapy, prayer, t'ai chi, and psychological therapies such as cognitive behavioral therapy. Clinical hypnosis is an important mind-body tool that serves as an adjunct to conventional medical care for the adolescent patient. Clinical hypnosis specifically uses self-directed therapeutic suggestions to cultivate the imagination and facilitate the mind-body connection, leading to positive emotional and physical well-being. There are many similarities between clinical hypnosis and other mind-body/self-regulatory modalities such as visual imagery, mindfulness meditation, yoga, and biofeedback that incorporate experiential learning and mechanisms for change. They may be viewed as subtypes of the hypnotic experience and share the common experience of trance as the entrée into self-empowered change in physiologic and psychological states. Clinical hypnosis can be used by health care providers to teach adolescents coping skills to deal with a wide variety of conditions such as chronic headaches, recurrent abdominal pain, anxiety, depression, grief and bereavement, phobias, anger, family stressors, sleep disorders, or enuresis. Clinical vignettes are given to help illustrate the effectiveness of hypnosis in adolescents.

Effects of Adolescent Universal Substance Misuse Preventive Interventions on Young Adult Depression Symptoms: Mediational Modeling

Depression symptoms are associated with impairments in functioning and have substantial health and economic consequences. Universal substance misuse prevention programs have shown effects on non-targeted mental health-related symptoms, but long-term effects are understudied. This cluster randomized controlled trial examined effects of both the LifeSkills Training (LST) and Strengthening Families Program: For Parents and Youth 10-14 (SFP 10-14) interventions, delivered during seventh grade, on age 22 young adult depression symptoms. The study was conducted in US rural Midwestern communities with a randomly-selected sample from a larger study (N = 670). Experimental conditions were LST+SFP 10-14, LST-only, and a control condition. Effects on age 22 depression symptoms were hypothesized as mediated through effects on age 21 relationship problems and illicit use of substances. Structural equation modeling with manifest and latent variables was conducted to test hypotheses; the intervention conditions were combined and compared with the control condition because analyses indicated a comparable pattern of effects between intervention conditions. Significant indirect intervention effects were found on age 22 depression symptoms via effects on the mediating variables (indirect effect: β = -0.06, 95 % CI [-0.10, -0.01], p = 0.011). Effect sizes for the young adult variables were between d = 0.17 and 0.29, which can be considered small, but nontrivial, especially in the context of public health benefits. Results support scaled-up implementation of school-based and family-focused universal substance misuse preventive interventions.

The randomized controlled trial of Head Start REDI: Sustained effects on developmental trajectories of social-emotional functioning

OBJECTIVE

This study assessed the sustained effects of Head Start REDI (Research-based, Developmentally Informed), a randomized controlled preschool preventive intervention, on children's developmental trajectories of social-emotional functioning into elementary school.

METHOD

Twenty-five Head Start centers with 44 classrooms were randomly assigned to deliver Head Start REDI or Head Start as usual. Head Start REDI featured an integrated language-emergent literacy and social-emotional skills curriculum and enhanced support for positive teaching practices. The 356 4-year-old children (54% girls; 25% African American; 17% Latino; 70% living in poverty) in those centers and classrooms were followed for 5 years (from preschool through third grade; 91% retention rate). Each year, teachers rated multiple domains of social-emotional functioning. Person-oriented latent class growth models were used to identify the different developmental trajectories of social-emotional functioning that children followed.

RESULTS

Tests of proportions revealed that children who had been in the Head Start REDI intervention were statistically significantly more likely than children in the control condition to follow the most optimal developmental trajectories of social competence, aggressive-oppositional behavior, learning engagement, attention problems, student-teacher closeness, and peer rejection (odds ratio = 1.60-1.93).

CONCLUSIONS

These findings suggest that enriching Head Start with evidence-based curriculum components and teaching practices can have long-lasting benefits for children's social-emotional functioning. These findings elucidate how high-quality preschool experiences promote core competencies that are critical to the school success of children living in poverty.

Parent Training to Reduce Problem Behaviors over the Transition to High School: Tests of Indirect Effects through Improved Emotion Regulation Skills

Adolescent problem behaviors are costly for individuals and society. Promoting the self-regulatory functioning of youth may help prevent the development of such behaviors. Parent-training and family intervention programs have been shown to improve child and adolescent self-regulation. This study helps fill gaps in knowledge by testing for indirect effects of the Common Sense Parenting® (CSP) program on reduced substance use, conduct problems, and school suspensions through previously identified short-term improvements in parents' reports of their children's emotion regulation skills. Over two cohorts, 321 low income families of 8th graders were enrolled and randomly assigned to either the standard CSP program, an adapted CSP Plus program, or a minimal-contact control condition. Pretest, posttest, 1-year follow-up, and 2-year follow-up survey assessments were completed by parents and students with 94% retention. Intent-to-treat multivariate path analyses were conducted. Neither intervention had statistically significant total effects on the three targeted adolescent outcomes. CSP, but not CSP Plus, had statistically significant indirect effects on reduced substance use and school suspensions at the 1-year follow-up as well as conduct problems and school suspensions at the 2-year follow-up through increased child emotion regulation skills at posttest. Findings provide some support for emotion regulation as one pathway through which the intervention was associated, indirectly, with reduced substance use, conduct problems, and school suspensions among at-risk students over the high school transition.

Mediation of Short and Longer Term Effects of an Intervention Program to Enhance Resilience in Immigrants from Mainland China to Hong Kong

Few clinical trials report on the active intervention components that result in outcome changes, although this is relevant to further improving efficacy and adapting effective programs to other populations. This paper presents follow-up analyses of a randomized controlled trial to enhance adaptation by increasing knowledge and personal resilience in two separate brief interventions with immigrants from Mainland China to Hong Kong (Yu et al., 2014b). The present paper extends our previous one by reporting on the longer term effect of the interventions on personal resilience, and examining whether the Resilience intervention worked as designed to enhance personal resilience. The four-session intervention targeted at self-efficacy, positive thinking, altruism, and goal setting. In this randomized controlled trial, 220 immigrants were randomly allocated to three arms: Resilience, Information (an active control arm), and Control arms. Participants completed measures of the four active components (self-efficacy, positive thinking, altruism, and goal setting) at baseline and immediately after the intervention. Personal resilience was assessed at baseline, post-intervention, and 3- and 6-month follow-ups. The results showed that the Resilience arm had greater increases in the four active components post-intervention. Changes in each of the four active components at the post-intervention assessment mediated enhanced personal resilience at the 3-month follow-up in the Resilience arm. Changes in self-efficacy and goal setting showed the largest effect size, and altruism showed the smallest. The arm effects of the Resilience intervention on enhanced personal resilience at the 6-month follow-up were mediated by increases of personal resilience post-intervention (Resilience vs. Control) and at the 3-month follow-up (Resilience vs. Information). These findings showed that these four active components were all mediators in this Resilience intervention. Our results of the effects of short term increases in personal resilience on longer term increase in personal resilience in some models suggest how changes in intervention outcomes might persist over time.

Delay Discounting Mediates Parent-Adolescent Relationship Quality and Risky Sexual Behavior for Low Self-Control Adolescents

Parent-adolescent relationship quality and delay discounting may play important roles in adolescents' sexual decision making processes, and levels of self-control during adolescence could act as a buffer within these factors. This longitudinal study included 219 adolescent (55 % male; mean age = 12.66 years at Wave 1; mean age = 15.10 years at Wave 2) and primary caregiver dyads. Structural equation modeling (SEM) was utilized to determine whether delay discounting mediated the association between parent-adolescent relationship quality and adolescents' risky sexual behavior and how this mediated association may differ between those with high versus low self-control. The results revealed parent-adolescent relationship quality plays a role in the development of risky sexual behavior indirectly through levels of delay discounting, but only for adolescents with low self-control. These findings could inform sex education policies and health prevention programs that address adolescent risky sexual behavior.

Social and Emotional Learning Services and Child Outcomes in Third Grade: Evidence from a Cohort of Head Start Participants

A variety of universal school-based social and emotional learning (SEL) programs have been designed in the past decades to help children improve social-emotional and academic skills. Evidence on the effectiveness of SEL programs has been mixed in the literature. Using data from a longitudinal follow-up study of children (n = 414) originally enrolled in a clustered randomized controlled trial (RCT) when they were in Head Start, we examined whether universal SEL services in third grade were associated with the development of children from disadvantaged families. We took advantage of pairwise matching in the RCT design to compare children who had similar family background and preschool experiences but received different doses of SEL services in third grade. The results showed that the frequent (i.e., weekly to daily) exposure to SEL opportunities was associated with favorable social-emotional and academic development in third grade, including increased social skills, student-teacher relationship, and academic skills, as well as reduced impulsiveness.

Evaluating the Psychometric Quality of Social Skills Measures: A Systematic Review

Introduction

Impairments in social functioning are associated with an array of adverse outcomes. Social skills measures are commonly used by health professionals to assess and plan the treatment of social skills difficulties. There is a need to comprehensively evaluate the quality of psychometric properties reported across these measures to guide assessment and treatment planning.

Objective

To conduct a systematic review of the literature on the psychometric properties of social skills and behaviours measures for both children and adults.

Methods

A systematic search was performed using four electronic databases: CINAHL, PsycINFO, Embase and Pubmed; the Health and Psychosocial Instruments database; and grey literature using PsycExtra and Google Scholar. The psychometric properties of the social skills measures were evaluated against the COSMIN taxonomy of measurement properties using pre-set psychometric criteria.

Results

Thirty-Six studies and nine manuals were included to assess the psychometric properties of thirteen social skills measures that met the inclusion criteria. Most measures obtained excellent overall methodological quality scores for internal consistency and reliability. However, eight measures did not report measurement error, nine measures did not report cross-cultural validity and eleven measures did not report criterion validity.

Conclusions

The overall quality of the psychometric properties of most measures was satisfactory. The SSBS-2, HCSBS and PKBS-2 were the three measures with the most robust evidence of sound psychometric quality in at least seven of the eight psychometric properties that were appraised. A universal working definition of social functioning as an overarching construct is recommended. There is a need for ongoing research in the area of the psychometric properties of social skills and behaviours instruments.

Resilience as Regulation of Developmental and Family Processes

Resilience can be defined as establishing equilibrium subsequent to disturbances to a system caused by significant adversity. When families experience adversity or transitions, multiple regulatory processes may be involved in establishing equilibrium, including adaptability, regulation of negative affect, and effective problem-solving skills. The authors' resilience-as-regulation perspective integrates insights about the regulation of individual development with processes that regulate family systems. This middle-range theory of family resilience focuses on regulatory processes across levels that are involved in adaptation: whole-family systems such as routines and sense of coherence; coregulation of dyads involving emotion regulation, structuring, and reciprocal influences between social partners; and individual self-regulation. Insights about resilience-as-regulation are then applied to family-strengthening interventions that are designed to promote adaptation to adversity. Unresolved issues are discussed in relation to resilience-as-regulation in families, in particular how risk exposure is assessed, interrelations among family regulatory mechanisms, and how families scaffold the development of children's resilience.

Behavioral inhibition and developmental risk: a dual-processing perspective

Behavioral inhibition (BI) is an early-appearing temperament characterized by strong reactions to novelty. BI shows a good deal of stability over childhood and significantly increases the risk for later diagnosis of social anxiety disorder (SAD). Despite these general patterns, many children with high BI do not go on to develop clinical, or even subclinical, anxiety problems. Therefore, understanding the cognitive and neural bases of individual differences in developmental risk and resilience is of great importance. The present review is focused on the relation of BI to two types of information processing: automatic (novelty detection, attention biases to threat, and incentive processing) and controlled (attention shifting and inhibitory control). We propose three hypothetical models (Top-Down Model of Control; Risk Potentiation Model of Control; and Overgeneralized Control Model) linking these processes to variability in developmental outcomes for BI children. We argue that early BI is associated with an early bias to quickly and preferentially process information associated with motivationally salient cues. When this bias is strong and stable across development, the risk for SAD is increased. Later in development, children with a history of BI tend to display normative levels of performance on controlled attention tasks, but they demonstrate exaggerated neural responses in order to do so, which may further potentiate risk for anxiety-related problems. We conclude by discussing the reviewed studies with reference to the hypothetical models and make suggestions regarding future research and implications for treatment.

Inhibitory control as a mediator of bidirectional effects between early oppositional behavior and maternal depression

Maternal depression is an established risk factor for child conduct problems, but relatively few studies have tested whether children's behavioral problems exacerbate mothers' depression or whether other child behavioral characteristics (e.g., self-regulation) may mediate bidirectional effects between maternal depression and child disruptive behavior. This longitudinal study examined the parallel growth of maternal depressive symptoms and child oppositional behavior from ages 2 to 5; the magnitude and timing of their bidirectional effects; and whether child inhibitory control, a temperament-based self-regulatory mechanism, mediated effects between maternal depression and child oppositionality. A randomized control trial of 731 at-risk families assessed children annually from ages 2 to 5. Transactional models demonstrated positive and bidirectional associations between mothers' depressive symptoms and children's oppositional behavior from ages 2 to 3, with a less consistent pattern of reciprocal relations up to age 5. Mediation of indirect mother-child effects and child evocative effects depended on the rater of children's inhibitory control. Findings are discussed in regard to how child evocative effects and self-regulatory mechanisms may clarify the transmission of psychopathology within families.

Systematic review of universal school-based resilience interventions targeting adolescent tobacco, alcohol or illicit drug use: review protocol

INTRODUCTION

Tobacco, alcohol and illicit drug use contribute significantly to global rates of morbidity and mortality. Despite evidence suggesting interventions designed to increase adolescent resilience may represent a means of reducing adolescent substance use, and schools providing a key opportunity to implement such interventions, existing systematic reviews assessing the effectiveness of school-based interventions targeting adolescent substance use have not examined this potential.

METHODS AND ANALYSIS

The aim of the systematic review is to determine whether universal interventions focused on enhancing the resilience of adolescents are effective in reducing adolescent substance use. Eligible studies will: include participants 5-18 years of age; report tobacco use, alcohol consumption or illicit drug use as outcomes; and implement a school-based intervention designed to promote internal (eg, self-esteem) and external (eg, school connectedness) resilience factors. Eligible study designs include randomised controlled trials, cluster randomised controlled trials, staggered enrolment trials, stepped wedged trials, quasi-randomised trials, quasi-experimental trials, time series/interrupted time-series trials, preference trials, regression discontinuity trials and natural experiment studies with a parallel control group. A search strategy including criteria for participants, study design, outcome, setting and intervention will be implemented in various electronic databases and information sources. Two reviewers will independently screen studies to assess eligibility, as well as extract data from, and assess risk of bias of included studies. A third reviewer will resolve any discrepancies. Attempts will be made to quantify trial effects by meta-analysis. Binary outcomes will be pooled and effect size reported using ORs. For continuous data, effect size of trials will be reported using a mean difference where trial outcomes report the same outcome using a consistent measure, or standardised mean difference where trials report a comparable measure. Otherwise, trial outcomes will be described narratively.

DISSEMINATION

Review findings will be disseminated via peer-reviewed journals and conferences.

Adolescent neurocognitive development, self-regulation, and school-based drug use prevention

Adolescence is marked by several key development-related changes, including neurocognitive changes. Cognitive abilities associated with self-regulation are not fully developed until late adolescence or early adulthood whereas tendencies to take risks and seek thrilling and novel experience seem to increase significantly throughout this phase, resulting in a discrepancy between increased susceptibility to poor regulation and lower ability to exercise self-control. Increased vulnerability to drug use initiation, maintenance, and dependence during adolescence may be explained based on this imbalance in the self-regulation system. In this paper, we highlight the relevance of schools as a setting for delivering adolescent drug use prevention programs that are based on recent findings from neuroscience concerning adolescent brain development. We discuss evidence from school-based as well as laboratory research that suggests that suitable training may improve adolescents' executive brain functions that underlie self-regulation abilities and, as a result, help prevent drug use and abuse. We note that considerable further research is needed in order (1) to determine that self-regulation training has effects at the neurocognitive level and (2) to effectively incorporate self-regulation training based on neuropsychological models into school-based programming.

Resilience, trauma, context, and culture

This article reviews the relationship between factors associated with resilience, and aspects of the individual's social ecology (environment) that promote and protect against the negative impact of exposure to traumatic events. It is shown that the Environment × Individual interactions related to resilience can be understood using three principles: (1) Resilience is not as much an individual construct as it is a quality of the environment and its capacity to facilitate growth (nurture trumps nature); (2) resilience looks both the same and different within and between populations, with the mechanisms that predict positive growth sensitive to individual, contextual, and cultural variation (differential impact); and (3) the impact that any single factor has on resilience differs by the amount of risk exposure, with the mechanisms that protect against the impact of trauma showing contextual and cultural specificity for particular individuals (cultural variation). A definition of resilience is provided that highlights the need for environments to facilitate the navigations and negotiations of individuals for the resources they need to cope with adversity. The relative nature of resilience is discussed, emphasizing that resilience can manifest as either prosocial behaviors or pathological adaptation depending on the quality of the environment.

[Resource-oriented assessment using the German Competence Analysis Questionnaire (Kompetenzanalyseverfahren, KANN) - verification of the KANN's validity as measured by the Child Behavior Checklist (CBCL/4-18) in the context of child and youth welfare]

OBJECTIVE

The German Competence Analysis Questionnaire (Kompetenzanalyseverfahren, KANN) is an external assessment tool used to determine observable personal resources (= competences) in children and adolescents. The present paper examines the validity of the KANN based on additionally collected data of behavior disorders as measured by the Child Behavior Checklist (CBCL/4-18). The main objective is to explore whether the KANN scales are able to differentiate between children and adolescents with or without internalizing and/or externalizing behavior disorders.

METHOD

The sample consists of n = 450 young people (aged 6 to 22 years) under the care of child and youth welfare services assessed between 2010 and 2012 by their group careworkers using KANN and CBCL as part of the ongoing quality development system "moses."

RESULTS

According to the discriminant analysis the KANN scale "Empathy & Fairness" differentiates very well between youths with or without behavior disorders, particularly those with externalizing problems. The KANN scale "Leisure Behavior & Peer Groups" contributes the highest rate of differentiation of internalizing problems. The hit ratios of the discriminant analyses reach values of up to 76.2 %.

CONCLUSIONS

The ability of the KANN scales to differentiate behavior disorders underlines the validity of the KANN.

Annual Research Review: Resilience--clinical implications

BACKGROUND

It is a universal finding that there is huge heterogeneity in people's responses to all kinds of stress and adversity. Resilience is an interactive phenomenon that is inferred from findings indicating that some individuals have a relatively good outcome despite having experienced serious adversities.

METHODS

Resilience can only be inferred if there has been testing of environmental mediation of risks and quantification of the degree of risk. The use of 'natural experiments' to test environmental mediation is briefly discussed. The literature is then reviewed on features associated with resilience in terms of (a) those that are neutral or risky in the absence of the risk experience (such as adoption); (b) brief exposure to risks and inoculation effects; (c) mental features (such as planning, self-regulation or a sense of personal agency); (d) features that foster those mental features; (e) turning point effects; (f) gene-environment interactions; (g) social relationships and promotive effects; and (h) the biology of resilience.

RESULTS

Clinical implications are considered with respect to (a) conceptual implications; (b) prevention; and (c) treatment.

CONCLUSION

Resilience findings do not translate into a clear programme of prevention and treatment, but they do provide numerous leads that focus on the dynamic view of what may be involved in overcoming seriously adverse experiences.

Annual Research Review: Resilience and child well-being--public policy implications

BACKGROUND

There has been an 8-fold increase in use of the term resilience within scientific and scholar literature over the last twenty years. The arena of public policy has also seen increasing use made of the concept, both with respect to child well-being and development and wider issues.

METHOD

A focal sample of literature comprising 108 papers addressing public policy implications of work on child resilience was identified by a structured bibliographic search.

RESULTS

This literature suggests that current work: is characterized by a breadth of sectoral engagement across the fields of education, social work, and health; demonstrates diversity with regard to the systemic levels--individual (biological and psychological), communal (including systems of faith and cultural identity), institutional and societal--with which it engages; but is based more upon conceptual rather than empirical analysis. Major themes of policy recommendation target strengthened family dynamics, increased capacity for counseling and mental health services, supportive school environments, development of community programs, promotion of socioeconomic improvement and adoption of a more comprehensive conception of resilience. Evaluations of resiliency-informed policy initiatives are limited in number, with greatest rigor in design associated with more discrete programmatic interventions.

CONCLUSION

A number of strategies to strengthen research-policy linkages are identified. These include greater commitment to operationalize indicators of resilience at all levels of analysis; more coherent engagement with the policy making process through explicit knowledge translation initiatives; and developing complex adaptive systems models amenable to exploring policy scenarios.

Preschoolers' delay of gratification predicts their body mass 30 years later

OBJECTIVE

To assess whether preschoolers' performance on a delay of gratification task would predict their body mass index (BMI) 30 years later.

STUDY DESIGN

In the late 1960s/early 1970s, 4-year-olds from a university-affiliated preschool completed the classic delay of gratification task. As part of a longitudinal study, a subset (n = 164; 57% women) were followed up approximately 30 years later and self-reported their height and weight. Data were analyzed using hierarchical regression.

RESULTS

Performance on the delay of gratification task accounted for a significant portion of variance in BMI (4%; P < .01), over and above the variance accounted for by sex alone (13%). Each additional minute that a preschooler delayed gratification predicted a 0.2-point reduction in BMI in adulthood.

CONCLUSION

Longer delay of gratification at age 4 years was associated with a lower BMI 3 decades later. Because this study is correlational, it is not possible to make causal inferences regarding the relationship between delay duration and BMI. Identifying children with greater difficulty in delaying gratification could help detect children at risk of becoming overweight or obese. Interventions that improve self-control in young children have been developed and might reduce children's risk of becoming overweight and also have positive effects on other outcomes important to society.

Diabetes resilience: a model of risk and protection in type 1 diabetes

Declining diabetes management and control are common as children progress through adolescence, yet many youths with diabetes do remarkably well. Risk factors for poor diabetes outcomes are well-researched, but fewer data describe processes that lead to positive outcomes such as engaging in effective diabetes self-management, experiencing high quality of life, and achieving in-range glycemic control. Resilience theory posits that protective processes buffer the impact of risk factors on an individual's development and functioning. We review recent conceptualizations of resilience theory in the context of type 1 diabetes management and control and present a theoretical model of pediatric diabetes resilience. Applications to clinical care and research include the development of preventive interventions to build or strengthen protective skills and processes related to diabetes and its management. The ultimate goal is to equip youths with diabetes and their families with the tools to promote both behavioral and health-related resilience in diabetes.

A cluster randomised trial of a school-based resilience intervention to decrease tobacco, alcohol and illicit drug use in secondary school students: study protocol

Background

Whilst schools provide a potentially appropriate setting for preventing substance use among young people, systematic review evidence suggests that past interventions in this setting have demonstrated limited effectiveness in preventing tobacco, alcohol and other drug use. Interventions that adopt a mental wellbeing approach to prevent substance use offer considerable promise and resilience theory provides one method to impact on adolescent mental well-being. The aim of the proposed study is to examine the efficacy of a resilience intervention in decreasing the tobacco, alcohol and illicit drug use of adolescents.

Methods

A cluster randomised controlled trial with schools as the unit of randomisation will be undertaken. Thirty two schools in disadvantaged areas will be allocated to either an intervention or a control group. A comprehensive resilience intervention will be implemented, inclusive of explicit program adoption strategies. Baseline surveys will be conducted with students in Grade 7 in both groups and again three years later when the student cohort is in Grade 10. The primary outcome measures will include self-reported tobacco, alcohol, marijuana and other illicit drug use. Comparisons will be made post-test between Grade 10 students in intervention and control schools to determine intervention effectiveness across all measures.

Discussion

To the authors’ knowledge this is the first randomised controlled trial to evaluate the effectiveness of a comprehensive school-based resilience intervention, inclusive of explicit adoption strategies, in decreasing tobacco, alcohol and illicit drug use of adolescents attending disadvantaged secondary schools.

Trial registration

ACTRN12611000606987

Low-income children's self-regulation in the classroom: scientific inquiry for social change

Over 21% of children in the United States today are poor, and the income gap between our nation's richest and poorest children has widened dramatically over time. This article considers children's self-regulation as a key mediating mechanism through which poverty has deleterious consequences for their later life outcomes. Evidence from field experiments suggests that low-income children's self-regulation is modifiable by early educational intervention, offering a powerful policy option for reducing poverty's negative impact. The author discusses ways that scientific models of self-regulation can be expanded to include multiple developmental periods and real-world classroom contexts. Recommendations for advances in research design, measurement, and analysis are discussed, as are implications for policy formation and evaluation.

Promoting Young Children's Social Competence through the Preschool PATHS Curriculum and MyTeachingPartner Professional Development Resources

RESEARCH FINDINGS

Children's (n = 980) social competence during prekindergarten was assessed as a function of their teachers' (n = 233) exposure to the Preschool Promoting Alternative Thinking Strategies (PATHS) curriculum and 2 levels of support through MyTeachingPartner, a Web-based approach to professional development. Children in classrooms that implemented PATHS had increased levels of teacher-reported social competence over the course of the year. There were no associations between the use of PATHS and reductions in teacher-reported social problems. The results also suggested that teachers who used the MyTeachingPartner website more often reported greater gains in children's social competence.

PRACTICE OR POLICY

These findings have implications for the development and dissemination of social-emotional learning curricula and the provision of effective implementation supports for teachers. Continued work on the best ways to integrate technology into the professional development of teachers, both in service and preservice, is likely to enhance the accessibility and quality of supports for teachers.

Transition to parenthood and substance use disorders: findings from a 30-year longitudinal study

BACKGROUND

This study examined the associations between the transition to parenthood and substance use disorders from ages 18 to 30 in a New Zealand birth cohort.

METHODS

Outcomes included: DSM-IV criteria for: (a) alcohol abuse/dependence (AAD) and (b) illicit substance abuse/dependence. The study also used measures transition to parenthood during the period 18-30 years; and observed covariate factors including: family socio-economic status; family functioning; childhood abuse exposure; childhood personal and behavioural characteristics; and psychosocial adjustment in adolescence. Data were analysed using repeated measures generalised estimating equation models, and conditional fixed effects regression modelling to control for confounding. Gender interactions were examined using moderated regression analyses.

RESULTS

Those who became parents had unadjusted odds of substance use disorder outcomes that were approximately 50% lower than those who had not become parents. Adjustment of the associations for both: (a) observed confounding factors and (b) non-observed fixed effects; strengthened the associations between parenthood status and substance use disorders. Custodial parents had odds of substance use disorders that were 57-78% lower than those who did not become parents after adjusting for non-observed fixed effects. Additional analyses suggested these effects were confined to custodial parents only. There was also evidence for gender×parenthood status interactions for AAD, with the effects of parenthood on AAD being stronger for females.

CONCLUSIONS

The results suggest that the transition to custodial parenthood may result in reduced risks of substance use disorder, particularly amongst female cohort members.

Infusing developmental neuroscience into school-based preventive interventions: implications and future directions

PURPOSE

Recent advances in developmental neuroscience have the potential to significantly impact the behavioral and academic outcomes of adolescents. By adopting a translational approach, we aim to promote the transfer of knowledge related to neurological, cognitive, and emotion regulatory factors that underlie youth's ability to respond to educational and prevention programming.

METHOD

This article synthesizes basic and applied research from the field of developmental neuroscience to highlight the significance of this work for the creation, evaluation, and tailoring of school-based preventive interventions designed to address aggressive behavior problems. We draw on research related to stress, social-cognitive factors, emotional perception and regulation, and executive functioning to identify potential neurodevelopmental mediators and moderators of prevention program impacts.

RESULTS

Findings suggest that a high level of brain plasticity characterizes early childhood and adolescent stages of development, providing optimal windows of opportunity for intervention. The available research emphasizes the importance of executive functioning and related emotional regulatory factors as potential mechanisms for change in educational and risk prevention models.

CONCLUSIONS

Neuroscience research provides insights into underlying mechanisms that, when appropriately targeted, can help optimize the impact of social-emotional learning curricula. Recommendations are made for how to apply relevant findings from neuroscience and related disciplines to improve behavioral and academic outcomes for school-aged youth. Additional research areas are identified to inform the creation of neurodevelopmentally sensitive preventive interventions targeting aggressive behavior problems which, in turn, are expected to affect academic outcomes.

A new mother-child play activity program to decrease parenting stress and improve child cognitive abilities: a cluster randomized controlled trial

Background

We propose a new play activity intervention program for mothers and children. Our interdisciplinary program integrates four fields of child-related sciences: neuroscience, preschool pedagogy, developmental psychology, and child and maternal psychiatry. To determine the effect of this intervention on child and mother psychosocial problems related to parenting stress and on the children's cognitive abilities, we performed a cluster randomized controlled trial.

Methodology/Principal Findings

Participants were 238 pairs of mothers and typically developing preschool children (ages 4–6 years old) from Wakakusa kindergarten in Japan. The pairs were asked to play at home for about 10 min a day, 5 days a week for 3 months. Participants were randomly assigned to the intervention or control group by class unit. The Parenting Stress Index (PSI) (for mothers), the Goodenough Draw-a-Man intelligence test (DAM), and the new S-S intelligence test (NS-SIT) (for children) were administered prior to and 3 months after the intervention period. Pre–post changes in test scores were compared between the groups using a linear mixed-effects model analysis. The primary outcomes were the Total score on the child domain of the PSI (for child psychosocial problems related to parenting stress), Total score on the parent domain of the PSI (for maternal psychosocial problems related to parenting stress), and the score on the DAM (for child cognitive abilities). The results of the PSI suggested that the program may reduce parenting stress. The results of the cognitive tests suggested that the program may improve the children's fluid intelligence, working memory, and processing speed.

Conclusions/Significance

Our intervention program may ameliorate the children's psychosocial problems related to parenting stress and increase their cognitive abilities.

Trial Registration

UMIN Clinical Trials Registry UMIN000002265

The role of general cognitive ability in moderating the relation of adverse life events to emotional and behavioural problems

Previous studies have established the role of various measures of cognitive functioning in dampening the association between adverse life events ('life stress') and adolescents' emotional and behavioural problems. However, it is not yet clear if general cognitive ability ('intelligence') is a protective factor. In this study of 1,175 10- to 19-year-olds in five secondary schools in England, we explored this issue. We found that even after controlling for sex, age, family poverty, and special educational needs, the association of life stress with emotional, hyperactivity, and conduct problems was significant. General cognitive ability moderated the association between life stress and conduct problems; among adolescents with higher than average general cognitive ability, the association between life stress and conduct problems was non-significant.

Attention Problems Mediate the Association between Severity of Physical Abuse and Aggressive Behavior in a Sample of Maltreated Early Adolescents

Empirical evidence has accumulated documenting an association between childhood physical abuse and aggressive behavior. Relatively fewer studies have explored possible mediating mechanisms that may explain this association. The purpose of the current study was to examine whether caregiver- and youth-reported attention problems mediate the association between physical abuse severity and aggressive behavior. A sample of 240 maltreated early adolescents (ages 9-11) and their caregivers were interviewed within 14 months of being removed from the home. Results from multiple regression analyses indicated that caregiver- and youth-reported attention problems were partial mediators of the association between physical abuse severity and aggressive behavior. These associations were significant even after controlling for children's intellectual functioning, sex, age, and severity of other maltreatment types. Possible explanations for the detrimental impact of physical abuse on behavior are discussed, along with the implications of the current study's results for interventions aimed at reducing early adolescent aggressive behavior.

A school-based resilience intervention to decrease tobacco, alcohol and marijuana use in high school students

Background

Despite schools theoretically being an ideal setting for accessing adolescents and preventing initiation of substance use, there is limited evidence of effective interventions in this setting. Resilience theory provides one approach to achieving such an outcome through improving adolescent mental well-being and resilience. A study was undertaken to examine the potential effectiveness of such an intervention approach in improving adolescent resilience and protective factor scores; and reducing the prevalence of adolescent tobacco, alcohol and marijuana use in three high schools.

Methods

A non-controlled before and after study was undertaken. Data regarding student resilience and protective factors, and measures of tobacco, alcohol and marijuana use were collected from grade 7 to 10 students at baseline (n = 1449) and one year following a three year intervention (n = 1205).

Results

Significantly higher resilience and protective factors scores, and significantly lower prevalence of substance use were evident at follow up.

Conclusions

The results suggest that the intervention has the potential to increase resilience and protective factors, and to decrease the use of tobacco, alcohol and marijuana by adolescents. Further more rigorous research is required to confirm this potential.

The impact of enhancing students' social and emotional learning: a meta-analysis of school-based universal interventions

This article presents findings from a meta-analysis of 213 school-based, universal social and emotional learning (SEL) programs involving 270,034 kindergarten through high school students. Compared to controls, SEL participants demonstrated significantly improved social and emotional skills, attitudes, behavior, and academic performance that reflected an 11-percentile-point gain in achievement. School teaching staff successfully conducted SEL programs. The use of 4 recommended practices for developing skills and the presence of implementation problems moderated program outcomes. The findings add to the growing empirical evidence regarding the positive impact of SEL programs. Policy makers, educators, and the public can contribute to healthy development of children by supporting the incorporation of evidence-based SEL programming into standard educational practice.