1
|
Naim R, Dombek K, German RE, Haller SP, Kircanski K, Brotman MA. An Exposure-Based Cognitive-Behavioral Therapy for Youth with Severe Irritability: Feasibility and Preliminary Efficacy. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024; 53:260-276. [PMID: 37851393 PMCID: PMC11024061 DOI: 10.1080/15374416.2023.2264385] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
OBJECTIVE Clinically impairing irritability and temper outbursts are among the most common psychiatric problems in youth and present transdiagnostically; however, few mechanistically informed treatments have been developed. Here, we test the acceptability, feasibility, and preliminary efficacy of a novel exposure-based treatment with integrated parent management skills for youth with severe irritability using a randomized between-subjects multiple baseline design. METHOD N = 41 patients (Age, Mean (SD) = 11.23 years (1.85), 62.5% male, 77.5% white) characterized by severe and impairing temper outbursts and irritability were randomized to different baseline observation durations (2, 4, or 6 weeks) prior to active treatment; 40 participants completed the 12 session treatment of exposure-based cognitive-behavioral therapy for irritability with integrated parent management skills. Masked clinician ratings were acquired throughout baseline and treatment phases, as well as 3- and 6-months post-treatment. To examine acceptability and feasibility, drop-out rates and adverse events were examined. Primary clinical outcome measures included clinician-administered measures of irritability severity and improvement. Secondary clinical outcome measures included multi-informant measures of irritability, depression, anxiety, and attention-deficit/hyperactivity disorder symptoms. RESULTS No patients dropped out once treatment began, and no adverse events were reported. Irritability symptoms improved during the active phase of treatment across all measurements (all βs > -0.04, ps < .011, Cohen's d range: -0.33 to -0.98). Treatment gains were maintained at follow-up (all βs(39) < -0.001, ps > .400). Sixty-five percent of patients were considered significantly improved or recovered post-treatment based on the primary clinician-rated outcome measure. CONCLUSIONS Results support acceptability, feasibility, and preliminary efficacy of this novel treatment for youth with severe irritability. Limitations and future directions are also discussed.
Collapse
Affiliation(s)
- Reut Naim
- School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Kelly Dombek
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Ramaris E. German
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Simone P. Haller
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Katharina Kircanski
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Melissa A. Brotman
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| |
Collapse
|
2
|
The Effects of Emotion Regulation Treatment on Disruptive Behavior Problems in Children: A Randomized Controlled Trial. Res Child Adolesc Psychopathol 2022; 50:895-905. [PMID: 35133557 PMCID: PMC9246778 DOI: 10.1007/s10802-022-00903-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2022] [Indexed: 12/02/2022]
Abstract
Disruptive behavior problems are a frequent reason for children’s referrals to psychological services and can have negative effects on social and academic functioning. Most treatment programs involve parents as recipients and implementation of intervention programs in school is low. Deficits in emotion regulation have recently been implicated in the development of disruptive behavior disorders, making child directed early intervention programs focusing on increasing emotion regulation skills feasible. The purpose of this study was to assess the effects of Tuning Your Temper, a brief cognitive behavioral program for children with disruptive behavior problems, in a randomized controlled trial. A total of 125 children with disruptive behavior problems at school, aged 6–11 years old were randomized to either intervention or wait-list control condition. Treatment was conducted at school. Assessments included teacher and parent ratings on the Strengths and Difficulties Questionnaire (SDQ) and the Disruptive Behavior Rating Scale (DBRS) pre- and post-treatment and at 6-month follow-up. Results showed a significant reduction in behavior problems for the treatment condition on both measures and effects were maintained at 6-month follow-up. Results were more robust for teacher ratings, with medium to large effect sizes. Tuning Your Temper appears to be a promising early intervention program for children with disruptive behavior problems at school.
Collapse
|
3
|
Parent Management Training Combined with Group-CBT Compared to Parent Management Training Only for Oppositional Defiant Disorder Symptoms: 2-Year Follow-Up of a Randomized Controlled Trial. Child Psychiatry Hum Dev 2022:10.1007/s10578-021-01306-3. [PMID: 35089501 DOI: 10.1007/s10578-021-01306-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/28/2021] [Indexed: 11/03/2022]
Abstract
Parent management training (PMT) is recommended treatment for children with oppositional defiant disorder (ODD) and child-directed cognitive behavior therapy (CBT) is also recommended for school-aged children. The current study examined 2-year follow-up effects of parent management training (PMT) combined with the CBT based group intervention Coping Power Program (CPP) compared to PMT only. Results showed long-term effectiveness of both PMT and PMT combined with CPP in reduced disruptive behavior problems and harsh parenting strategies, and increased emotion regulation- and social communication skills. The earlier reported increase in emotion regulation- and social communication skills in the PMT with CPP condition during treatment remained stable while the PMT condition showed continued improvement during the follow-up period. To conclude, PMT with CPP did generally not provide significant benefits at the 2-year follow-up compared to PMT, apart from an improvement earlier in time regarding emotion regulation- and social communication skills.Trial registration number ISRCTN10834473, date of registration: 23/12/2015.
Collapse
|
4
|
Universal Screening in Positive School Mental Health Using the ASEBA Methodology for Teachers: A Pilot Epidemiological Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211807. [PMID: 34831563 PMCID: PMC8617970 DOI: 10.3390/ijerph182211807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/06/2021] [Accepted: 11/07/2021] [Indexed: 11/19/2022]
Abstract
School-based detection and intervention are critical components in ensuring positive mental health in children, with teachers playing an essential role in assessing students’ well-being. The current research aims to be a pilot epidemiological study on positive school mental health in Malaga, Spain, using the Achenbach System of Empirically Based Assessment (ASEBA). Data were collected in the COVID-19 pre-pandemic setting, using the Caregiver-Teacher Report Form (C-TRF) and the Teacher Report Form (TRF) in a sample of 420 children, who were between 5 and 8 years old at the time of the data collection. In 5-year-old children, the DSM-oriented scale with the highest clinical prevalence corresponds to attention deficit and hyperactivity problems (1.13%). In this same sub-sample, clinical levels of externalizing problems (4.52%) were non-significantly more common than internalizing conditions (1.69%). As for children between 6 and 8 years old, the DSM-oriented scale with the highest prevalence of clinical scores corresponds to anxiety problems (4.12%) and conduct problems (2.88%). Clinical levels of externalizing problems (9.47%) were non-significantly more prevalent than internalizing problems (6.58%). The results present 95% confidence intervals prevalence data in the general population and sex-differentiated descriptive statistics. The results are discussed according to their implication for school mental health.
Collapse
|
5
|
Parenting and Sibling Relationships in Family with Disruptive Behavior Disorders. Are Non-Clinical Siblings More Vulnerable for Emotional and Behavioral Problems? Brain Sci 2021; 11:brainsci11101308. [PMID: 34679373 PMCID: PMC8534172 DOI: 10.3390/brainsci11101308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/27/2021] [Accepted: 09/27/2021] [Indexed: 11/17/2022] Open
Abstract
Disruptive Behavior Disorders (DBD) are the most common mental health disorders in the school-aged child population. Although harsh parenting is a key risk factor in the shaping of DBD, studies neglect the presence of siblings and differential parenting. This study aims to compare: (1) parenting style and sibling relationship in sibling dyads of clinical families, composed of a DBD child and a non-clinical sibling, with control families composed of two non-clinical siblings; (2) parenting style, sibling relationship, and emotional and behavioral problems in DBD child, non-clinical sibling, and non-clinical child of control group. Sixty-one families (composed of mother and sibling dyads), divided into clinical (n = 27) and control (n = 34) groups, completed the APQ, SRI, and CBCL questionnaires. Results indicated differential parenting in clinical families, compared to control group families, with higher negative parenting toward the DBD child than the sibling; no difference emerged in sibling relationship within sibling dyads (clinical vs. control). Finally, externalizing and internalizing problems were higher in DBD children and their siblings, compared to control, indicating DBD sibling psychopathology vulnerability. Findings suggest inclusion of siblings in the clinical assessment and rehabilitative intervention of DBD children, given that the promotion of positive parenting could improve mental health in the offspring.
Collapse
|
6
|
Burrow-Sánchez JJ, Totsky J, Ratcliff BR, Corrales C. Generalizing treatment outcomes to externalizing behaviors for Latino/a adolescents with substance use disorders: A secondary analysis. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2021; 35:797-802. [PMID: 33734782 DOI: 10.1037/adb0000713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Substance use treatment for adolescents may decrease not only substance use, but also other related outcomes such as externalizing behaviors. Although positively correlated to substance use in youth, externalizing behaviors are not commonly measured as outcomes in the context of substance use treatment. This study seeks to generalize the outcomes of substance use treatment to externalizing behaviors in a sample of Latino/a adolescents who participated in a randomized clinical trial. METHOD Secondary data analysis was conducted using a longitudinal mixed model to test the outcomes of two versions of a cognitive-behavioral substance use treatment (i.e., standard and culturally accommodated) on externalizing behaviors. Participants were Latino/a adolescents (N = 70) diagnosed with a substance use disorder randomized into one of the two study conditions. RESULTS The results indicated that Latino/a adolescents in both treatment conditions significantly decreased in self-reported externalizing behaviors from pretreatment to 12-months posttreatment. CONCLUSIONS Implications from this study suggest that participation in substance use treatment for Latino/a adolescents may also generalize to other outcomes such as externalizing behaviors. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
|
7
|
Toohey MJ. Irritability characteristics and parameters in an international sample. J Affect Disord 2020; 263:558-567. [PMID: 31989992 DOI: 10.1016/j.jad.2019.11.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 09/05/2019] [Accepted: 11/08/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND Irritability is a symptom of fifteen psychiatric disorders and is widely known to scholars and the public. However, little is known about irritability as an individual construct. The purpose of the current study is to identify conceptualizations of specific characteristics of irritability. METHODS In this study, 402 participants from 10 countries answered nine qualitative questions about their personal causes, experience, and consequences of irritability as well as how they perceived the relationship between irritability and anger. They also answered three quantitative questions about the frequency, intensity, and duration of their irritability. RESULTS Results indicated that 99.3% of participants reported a lifetime incidence of irritability. On average, participants reported feeling irritable approximately one to two times per week for 30 min with an intensity that was somewhat bothersome. Women reported feeling irritable for a longer duration than men, and residents of China, Singapore, and the USA generally reported having a longer duration than residents of Ireland and the UK. Some themes that appeared unique to irritability were the physiological/biological/internal aspects of irritability and treatments that address emotional and physiological coping such as relaxation and recreation. LIMITATIONS Many participants equated irritability with anger, and generalizations by countries should be interpreted with caution due to a small sample within each country. CONCLUSIONS These findings support the conceptualization of irritability as a universal construct. It is recommended that future research continue to explore irritability to better help understand it as an independent construct in the context of diagnosis, assessment, research, and treatment.
Collapse
Affiliation(s)
- Michael J Toohey
- Antioch University Seattle 2400 3rd Avenue #200, Seattle, WA 98121, USA.
| |
Collapse
|
8
|
Yao E, Li Y, Wang C, Hui J. Understanding confidentiality breach in adolescent mental health sessions: an integrated model of culture and parenting. ETHICS & BEHAVIOR 2020. [DOI: 10.1080/10508422.2020.1719105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Elvin Yao
- Division of Behavioral & Organizational Sciences, Claremont Graduate University
| | - Yuhua Li
- Chinese Center for Disease Prevention and Control
| | - Chunhui Wang
- Chinese Center for Disease Prevention and Control
| | - Jianwen Hui
- Chinese Center for Disease Prevention and Control
| |
Collapse
|
9
|
Nickerson AB, Shisler SM, Eiden RD, Ostrov JM, Schuetze P, Godleski SA, Delmerico AM. A Longitudinal Study of Gun Violence Attitudes: Role of Childhood Aggression and Exposure to Violence, and Early Adolescent Bullying Perpetration and Victimization. JOURNAL OF SCHOOL VIOLENCE 2020; 19:62-76. [PMID: 35401061 PMCID: PMC8993126 DOI: 10.1080/15388220.2019.1703716] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
This prospective study examined the effects of early childhood physical aggression and violence exposure on bullying victimization/perpetration and attitudes toward guns and violence in early adolescence (EA) in a high-risk sample. Participants included 216 mother-child dyads from an ongoing longitudinal study using multi-method assessments (e.g., classroom observations, laboratory assessment, parent-, teacher-, and child self-reports). Results supported a developmental pathway from early adversity (i.e., prenatal substance use) to aggression at kindergarten age to bullying perpetration and gun violence attitudes (aggressive responses to shame) in EA. Higher peer victimization was also associated with aggressive responses to shame in EA. Results are discussed in light of the complexity of the motives for aggression and the need for prevention and early intervention.
Collapse
Affiliation(s)
- Amanda B Nickerson
- Alberti Center for Bullying Abuse Prevention, University at Buffalo, The State University of New York, NY, USA
| | - Shannon M Shisler
- Clinical and Research Institute on Addictions and Department of Pediatrics, University at Buffalo, The State University of New York, NY, USA
| | - Rina D Eiden
- Department of Psychology, Consortium for Combating Substance Abuse, Pennsylvania State University, Pennsylvania, PA, USA
| | - Jamie M Ostrov
- Department of Psychology, University at Buffalo, The State University of New York, NY, USA
| | - Pamela Schuetze
- Department of Psychology, Buffalo State, The State University of New York, NY, USA
| | | | - Alan M Delmerico
- Institute for Community Health Promotion, Buffalo State, The State University of New York, NY, USA
| |
Collapse
|
10
|
Stringaris A, Vidal-Ribas P, Brotman MA, Leibenluft E. Practitioner Review: Definition, recognition, and treatment challenges of irritability in young people. J Child Psychol Psychiatry 2018; 59:721-739. [PMID: 29083031 DOI: 10.1111/jcpp.12823] [Citation(s) in RCA: 117] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/29/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND Irritability is one of the most common reasons for referral to child and adolescent mental health services and is the main characteristic of the new diagnosis of disruptive mood dysregulation disorder (DMDD). However, the recognition and management of irritability presents a major challenge in clinical practice and may be partly responsible for the dramatic increase in antipsychotic prescribing in recent years. METHODS In this review, we provide up-to-date information on the definition and mechanisms underlying irritability, and its assessment in clinical practice. We aim to discuss the latest research on DMDD, and the presence of severe irritability in the context of other disorders, as well as to recommend a treatment algorithm. RESULTS Severe irritability is associated with aberrant reward processing and bias toward threatening stimuli. Several measures are available to easily assess irritability. The recent diagnosis of DMDD captures children whose main problem is severe irritability and differ from those with bipolar disorder in longitudinal outcomes, family history, and behavioral and neural correlates. Treatment of irritability might depend on the context it appears. Indirect evidence suggests that parent management training (PMT) and cognitive behavioral therapy (CBT) are the most supported psychological treatments for irritability. CONCLUSIONS Irritability, recognized as a mood problem rather than a purely behavioral manifestation, is a common condition for young people. Practitioners should not ignore irritability as it is associated with substantial morbidity and impairment. Although there are no trials with irritability as main outcome, clinicians can apply several existing pharmacological and psychological interventions for its treatment. Also, new promising approaches relying on pathophysiological findings, such as exposure-based cognitive behavioral therapy techniques and interpretation bias training (IBT), are being currently investigated.
Collapse
Affiliation(s)
- Argyris Stringaris
- Mood Brain and Development Unit, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Pablo Vidal-Ribas
- Mood Brain and Development Unit, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.,Institute of Psychiatry, Psychology and Neuroscience, Department of Child and Adolescent Psychiatry, King's College London, London, UK
| | - Melissa A Brotman
- Section on Mood Dysregulation and Neuroscience, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Ellen Leibenluft
- Section on Mood Dysregulation and Neuroscience, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| |
Collapse
|
11
|
The Feasibility and Effectiveness of School-Based Modular Therapy: A Systematic Literature Review. SCHOOL MENTAL HEALTH 2018. [DOI: 10.1007/s12310-018-9270-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
|
12
|
Externalizing Behavior in at-Risk Preadolescents: Relationships among Effortful Control, Affective Experiences, and Autonomic Psychophysiology. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2017. [DOI: 10.1007/s10862-017-9604-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
13
|
Dori N, Green T, Weizman A, Gothelf D. The Effectiveness and Safety of Antipsychotic and Antidepressant Medications in Individuals with 22q11.2 Deletion Syndrome. J Child Adolesc Psychopharmacol 2017; 27:83-90. [PMID: 26131914 DOI: 10.1089/cap.2014.0075] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the effectiveness and safety of antipsychotic and antidepressant medications in individuals with 22q11.2 deletion syndrome (22q11.2 DS) and psychiatric comorbidity. METHODS We used a record review, structured clinical interviews, and the Clinical Global Impressions (CGI) scale to retrospectively assess the effectiveness and safety of antipsychotic medications for schizophrenia spectrum disorders and of antidepressant medications for depressive and anxiety disorders in 40 individuals with 22q11.2DS. RESULTS We observed significant improvement in CGI-Severity scores in individuals with 22q11.2DS treated with antipsychotic or antidepressant medications, and a ∼50% response rate based on the CGI-Improvement score. Adverse events were similar in types and rates to those reported in non-22q11.2 individuals treated with antipsychotics or antidepressants. CONCLUSIONS Our data show that treatment with antipsychotics and antidepressants may be effective while being relatively safe in individuals with 22q11.2DS. Antipsychotic and antidepressant medications should be considered in any individual with 22q11.2DS who has a psychiatric morbidity, such as psychosis or mood or anxiety disorders. Although the psychotropic medications were generally well tolerated in our sample, more rigorous metabolic and cardiovascular measures are required in future studies to conclusively verify the safety of these medications.
Collapse
Affiliation(s)
- Netta Dori
- 1 Beer Yaakov-Ness Ziona Mental Health Center , Israel .,2 Sackler Faculty of Medicine, Tel Aviv University , Israel
| | - Tamar Green
- 2 Sackler Faculty of Medicine, Tel Aviv University , Israel .,3 Center for Interdisciplinary Brain Sciences Research, Stanford University School of Medicine , Stanford, California
| | - Abraham Weizman
- 2 Sackler Faculty of Medicine, Tel Aviv University , Israel .,4 Geha Mental Health Center , Petah Tikva, Israel
| | - Doron Gothelf
- 2 Sackler Faculty of Medicine, Tel Aviv University , Israel .,5 The Child Psychiatry Unit, Edmond and Lily Safra Children's Hospital , Sheba Medical Center, Tel Hashomer, Israel
| |
Collapse
|
14
|
Davies PT, Hentges RF, Coe JL, Martin MJ, Sturge-Apple ML, Cummings EM. The multiple faces of interparental conflict: Implications for cascades of children's insecurity and externalizing problems. JOURNAL OF ABNORMAL PSYCHOLOGY 2016; 125:664-78. [PMID: 27175983 DOI: 10.1037/abn0000170] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This multistudy article examined the relative strength of mediational pathways involving hostile, disengaged, and uncooperative forms of interparental conflict, children's emotional insecurity, and their externalizing problems across 2 longitudinal studies. Participants in Study 1 consisted of 243 preschool children (M age = 4.60 years) and their parents, whereas Study 2 consisted of 263 adolescents (M age = 12.62 years) and their parents. Both studies utilized multimethod, multi-informant assessment batteries within a longitudinal design with 3 measurement occasions. Across both studies, lagged, autoregressive tests of the mediational paths revealed that interparental hostility was a significantly stronger predictor of the prospective cascade of children's insecurity and externalizing problems than interparental disengagement and low levels of interparental cooperation. Findings further indicated that interparental disengagement was a stronger predictor of the insecurity pathway than was low interparental cooperation for the sample of adolescents in Study 2. Results are discussed in relation to how they inform and advance developmental models of family risk. (PsycINFO Database Record
Collapse
Affiliation(s)
- Patrick T Davies
- Department of Clinical and Social Sciences in Psychology, University of Rochester
| | - Rochelle F Hentges
- Department of Clinical and Social Sciences in Psychology, University of Rochester
| | - Jesse L Coe
- Department of Clinical and Social Sciences in Psychology, University of Rochester
| | - Meredith J Martin
- Department of Clinical and Social Sciences in Psychology, University of Rochester
| | | | | |
Collapse
|
15
|
Parental psychological control and aggression in youth: Moderating effect of emotion dysregulation. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2016. [DOI: 10.1016/j.appdev.2016.02.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
16
|
Cognitive-behavioral therapy for externalizing disorders: A meta-analysis of treatment effectiveness. Behav Res Ther 2015; 75:60-71. [DOI: 10.1016/j.brat.2015.10.008] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 10/23/2015] [Accepted: 10/28/2015] [Indexed: 01/09/2023]
|
17
|
Teacher-Reported Irritable and Defiant Dimensions of Oppositional Defiant Disorder: Social, Behavioral, and Academic Correlates. SCHOOL MENTAL HEALTH 2015. [DOI: 10.1007/s12310-015-9163-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
18
|
|
19
|
Rodriguez MA, Fang CM, Gao J, Robins C, Rosenthal MZ. Perceptions of the Limitations of Confidentiality Among Chinese Mental Health Practitioners, Adolescents and Their Parents. ETHICS & BEHAVIOR 2015. [DOI: 10.1080/10508422.2015.1038748] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
20
|
Masi G, Milone A, Paciello M, Lenzi F, Muratori P, Manfredi A, Polidori L, Ruglioni L, Lochman JE, Muratori F. Efficacy of a multimodal treatment for disruptive behavior disorders in children and adolescents: focus on internalizing problems. Psychiatry Res 2014; 219:617-24. [PMID: 25060833 DOI: 10.1016/j.psychres.2014.05.048] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Revised: 03/26/2014] [Accepted: 05/22/2014] [Indexed: 10/25/2022]
Abstract
Disruptive Behavior Disorders (DBDs) are among the most common reasons for youth referrals to mental health clinics. Aim of this study is to compare short and medium term efficacy of a multimodal treatment program (MTP), compared to community care (treatment-as-usual, TAU). The sample included 135 youths with DBDs (113 males, age range 9-15 years, mean age 12±2.5 years) were assigned either to a MTP (n=64), or addressed to community care for a TAU (n=71). Outcome measures were the Child Behaviour Checklist (CBCL) and the Children's Global Assessment Scale (C-GAS). All subjects were assessed at the baseline (T0), after 1-year treatment (T1) and after a 2-year follow-up (T2). Compared with patients receiving TAU, youths in the MTP showed, both at T1 and T2, significantly lower scores on CBCL Externalizing Scale, Internalizing Scale, Anxious/Depressed, Social Problems, and Aggressive Behavior, and higher scores at the C-GAS. Improvement in Internalizing Scales was particularly evident, with a shift from the clinical to the non-clinical range. Rate of use of mental health services and scholastic failure were reduced in the MTP. It is suggested that the improvement of the Internalizing symptoms is a crucial component of the therapeutic process in this MTP.
Collapse
Affiliation(s)
- Gabriele Masi
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno 331, Calambrone, Pisa, Italy
| | - Annarita Milone
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno 331, Calambrone, Pisa, Italy
| | | | - Francesca Lenzi
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno 331, Calambrone, Pisa, Italy; Clinical-Experimental Department of Medicine and Pharmacology, University of Messina, Italy
| | - Pietro Muratori
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno 331, Calambrone, Pisa, Italy
| | - Azzurra Manfredi
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno 331, Calambrone, Pisa, Italy
| | - Lisa Polidori
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno 331, Calambrone, Pisa, Italy
| | - Laura Ruglioni
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno 331, Calambrone, Pisa, Italy.
| | - John E Lochman
- Department of Psychology, The University of Alabama, Tuscaloosa, AL, USA
| | - Filippo Muratori
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno 331, Calambrone, Pisa, Italy
| |
Collapse
|
21
|
McGoron L, Sturner R, Howard B, Barry TD, Seymour K, Tomeny TS, Morrel T, Ellis BM, Marks D. Parents' goals for ADHD care in a clinical pediatric sample. Clin Pediatr (Phila) 2014; 53:949-59. [PMID: 25082952 PMCID: PMC4312546 DOI: 10.1177/0009922814543323] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This report describes goals parents have for their children with attention deficit/hyperactivity disorder (ADHD) when coming for a pediatric visit. METHOD Data were collected from 441 parents of children presenting to either a primary care pediatric practice or a developmental behavioral pediatric practice. Parents were asked to report their top 1 or 2 goals for improvement for their children, and responses were coded into 17 categories. These categories were further grouped into 7 goal composites and examined in relation to demographic characteristics of the families, office type, and symptomology. RESULTS Goals related to reducing symptoms of inattention were most common, but goals were heterogeneous in nature. Goals were meaningfully, but modestly, related to symptomology. In several instances, symptoms of comorbid conditions interacted with symptoms of ADHD in relation to specific goals being reported. CONCLUSIONS Parents' goals extended beyond ADHD symptoms. Pediatricians need an array of resources to address parents' goals.
Collapse
Affiliation(s)
- Lucy McGoron
- Total Child Health, Inc, Baltimore, MD, USA The University of Delaware, Newark, DE, USA
| | - Raymond Sturner
- The Center for the Promotion of Child Development through Primary Care, Baltimore, MD, The Johns Hopkins University School of Medicine, Department of Pediatrics, Baltimore, MD
| | - Barbara Howard
- Total Child Health, Inc., Baltimore, MD, The Johns Hopkins University School of Medicine, Department of Pediatrics, Baltimore, MD
| | - Tammy D. Barry
- The University of Southern Mississippi, Department of Psychology, Hattiesburg, MD
| | - Karen Seymour
- The Johns Hopkins Hospital Children's Center, Division of Child and Adolescent Psychiatry, Baltimore MD
| | - Theodore S. Tomeny
- The University of Southern Mississippi, Department of Psychology, Hattiesburg, MS
| | | | - Brandi M. Ellis
- The University of Southern Mississippi, Department of Psychology, Hattiesburg, MS
| | | |
Collapse
|
22
|
Serotonergic, noradrenergic and dopaminergic markers are related to cognitive function in adults with 22q11 deletion syndrome. Int J Neuropsychopharmacol 2014; 17:1159-65. [PMID: 24713114 DOI: 10.1017/s1461145714000376] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Patients with 22q11 deletion syndrome (22q11DS) have a high prevalence of psychiatric disorders and intellectual disability. At present the neurobiology underlying psychopathology in 22q11DS is still not understood. In the present study, we analyzed urinary serotonergic, dopaminergic and noradrenergic markers in 67 adults with 22q11DS. Levels of serotonin and the catecholamine metabolite homovanillic acid were significantly lower in the 22q11DS subjects compared to healthy controls. Within the 22q11DS group, levels of dopamine, homovanillic acid, norepinephrine, vanillyl mandelic acid and serotonin positively correlated with Full Scale Intelligence Quotient scores. Our results suggest that cognitive deficits in 22q11DS are associated with abnormal function of several neurotransmitters.
Collapse
|
23
|
Paediatric European Risperidone Studies (PERS): context, rationale, objectives, strategy, and challenges. Eur Child Adolesc Psychiatry 2014; 23:1149-60. [PMID: 24337449 PMCID: PMC4246122 DOI: 10.1007/s00787-013-0498-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2013] [Accepted: 11/13/2013] [Indexed: 11/11/2022]
Abstract
In children and adolescents with conduct disorder (CD), pharmacotherapy is considered when non-pharmacological interventions do not improve symptoms and functional impairment. Risperidone, a second-generation antipsychotic is increasingly prescribed off-label in this indication, but its efficacy and tolerability is poorly studied in CD, especially in young people with normal intelligence. The Paediatric European Risperidone Studies (PERS) include a series of trials to assess short-term efficacy, tolerability and maintenance effects of risperidone in children and adolescents with CD and normal intelligence as well as long-term tolerability in a 2-year pharmacovigilance. In addition to its core studies, secondary PERS analyses will examine moderators of drug effects. As PERS is a large-scale academic project involving a collaborative network of expert centres from different countries, it is expected that results will lead to strengthen the evidence base for the use of risperidone in CD and improve standards of care. Challenging issues faced by the PERS consortium are described to facilitate future developments in paediatric neuropsychopharmacology.
Collapse
|
24
|
Bentley MJ, Lin H, Fernandez TV, Lee M, Yrigollen CM, Pakstis AJ, Katsovich L, Olds DL, Grigorenko EL, Leckman JF. Gene variants associated with antisocial behaviour: a latent variable approach. J Child Psychol Psychiatry 2013; 54:1074-85. [PMID: 23822756 PMCID: PMC3766409 DOI: 10.1111/jcpp.12109] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/03/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of this study was to determine if a latent variable approach might be useful in identifying shared variance across genetic risk alleles that is associated with antisocial behaviour at age 15 years. METHODS Using a conventional latent variable approach, we derived an antisocial phenotype in 328 adolescents utilizing data from a 15-year follow-up of a randomized trial of a prenatal and infancy nurse-home visitation programme in Elmira, New York. We then investigated, via a novel latent variable approach, 450 informative genetic polymorphisms in 71 genes previously associated with antisocial behaviour, drug use, affiliative behaviours and stress response in 241 consenting individuals for whom DNA was available. Haplotype and Pathway analyses were also performed. RESULTS Eight single-nucleotide polymorphisms (SNPs) from eight genes contributed to the latent genetic variable that in turn accounted for 16.0% of the variance within the latent antisocial phenotype. The number of risk alleles was linearly related to the latent antisocial variable scores. Haplotypes that included the putative risk alleles for all eight genes were also associated with higher latent antisocial variable scores. In addition, 33 SNPs from 63 of the remaining genes were also significant when added to the final model. Many of these genes interact on a molecular level, forming molecular networks. The results support a role for genes related to dopamine, norepinephrine, serotonin, glutamate, opioid and cholinergic signalling as well as stress response pathways in mediating susceptibility to antisocial behaviour. CONCLUSIONS This preliminary study supports use of relevant behavioural indicators and latent variable approaches to study the potential 'co-action' of gene variants associated with antisocial behaviour. It also underscores the cumulative relevance of common genetic variants for understanding the aetiology of complex behaviour. If replicated in future studies, this approach may allow the identification of a 'shared' variance across genetic risk alleles associated with complex neuropsychiatric dimensional phenotypes using relatively small numbers of well-characterized research participants.
Collapse
Affiliation(s)
- Mary Jane Bentley
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut
| | - Haiqun Lin
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut,Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut
| | - Thomas V. Fernandez
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut
| | - Maria Lee
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut
| | - Carolyn M. Yrigollen
- Department of Biochemistry and Molecular Medicine, University of California, Davis
| | - Andrew J. Pakstis
- Department of Genetics, Yale University School of Medicine, New Haven, Connecticut
| | - Liliya Katsovich
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut
| | - David L. Olds
- Department of Pediatrics, School of Medicine, University of Colorado Denver, Colorado
| | - Elena L. Grigorenko
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut,Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut
| | - James F. Leckman
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut
| |
Collapse
|
25
|
Kurowski BG, Wade SL, Kirkwood MW, Brown TM, Stancin T, Taylor HG. Online problem-solving therapy for executive dysfunction after child traumatic brain injury. Pediatrics 2013; 132:e158-66. [PMID: 23753094 PMCID: PMC3691538 DOI: 10.1542/peds.2012-4040] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Executive dysfunction after traumatic brain injury (TBI) in children is common and leads to significant problems in functioning across multiple settings. The objective of this study was to evaluate the efficacy of a web-based counselor-assisted problem solving (CAPS) intervention compared with an Internet resource comparison (IRC) for treatment of executive dysfunction within 12 months after complicated mild to severe TBI in adolescents. We hypothesized that CAPS would significantly improve parent ratings of executive dysfunction compared with an IRC. METHODS Participants included 132 adolescents aged 12 to 17 years who sustained a complicated mild to severe TBI within 1 to 6 months before study enrollment. Study design was a multisite, assessor-blinded, randomized controlled trial. Study sites included 3 tertiary pediatric hospitals and 2 tertiary general medical centers. The main outcome measure was primary caregiver Behavioral Rating Inventory of Executive Function Global Executive Composite at baseline and 6-month follow-up. Generalized linear models that controlled for baseline scores were used to compare the CAPS and IRC scores. RESULTS In older teens, the CAPS group showed significant improvement in executive function behaviors at 6-month follow-up compared with the IRC group (F = 6.74, P = .01, Cohen's d = 0.63). CONCLUSIONS Findings indicate that web-based CAPS improves primary caregiver-rated executive functioning within the first 12 months after TBI in older adolescents. Future research needs to define the optimal timing after injury for delivery of CAPS and characteristics of individuals and families who are most likely to benefit from CAPS.
Collapse
Affiliation(s)
- Brad G. Kurowski
- Division of Physical Medicine and Rehabilitation, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Shari L. Wade
- Division of Physical Medicine and Rehabilitation, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Michael W. Kirkwood
- Department of Physical Medicine and Rehabilitation, Children’s Hospital Colorado and University of Colorado School of Medicine, Aurora, Colorado
| | - Tanya M. Brown
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Terry Stancin
- Division of Pediatric Psychology, Department of Pediatrics, MetroHealth Medical Center and Case Western Reserve University, Cleveland, Ohio; and
| | - H. Gerry Taylor
- Division of Developmental and Behavioral Pediatrics and Psychology, Department of Pediatrics, Case Western Reserve University and Rainbow Babies and Children’s Hospital, University Hospitals Case Medical Center, Cleveland, Ohio
| |
Collapse
|
26
|
Olfson M. Epidemiologic and clinical perspectives on antipsychotic treatment of children and adolescents. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2012; 57:715-6. [PMID: 23228228 DOI: 10.1177/070674371205701201] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Mark Olfson
- Professor of Clinical Psychiatry, Columbia University, Department of Psychiatry, New York State Psychiatric Institute, New York, New York
| |
Collapse
|
27
|
Bettencourt A, Farrell A, Liu W, Sullivan T. Stability and change in patterns of peer victimization and aggression during adolescence. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2012. [PMID: 23186101 DOI: 10.1080/15374416.2012.738455] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study identified classes of adolescents who differed in their patterns of reported aggression and victimization, examined the stability of these patterns, and explored factors associated with changes in patterns across time. Participants were 477 students from an urban and an adjoining county school system. The overall sample was 48% male and had an average age of 11.3 years. The urban sample was predominantly African American (80%); the county sample was primarily Caucasian (40%) and African American (38%). Self-report aggression and victimization measures completed at the beginning of sixth grade and the end of seventh grade were analyzed using latent class analyses and latent transition analyses. Support was found for four classes: nonvictimized aggressors, aggressive-victims, predominantly victimized, and well-adjusted youth. Emotion dysregulation, anxiety, and site were associated with membership in the aggressive-victim class in the expected direction, providing support for the validity of the classes. The well-adjusted class was the most stable in class membership over time; the predominantly victimized class was the least stable. In addition, nonvictimized aggressors and predominantly victimized youth were more likely than those in the well-adjusted class to transition into the aggressive-victim class. These findings suggest notable stability in aggressor/victim classes over time and emphasize the importance of developing prevention programs that target the unique needs of distinct aggressor/victim classes in adolescence.
Collapse
Affiliation(s)
- Amie Bettencourt
- Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205, USA.
| | | | | | | |
Collapse
|
28
|
Abstract
PURPOSE OF REVIEW The aim is to discuss the clinical features of psychiatric illness in 22q11.2 deletion syndrome (22q11DS), and to review current evidence that a core neuropsychiatric phenotype could underlie the full spectrum of different presentations. RECENT FINDINGS Individuals carrying the 22q11.2 microdeletion are at risk for diverse psychiatric diagnoses across the lifespan, including schizophrenia in a significant minority, and anxiety or mood disorder in the majority. Symptoms and cognitive disruptions can be grouped into domains: attention-executive deficits, social-cognitive deficits, anxiety-affective dysregulation, and psychotic phenomena. These domains do not respect the boundaries of traditional diagnostic categories, and can be consistently recognized in children, adolescents and adults. There is early evidence that some symptom-domain disruptions may predict adult psychiatric morbidity. SUMMARY If a core neuropsychiatric phenotype does exist in 22q11DS, its detection is likely to require dimensional assessment of subtle aspects of cognitive and emotional processing, not encompassed by current diagnostic systems. A core phenotype would account for disruptions across multiple symptom domains, directly reflecting genetic and neurobiological mechanisms. Relative severity of a core phenotype would predict risk for multiple psychiatric disorders, and could, therefore, be an important target for therapeutic and preventive interventions. A core phenotype meeting these criteria has not yet been defined for 22q11DS.
Collapse
|