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Bell KA, Gratch I, Ebo T, Cha CB. Examining Discrepant Reports of Adolescents' Self-Injurious Thoughts and Behaviors: A Focus on Racial and Ethnic Minority Families. Arch Suicide Res 2022; 26:1505-1519. [PMID: 34019780 DOI: 10.1080/13811118.2021.1925607] [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] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Adolescents and their parents do not always see eye to eye. This principle applies to multi-informant reports of adolescents' self-injurious thoughts and behaviors. Although prior work has revealed the presence of parent-adolescent discrepant reports, we have little insight into exactly who is most likely to display such discrepancies. To address this knowledge gap, the present investigation examines demographic correlates of parent-adolescent reports of adolescents' self-injurious thoughts and behaviors, with a focus on race and ethnicity. METHOD The sample included 45 dyads of adolescents (M = 15.79 years, SD = 1.42) and their parents reporting on adolescents' history of suicide ideation, suicide plan, suicide gesture, suicide attempt, and nonsuicidal self-injury (NSSI). RESULTS Greater discrepancies in reports of adolescents' suicide ideation and NSSI were observed among racial minority parent-adolescent dyads (Black, Asian, Multiracial, Other) relative to White dyads. Racial minority parents tended to report less suicide ideation and NSSI observed in their adolescents compared to adolescents' self-report. Moreover, Hispanic parents tended to report less NSSI relative to adolescents' self-report. Parent-adolescent discrepancies did not consistently correspond with other characteristics such as age and sexual orientation. CONCLUSION Racial minority parent-adolescent dyads, relative to White parent-adolescent dyads, are less likely to see eye to eye on adolescents' suicidal and nonsuicidal self-harming tendencies.
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Payen A, Chen MJ, Carter TG, Kilmer RP, Bennett JM. Childhood ADHD, Going Beyond the Brain: A Meta-Analysis on Peripheral Physiological Markers of the Heart and the Gut. Front Endocrinol (Lausanne) 2022; 13:738065. [PMID: 35299964 PMCID: PMC8921263 DOI: 10.3389/fendo.2022.738065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 01/17/2022] [Indexed: 12/03/2022] Open
Abstract
UNLABELLED Attention-Deficit/Hyperactivity Disorder (ADHD) is the most common neurodevelopmental disorder diagnosed in children. Questions regarding its increased diagnostic rates and pharmacological treatments in developing children have led to a more holistic review of the multi-system pathophysiology observed in ADHD. The dopaminergic neurotransmitter system, known for its influence on reward-motivated behaviors and motor control, and the frontostriatal systems, that mediate motor, cognition, and behavior, are associated with ADHD's development. However, studies have shown that these neural systems do not wholly account for ADHD's multilayered and heterogeneous symptom presentation. For instance, the literature suggests that emotional dysregulation, the inability to regulate one's emotional responses to provoking stimuli, is associated with increased risk for social impairment in ADHD. A broader examination of physiological systems in children with ADHD has found potential markers in the heart-brain and gut-brain axes that correspond with certain behaviors associated with emotional dysregulation in recent studies. Hence, the purpose of this meta-analysis is to aggregate ten applicable published case studies and analyze task-related heart rate reactivity (HRR; n = 5 studies) and gut microbiota (n = 5 studies) data in children with and without ADHD. Data from a total of 531 youth with ADHD and 603 youth without ADHD revealed significant small and medium effect sizes for higher Chao1 levels and Actinobacteria levels in the ADHD group, respectively, but no evidence of altered task-related HRR. Thus, further research into multi-system psychophysiological measures of emotional dysregulation and ADHD is warranted. The clinical, empirical, and educational implications of these findings are discussed. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/prospero/, identifier PROSPERO (CRD42021236819).
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Affiliation(s)
- Ameanté Payen
- Health Psychology PhD Program, University of North Carolina at Charlotte, Charlotte, NC, United States
| | - Michelle J. Chen
- Health Psychology PhD Program, University of North Carolina at Charlotte, Charlotte, NC, United States
| | - T. Grace Carter
- Health Psychology PhD Program, University of North Carolina at Charlotte, Charlotte, NC, United States
| | - Ryan P. Kilmer
- Health Psychology PhD Program, University of North Carolina at Charlotte, Charlotte, NC, United States
- Department of Psychological Science, University of North Carolina at Charlotte, Charlotte, NC, United States
| | - Jeanette M. Bennett
- Health Psychology PhD Program, University of North Carolina at Charlotte, Charlotte, NC, United States
- Department of Psychological Science, University of North Carolina at Charlotte, Charlotte, NC, United States
- *Correspondence: Jeanette M. Bennett,
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Zhang L, Bo A, Lu W. To Unfold the Immigrant Paradox: Maltreatment Risk and Mental Health of Racial-Ethnic Minority Children. Front Public Health 2021; 9:619164. [PMID: 33681132 PMCID: PMC7925415 DOI: 10.3389/fpubh.2021.619164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 01/25/2021] [Indexed: 11/18/2022] Open
Abstract
Children of immigrants are often considered to be at increased risk of mental health problems due to families' immigration-related stress and perceived discrimination and prejudice from the host country. However, many studies found them to have better developmental outcomes than children with native-born parents in the U.S. This study aims to unfold this paradoxical phenomenon using data from a population-based cohort of children born in large U.S. cities. Specifically, we investigated differences in mental health outcomes between children of immigrants and those with native-born parents, stratified by children's race-ethnicity. We also explored the mediating role of child maltreatment risk in the association of parental nativity status and race-ethnicity with children's mental health. Our findings supported the immigrant paradox, with better self-reported and parent-reported internalizing and externalizing outcomes in Hispanic and Black children of immigrants than their same race-ethnicity peers and White children of native-born. Such immigrant-native variations were partially explained by parents' physically and psychologically abusive behaviors. Hispanic and Black children with immigrant parents were less likely to be physically or psychologically abused than their peers of native-born at ages 4-5, which translated into mental health advantages of children of immigrants at age 9. Our findings shed light on future research to further clarify the mechanism underlying different parenting practices between same race-ethnicity immigrants and native-born families so that culturally responsive interventions can be developed to safeguard racial-ethnic minority children's mental health.
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Affiliation(s)
- Liwei Zhang
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Ai Bo
- Department of Social Work, Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - Wenhua Lu
- Department of Community Health and Social Medicine, School of Medicine, City University of New York, New York, NY, United States
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Zilcha-Mano S, Shimshoni Y, Silverman WK, Lebowitz ER. Parent-Child Agreement on Family Accommodation Differentially Predicts Outcomes of Child-Based and Parent-Based Child Anxiety Treatment. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2020; 50:427-439. [PMID: 32401557 DOI: 10.1080/15374416.2020.1756300] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Objectives: Family accommodation is linked to poor treatment outcomes for childhood anxiety. Progress in research on the role of accommodation in treatment has been hindered by the relatively weak association between child and parent reports on accommodation. In this study, we suggest that parent-child agreement on family accommodation may provide a dependable estimation of this construct, and investigated whether the level of parent-child agreement on family accommodation predicts subsequent treatment outcome. We further examined whether the effect was greater in Supportive Parenting for Anxious Childhood Emotions (SPACE), which directly targets family accommodation, than in individual child-focused cognitive behavioral therapy (CBT).Methods: Participants were 104 children (aged 6-15) with anxiety disorders, and their mothers, randomized to SPACE or CBT. Accommodation was rated by mothers and children before treatment, halfway through treatment, and at treatment end, using respective versions of Family Accommodation Scale-Anxiety. To accurately estimate agreement, we conducted multilevel response surface analysis by polynomial regression, with agreement on accommodation at each time point predicting subsequent child anxiety severity, over the course of treatment.Results: Parent-child agreement and disagreement on accommodation were significant predictors of subsequent anxiety symptom severity. Different results were obtained for SPACE and CBT, suggesting potentially distinct underlying mechanisms.Conclusions: The findings suggest treatment-specific roles of accommodation in SPACE vs. CBT. Multiple-informant assessment of accommodation provides important information, which may have important implications for optimal treatment personalization.
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Affiliation(s)
| | - Yaara Shimshoni
- Child Study Center, School of Medicine, Yale University, Child Study Center, School of Medicine
| | - Wendy K Silverman
- Child Study Center, School of Medicine, Yale University, Child Study Center, School of Medicine
| | - Eli R Lebowitz
- Child Study Center, School of Medicine, Yale University, Child Study Center, School of Medicine
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Liverpool S, Webber H, Matthews R, Wolpert M, Edbrooke-Childs J. A Mobile App to Support Parents Making Child Mental Health Decisions: Protocol for a Feasibility Cluster Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e14571. [PMID: 31414665 PMCID: PMC6712959 DOI: 10.2196/14571] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 06/12/2019] [Accepted: 06/28/2019] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Shared decision making (SDM) is recognized as a person-centered approach to improving health care quality and outcomes. Few digital interventions to improve SDM have been tested in child and adolescent mental health (CAMH) settings. One such intervention is Power Up, a mobile phone app for young people (YP), which has shown some evidence of promise that YP who received Power Up reported greater levels of SDM. However, even though parents play a critical role in CAMH care and treatment, they often feel excluded from services. OBJECTIVE This protocol is for a pilot trial to determine the feasibility of a large-scale randomized trial to develop and evaluate a Web app called Power Up for Parents (PUfP) to support parents and promote involvement in CAMH decisions. METHODS A 2-stage process, consisting of the development stage and pilot-testing stage of the initial PUfP prototype, will be conducted. At the development stage, a qualitative study with parents and clinicians will be conducted. The interviews will aim to capture the experience of making CAMH decisions, preferences for involvement in SDM, and determine situations within which PUfP can be useful. At the pilot-testing stage, up to 90 parents and their clinicians will be invited to participate in the testing of the prototype. Parents will be randomly allocated to receive the intervention or be part of the control group. This study design will allow us to assess the acceptability and usefulness of PUfP in addition to examining the feasibility of a prospective randomized trial. Clinicians' perceptions of the prototype and how it has influenced parents' involvement in SDM will also be examined. RESULTS Recruitment began in January 2019 and is scheduled to last for 10 months. Interviews and baseline data collection are currently in progress. To date, 11 CAMH sites have been recruited to take part in the study. It is anticipated that data collection will be completed by October 2019. CONCLUSIONS The lack of parents' involvement in CAMH care and treatment can lead to higher rates of dropout from care and lower adherence to therapeutic interventions. There are significant benefits to be gained globally if digital SDM interventions are adopted by parents and shown to be successful in CAMH settings. TRIAL REGISTRATION ISRCTN Registry ISRCTN39238984; http://www.isrctn.com/ISRCTN39238984. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/14571.
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Affiliation(s)
- Shaun Liverpool
- Faculty of Life Sciences, University College London, London, United Kingdom
| | | | | | - Miranda Wolpert
- Faculty of Life Sciences, University College London, London, United Kingdom
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Eckshtain D, Marchette LK, Schleider J, Evans S, Weisz JR. Parental Depressive Symptoms as a Predictor of Outcome in the Treatment of Child Internalizing and Externalizing Problems. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2019; 47:459-474. [PMID: 29808395 PMCID: PMC6261702 DOI: 10.1007/s10802-018-0446-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Child internalizing and externalizing problems have been identified as high priority intervention targets by the World Health Organization. Parental depression is a risk factor for development of these childhood problems and may negatively influence intervention outcomes; however, studies have rarely assessed its influence on these outcomes. The present study assessed whether baseline parental depressive symptoms predicted psychotherapy outcomes among children treated for clinically significant internalizing and externalizing problems. The sample included 142 children (79 with primary internalizing problems, 63 with primary externalizing problems). Children were aged 7-13, 67.6% boys, and race included Caucasian (46.5%), African-American (9.9%), Latino (5.6%), Asian (1.4%), and multi-racial (32.4%). Analyses focused on child- and parent-reported weekly trajectories of change and post-treatment symptoms among children treated for internalizing and externalizing problems whose parents did (N = 28 and 25) and did not (N = 51 and 38) have elevated depressive symptoms. For children with internalizing problems, growth curve analyses showed markedly different trajectories, by child- and parent-report: children with less depressed parents showed significantly steeper symptom declines than did children with more depressed parents, who showed an increase in symptoms. ANCOVAs showed marginally lower post-treatment symptoms for children of less depressed versus more depressed parents (p = 0.064 by child-report). For children with externalizing problems, growth curve analyses showed trajectories in the opposite direction, by child- and parent-report; however, ANCOVAs showed no group differences at post-treatment. These findings suggest that it may be important to consider the impact of parental depressive symptoms when treating child internalizing and externalizing problems.
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Affiliation(s)
- Dikla Eckshtain
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 185 Cambridge Street, Boston, MA, 02114, USA.
| | - Lauren Krumholz Marchette
- Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, 1493 Cambridge St, Cambridge, MA, 02139, USA
| | - Jessica Schleider
- Department of Psychology, Harvard University, 1032 William James Hall, 33 Kirkland Street, Cambridge, MA, 02138, USA
| | - Spencer Evans
- Department of Psychology, Harvard University, 1032 William James Hall, 33 Kirkland Street, Cambridge, MA, 02138, USA
| | - John R Weisz
- Department of Psychology, Harvard University, 1032 William James Hall, 33 Kirkland Street, Cambridge, MA, 02138, USA
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An Exploration of Parent-Youth Agreement on Functional Impairment in Adolescents Utilizing Outpatient Mental Health Services. Healthcare (Basel) 2018; 6:healthcare6030106. [PMID: 30200203 PMCID: PMC6164739 DOI: 10.3390/healthcare6030106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 08/15/2018] [Accepted: 08/28/2018] [Indexed: 11/16/2022] Open
Abstract
Parent-youth agreement on the youth’s functional impairment may have important implications for mental health service utilization, assessment, therapy goal development, and treatment engagement for adolescents. The present study examines parent-youth agreement on their perceptions of youth functional impairment in a predominantly racial/ethnic minority sample of adolescents utilizing outpatient mental health services. Parent and youth functional impairment ratings were compared, and agreement was estimated in multiple ways. On average, parents indicated higher levels of youth functional impairment compared to youth in their overall scores, and when differences existed between parents and youth at the functioning domain and item level. Although there was similarity in the proportion of parents and youth who reported total impairment above the clinical cut-off, actual agreement between parent-youth pairs was only slight. There appeared to be substantial variation in agreement levels when identifying problems in functional impairment at the domain and item levels, and some areas of strong consensus were identified. These findings highlight the need to consider parent-youth agreement in perceptions of functional impairment and the complexities that may underlie this agreement.
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8
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Frazier EA, Liu RT, Massing-Schaffer M, Hunt J, Wolff J, Spirito A. Adolescent but Not Parent Report of Irritability Is Related to Suicidal Ideation in Psychiatrically Hospitalized Adolescents. Arch Suicide Res 2016; 20:280-9. [PMID: 26192804 DOI: 10.1080/13811118.2015.1004497] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Identifying trans-diagnostic risk factors for suicidality may improve assessment and treatment. This study examined the degree to which clinician ratings of adolescent irritability, based on adolescent versus parent report, were associated with adolescent suicidal ideation beyond established risk factors (i.e., female gender, depressive, substance use, oppositional defiant, conduct, and post-traumatic stress disorders). METHODS Hierarchical linear regression was used to analyze 322 adolescent inpatients (40.4% male) and 197 parents. RESULTS Adolescent-rated irritability (p<0.001) and depression (p<0.001) were positively associated with adolescent suicidal ideation beyond all other factors. Parent-rated adolescent irritability was unrelated to adolescent suicidal ideation. CONCLUSION Results suggest irritability is an important factor in determining suicide risk, and adolescent report of irritability may be more important in gauging suicide risk than parent report.
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Varni JW, Thissen D, Stucky BD, Liu Y, Magnus B, He J, DeWitt EM, Irwin DE, Lai JS, Amtmann D, DeWalt DA. Item-level informant discrepancies between children and their parents on the PROMIS(®) pediatric scales. Qual Life Res 2015; 24:1921-37. [PMID: 25560776 PMCID: PMC5127650 DOI: 10.1007/s11136-014-0914-2] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The study objective was to describe the individual item-level discrepancies between children ages 8-17 years and their parents for the PROMIS(®) pediatric scales. Contextual effects on item-level informant discrepancies for the pediatric pain interference items were further analyzed conditional on whether the child, the parent, or anyone else in the household experienced chronic pain. METHODS Parallel pediatric self-report and parent proxy-report items were completed by approximately 300 parent-child dyads depending on form assignment and individual nonresponse. Agreement between parent and child responses to individual items was measured using the polychoric correlation coefficient and weighted κ. The Chi-square test of symmetry was utilized for a comparison of the pattern of parent-child item discrepancies on the response scales, and the differences between the child and parent responses on the 1-5 item response scale are summarized . RESULTS A continuum of higher item-level parent-child discrepancies was demonstrated starting with peer relationships, anger, anxiety, and depressive symptoms, followed by progressively lower parent-child discrepancies for energy, fatigue, asthma impact, pain interference, upper extremity, and mobility items. Parent-child discrepancies for pain interference items were lower in the context of chronic pain either in the child or in the parent. CONCLUSIONS Parent-child item-level discrepancies were lower for more objective or visible items than for items measuring internal states or less observable items measuring latent variables such as peer relationships and fatigue. Future research should focus on the child and parent characteristics that influence domain-specific item-level discrepancies, and under what conditions item-level parent-child discrepancies predict child health outcomes.
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Affiliation(s)
- James W Varni
- Department of Pediatrics, College of Medicine, Texas A&M University, College Station, TX, USA,
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Buskirk-Cohen AA. Effectiveness of a Creative Arts Summer Camp: Benefits of a Short-Term, Intensive Program on Children’s Social Behaviors and Relationships. JOURNAL OF CREATIVITY IN MENTAL HEALTH 2015. [DOI: 10.1080/15401383.2014.946637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Treatment expectations among adolescents with chronic musculoskeletal pain and their parents before an initial pain clinic evaluation. Clin J Pain 2014; 30:17-26. [PMID: 23446075 DOI: 10.1097/ajp.0b013e3182851735] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To understand expectations regarding treatment recommendations among treatment-seeking adolescents with chronic musculoskeletal pain and their parents. METHODS A total of 102 adolescent-parent dyads were recruited at the time of initial contact with a multidisciplinary pain management clinic. Each participant completed reports of adolescent pain intensity and disability, biopsychosocial perspective of pain, and treatment expectations related to recommendations and feedback for a vignette description of an adolescent presenting at an initial multidisciplinary pain clinic evaluation. RESULTS Descriptive findings for individual treatment expectations and adolescent-parent dyad agreement statistics were examined. Slight to fair levels of agreement occurred for 50% of the expectations assessed. The strongest shared expectations were for recommendations to return to school, pursue psychological counseling, and pursue PT/OT treatment. Stronger agreement occurred for items reflecting alternative, emotional, behavioral, and activity recommendations with weaker agreement for medical interventions (eg, medication and surgery). Correlations emerged between individual expectations and adolescent pain intensity, disability, with the greatest number of significant relationships found for adolescent and parent expectations and biopsychosocial perspectives of pain. DISCUSSION Our results document that adolescents and parents show modest levels of agreement on expectations for treatment at the time of an initial pain clinic evaluation. This may relate to expectations being internal perspectives not clearly expressed within families; thus, the initial treatment consultation may provide an important opportunity to create and align appropriate expectations. Implications of our findings are considered with respect to education, treatment, and future research to understand factors that contribute to treatment adherence and outcomes.
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Hart SL, Hodgkinson SC, Belcher HME, Hyman C, Cooley-Strickland M. Somatic symptoms, peer and school stress, and family and community violence exposure among urban elementary school children. J Behav Med 2013; 36:454-65. [PMID: 22772584 PMCID: PMC3726557 DOI: 10.1007/s10865-012-9440-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2011] [Accepted: 06/15/2012] [Indexed: 10/28/2022]
Abstract
Somatic symptoms are a common physical response to stress and illness in childhood. This study assessed 409, primarily African American (85.6 %), urban elementary school children to examine the association between: (1) somatic symptoms and potential external stressors (school and peer stress, family conflict, and community violence) and (2) parent and child agreement on children's self-report of somatic symptoms. The odds of self-report of somatic complaints were significantly associated with family conflict, school and peer stress, and community violence exposure (OR = 1.26, 95 % CI: 1.05-1.50; OR = 1.18, 95 % CI 1.08-1.28; and OR = 1.02, 95 % CI: 1.00-1.05, respectively). Identifying the associations between social, family, and community based stress and somatic symptoms may improve the quality of life for children living in urban environments through early identification and treatment.
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Affiliation(s)
- Shayla L. Hart
- Department of Psychology, Howard University, Washington, DC, USA
| | | | - Harolyn M. E. Belcher
- Family Center at Kennedy Krieger Institute, 707 North Broadway, Baltimore, MD 21205, USA. Johns Hopkins University School of Medicine, Baltimore, MD, USA. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Corine Hyman
- Family Center at Kennedy Krieger Institute, 707 North Broadway, Baltimore, MD 21205, USA
| | - Michele Cooley-Strickland
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. University of California, Los Angeles, Los Angeles, CA, USA
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Karpenko V, Owens JS. Adolescent psychotherapy outcomes in community mental health: how do symptoms align with target complaints and perceived change? Community Ment Health J 2013; 49:540-52. [PMID: 22752551 DOI: 10.1007/s10597-012-9515-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2011] [Accepted: 06/21/2012] [Indexed: 10/28/2022]
Abstract
This study examined the relationship between clinically significant symptom change (rated by youth and parents), severity of client-defined primary presenting problems (i.e., Target Complaints), and perceived change in therapy. Participants were 117 adolescents receiving outpatient therapy and their parents. Participants completed the following measures at intake and 3 months into treatment: Ohio Scales, Target Complaints, and Perceived Change. Results indicate significant correspondence between clinically significant symptom change and other outcomes, offering preliminary evidence that global symptom measures represent change that is meaningful to adolescent clients. However, the modest magnitude of the correspondence also suggests that such measures as perceived change and individualized Target Complaints may offer unique utility in capturing the multidimensional nature of outcomes in youth therapy and provide useful avenues for future research focused on enhancing client engagement and retention. Recommendations for outcome assessment in community mental health centers are provided.
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Bridges JFP, Searle SC, Selck FW, Martinson NA. Designing family-centered male circumcision services: a conjoint analysis approach. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2012; 5:101-11. [PMID: 22510052 DOI: 10.2165/11592970-000000000-00000] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Male circumcision (MC) has become an important weapon in the fight against HIV/AIDS in many Sub-Saharan African countries. The successful implementation of a national MC program requires the design of circumcision services that are attractive to young men of various ages. For many potential clients, mothers and/or fathers will play an important role in the decision to be circumcised, and hence services will need to be designed with the preferences of mothers, fathers, and sons in mind. OBJECTIVE Our objective was to value multiple design characteristics of potential community-based MC services from the perspectives of mothers, fathers, and sons in Johannesburg, South Africa, and to test for concordance between their values for the design characteristics. METHODS Potential design characteristics of MC services were identified through open-ended interviews with key informants (n = 25). Preferences were estimated using conjoint analysis implemented as part of a cluster randomized household survey. Each participant was randomized to receive one of two possible blocks of conjoint analysis, each consisting of six forced-choice tasks comparing two possible MC services varying on 11 design characteristics. With only two levels for each attribute, our experimental design utilized a main effects orthogonal array. Data were analyzed using linear probability models, with tests of concordance of values using Wald tests generated from stratified estimates calculated using restricted least square estimation. RESULTS A racially and geographically diverse sample consisting of 204 fathers, 204 mothers, and 237 sons completed the survey. In aggregate, requiring a follow-up visit was the most valued design factor (p < 0.001), followed by having a lower infection rate (p < 0.001), having less pain (p = 0.001), and a private waiting room (p = 0.001). Based on stratified analysis, sons also valued having the risks and benefits of MC explained (p = 0.01) and mothers valued requiring an HIV test as part of the procedure. Requiring an HIV test was the most significant difference between the respondents (p = 0.03), with sons finding it somewhat repulsive (p = 0.30). CONCLUSION Our findings suggest that valuation of aspects of MC clinic design can diverge by decision maker. To better ensure utilization of services, these variations should be taken into account to prior to implementation of a national strategy in South Africa.
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Affiliation(s)
- John F P Bridges
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Hudson JL, Rapee RM. Parental Perceptions of Overprotection: Specific to Anxious Children or Shared Between Siblings? BEHAVIOUR CHANGE 2012. [DOI: 10.1375/bech.2005.22.3.185] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractParents of children with anxiety disorders (n = 45) and parents of nonclinical children (n = 33) were interviewed regarding the rearing of two children in their family. The purpose of the study was to determine whether overprotective parenting, according to parent report, occurs specifically in the context of relationships with the anxiety-disordered child or whether parents also perceive themselves to be overprotective of the anxious child's sibling. Self-reports of overprotection by parents of anxious children were also compared to self-reports of overprotection by parents of nonclinical children. Mothers in the clinical group were more likely to report that they were more protective of the anxious child than they were to report being either more protective of the sibling or equally protective of both children. Both mothers and fathers in the clinical group were no more likely than nonclinical parents to perceive themselves as being more protective overall than other parents.
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De Los Reyes A, Alfano CA, Beidel DC. Are clinicians' assessments of improvements in children's functioning "global"? JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2011; 40:281-94. [PMID: 21391024 DOI: 10.1080/15374416.2011.546043] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In this study, the authors examined the relations among clinician ratings of treatment improvement and discrepancies between parent and blinded laboratory rater reports of child social functioning administered before and after treatment for social anxiety disorder. Participants included a clinic sample of 101 children (7-16 years old; M = 11.67, SD = 2.57; 51 girls, 81% Caucasian) receiving treatment as part of a two-site controlled trial. Overall, clinician ratings reflected lack of improvement when parents reported persistent (i.e., pre- to posttreament) social functioning deficits not reported by blinded raters. However, when blinded raters reported persistent social skill deficits not reported by parents, we did not observe the same effect on clinician ratings as we did when the direction of discrepant reports was reversed. We replicated these observations in a subset of participants (n = 81) providing parent and child pre-post reports of social anxiety symptoms. These findings have implications for the interpretations of clinical ratings as "primary outcome measures" within controlled trials.
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Affiliation(s)
- Andres De Los Reyes
- Department of Psychology, University of Maryland at College Park, Biology/Psychology Building, Room 3123H, College Park, MD 20742, USA.
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17
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De Los Reyes A, Youngstrom EA, Pabón SC, Youngstrom JK, Feeny NC, Findling RL. Internal consistency and associated characteristics of informant discrepancies in clinic referred youths age 11 to 17 years. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2011; 40:36-53. [PMID: 21229442 PMCID: PMC3078639 DOI: 10.1080/15374416.2011.533402] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In this study, we examined the internal consistency of informant discrepancies in reports of youth behavior and emotional problems and their unique relations with youth, caregiver, and family characteristics. In a heterogeneous multisite clinic sample of 420 youths (ages 11-17 years), high internal consistency estimates were observed across measures of informant discrepancies. Further, latent profile analyses identified systematic patterns of discrepancies, characterized by their magnitude and direction (i.e., which informant reported greater youth problems). In addition, informant discrepancies systematically and uniquely related to informants' own perspectives of youth mood problems, and these relations remained significant after taking into account multiple informants' reports of informant characteristics widely known to relate to informant discrepancies. These findings call into question the prevailing view of informant discrepancies as indicative of unreliability and/or bias on the part of informants' reports of youths' behavior.
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Affiliation(s)
- Andres De Los Reyes
- Department of Psychology, University of Maryland at College Park, College Park, MD 20742, USA.
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18
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Kendall PC, Drabick DAG. Problems for the Book of Problems? Diagnosing Mental Health Disorders Among Youth. ACTA ACUST UNITED AC 2010; 17:265-271. [PMID: 24058273 DOI: 10.1111/j.1468-2850.2010.01218.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
As an introduction to the Special Issue that includes a series of articles on comorbid mental health conditions among youth, some issues pertinent to the diagnostic system are considered. The discussion of illustrative issues that affect the diagnoses of mental health problems among youth includes reminders to consider the source, the time frame, what's normal, the situation, the data, and the effect of changing diagnostic criteria. We support the DSM and ICD efforts to continue to develop as instruments by relying on the data.
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Baker-Ericzén MJ, Jenkins MM, Brookman-Frazee L. Clinician and Parent Perspectives on Parent and Family Contextual Factors that Impact Community Mental Health Services for Children with Behavior Problems. CHILD & YOUTH CARE FORUM 2010; 39:397-419. [PMID: 21170419 PMCID: PMC2995316 DOI: 10.1007/s10566-010-9111-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The present study employed qualitative methods to examine multiple stakeholder perspectives regarding the role of parent and family contextual factors on community child mental health treatment for children with behavior problems. Findings suggest agreement between clinicians and parents on the number, types and importance of parent and family factors in children's mental health services; however, stakeholders differed in reports of which factors were most salient. Specifically, clinicians endorsed most factors as being equally salient, while parents described a few salient factors, with parental stress and inadequate social support being the most frequently discussed. These qualitative data further elucidate the context of community services and have implications for evidence-based practice implementation and improving community care.
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Affiliation(s)
- Mary J. Baker-Ericzén
- Child and Adolescent Services Research Center (CASRC), Rady Children’s Hospital, San Diego, 3020 Children’s Way MC 5033, San Diego, CA 92123 USA
- School of Leadership and Educational Sciences, University of San Diego, San Diego, CA 92123 USA
| | - Melissa M. Jenkins
- Department of Psychology, University of North Carolina, Chapel Hill, NC 27599 USA
| | - Lauren Brookman-Frazee
- Child and Adolescent Services Research Center (CASRC), Rady Children’s Hospital, San Diego, 3020 Children’s Way MC 5033, San Diego, CA 92123 USA
- Department of Psychiatry, University of California, San Diego, CA 92123 USA
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Thoma RJ, Hill DE, Tonigan JS, Kuny AV, Vermont LN, Lewine JD. Adolescent Self-reported Alcohol/other Drug Use Consequences: Moderators of Self and Parent Agreement. ALCOHOLISM TREATMENT QUARTERLY 2010; 28:101-110. [PMID: 21698067 DOI: 10.1080/07347321003648315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
While the reliability of assessment instruments designed for use with adults is well established, much less is known about the adequacy of these instruments for adolescent substance abusers. As part of a comprehensive intake evaluation, the Inventory of Drug Use Consequences (InDUC) was administered both to forty adolescents assigned to a probationary substance abuse treatment program and to one of their parents. The correlation was statistically significant between Parent and Adolescent InDUC score(s), but the interrater reliability was relatively low. IQ scores and level of substance use were considered as moderator variables, but neither showed a significant effect. History of head injury, however, significantly moderated this relationship; those adolescents reporting no history of head injury showed little correspondence with Parent InDUC Score(s), whereas those adolescents with a history of head injury showed significant correlations with parent InDUC scores. This suggests that a history of head injury may affect the way in which adolescents perceive substance-related consequences.
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Affiliation(s)
- Robert J Thoma
- University of New Mexico, Department of Psychiatry, Albuquerque, NM
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