Identifying an efficient set of items sensitive to clinical-range externalizing problems in children

A Smartphone App for Parental Management of Adolescent Conduct Problems: Randomized Clinical Trial of iKinnect

OBJECTIVE

This study evaluates iKinnect, a linked caregiver-teen mobile app system designed to address serious adolescent conduct problems through a focus on key targets of evidence-based treatments for juvenile offending, such as parent expectation setting, monitoring, consistency, and positive reinforcement. Additional gamification and autonomy-supporting features are designed to maximize youth engagement. Digital therapeutics such as mobile apps have great potential to expand access to effective interventions, particularly for youth who engage in serious conduct problems and substance abuse, since most never receive an evidence-based treatment and few apps exist for these concerns.

METHODS

This randomized clinical trial used a short-term (12 week) longitudinal design with four time points. Recruited was a U.S. national sample of teens (n = 72, age 13-17, 59.7% male, 68.1% White) receiving services for a serious conduct problem and their primary caregiver. The efficacy of iKinnect, used by parent and teen dyads, was measured against an active control condition, Life360, an app that provided mutual GPS-based location tracking to dyads.

RESULTS

Across 12 weeks of app use, youth who used iKinnect showed significantly greater reductions in alcohol use, marijuana use, school delinquency, status offenses, and general delinquency than did controls. Parents who used iKinnect Reported greater improvements in structure/rule clarity and discipline consistency relative to control parents. Teen and parent iKinnect app use and acceptability ratings were high.

CONCLUSIONS

Real-world use of iKinnect in future applications can, like other emerging digital health technologies, help to expand the reach of evidence-based interventions to children, youth, and families.Registered at clinicaltrials.gov (NCT03065517).

The Quality of Mother-Child Feeding Interactions Predicts Psychopathological Symptoms in Offspring and Mothers Seven Years Later: A Longitudinal Study on the General Population

The increased risk of internalizing and externalizing symptoms in children has been observed in the presence of maternal psychopathology. This study aimed to investigate a potential pathway involving the quality of early interactions between mothers and their children. A sample of 150 mother-child dyads underwent assessment when the children were 3 years old and around the age of 10. Video recordings of feeding exchanges between mothers and children were analyzed to evaluate the quality of mother-child interactions. Maternal psychopathology and child internalizing and externalizing symptoms were measured through self-report and report-form measures completed by mothers. The quality of mother-child feeding interactions at three years of age significantly differentiated (p < 0.001), eight years later, between mothers at high and low psychopathological risk and between children exhibiting clinical and subclinical internalizing symptoms. Clinically relevant child symptoms were notably more prevalent when the mother-child interaction quality at three years of age was maladaptive, particularly in the context of concurrent high maternal psychopathological risk. The study findings underscore the importance of focusing on the early quality of mother-child feeding interactions to identify potential situations of maternal and child clinical risk for the development of psychopathological symptoms and to guide preemptive measures and policies.

Creating a developmental scale to chart the development of psychopathology with different informants and measures across time

Research Domain Criteria (RDoC) aims to advance a dimensional, multilevel understanding of psychopathology across the life span. Two key challenges exist in applying a developmental perspective to RDoC: First, the most accurate informants for assessing a person's psychopathology often differ across development (e.g., parents and teachers may be better informants of a person's externalizing problems in early childhood, whereas peer- and self-report may also be important to assess in adolescence). Second, many constructs change in their behavioral manifestation across development (i.e., heterotypic continuity). Thus, different informants and measures across time may be necessary to account for the construct's changing manifestation. The challenge of using different informants and measures of a construct across time is ensuring that the same construct is assessed in a comparable way across development. Vertical scaling creates a developmental scale to link scores from changing informants and measures to account for heterotypic continuity and study people's development of psychopathology across the life span. This is the first study that created a developmental scale to assess people's development by putting different informants and measures on the same scale. We examined the development of externalizing problems from ages 2 to 15 years (N = 1,364) using annual ratings by mothers, fathers, teachers, other caregivers, and self-report. The developmental scale linked different informants and measures on the same scale. This allowed us to chart people's growth trajectories and to identify multilevel risk factors, including poor verbal comprehension. Creating a developmental scale may be crucial to advance RDoC's goal of studying the development of psychopathology across the life span. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Creating a Developmental Scale to Account for Heterotypic Continuity in Development: A Simulation Study

Many psychological constructs show heterotypic continuity-their behavioral manifestations change with development but their meaning remains the same. However, research has paid little attention to how to account for heterotypic continuity. A promising approach to account for heterotypic continuity is creating a developmental scale using vertical scaling. A simulation was conducted to compare creating a developmental scale using vertical scaling to traditional approaches of longitudinal assessment. Traditional approaches that failed to account for heterotypic continuity resulted in less accurate growth estimates, at the person- and group level. Findings suggest that ignoring heterotypic continuity may result in faulty developmental inferences. Creating a developmental scale with vertical scaling is recommended to link different measures across time and account for heterotypic continuity.

Studying a Moving Target in Development: The Challenge and Opportunity of Heterotypic Continuity

Many psychological constructs show heterotypic continuity-their behavioral manifestations change with development but their meaning remains the same (e.g., externalizing problems). However, research has paid little attention to how to account for heterotypic continuity. Conceptual and methodological challenges of heterotypic continuity may prevent researchers from examining lengthy developmental spans. Developmental theory requires that measurement accommodate changes in manifestation of constructs. Simulation and empirical work demonstrate that failure to account for heterotypic continuity when collecting or analyzing longitudinal data results in faulty developmental inferences. Accounting for heterotypic continuity may require using different measures across time with approaches that link measures on a comparable scale. Creating a developmental scale (i.e., developmental scaling) is recommended to link measures across time and account for heterotypic continuity, which is crucial in understanding development across the lifespan. The current synthesized review defines heterotypic continuity, describes how to identify it, and presents solutions to account for it. We note challenges of addressing heterotypic continuity, and propose steps in leveraging opportunities it creates to advance empirical study of development.

Practical consequences of model misfit when using rating scales to assess the severity of attention problems in children

OBJECTIVES

In this study, we examined the consequences of ignoring violations of assumptions underlying the use of sum scores in assessing attention problems (AP) and if psychometrically more refined models improve predictions of relevant outcomes in adulthood.

METHODS

Tracking Adolescents' Individual Lives data were used. AP symptom properties were examined using the AP scale of the Child Behavior Checklist at age 11. Consequences of model violations were evaluated in relation to psychopathology, educational attainment, financial status, and ability to form relationships in adulthood.

RESULTS

Results showed that symptoms differed with respect to information and difficulty. Moreover, evidence of multidimensionality was found, with two groups of items measuring sluggish cognitive tempo and attention deficit hyperactivity disorder symptoms. Item response theory analyses indicated that a bifactor model fitted these data better than other competing models. In terms of accuracy of predicting functional outcomes, sum scores were robust against violations of assumptions in some situations. Nevertheless, AP scores derived from the bifactor model showed some superiority over sum scores.

CONCLUSION

These findings show that more accurate predictions of later-life difficulties can be made if one uses a more suitable psychometric model to assess AP severity in children. This has important implications for research and clinical practice.

Testing a Higher Order Model of Internalizing and Externalizing Behavior: The Role of Aggression Subtypes

This study assessed how the forms and functions of aggression fit into a higher order model of internalizing and externalizing behavior, for children in early childhood (N = 332, M age = 47.11 months, SD = 7.32). The lower order internalizing factors were depressed affect, anxious-fearfulness, and asocial behavior (i.e., social withdrawal) and the lower order externalizing factors were deception and hyperactivity. The forms and functions of aggression were crossed to create four factors: reactive relational, reactive physical, proactive relational, and proactive physical aggression. Seven confirmatory factor models were tested. Results supported a two-factor externalizing model where reactive and proactive relational aggression and deception loaded on one externalizing factor and reactive and proactive physical aggression and hyperactivity loaded on another externalizing factor.