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Liu RT, Bettis AH, Lawrence HR, Walsh RFL, Sheehan AE, Pollak OH, Stephenson AR, Kautz MM, Marlowe RM. Measures of Suicidal Thoughts and Behaviors in Children and Adolescents: A Systematic Review and Recommendations for Use in Clinical and Research Settings. Assessment 2024:10731911241249438. [PMID: 38742801 DOI: 10.1177/10731911241249438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Empirically supported measures of suicidal thoughts and behaviors (STBs) are needed to serve as reference outcomes for suicide risk screening tools and to monitor severity and treatment progress in children and adolescents with STBs. The present paper systematically reviewed existing measures of STBs in youth and studies evaluating their psychometric properties and clinical utility. Measures were then evaluated on reliability, validity, and clinical utility. Sixteen articles (20 independent samples) were found with psychometric data with youth samples for eight measures. Interview-based measures were found to have the strongest psychometric support and clinical utility. Significant limitations exist for all self-report measures due to inherent characteristics of these measures that cannot be remedied through additional psychometric study. There is an urgent need for the development and validation of new self-report measures of STBs, particularly for preadolescent children, sexual and gender minority youth, and racial/ethnic minority youth.
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Affiliation(s)
- Richard T Liu
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
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Stefana A, Jolić Marjanović Z, Dimitrijević A. The Brief Version of the Mentalization Scale (MentS-12): Evidence-Based Assessment of Mentalizing Capacity. J Pers Assess 2024:1-10. [PMID: 38591956 DOI: 10.1080/00223891.2024.2326884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 02/20/2024] [Indexed: 04/10/2024]
Abstract
Recognizing the need for a concise self-report measure of mentalizing capacity, we developed a 12-item iteration of the well-established Mentalization Scale (MentS). Using college student and community samples of Serbian adults (N = 566), we performed a precise selection of items and then examined the psychometric attributes of the shortened scale (MentS-12). The new scale maintains the original three-dimensional structure: self-related mentalization, other-related mentalization, and motivation to mentalize. MentS-12 proves to be both reliable and structurally consistent. To improve its utility in therapeutic contexts, we determined clinical change thresholds for both the complete and abbreviated forms. We hope that its feasibility stimulates the integration of the MentS-12 in longitudinal research projects and real-world clinical settings.
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Affiliation(s)
- Alberto Stefana
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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Evans SC, Karlovich AR, Khurana S, Edelman A, Buza B, Riddle W, López-Sosa D. Evidence Base Update on the Assessment of Irritability, Anger, and Aggression in Youth. 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; 53:277-308. [PMID: 38275270 PMCID: PMC11042996 DOI: 10.1080/15374416.2023.2292041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
OBJECTIVE Irritability, anger, and aggression have garnered significant attention from youth mental health researchers and clinicians; however, fundamental challenges of conceptualization and measurement persist. This article reviews the evidence base for assessing these transdiagnostic constructs in children and adolescents. METHOD We conducted a preregistered systematic review of the evidence behind instruments used to measure irritability, anger, aggression, and related problems in youth. Searches were conducted in PsycINFO and PubMed, identifying 4,664 unique articles. Eligibility criteria focused on self- and proxy-report measures with peer-reviewed psychometric evidence from studies in English with youths ages 3-18. Additional measures were found through ancillary search strategies (e.g. book chapters, review articles, test publishers). Measures were screened and coded by multiple raters with acceptable reliability. RESULTS Overall, 68 instruments met criteria for inclusion, with scales covering irritability (n = 15), anger (n = 19), aggression (n = 45), and/or general overt externalizing problems (n = 27). Regarding overall psychometric support, 6 measures (8.8%) were classified as Excellent, 46 (67.6%) were Good, and 16 (23.5%) were Adequate. Descriptive information (e.g. informants, scales, availability, translations) and psychometric properties (e.g. reliability, validity, norms) are summarized. CONCLUSIONS Numerous instruments for youth irritability, anger, and aggression exist with varying degrees of empirical support for specific applications. Although some measures were especially strong, none had uniformly excellent properties across all dimensions, signaling the need for further research in particular areas. Findings promote conceptual clarity while also producing a well-characterized toolkit for researchers and clinicians addressing transdiagnostic problems affecting youth.
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Affiliation(s)
- Spencer C. Evans
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | | | - Sakshi Khurana
- Department of Psychology, University of Miami, Coral Gables, FL, USA
- Department of Psychology, Harvard University, Cambridge, MA, USA
- College of Education, DePaul University, Chicago, IL, USA
| | - Audrey Edelman
- Department of Psychology, University of Miami, Coral Gables, FL, USA
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Bianca Buza
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - William Riddle
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Denise López-Sosa
- Department of Psychology, University of Miami, Coral Gables, FL, USA
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Lindström T, Bergman TH, Annerstedt M, Forster M, Bölte S, Hirvikoski T. Psychometric Properties of the Parental Stress Scale in Swedish Parents of Children with and without Neurodevelopmental Conditions. Scand J Child Adolesc Psychiatr Psychol 2024; 12:10-22. [PMID: 38645569 PMCID: PMC11027036 DOI: 10.2478/sjcapp-2024-0002] [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] [Indexed: 04/23/2024] Open
Abstract
Background Parents of children with neurodevelopmental conditions (NDC) are at risk of experiencing elevated levels of parental stress. Access to robust instruments to assess parental stress is important in both clinical and research contexts. Objective: We aimed to evaluate the psychometric properties of a Swedish version of the Parental Stress Scale (PSS), completed by parents of 3- to 17-year-old children, with and without NDCs. Method Main analyses were conducted on data from three independent samples: a community sample (n=1018), a treatment-seeking sample of parents of children with various disabilities (n=653), and a sample of parents of children with Attention-Deficit/Hyperactivity Disorder (ADHD) who themselves reported varying ADHD symptom severities (n=562). Additional analyses were enabled by the use of data from a complementary test-retest sample (n=337). Results The internal consistency of the PSS was good (Cronbach's alpha, α=.87) and its test-retest reliability moderate (ICC=.66). The scale correlated in the expected direction with related constructs (r=.50-.56 in the community sample). An exploratory factor analysis found its internal structure to reflect two aspects of parental stress: Lack of Parental Rewards and Role Satisfaction (factor 1, α=.90) and Parental Stressors and Distress (factor 2, α=.85). The treatment-seeking parents of children with disabilities reported higher parental stress than community reference parents (p<.001; Cohen's d=1.17). Moreover, we found that parents with high ADHD symptom severity reported higher parental stress than parents with low ADHD symptom severity (p<.001; d=0.39). Conclusion In summary, we found evidence in support of the reliability and validity of the PSS, which overall was judged to be useful as a measure of parental stress in a Swedish context. In addition, our results underline the importance of considering parental stress and related needs in assessments and intervention planning involving families of children with NDCs.
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Affiliation(s)
- Therese Lindström
- Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Center for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Tiina Holmberg Bergman
- Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Center for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Mathilde Annerstedt
- Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Center for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Martin Forster
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
| | - Sven Bölte
- Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Center for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Tatja Hirvikoski
- Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Center for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
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Widiger TA, Hines A, Crego C. Evidence-Based Assessment of Personality Disorder. Assessment 2024; 31:191-198. [PMID: 37231676 DOI: 10.1177/10731911231176461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The purpose of this article is to provide a description and discussion of the evidence-based assessment of personality disorder. Considered herein is the assessment of the Section II personality disorders included within the fifth edition of the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.; DSM-5-TR), within Section III of DSM-5-TR, and within the 11th edition of the World Health Organization's International Classification of Diseases (WHO). The recommendation for an evidence-based assessment is for a multimethod approach: first administer a self-report inventory to alert the clinician to maladaptive personality functioning that might not have otherwise been anticipated, followed by a semi-structured interview to verify the personality disorder's presence. The validity of this multimethod strategy can be improved further by considering the impact of other disorders on the assessment, documenting temporal stability, and establishing a compelling, empirical basis for cutoff points.
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Abstract
Anxiety disorders (ADs) frequently lead to significant impairment across important domains of youth functioning. Yet until recently, clinical research and assessment have largely neglected the measurement of anxiety-related impairment. In this article, we review the evidence for five extant rating scales of youth anxiety-related impairment, guided by widely used evaluative criteria. Emerging psychometric data show the potential utility of these rating scales for achieving different assessment functions. Of the five scales, the Child Anxiety Impact Scale, particularly the parent-report version, has been the most researched one. Promising psychometric data support its use for assessing anxiety-related impairment in school, social, and family/home domains of functioning. We conclude with recommendations for growing this research base and for incorporating these rating scales into the youth AD clinical and research assessment process.
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Affiliation(s)
- Rebecca G Etkin
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - Eli R Lebowitz
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - Wendy K Silverman
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA
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Zimmermann R, Konjufca J, Sakejo P, Kilonzo M, Quevedo Y, Blum K, Biba E, Mosha T, Cottin M, Hernández C, Kaaya S, Arenliu A, Behn A. Mental Health Information Reporting Assistant (MHIRA)-an open-source software facilitating evidence-based assessment for clinical services. BMC Psychiatry 2023; 23:706. [PMID: 37784115 PMCID: PMC10544613 DOI: 10.1186/s12888-023-05201-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 09/18/2023] [Indexed: 10/04/2023] Open
Abstract
Evidence-based assessment (EBA) in mental health is a critical aspect of improving patient outcomes and addressing the gaps in mental health care. EBA involves the use of psychometric instruments to gather data that can inform clinical decision-making, inform policymakers, and serve as a basis for research and quality management. Despite its potential, EBA is often hindered by barriers such as workload and cost, leading to its underutilization. Regarding low- and middle-income countries (LMIC), the implementation of EBA is recognized as a key strategy to address and close the prevalent mental health treatment gap.To simplify the application of EBA including in LMIC, an international team of researchers and practitioners from Tanzania, Kosovo, Chile, and Switzerland developed the Mental Health Information Reporting Assistant (MHIRA). MHIRA is an open-source electronic health record that streamlines EBA by digitising psychometric instruments and organising patient data in a user-friendly manner. It provides immediate and convenient reports to inform clinical decision-making.The current article provides a comprehensive overview of the features and technical details of MHIRA, as well as insights from four implementation scenarios. The experience gained during the implementations as well as the user-feedback suggests that MHIRA has the potential to be successfully implemented in a variety of clinical contexts and simplify the use of EBA. However, further research is necessary to establish its potential to sustainably transform healthcare services and impact patient outcomes.In conclusion, MHIRA represents an important step in promoting the widespread adoption of EBA in mental health. It offers a promising solution to the barriers that have limited the use of EBA in the past and holds the potential to improve patient outcomes and support the ongoing efforts to address gaps in mental health care.
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Affiliation(s)
- Ronan Zimmermann
- Psychiatric University Hospitals of Basel, Basel, Switzerland.
- Faculty of Psychology, University of Basel, Basel, Switzerland.
| | - Jon Konjufca
- Faculty of Psychology, University of Basel, Basel, Switzerland
- University of Prishtina "Hasan Prishtina", Pristina, Kosovo
| | - Peter Sakejo
- Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | - Mrema Kilonzo
- Faculty of Psychology, University of Basel, Basel, Switzerland
- Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | - Yamil Quevedo
- Millennium Institute for Depression and Personality Research (MIDAP), Santiago, Chile
| | - Kathrin Blum
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
| | | | | | - Marianne Cottin
- Millennium Institute for Depression and Personality Research (MIDAP), Santiago, Chile
- Universidad Finis Terrae, Santiago, Chile
| | - Cristóbal Hernández
- Millennium Institute for Depression and Personality Research (MIDAP), Santiago, Chile
- Universidad Adolfo Ibáñez, Santiago, Chile
| | - Sylvia Kaaya
- Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | | | - Alex Behn
- Millennium Institute for Depression and Personality Research (MIDAP), Santiago, Chile
- Pontificia Universidad Católica de Chile, Santiago, Chile
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Cohen JR, Stutts M. Interpersonal Well-Being and Suicidal Outcomes in a Nationally Representative Study of Adolescents: A Translational Study. Res Child Adolesc Psychopathol 2023; 51:1327-1341. [PMID: 37222862 DOI: 10.1007/s10802-023-01068-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2023] [Indexed: 05/25/2023]
Abstract
Adolescent suicide continues to rise despite burgeoning research on interpersonal risk for suicide. This may reflect challenges in applying developmental psychopathology research into clinical settings. In response, the present study used a translational analytic plan to examine indices of social well-being most accurate and statistically fair for indexing adolescent suicide. Data from the National Comorbidity Survey Replication Adolescent Supplement were used. Adolescents aged 13-17 (N = 9,900) completed surveys on traumatic events, current relationships, and suicidal thoughts and attempts. Both frequentist (e.g., receiver operating characteristics) and Bayesian (e.g., Diagnostic Likelihood Ratios; DLRs) techniques provided insight into classification, calibration, and statistical fairness. Final algorithms were compared to a machine learning-informed algorithm. Overall, parental care and family cohesion best classified suicidal ideation, while these indices and school engagement best classified attempts. Multi-indicator algorithms suggested adolescents at high risk across these indices were approximately 3-times more likely to engage in ideation (DLR = 3.26) and 5-times more likely to engage in attempts (DLR = 4.53). Although equitable for attempts, models for ideation underperformed in non-White adolescents. Supplemental, machine learning-informed algorithms performed similarly, suggesting non-linear and interactive effects did not improve model performance. Future directions for interpersonal theories for suicide are discussed and clinical implications for suicide screening are demonstrated.
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Affiliation(s)
- Joseph R Cohen
- Department of Psychology, University of Illinois Urbana-Champaign, Champaign, IL, 61820, USA.
| | - Morgan Stutts
- Department of Psychology, University of Illinois Urbana-Champaign, Champaign, IL, 61820, USA
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Stefana A, Langfus JA, Vieta E, Fusar-Poli P, Youngstrom EA. Development and Initial Validation of the in-Session Patient Affective Reactions Questionnaire (SPARQ) and the Rift In-Session Questionnaire (RISQ). J Clin Med 2023; 12:5156. [PMID: 37568559 PMCID: PMC10420232 DOI: 10.3390/jcm12155156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/03/2023] [Accepted: 08/03/2023] [Indexed: 08/13/2023] Open
Abstract
This article discusses the development and preliminary validation of a self-report inventory of the patient's perception of, and affective reaction to, their therapist during a psychotherapy session. First, we wrote a pool of 131 items, reviewed them based on subject matter experts' review, and then collected validation data from a clinical sample of adult patients in individual therapy (N = 701). We used exploratory factor analysis and item response theory graded response models to select items, confirmatory factor analysis (CFA) to test the factor structure, and k-fold cross-validation to verify model robustness. Multi-group CFA examined measurement invariance across patients with different diagnoses (unipolar depression, bipolar disorder, and neither of these). Three factors produced short scales retaining the strongest items. The in-Session Patient Affective Reactions Questionnaire (SPARQ) has a two-factor structure, yielding a four-item Negative affect scale and a four-item Positive affect scale. The Relationship In-Session Questionnaire (RISQ) is composed of four items from the third factor with dichotomized responses. Both scales showed excellent psychometric properties and evidence of metric invariance across the three diagnostic groups: unipolar depression, bipolar disorder, and neither of these. The SPARQ and the RISQ scale can be used in clinical or research settings, with particular value for capturing the patient's perspectives about their therapist and session-level emotional processes.
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Affiliation(s)
- Alberto Stefana
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy;
| | - Joshua A. Langfus
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (J.A.L.); (E.A.Y.)
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, 08028 Barcelona, Catalonia, Spain;
| | - Paolo Fusar-Poli
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy;
- OASIS Service, South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK
| | - Eric A. Youngstrom
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (J.A.L.); (E.A.Y.)
- Helping Give Away Psychological Science (HGAPS), 501c3, Chapel Hill, NC 27599, USA
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Zapf H, Boettcher J, Haukeland Y, Orm S, Coslar S, Wiegand-Grefe S, Fjermestad K. A Systematic Review of Parent-Child Communication Measures: Instruments and Their Psychometric Properties. Clin Child Fam Psychol Rev 2023; 26:121-142. [PMID: 36166179 PMCID: PMC9879831 DOI: 10.1007/s10567-022-00414-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2022] [Indexed: 02/02/2023]
Abstract
Parent-child communication represents an important variable in clinical child and family psychology due to its association with a variety of psychosocial outcomes. To give an overview of instruments designed to measure the quality of parent-child communication from the child's (8-21 years) perspective and to assess the psychometric quality of these instruments, we performed a systematic literature search in Medline and PsycInfo (last: February 25, 2022). Peer-reviewed journal articles published in English with a child-rated instrument measuring the quality of parent-child communication were included. Initial screening for eligibility and inclusion, subsequent data extraction, and quality assessment were conducted by couples of review team members. Based on the screening of 5115 articles, 106 studies reported in 126 papers were included. We identified 12 parent-child communication instruments across the studies. The Parent-Adolescent Communication Scale (PACS) was used in 75% of the studies. On average, the evidence for psychometric quality of the instruments was low. Few instruments were used in clinical and at-risk samples. Several instruments are available to rate parent-child communication from the child's perspective. However, their psychometric evidence is limited and the theoretical foundation is largely undocumented. This review has limitations with regard to selection criteria and language bias.Registration PROSPERO: CRD42021255264.
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Affiliation(s)
- Holger Zapf
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
| | - Johannes Boettcher
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | | | - Stian Orm
- Division Mental Health Care, Innlandet Hospital Trust, Brumunddal, Norway
| | - Sarah Coslar
- Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Silke Wiegand-Grefe
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
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11
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Becker-Haimes EM, Wislocki K, DiDonato S, Beidas RS, Jensen-Doss A. Youth Trauma Histories are Associated with Under-diagnosis and Under-treatment of Co-occurring Youth Psychiatric Symptoms. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023; 52:184-195. [PMID: 34038229 PMCID: PMC8617069 DOI: 10.1080/15374416.2021.1923020] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE We examined whether in the presence of trauma exposure, non-traumatic stress-related symptoms are interpreted by mental health clinicians as less salient than the trauma exposure and are de-emphasized as a treatment target, consistent with a diagnostic overshadowing bias. METHODS Using an adapted version of a diagnostic overshadowing bias experimental paradigm, mental health clinicians (N = 266, M age = 34.4 years, 82% female) were randomly assigned to receive two of six clinical vignette variations. Vignette 1 described an adolescent with obsessive-compulsive disorder (OCD). Vignette 2 described a pre-adolescent with oppositional defiant disorder (ODD). Vignettes were identical except for whether the youth reported exposure to a potentially traumatic event (PTE; no PTE, sexual PTE, or physical PTE). Clinicians received one vignette with a PTE and one without, counterbalancing order. Clinicians rated the likelihood the youth met criteria for various diagnoses and the appropriateness of various treatments on 7-point scales. RESULTS Across both vignettes, clinicians rated the target diagnosis (OCD in Vignette 1, ODD in Vignette 2) as less likely for vignettes with a PTE than for the same vignettes without a PTE. Clinicians also rated evidence-based treatment modalities for target diagnoses as less appropriate in the presence of a PTE than when a PTE was present. CONCLUSIONS Consistent with possible bias, clinicians may under-recognize and under-treat non-traumatic stress-related mental health symptoms in youth with a co-occurring trauma history. Future work to validate this bias in real-world practice is indicated.
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Affiliation(s)
- Emily M. Becker-Haimes
- Department of Psychiatry, University of Pennsylvania
Perelman School of Medicine, Philadelphia, PA
- Hall Mercer Community Mental Health, University of
Pennsylvania Health System
| | - Katherine Wislocki
- Department of Psychiatry, University of Pennsylvania
Perelman School of Medicine, Philadelphia, PA
| | - Stephen DiDonato
- College of Nursing, Thomas Jefferson University,
Philadelphia, PA
| | - Rinad S. Beidas
- Department of Psychiatry, University of Pennsylvania
Perelman School of Medicine, Philadelphia, PA
- Department of Medical Ethics and Health Policy, University
of Perelman School of Medicine, Philadelphia, PA
- Penn Implementation Science Center at the Leonard Davis
Institute of Health Economics (PISCE@LDI), University of Pennsylvania
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12
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De Los Reyes A, Epkins CC, Asmundson GJG, Augenstein TM, Becker KD, Becker SP, Bonadio FT, Borelli JL, Boyd RC, Bradshaw CP, Burns GL, Casale G, Causadias JM, Cha CB, Chorpita BF, Cohen JR, Comer JS, Crowell SE, Dirks MA, Drabick DAG, DuPaul GJ, Ehrlich KB, Evans SC, Evans SW, Felton JW, Fite PJ, Gadow KD, Galán CA, Garbacz SA, Gaylord-Harden N, Humphreys KL, Gerber AH, Hogue A, Ivanova MY, Jarrett MA, Jensen-Doss A, Kang E, Kendall PC, Laird RD, Langberg JM, Langer DA, Lee SS, Lerner MD, Lippold MA, Luebbe AM, Makol BA, McLeod BD, McMahon RJ, Miller M, Ohannessian CM, Ollendick TH, Piña A, Prinstein MJ, Rabinowitz J, Reynolds EK, Salekin RT, Schleider JL, Scott JC, Tackett JL, Talbott E, Silverman WK, Spears AP, von der Embse N, Wakschlag LS, Wang M, Watts AL, Weisz JR, White BA, White SW, Youngstrom EA. Editorial Statement About JCCAP's 2023 Special Issue on Informant Discrepancies in Youth Mental Health Assessments: Observations, Guidelines, and Future Directions Grounded in 60 Years of Research. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023; 52:147-158. [PMID: 36652590 DOI: 10.1080/15374416.2022.2158842] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Andres De Los Reyes
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland
| | | | | | | | | | - Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati
| | | | | | - Rhonda C Boyd
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia
| | | | | | - Gino Casale
- Institute for Educational Research, University of Wuppertal
| | | | - Christine B Cha
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | | | | | - Jonathan S Comer
- Center for Children and Families, Department of Psychology, Florida International University
| | | | | | | | | | | | | | | | | | - Paula J Fite
- Clinical Child Psychology Program, University of Kansas
| | | | | | | | | | | | | | | | | | | | | | - Erin Kang
- Department of Psychology, Montclair State University
| | | | - Robert D Laird
- Department of Human Development and Family Studies, University of Alabama
| | - Joshua M Langberg
- Graduate School of Applied and Professional Psychology, Rutgers University
| | | | - Steve S Lee
- Department of Psychology, University of California
| | | | | | | | | | - Bryce D McLeod
- Department of Psychology, Virginia Commonwealth University
| | - Robert J McMahon
- Department of Psychology, Simon Fraser University.,B.C. Children's Hospital
| | - Meghan Miller
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California
| | | | - Thomas H Ollendick
- Department of Psychology, Virginia Polytechnic Institute and State University
| | - Armando Piña
- Department of Psychology, Arizona State University
| | | | | | | | | | | | - Judith C Scott
- Clinical Department, School of Social Work, Boston University
| | | | | | | | - Angela Page Spears
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | | | - Lauren S Wakschlag
- Department of Medical Social Sciences, Feinberg School of Medicine & Institute for Innovations in Developmental Sciences, Northwestern University
| | - Mo Wang
- Department of Management, University of Florida
| | - Ashley L Watts
- Department of Psychological Sciences, University of Missouri
| | | | | | | | - Eric A Youngstrom
- Department of Psychology and Neuroscience, University of North Carolina.,Helping Give Away Psychological Science
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13
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Pender E, Kostak L, Sutton K, Naccarato C, Tsai A, Chung T, Daughters S. Resources for the Assessment and Treatment of Substance Use Disorder in Adolescents. WIKIJOURNAL OF MEDICINE 2023. [DOI: 10.15347/wjm/2023.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023] Open
Abstract
Substance Use Disorder (SUD) is understood as the persistent use of substances to the detriment of the individual's livelihood and wellness. SUD can have serious mental, physical, and social ramifications if not properly addressed. Though SUD can develop at any age, it is especially important to address in adolescents, given rising prevalence of certain substances (e.g. cannabis) in that age group and poor prognosis associated with early-onset SUD.[1][2] Data from the National Survey on Drug Use and Health show the lifetime use of illicit drugs in people ages 12-17 is 20.9%.[3] The same survey found the rate of Substance Use Disorder in the past year for people ages 12-17 who used illicit drugs or alcohol to be 6.3% in 2020.[3] This paper is intended for clinicians and lay people to gain a deeper understanding of SUD in adolescents, particularly relating to alcohol, cannabis, nicotine, and opioids. Though alcohol, cannabis, and nicotine are the substances most commonly used by this age demographic nationally,[4] opioid use – and resulting deaths – have been on the rise. According to the Centers for Disease Control and Prevention (CDC), opioids were connected to about 75% of the nearly 92,000 drug deaths in 2020.[5] Beyond significant death rates in the general population, recent spikes in adolescent death rate tied to the synthetic opioid fentanyl – which held a relatively stable death rate from 2010 to 2019 until seeing a 94% increase from 2019 to 2020 and additional 20% increase to 2021 - warrants inquiry into opioids for this population.[6] Each of these substances can have adverse, long-lasting effects on health if not managed properly, resulting in seriously compromised lifelong wellbeing.[7] This article explores SUD prevalence and reviews diagnostic criteria in relation to adolescence, including a synopsis of changes in SUD classification between the DSM-IV and DSM-5 and discussion of ICD-11 and the Research Domain Criteria (RDoC) as a basis for research related to substance use. Effective assessment and consideration of co-occurring disorders are covered as well. Although the prognosis of SUD varies by an individual's environment and circumstances, a modal developmental course for SUD is discussed. Finally, a curated list of nationally recognized resources including hotlines, treatment locators, informational sites, and support groups is provided, along with tools to compile local resources. By addressing these aspects of adolescent SUD, the research team offers a broader view of its prevalence in the United States, key warning signs and comorbidities, and possible assessments and treatments for adolescents with SUD.
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14
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Stefana A, Fusar-Poli P, Gnisci C, Vieta E, Youngstrom EA. Clinicians' Emotional Reactions toward Patients with Depressive Symptoms in Mood Disorders: A Narrative Scoping Review of Empirical Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15403. [PMID: 36430122 PMCID: PMC9692756 DOI: 10.3390/ijerph192215403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
The purpose of this article is to narratively review the empirical literature on clinicians' emotional, cognitive, and behavioral responses (i.e., countertransference) to depressive and other symptoms of patients with mood disorders. Therapist subjective responses (countertransference) can negatively affect both diagnostic and therapeutic processes, especially when they are not recognized and managed promptly. However, at the same time, countertransference recognition, processing, and management can help inform the diagnostic process and improve the therapy process and outcome. In the last couple of decades, the number of studies that empirically explore countertransference toward mood disordered patients, as well as its relationship with various characteristics of both patients and treatment, has increased. Current evidence suggests that patients with depression tend to elicit more positive feelings among clinicians than patients with other severe mental disorders such as borderline personality disorder or schizophrenia. Furthermore, it documents the existence of associations between patients' severity of depressive symptoms and clinicians' subjective reactions, although the results regarding which specific countertransference patterns are evoked in relation to the different phases of the treatment are not entirely consistent. Lastly, growing evidence suggests the presence of clinicians' specific emotional reactions towards patients with suicidal ideation and behavior.
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Affiliation(s)
- Alberto Stefana
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
| | - Paolo Fusar-Poli
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
- OASIS Service, South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London WC2R 2LS, UK
| | - Cristina Gnisci
- Riabilmente—Centro di Riabilitazione Monterotondo, Monterotondo, 00015 Roma, Italy
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, University of Barcelona Hospital Clinic, IDIBAPS, CIBER-SAM, 08007 Barcelona, Catalonia, Spain
| | - Eric A. Youngstrom
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Helping Give Away Psychological Science (HGAPS.org), Chapel Hill, NC 27599, USA
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15
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Knudsen KS, Becker KD, Guan K, Gellatly R, Patel VH, Malik K, Boustani MM, Mathur S, Chorpita BF. A pilot study to evaluate feasibility and acceptability of training mental health workers in India to select case-specific intervention procedures within a dynamic modular treatment designed for a low-resource setting. J Eval Clin Pract 2022; 28:531-541. [PMID: 34622536 DOI: 10.1111/jep.13623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 09/09/2021] [Accepted: 09/12/2021] [Indexed: 11/30/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES A key consideration in designing scalable solutions for improving global mental health involves balancing the need for interventions to be uncomplicated for mental health workers (MHWs) and the need for the intervention to be widely applicable to many clients. Often these needs are in competition, since interventions are routinely simplified by removing procedures or reducing their dynamic responsivity, which in turn lowers their overall utility in serving large, clinically diverse populations. The principal aim of this pilot study involved evaluating the feasibility and acceptability of a brief strategy designed to delegate problem classification and practice selection to MHWs operating within a flexible, modular, cognitive behavioural protocol. A secondary aim involved gathering data on which to base a hypothesis regarding the potential effectiveness of this strategy. METHOD Within an open trial, an educationally diverse sample of local MHWs in India (N = 18) reviewed fictional case vignettes, classified mental health problems, and then selected practices before and after a two-hour training that included a one-page decision-making resource. Feasibility was measured by assessing the integrity of the study protocol and training, the measurement and administration of questionnaires as well as study recruitment and completion. Acceptability of the intervention was measured by MHW-perceived performance, ease of use, value, importance, and intention for continued use. Decision-making accuracy was assessed by comparing MHWs' clinical decisions with criteria established through consensus among psychologists with expertise in modular protocols. RESULTS Results suggested high feasibility and acceptability on all metrics. Secondary analysis revealed that MHW's decision-making accuracy and confidence also significantly improved, providing a basis for the hypothesis that this brief approach is useful for building MHW capacity in low-resource settings. CONCLUSION Overall these findings provide initial support for these methods and potential training outcomes to test within a larger, randomized controlled trial.
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Affiliation(s)
- Kendra S Knudsen
- Department of Psychology, University of California, Los Angeles, California, USA
| | - Kimberly D Becker
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| | - Karen Guan
- Department of Psychology, University of California, Los Angeles, California, USA
| | - Resham Gellatly
- Department of Psychology, University of California, Los Angeles, California, USA
| | - Vikram H Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Maya M Boustani
- Department of Psychology, Loma Linda University, Loma Linda, California, USA
| | | | - Bruce F Chorpita
- Department of Psychology, University of California, Los Angeles, California, USA
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16
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Bonadio FT, Evans SC, Cho GY, Callahan KP, Chorpita BF, Weisz JR. Whose Outcomes Come Out? Patterns of Caregiver- and Youth-reported Outcomes Based on Caregiver-youth Baseline Discrepancies. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2022; 51:469-483. [PMID: 34424107 DOI: 10.1080/15374416.2021.1955367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Discrepancies between caregiver and youth reports of emotional and behavioral symptoms are well-documented, with cross-informant correlations often falling in the low to moderate range. Studies have shown that caregiver-youth (dis)agreement in reporting of youth symptoms is related to treatment outcomes. However, commonly used methods for exploring reporter discrepancies (e.g., difference scores) are limited by their inability to assess discrepancies across multiple symptom domains simultaneously, and thus these previous findings do not explore multiple patterns of (dis)agreement. METHOD We used latent profile analysis (LPA) to identify subgroups of clinically referred youths based on patterns of caregiver- and youth-reported internalizing and externalizing symptoms for 174 caregiver-youth dyads. Longitudinal multilevel models were used to examine changes in weekly caregiver- and youth-reported internalizing symptoms, externalizing symptoms, and top problems for identified subgroups. RESULTS The LPA identified four latent subgroups: (a) Caregiver Internalizing (9%), (b) Caregiver Internalizing-Externalizing (45%), (c) Youth Internalizing (7%), and (d) Caregiver-Youth Internalizing-Externalizing (39%). Clinical outcomes varied across informants and subgroups. Significant improvements in caregiver- and youth-reported outcome measures were documented within the Caregiver Internalizing, Caregiver Internalizing-Externalizing, and Caregiver-Youth Internalizing-Externalizing subgroups. However, only youth-reported improvements were detected in the Youth Internalizing subgroup. The results show differences in treatment outcomes across caregiver-youth informant subgroups. CONCLUSIONS These findings suggest how youth and caregiver baseline data could provide guidance for clinicians in interpreting discrepant reporting and its relevance to change during treatment.
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Affiliation(s)
- F Tony Bonadio
- The Institute for Innovation & Implementation, University of Maryland School of Social Work
| | - Spencer C Evans
- Department of Psychology, Harvard University
- Department of Psychology, University of Miami
| | - Grace Y Cho
- Department of Psychology, Harvard University
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst
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17
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Cottin M, Blum K, Konjufca J, Quevedo Y, Kaaya S, Behn A, Schmeck K, Sharp C, Zimmermann R. Digital use of standardised assessment tools for children and adolescents: can available paper-based questionnaires be used free of charge in electronic format? BMC Psychiatry 2022; 22:379. [PMID: 35659275 PMCID: PMC9166519 DOI: 10.1186/s12888-022-04023-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 05/23/2022] [Indexed: 11/29/2022] Open
Abstract
QUESTION Most adolescents live in low- and middle-income countries (LMIC), and about 10% of them face mental problems. The mental health provision gap in low- and middle-income countries could be addressed by evidence-based practices, however costs are implementational barriers. Digitalization can improve the accessibility of these tools and constitutes a chance for LMIC to use them more easily at a low cost. We reviewed free and brief evidence-based mental health assessment tools available for digital use to assess psychopathology across different domains in youth. METHODS For the current study, instruments from a recent review on paper-based instruments were re-used. Additionally, a systematic search was conducted to add instruments for the personality disorder domain. We searched and classified the copyright and license terms available from the internet in terms of free usage and deliverability in a digital format. In the case that this information was insufficient, we contacted the authors. RESULTS In total, we evaluated 109 instruments. Of these instruments, 53 were free and digitally usable covering 11 mental health domains. However, retrieving information on copyright and license terms was very difficult. CONCLUSIONS Free and digitally adaptable instruments are available, supporting the strategy of using instruments digitally to increase access. The instrument's authors support this initiative, however, the lack of copyright information and the difficulties in contacting the authors and licence holders are barriers to using this strategy in LMIC. A comprehensive, online instrument repository for clinical practice would be an appropriate next step to make the instruments more accessible and reduce implementation barriers.
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Affiliation(s)
- Marianne Cottin
- grid.488997.3Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile ,grid.443909.30000 0004 0385 4466Department of Psychiatry East Campus, Faculty of Medicine, University of Chile, Santiago, Chile ,grid.440629.d0000 0004 5934 6911School of Psychology, Finis Terrae University, Santiago, Chile ,grid.7870.80000 0001 2157 0406School of Psychology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Kathrin Blum
- grid.6612.30000 0004 1937 0642Child and Adolescent Psychiatric Research Department, Psychiatric University Hospitals of the University of Basel, Basel, Switzerland
| | - Jon Konjufca
- grid.449627.a0000 0000 9804 9646University of Prishtina, Pristina, Kosovo ,grid.6612.30000 0004 1937 0642Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland
| | - Yamil Quevedo
- grid.488997.3Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile ,grid.443909.30000 0004 0385 4466Department of Psychiatry East Campus, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Sylvia Kaaya
- grid.25867.3e0000 0001 1481 7466Department of Psychiatry and Mental Health, School of Medicine, Muhimbili University of Health and Allied Science, Dar es Salaam, Tanzania ,grid.266436.30000 0004 1569 9707Department of Psychology, University of Houston, Houston, TX USA
| | - Alex Behn
- grid.488997.3Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile ,grid.7870.80000 0001 2157 0406School of Psychology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Klaus Schmeck
- grid.6612.30000 0004 1937 0642Child and Adolescent Psychiatric Research Department, Psychiatric University Hospitals of the University of Basel, Basel, Switzerland ,grid.6612.30000 0004 1937 0642Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland
| | - Carla Sharp
- grid.266436.30000 0004 1569 9707Department of Psychology, University of Houston, Houston, TX USA
| | - Ronan Zimmermann
- Child and Adolescent Psychiatric Research Department, Psychiatric University Hospitals of the University of Basel, Basel, Switzerland. .,Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland.
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18
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Aydin S, Siebelink BM, Crone MR, van Ginkel JR, Numans ME, Vermeiren RRJM, Michiel Westenberg P. The diagnostic process from primary care to child and adolescent mental healthcare services: the incremental value of information conveyed through referral letters, screening questionnaires and structured multi-informant assessment. BJPsych Open 2022; 8:e81. [PMID: 35388780 PMCID: PMC9059622 DOI: 10.1192/bjo.2022.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 02/08/2022] [Accepted: 03/16/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND A variety of information sources are used in the best-evidence diagnostic procedure in child and adolescent mental healthcare, including evaluation by referrers and structured assessment questionnaires for parents. However, the incremental value of these information sources is still poorly examined. AIMS To quantify the added and unique predictive value of referral letters, screening, multi-informant assessment and clinicians' remote evaluations in predicting mental health disorders. METHOD Routine medical record data on 1259 referred children and adolescents were retrospectively extracted. Their referral letters, responses to the Strengths and Difficulties Questionnaire (SDQ), results on closed-ended questions from the Development and Well-Being Assessment (DAWBA) and its clinician-rated version were linked to classifications made after face-to-face intake in psychiatry. Following multiple imputations of missing data, logistic regression analyses were performed with the above four nodes of assessment as predictors and the five childhood disorders common in mental healthcare (anxiety, depression, autism spectrum disorders, attention-deficit hyperactivity disorder, behavioural disorders) as outcomes. Likelihood ratio tests and diagnostic odds ratios were computed. RESULTS Each assessment tool significantly predicted the classified outcome. Successive addition of the assessment instruments improved the prediction models, with the exception of behavioural disorder prediction by the clinician-rated DAWBA. With the exception of the SDQ for depressive and behavioural disorders, all instruments showed unique predictive value. CONCLUSIONS Structured acquisition and integrated use of diverse sources of information supports evidence-based diagnosis in clinical practice. The clinical value of structured assessment at the primary-secondary care interface should now be quantified in prospective studies.
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Affiliation(s)
- Semiha Aydin
- Department of Developmental and Educational Psychology, Leiden University, The Netherlands; Department of Child and Adolescent Psychiatry, Leiden University Medical Centre, The Netherlands; and Department of Public Health and Primary Care, Leiden University Medical Centre, The Netherlands
| | - Bart M. Siebelink
- Department of Child and Adolescent Psychiatry, Leiden University Medical Centre, The Netherlands
| | - Matty R. Crone
- Department of Public Health and Primary Care, Leiden University Medical Centre, The Netherlands
| | - Joost R. van Ginkel
- Methodology and Statistics Unit, Institute of Psychology, Leiden University, The Netherlands
| | - Mattijs E. Numans
- Department of Public Health and Primary Care, Leiden University Medical Centre, The Netherlands
| | - Robert R. J. M. Vermeiren
- Department of Child and Adolescent Psychiatry, Leiden University Medical Centre, The Netherlands; and Youz, Parnassia Group, The Netherlands
| | - P. Michiel Westenberg
- Department of Developmental and Educational Psychology, Leiden University, The Netherlands
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19
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Modrowski CA, Sheerin KM, Owens T, Pine SM, Shea LM, Frazier E, Lowenhaupt E. Piloting an Evidence-Based Assessment Protocol for Incarcerated Adolescents. EVIDENCE-BASED PRACTICE IN CHILD AND ADOLESCENT MENTAL HEALTH 2022; 8:525-540. [PMID: 38144516 PMCID: PMC10745203 DOI: 10.1080/23794925.2022.2051216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2023]
Abstract
Although evidence-based assessment is considered an essential component of evidence-based practice, few adolescents have access to evidence-based assessment. Despite experiencing high rates of mental health disorders, incarcerated justice-involved adolescents are rarely able to access evidence-based psychiatric care. In this article, we discuss the components of an evidence-based assessment protocol designed and piloted with incarcerated adolescents involved in Rhode Island's juvenile justice system. In particular, we describe the components of our evidence-based protocol, ways in which evidence-based assessment may need to be modified when working with this population, and discuss policy and clinical implications relevant to increasing access to evidence-based assessment among incarcerated adolescents.
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20
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Ward T, Haig BD, McDonald M. Translating science into practice in clinical psychology: A reformulation of the evidence-based practice inquiry model. THEORY & PSYCHOLOGY 2021. [DOI: 10.1177/09593543211059816] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The model of evidence-based practice (EBP) directs clinicians to integrate the best available research evidence, clinical expertise, client preferences and values, and social and cultural factors in the assessment and treatment of psychological problems. Despite its many strengths, the five-step inquiry component of the EBP model suffers from several conceptual and practical problems that make it difficult to implement in practice. In this article, we first outline the transdisciplinary EBP model. Second, several criticisms of the overall EBP model are outlined and briefly discussed. Third, five pressing problems in the inquiry component of the EBP model are identified: (a) information overload, (b) a focus on questions rather than tasks, (c) neglect of theory, (d) difficulty dealing with conflicting evidence, and (e) an oversimplified view of the role of values in research and practice. Fourth, we suggest ways of modifying the inquiry part of the model to address these problems.
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21
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Van Meter A, Correll CU, Ahmad W, Dulin M, Saito E. Symptoms and Characteristics of Youth Hospitalized for Depression: Subthreshold Manic Symptoms Can Help Differentiate Bipolar from Unipolar Depression. J Child Adolesc Psychopharmacol 2021; 31:545-552. [PMID: 34637626 DOI: 10.1089/cap.2021.0057] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background: Most people who have major depressive disorder (MDD) or bipolar disorder (BD) will have their first episode of depression in adolescence. However, in the absence of significant [hypo]manic symptoms, there are no clear guidelines for distinguishing bipolar from unipolar depression, which can lead to misdiagnosis and ineffective/harmful treatment. We aimed to compare phenomenological differences among youth with MDD or BD hospitalized for an acute episode of depression. Methods: A retrospective electronic chart review of adolescents hospitalized in an acute care inpatient unit who had a discharge diagnosis of MDD, MDD with mixed or psychotic features (MDD+), BD-I-current episode depressed, or BD-II-current episode depressed, was performed. Results: Altogether, 598 patients (mean age = 15.1 ± 1.5 years, female = 71%, and White = 46%) met study inclusion criteria, i.e., BD-I: n = 39, BD-II: n = 84, MDD: n = 422, and MDD+: n = 53 patients. The admission Hamilton Depression Rating Scale (HAMD) total score was significantly higher in the BD-I (29.3 ± 9.1) and MDD+ (31.2 ± 9.3) groups versus the MDD group (24.3 ± 9.7) (p < 0.05). Although there were some group differences in the severity of individual depression symptoms, these did not line up neatly across BD and MDD groups. At admission, Young Mania Rating Scale (YMRS) total scores were significantly higher in the BD-I (14.4 ± 7.4), BD-II (13.8 ± 6.5), and MDD+ groups (14.3 ± 6.6) versus the MDD group (8.2 ± 4.6, p < 0.05). Additionally, 9 of 11 and 4 of 11 YMRS items scored significantly higher in the BD-II and BD-I groups versus the MDD group, respectively. The motor activity and hypersexuality items, in particular, were scored consistently higher in the BD groups than MDD groups. Limitations: All diagnoses were made based on a clinical interview and not a structured diagnostic interview, and some of the subgroup sample sizes were relatively modest, limiting the power for group comparisons. Conclusion: The presence of subsyndromal manic symptoms during an episode of MDD currently offers the clearest way by which to differentiate bipolar depression from unipolar depression.
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Affiliation(s)
- Anna Van Meter
- Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, New York, USA.,Feinstein Institutes for Medical Research, Institute for Behavioral Science, Manhasset, New York, USA.,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, Hempstead, New York, USA
| | - Christoph U Correll
- Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, New York, USA.,Feinstein Institutes for Medical Research, Institute for Behavioral Science, Manhasset, New York, USA.,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, Hempstead, New York, USA.,Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Wasiq Ahmad
- Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, New York, USA.,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, Hempstead, New York, USA
| | - Morganne Dulin
- Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, New York, USA.,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, Hempstead, New York, USA
| | - Ema Saito
- Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, New York, USA.,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, Hempstead, New York, USA
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22
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Mazefsky CA, Conner CM, Breitenfeldt K, Leezenbaum N, Chen Q, Bylsma LM, Pilkonis P. Evidence Base Update for Questionnaires of Emotion Regulation and Reactivity for Children and Adolescents. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2021; 50:683-707. [PMID: 34436940 DOI: 10.1080/15374416.2021.1955372] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objective: Emotion regulation (ER) is a multi-faceted and dynamic process relevant to both normative emotional development and transdiagnostic emotional dysfunction for a range of psychological disorders. There has been tremendous growth in ER research over the past decade, including the development of numerous new measures to assess ER. This Evidence Base Update included a systematic review to identify self- and informant-report questionnaire measures of ER for children and adolescents, including measures of ER strategies and effectiveness (or emotion dysregulation).Methods: PubMed, PsycInfo, and Health and Psychosocial Instruments databases were searched using the terms emotion OR affect AND regulation OR control OR reactivity OR response, as well as terms related to questionnaires and psychometrics, restricted to articles on youth (< 18 years old). Each measure's psychometrics was evaluated based on modified criteria by De Los Reyes and Langer (2018).Results: Nine-hundred ninety-seven papers were identified yielding 87 measures that met inclusion for review. Although the majority (60%) of identified ER measures could not be recommended based on these criteria, 8% were Excellent, 14% were Good, and 17% were Adequate. The recommended measures included: 11 general ER measures (5 focused on strategies, 5 focused on dysregulation/ effectiveness), 13 measures of ER as it relates to specific emotions or contexts such as irritability or peer stress (4 focused on strategies, 9 focused on dysregulation/effectiveness), and 11 measures of other constructs that include an ER subscale (all focused on dysregulation). Conclusions: The characteristics, strengths, and weaknesses of the recommended ER measures are described in order to guide measure selection for clinical or research uses. A synthesis of themes identified during this review includes commonly observed areas of weakness and gaps in the literature to provide a foundation for future research and measure development.
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Affiliation(s)
- Carla A Mazefsky
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | - Caitlin M Conner
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | | | - Nina Leezenbaum
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | - Qi Chen
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | - Lauren M Bylsma
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | - Paul Pilkonis
- Department of Psychiatry, University of Pittsburgh School of Medicine
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23
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Van Meter AR, Hafeman DM, Merranko J, Youngstrom EA, Birmaher BB, Fristad MA, Horwitz SM, Arnold LE, Findling RL. Generalizing the Prediction of Bipolar Disorder Onset Across High-Risk Populations. J Am Acad Child Adolesc Psychiatry 2021; 60:1010-1019.e2. [PMID: 33038454 PMCID: PMC8075632 DOI: 10.1016/j.jaac.2020.09.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 09/08/2020] [Accepted: 09/19/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Risk calculators (RC) to predict clinical outcomes are gaining interest. An RC to estimate risk of bipolar spectrum disorders (BPSD) could help reduce the duration of undiagnosed BPSD and improve outcomes. Our objective was to adapt an RC previously validated in the Pittsburgh Bipolar Offspring Study (BIOS) sample to achieve adequate predictive ability in both familial high-risk and clinical high-risk youths. METHOD Participants (aged 6-12 years at baseline) from the Longitudinal Assessment of Manic Symptoms (LAMS) study (N = 473) were evaluated semi-annually. Evaluations included a Kiddie Schedule for Affective Disorders (K-SADS) interview. After testing an RC that closely approximated the original, we made modifications to improve model prediction. Models were trained in the BIOS data, which included biennial K-SADS assessments, and tested in LAMS. The final model was then trained in LAMS participants, including family history of BPSD as a predictor, and tested in the familial high-risk sample. RESULTS Over follow-up, 65 youths newly met criteria for BPSD. The original RC identified youths who developed BPSD only moderately well (area under the curve [AUC] = 0.67). Eliminating predictors other than the K-SADS screening items for mania and depression improved accuracy (AUC = 0.73) and generalizability. The model trained in LAMS, including family history as a predictor, performed well in the BIOS sample (AUC = 0.74). CONCLUSION The clinical circumstances under which the assessment of symptoms occurs affects RC accuracy; focusing on symptoms related to the onset of BPSD improved generalizability. Validation of the RC under clinically realistic circumstances will be an important next step.
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Affiliation(s)
- Anna R Van Meter
- The Feinstein Institutes for Medical Research, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, and The Zucker Hillside Hospital, Glen Oaks, New York.
| | | | - John Merranko
- The University of Pittsburgh Medical Center, Pennsylvania
| | | | | | - Mary A Fristad
- The Ohio State University College of Medicine, Columbus, Ohio; Nationwide Children's Hospital, Columbus, Ohio
| | | | - L Eugene Arnold
- The Ohio State University College of Medicine, Columbus, Ohio
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Santamaría-Villar MB, Gilar-Corbi R, Pozo-Rico T, Castejón JL. Teaching Socio-Emotional Competencies Among Primary School Students: Improving Conflict Resolution and Promoting Democratic Co-existence in Schools. Front Psychol 2021; 12:659348. [PMID: 34220629 PMCID: PMC8249732 DOI: 10.3389/fpsyg.2021.659348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 05/24/2021] [Indexed: 12/30/2022] Open
Abstract
Teaching socio-emotional skills among primary school students is the key to creating a climate of cooperation in classrooms and reducing disruptive or aggressive behaviors among students. The primary goal of this research is to present an educational proposal for imparting socio-emotional competencies among primary school students. We attempt to impart socio-emotional competencies based on: (1) fostering self-knowledge, self-esteem, and respect for others among students; (2) developing behaviors that allow them to perceive and express feelings and self-regulating emotions; and (3) developing assertive communication skills aimed at improving conflict resolution. This program has been designed in such a way that it is implemented throughout the academic year by organizing bi-monthly sessions of 45 min each, held until the completion of 15 sessions. The sample consists of 100 students in the third grade, with the control and experimental groups having an equal number of students (50 each). The instruments used for this research are: (a) BarOn Emotional Quotient Inventory (Youth Version [BarOn EQ-i:YV]): used for measuring emotional and social functioning; (b) the Matson Evaluation of Social Skills with Youngsters (MESSY): used for assessing social skills; and (c) Questionnaire for the Assessment of School Violence in Preschool and Primary School Questionnaire. To check the effectiveness of the educational intervention, a quasi-experimental design, along with pretest-posttest control group design, is used in accordance with the general linear model. Its effectiveness is also checked using repeated measures analysis of variance. The results show that the program is useful in preventing violent behaviors in the educational field and promoting the development of socio-emotional skills among third grade students. Finally, the applicability of the program to other educational contexts is discussed to enhance students' personal development and decrease the levels of violence found in primary school.
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Affiliation(s)
| | - Raquel Gilar-Corbi
- Department of Developmental and Educational Psychology, University of Alicante, Alicante, Spain
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Watkins MW, Canivez GL. Are There Cognitive Profiles Unique to Students With Learning Disabilities? A Latent Profile Analysis of Wechsler Intelligence Scale for Children–Fourth Edition Scores. SCHOOL PSYCHOLOGY REVIEW 2021. [DOI: 10.1080/2372966x.2021.1919923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Frazier TW, Coury DL, Sohl K, Wagner KE, Uhlig R, Hicks SD, Middleton FA. Evidence-based use of scalable biomarkers to increase diagnostic efficiency and decrease the lifetime costs of autism. Autism Res 2021; 14:1271-1283. [PMID: 33682319 PMCID: PMC8251791 DOI: 10.1002/aur.2498] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 10/22/2020] [Accepted: 02/14/2021] [Indexed: 01/01/2023]
Abstract
Challenges associated with the current screening and diagnostic process for autism spectrum disorder (ASD) in the US cause a significant delay in the initiation of evidence-based interventions at an early age when treatments are most effective. The present study shows how implementing a second-order diagnostic measure to high risk cases initially flagged positive from screening tools can further inform clinical judgment and substantially improve early identification. We use two example measures for the purposes of this demonstration; a saliva test and eye-tracking technology, both scalable and easy-to-implement biomarkers recently introduced in ASD research. Results of the current cost-savings analysis indicate that lifetime societal cost savings in special education, medical and residential care are estimated to be nearly $580,000 per ASD child, with annual cost savings in education exceeding $13.3 billion, and annual cost savings in medical and residential care exceeding $23.8 billion (of these, nearly $11.2 billion are attributable to Medicaid). These savings total more than $37 billion/year in societal savings in the US. Initiating appropriate interventions faster and reducing the number of unnecessary diagnostic evaluations can decrease the lifetime costs of ASD to society. We demonstrate the value of implementing a scalable highly accurate diagnostic in terms of cost savings to the US. LAY SUMMARY: This paper demonstrates how biomarkers with high accuracy for detecting autism spectrum disorder (ASD) could be used to increase the efficiency of early diagnosis. Results also show that, if more children with ASD are identified early and referred for early intervention services, the system would realize substantial costs savings across the lifespan.
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Affiliation(s)
- Thomas W. Frazier
- Department of PsychologyJohn Carroll UniversityUniversity HeightsOhioUSA
| | - Daniel L. Coury
- Department of Developmental and Behavioral PediatricsNationwide Children's HospitalColumbusOhioUSA
| | - Kristin Sohl
- Department of Child HealthUniversity of MissouriColumbiaMissouriUSA
| | | | | | - Steven D. Hicks
- Department of Pediatrics, Division of Academic General PediatricsPenn State College of MedicineHersheyPennsylvaniaUSA
| | - Frank A. Middleton
- Department of Neuroscience & PhysiologyState University of New York Upstate Medical UniversitySyracuseNew YorkUSA,Department of PediatricsState University of New York Upstate Medical UniversitySyracuseNew YorkUSA
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Cena L, Biban P, Janos J, Lavelli M, Langfus J, Tsai A, Youngstrom EA, Stefana A. The Collateral Impact of COVID-19 Emergency on Neonatal Intensive Care Units and Family-Centered Care: Challenges and Opportunities. Front Psychol 2021; 12:630594. [PMID: 33716895 PMCID: PMC7943863 DOI: 10.3389/fpsyg.2021.630594] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 01/25/2021] [Indexed: 12/28/2022] Open
Abstract
The ongoing Coronavirus disease 2019 (COVID-19) pandemic is disrupting most specialized healthcare services worldwide, including those for high-risk newborns and their families. Due to the risk of contagion, critically ill infants, relatives and professionals attending neonatal intensive care units (NICUs) are undergoing a profound remodeling of the organization and quality of care. In particular, mitigation strategies adopted to combat the COVID-19 pandemic may hinder the implementation of family-centered care within the NICU. This may put newborns at risk for several adverse effects, e.g., less weight gain, more nosocomial infections, increased length of NICU stay as well as long-term worse cognitive, emotional, and social development. This article aims to contribute to deepening the knowledge on the psychological impact of COVID-19 on parents and NICU staff members based on empirical data from the literature. We also provided evidence-based indications on how to safely empower families and support NICU staff facing such a threatening emergency, while preserving the crucial role of family-centered developmental care practices.
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Affiliation(s)
- Loredana Cena
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Paolo Biban
- Department of Neonatal and Pediatric Critical Care, Verona University Hospital, Verona, Italy
| | - Jessica Janos
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Manuela Lavelli
- Department of Human Sciences, University of Verona, Verona, Italy
| | - Joshua Langfus
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Angelina Tsai
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Eric A. Youngstrom
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Alberto Stefana
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
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Continuous quality improvement in measure development: Lessons from building a novel clinical feedback system. Qual Life Res 2021; 30:3085-3096. [PMID: 33591432 PMCID: PMC8528746 DOI: 10.1007/s11136-021-02768-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 11/03/2022]
Abstract
Purpose While the use of clinical feedback systems has become commonplace in psychological treatment, many of the most common instruments used for this purpose have not changed in decades. This paper describes the first four cycles of a measure development method designed to embrace continuous quality improvement. Methods Using techniques and philosophies developed in business management and academia—lean continuous quality improvement, action research, and practice research networks—we iterated through multiple cycles of development with the goal of creating an optimal clinical feedback system. These cycles emphasize building capacity to receive and implement feedback from a variety of stakeholders, especially patients and providers of behavioral health services, while also being responsive to quantitative findings from measure development. Results Iterating measure development with stakeholder feedback over the course of 5 years has resulted in a novel measurement system with 19 subscales administered via branching logic, and a supporting practice research network to sustain development. Conclusion In developing a new clinical feedback system, the less-frequently-discussed practical aspects of measure development require close attention. Specifically, being willing to embrace change, planning for iteration, and systematically seeking stakeholder feedback are identified as central methods for improving clinical feedback systems.
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Etkin RG, Shimshoni Y, Lebowitz ER, Silverman WK. Using Evaluative Criteria to Review Youth Anxiety Measures, Part I: Self-Report. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2021; 50:58-76. [PMID: 32915074 PMCID: PMC7914129 DOI: 10.1080/15374416.2020.1802736] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Evidence-based assessment serves several critical functions in clinical child psychological science, including being a foundation for evidence-based treatment delivery. In this Evidence Base Update, we provide an evaluative review of the most widely used youth self-report measures assessing anxiety and its disorders. Guided by a set of evaluative criteria (De Los Reyes & Langer, 2018), we rate the measures as Excellent, Good, or Adequate across their psychometric properties (e.g., construct validity). For the eight measures evaluated, most ratings assigned were Good followed by Excellent, and the minority of ratings were Adequate. We view these results overall as positive and encouraging, as they show that these youth anxiety self-report measures can be used with relatively high confidence to accomplish key assessment functions. Recommendations and future directions for further advancements to the evidence base are discussed.
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Assessing the Impact of Sequential Data Presentation on Specific Learning Disabilities Identification Decisions Using Patterns of Strengths and Weaknesses Methods. JOURNAL OF PSYCHOEDUCATIONAL ASSESSMENT 2020. [DOI: 10.1177/0734282920983951] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Patterns of strengths and weaknesses represent relatively novel methods for identifying specific learning disabilities (SLD) with proponents asserting that the incorporation of multiple sources of assessment data and professional judgment play a key role in their utility. In this study, we examined if the sequential presentation of assessment data impacted school psychologists’ ratings as to whether or not hypothetical students depicted in special education evaluation vignettes should be identified with SLD. Results showed that when participants viewed vignettes that were indicative of SLD (i.e., SLD positive), SLD likelihood ratings increased with the additional presentation of assessment data sources over time. However, when participants viewed vignettes that were indicative of a student not having SLD (i.e., SLD negative), SLD likelihood ratings were relatively consistent over time. Moreover, participants demonstrated relatively high levels of confidence in their SLD identification decisions, and in SLD negative vignettes, confidence increased after the fourth assessment data source was presented. Implications for SLD identification are discussed.
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Van Meter AR, Anderson EA. Evidence Base Update on Assessing Sleep in Youth. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2020; 49:701-736. [PMID: 33147074 DOI: 10.1080/15374416.2020.1802735] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Sleep is vital to youth well-being and when it becomes disturbed - whether due to environmental or individual factors - mental and physical health suffer. Sleep problems can also be a symptom of underlying mental health disorders. Assessing different components of sleep, including quality and hygiene, can be useful both for identifying mental health problems and for measuring changes in well-being over time. However, there are dozens of sleep-related measures for youth and it can be difficult to determine which to select for a specific research or clinical purpose. The goal of this review was to identify sleep-related measures for clinical and/or research use in youth mental health settings, and to update the evidence base on this topic. METHOD We generated a list of candidate measures based on other reviews and searched in PubMed and PsycINFO using the terms "sleep" AND (measure OR assessment OR questionnaire) AND (psychometric OR reliability OR validity). Search results were limited to studies about children and adolescents (aged 2-17) published in English. Additional criteria for inclusion were that there had to be at least three publications reporting on the measure psychometrics in community or mental health populations. Sleep measures meeting these criteria were evaluated using the criteria set by De Los Reyes and Langer (2018). RESULTS Twenty-six measures, across four domains of sleep - insomnia, sleep hygiene, sleepiness, sleep quality - met inclusion criteria. Each measure had at least adequate clinical utility. No measure(s) emerged as superior across psychometric domains. CONCLUSION Clinicians and researchers must evaluate sleep measures for each use case, as the intended purpose will dictate which measure is best. Future research is necessary to evaluate measure performance in transdiagnostic mental health populations, including youth with serious mental illness.
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Affiliation(s)
- Anna R Van Meter
- Department of Psychiatry, Zucker Hillside Hospital.,Feinstein Institutes for Medical Research, Institute for Behavioral Science.,Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
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Youngstrom EA. Editorial: Fast, Good, Cheap: Pick Two. Computer-Assisted Diagnostic Interviewing. J Am Acad Child Adolesc Psychiatry 2020; 59:1215-1217. [PMID: 32084528 DOI: 10.1016/j.jaac.2020.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 01/31/2020] [Indexed: 11/19/2022]
Abstract
Diagnosis is fundamental to clinical practice. Patients look to us to make sense of their problems, give them a name, unlock access to services, organize treatment, and lead to better outcomes. Gibbons et al.1 developed and validated a computer-assisted diagnostic interview that covers common clinical problems. Using two large samples, they statistically calibrated a pool of 1,060 items so that adaptive testing can yield a precise estimate of problem severity. The method is akin to the way that college admissions tests are being shortened than the older "skip out" method of discontinuing sections of an interview based on gate-keeping questions. Gibbons et al.1 take several extra steps to build a more complete foundation for clinical use, including validation in a second, different sample, as well as investigating retest reliability. The product is a tool that could enhance mental health care, and have a transformative effect in many systems of care and regions of the world.
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Dryburgh NSJ, Khullar TH, Sandre A, Persram RJ, Bukowski WM, Dirks MA. Evidence Base Update for Measures of Social Skills and Social Competence in Clinical Samples of Youth. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2020; 49:573-594. [PMID: 32697122 DOI: 10.1080/15374416.2020.1790381] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Social skills and social competence are key transdiagnostic processes in developmental psychopathology and are the focus of an array of clinical interventions. In this Evidence Base Update, we evaluated the psychometric properties of measures of social skills and social competence used with clinical samples of children and adolescents. A systematic literature search yielded eight widely used measures of social skills and one measure of social competence. Applying the criteria identified by Youngstrom et al. (2017), we found that, with some exceptions, these measures had adequate to excellent norms, internal consistency, and test-retest reliability. There was at least adequate evidence of construct validity and treatment sensitivity in clinical samples for nearly all measures assessed. Many of the scales included items assessing constructs other than social skills and competence (e.g., emotion regulation). Development of updated tools to assess youth's effectiveness in key interpersonal situations, including those occurring online, may yield clinical dividends.
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Becker-Haimes EM, Tabachnick AR, Last BS, Stewart RE, Hasan-Granier A, Beidas RS. Evidence Base Update for Brief, Free, and Accessible Youth Mental Health Measures. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2020; 49:1-17. [PMID: 31825683 PMCID: PMC6962529 DOI: 10.1080/15374416.2019.1689824] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Evidence-based assessment (EBA) is foundational to high-quality mental health care for youth and is a critical component of evidence-based practice delivery, yet is underused in the community. Administration time and measure cost are barriers to use; thus, identifying and disseminating brief, free, and accessible measures are critical. This Evidence Base Update evaluates the empirical literature for brief, free, and accessible measures with psychometric support to inform research and practice with youth. A systematic review using PubMed and PsycINFO identified measures in the following domains: overall mental health, anxiety, depression, disruptive behavior, traumatic stress, disordered eating, suicidality, bipolar/mania, psychosis, and substance use. To be eligible for inclusion, measures needed to be brief (50 items or less), free, accessible, and have psychometric support for their use with youth. Eligible measures were evaluated using adapted criteria established by De Los Reyes and Langer (2018) and were classified as having excellent, good, or adequate psychometric properties. A total of 672 measures were identified; 95 (14%) met inclusion criteria. Of those, 21 (22%) were "excellent," 34 (36%) were "good," and 40 (42%) were "adequate." Few measures had support for their use to routinely monitor progress in therapy. Few measures with excellent psychometric support were identified for disordered eating, suicidality, psychosis, and substance use. Future research should evaluate existing measures for use with routine progress monitoring and ease of implementation in community settings. Measure development is needed for disordered eating, suicidality, psychosis, and substance use to increase availability of brief, free, accessible, and validated measures.
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Affiliation(s)
- Emily M. Becker-Haimes
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3 floor, Philadelphia, PA 19104, USA, 215-573-5614
- Hall Mercer Community Mental Health, Philadelphia, PA
| | | | - Briana S. Last
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3 floor, Philadelphia, PA 19104, USA, 215-573-5614
| | - Rebecca E. Stewart
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3 floor, Philadelphia, PA 19104, USA, 215-573-5614
| | - Anisa Hasan-Granier
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3 floor, Philadelphia, PA 19104, USA, 215-573-5614
| | - Rinad S. Beidas
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3 floor, Philadelphia, PA 19104, USA, 215-573-5614
- Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
- Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania
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Pendergast LL, Youngstrom EA, Ruan-Iu L, Beysolow D. The Nomogram: A Decision-Making Tool for Practitioners
Using Multitiered Systems of Support. SCHOOL PSYCHOLOGY REVIEW 2019. [DOI: 10.17105/spr-2017-0097.v47-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Lockwood AB, Farmer RL. The cognitive assessment course: Two decades later. PSYCHOLOGY IN THE SCHOOLS 2019. [DOI: 10.1002/pits.22298] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Adam B. Lockwood
- Department of PsychologyWestern Kentucky UniversityBowling Green Kentucky
| | - Ryan L. Farmer
- College of Education, Health and AviationOklahoma State UniversityStillwater Oklahoma
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Holly LE, Fenley AR, Kritikos TK, Merson RA, Abidin RR, Langer DA. Evidence-Base Update for Parenting Stress Measures in Clinical Samples. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2019; 48:685-705. [DOI: 10.1080/15374416.2019.1639515] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | - Alicia R. Fenley
- Department of Psychological and Brain Sciences, Boston University
| | | | - Rachel A. Merson
- Department of Psychological and Brain Sciences, Boston University
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Cohen JR, So FK, Young JF, Hankin BL, Lee BA. Youth Depression Screening with Parent and Self-Reports: Assessing Current and Prospective Depression Risk. Child Psychiatry Hum Dev 2019; 50:647-660. [PMID: 30737605 PMCID: PMC6613974 DOI: 10.1007/s10578-019-00869-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Few studies have examined the incremental validity of multi-informant depression screening approaches. In response, we examined how recommendations for using a multi-informant approach may vary for identifying concurrent or prospective depressive episodes. Participants included 663 youth (AgeM = 11.83; AgeSD = 2.40) and their caregiver who independently completed youth depression questionnaires, and clinical diagnostic interviews, every 6 months for 3 years. Receiver operating characteristic (ROC) analyses showed that youth-report best predicted concurrent episodes, and that both youth and parent-report were necessary to adequately forecast prospective episodes. More specifically, youth-reported negative mood symptoms and parent-reported anhedonic symptoms incrementally predicted future depressive episodes. Findings were invariant to youth's sex and age, and results from person and variable-centered analyses suggested that discrepancies between informants were not clinically meaningful. Implications for future research and evidence-based decision making for depression screening initiatives are discussed.
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Affiliation(s)
- Joseph R. Cohen
- Department of Psychology, University of Illinois Urbana-Champaign, Champaign, IL
| | - Felix K. So
- Department of Psychology, University of Illinois Urbana-Champaign, Champaign, IL
| | - Jami F. Young
- CDepartment of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Benjamin L. Hankin
- Department of Psychology, University of Illinois Urbana-Champaign, Champaign, IL
| | - Brenda A. Lee
- Department of Psychology, University of Illinois Urbana-Champaign, Champaign, IL
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Cohen JR, So FK, Hankin BL, Young JF. Translating Cognitive Vulnerability Theory Into Improved Adolescent Depression Screening: A Receiver Operating Characteristic Approach. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2019; 48:582-595. [PMID: 29368955 PMCID: PMC6060010 DOI: 10.1080/15374416.2017.1416617] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Traditionally, screening research tests how well a given symptom inventory can identify a concurrent depressive episode. Although developmental psychopathology could inform screening protocols for a myriad of depression outcomes (e.g., prospective depressive episodes), approaches typically used in research make it difficult to translate these findings. Using a translational analytic approach and multiwave longitudinal study design, we examined how screening for cognitive vulnerabilities (rumination, dysfunctional attitudes, and attributional style) may improve our ability to identify concurrent depressive episodes, prospective depressive episodes, first lifetime episodes of depression, and recurrent major depressive episodes. There were 473 sixth-grade (early adolescents) and ninth-grade (middle adolescents; AgeM = 13.15, AgeSD = 1.62) students who completed baseline self-report cognitive vulnerability and depressive symptom measures. At baseline and every 6 months for 3 years, pediatric depression interviews were completed by the caregiver and youth. A receiver operating characteristic (ROC) approach was utilized to test our aims. Distinct algorithms best forecasted our depression outcomes. Rumination and attributional style emerged as unique and incrementally valid predictors for prospective episodes after controlling for baseline depressive symptoms. Rumination was the only unique predictor for first lifetime depressive episodes. For recurrent major depression, rumination in early adolescence and attributional style in middle adolescence served as incremental predictors beyond baseline depressive symptoms. Proposed cutoffs and diagnostic likelihood ratios are offered for algorithms for each depression outcome. Assessing cognitive vulnerability represents a feasible method to improve depression screening initiatives. Using an ROC-informed approach can help prevention initiatives better leverage the considerable gains made within developmental psychopathology research.
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Affiliation(s)
- Joseph R Cohen
- a Department of Psychology , University of Illinois at Urbana Champaign
| | - Felix K So
- a Department of Psychology , University of Illinois at Urbana Champaign
| | - Benjamin L Hankin
- a Department of Psychology , University of Illinois at Urbana Champaign
| | - Jami F Young
- b Department of Child and Adolescent Psychiatry and Behavioral Sciences , Children's Hospital of Philadelphia
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Reyes ADL, Langer DA. Assessment and the Journal of Clinical Child and Adolescent Psychology's Evidence Base Updates Series: Evaluating the Tools for Gathering Evidence. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2019; 47:357-365. [PMID: 29768054 DOI: 10.1080/15374416.2018.1458314] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
In 2014, Michael Southam-Gerow and Mitch Prinstein launched the Evidence Base Updates series. As invited contributors, authors of Evidence Base Updates articles offer the field an invaluable resource: regular evaluations of the latest data on tools for addressing the mental health needs of children and adolescents. Until now, authors of Evidence Base Updates articles have focused exclusively on evaluating treatment techniques. In this article, we outline how the Evidence Base Updates series will evolve to also include evaluations of assessment techniques. In our treatment-focused updates, contributors follow strict criteria when evaluating the evidence. Following these criteria allows authors of Evidence Base Updates articles to provide mental health professionals with clear "take-home messages" about the evidence underlying the treatments evaluated. Similarly, we outline the criteria that authors will follow when preparing Evidence Base Updates articles that evaluate assessments. We also highlight the formats of these articles, which will include evaluations of condition-focused measures (e.g., anxiety, conduct problems); transdiagnostic constructs (e.g., parenting, rumination); specific, widely used measures that cut across conditions; and updates on field-wide considerations regarding measurement (e.g., clinical utility, incremental validity).
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Affiliation(s)
- Andres De Los Reyes
- a Comprehensive Assessment and Intervention Program, Department of Psychology , University of Maryland at College Park
| | - David A Langer
- b Department of Psychological and Brain Sciences , Boston University
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Danielson M, Månsdotter A, Fransson E, Dalsgaard S, Larsson JO. Clinicians' attitudes toward standardized assessment and diagnosis within child and adolescent psychiatry. Child Adolesc Psychiatry Ment Health 2019; 13:9. [PMID: 30792803 PMCID: PMC6371426 DOI: 10.1186/s13034-019-0269-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 01/31/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND There is a strong call for clinically useful standardized assessment tools in everyday child and adolescent psychiatric practice. The attitudes of clinicians have been raised as a key-facilitating factor when implementing new methods. An explorative study was conducted aimed to investigate the clinicians' attitudes regarding standardized assessments and usefulness of diagnoses in treatment planning. METHODS 411 mental health service personnel working with outpatient and inpatient assessment and treatment within the specialist child and adolescent mental health services, Stockholm County Council were asked to participate in the study, of which 345 (84%) agreed answer a questionnaire. The questionnaire included questions regarding Attitudes toward Standardized Assessment and Utility of Diagnosis. Descriptive analyses were performed and four subscales were compared with information from a similar study in US using the same instruments. The demographic and professional characteristics (age, working years, gender, education, profession, management position, involvement in assessment, level of service) in terms of prediction of attitudes were studied by univariate and multivariate linear regressions. RESULTS Overall, the clinicians had quite positive attitudes and were more positive compared to a similar study conducted in the US earlier. There were differences in attitudes due to several characteristics but the only characteristic predicting all subscales was type of profession (counselor, nurse, psychiatrist, psychologist, other), with counselors being less positive than other groups. CONCLUSION The overall positive attitudes toward standard assessment are of importance in the development of evidence-based practice and our study implies that clinicians in general value and are willing to use standardized assessment. Nevertheless, there are specific issues such as adequate training and available translated assessment instrument that need to be addressed. When implementing new methods in practice, there are general as well as specific resistances that need to be overcome. Studies in different cultural settings are of importance to further extend the knowledge of what is general and what is specific barriers.
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Affiliation(s)
- M. Danielson
- 0000 0004 1937 0626grid.4714.6Department of Women’s and Children’s Health, Karolinska Institutet, 171 77 Stockholm, Sweden ,0000 0001 2326 2191grid.425979.4Stockholm Child and Adolescent Psychiatry, Stockholm County Council, Box 17914, 118 95 Stockholm, Sweden
| | - A. Månsdotter
- 0000 0004 0623 991Xgrid.412215.1Department of Public Health and Clinical Medicine, 901 87 Umeå, Sweden
| | - E. Fransson
- 0000 0004 1936 9377grid.10548.38Centre for Health Equity Studies, Department of Public Health Sciences, Stockholm University, 106 91 Stockholm, Sweden ,0000 0004 1937 0626grid.4714.6Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - S. Dalsgaard
- 0000 0001 1956 2722grid.7048.bThe National Centre for Register-based Research (NCRR) and Centre for Integrated Register-based Research at AU (CIRRAU), Aarhus University, Fuglesangs Alle 4, 8210 Aarhus V, Denmark
| | - J-O. Larsson
- 0000 0004 1937 0626grid.4714.6Department of Women’s and Children’s Health, Karolinska Institutet, 171 77 Stockholm, Sweden ,0000 0001 2326 2191grid.425979.4Stockholm Child and Adolescent Psychiatry, Stockholm County Council, Box 17914, 118 95 Stockholm, Sweden
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Los Reyes AD, Makol BA, Racz SJ, Youngstrom EA, Lerner MD, Keeley LM. The Work and Social Adjustment Scale for Youth: A Measure for Assessing Youth Psychosocial Impairment Regardless of Mental Health Status. JOURNAL OF CHILD AND FAMILY STUDIES 2019; 28:1-16. [PMID: 33311964 PMCID: PMC7731438 DOI: 10.1007/s10826-018-1238-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
A key component of delivering mental health services involves evaluating psychosocial impairments linked to mental health concerns. Youth may experience these impairments in various ways (e.g., dysfunctional family and/or peer relationships, poor school performance). Importantly, youth may display symptoms of mental illness without co-occurring psychosocial impairments, and the reverse may be true. However, all available instruments for assessing youth psychosocial impairments presume the presence of mental health concerns among those assessed. Consequently, key gaps exist in knowledge about the developmental psychopathology of psychosocial impairments; and thus how to understand impairments in the context of youth mental health. To address these issues we developed a modified version of a 5-item measure of adult psychosocial impairments (i.e., Work and Social Adjustment Scale for Youth [WSASY]) and tested its psychometric properties. A mixed clinical/community sample of adolescents and parents completed parallel versions of the WSASY, along with a multi-domain, multi-method battery of measures of adolescent internalizing and externalizing concerns, parent psychosocial functioning, adolescent-parent conflict, adolescent peer functioning, and observed social skills. On both versions of the WSASY, increased scores related to increased adolescent mental health concerns, adolescent-parent conflict, parent psychosocial dysfunction, and peer-related impairments. WSASY scores also distinguished adolescents who displayed co-occurring mental health concerns from those who did not, and related to observed social skills deficits within social interactions with unfamiliar peers. The WSASY opens doors to new areas of inquiry regarding the developmental psychopathology of impairment, including questions regarding the onset of impairments and their links to mental health.
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Affiliation(s)
- Andres De Los Reyes
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland, College Park, MD 20742
| | - Bridget A Makol
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland, College Park, MD 20742
| | - Sarah J Racz
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland, College Park, MD 20742
| | - Eric A Youngstrom
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC 27599
| | - Matthew D Lerner
- Department of Psychology, Stony Brook University, Stony Brook, NY 11794
| | - Lauren M Keeley
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland, College Park, MD 20742
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Youngstrom EA, Van Meter A, Frazier TW, Youngstrom JK, Findling RL. Developing and Validating Short Forms of the Parent General Behavior Inventory Mania and Depression Scales for Rating Youth Mood Symptoms. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2018; 49:162-177. [DOI: 10.1080/15374416.2018.1491006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Eric A. Youngstrom
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | - Anna Van Meter
- Department of Psychiatry Research, Zucker Hillside Hospital
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Abstract
OBJECTIVES With our study we aimed to (1) understand what factors uniquely conferred risk for physical and sexual forms of teen dating violence (TDV) perpetration and (2) create a screening algorithm to quantify perpetration risk on the basis of these factors. METHODS A total of 1031 diverse public high school students living in Southeast Texas participated in our study (56% female; 29% African American, 28% white, and 31% Hispanic). Self-report measures concerning TDV and associated risk factors were completed annually for 6 years. RESULTS Results suggested that family violence (domestic violence exposure, maltreatment) together with deficits in conflict resolution incrementally improved our forecasts above and beyond lifetime history of physical TDV perpetration (net reclassification improvement = 0.44; 95% confidence interval [CI] = 0.30-0.59). Meanwhile, a violent dating history (TDV sexual perpetration, sexual victimization, and emotional perpetration) and acceptance of TDV incrementally improved our models for forecasting sexual forms of perpetration (net reclassification improvement = 0.41; 95% CI = 0.24-0.58). These models adequately discriminated between future perpetrators and nonoffenders (area under the curve statistic >0.70; 95% CI: 0.69-0.74). Overall, adolescents with positive test results on our algorithms were over twice as likely to perpetrate dating violence over the course of 6 years. CONCLUSIONS Our study represents one of the first applications of reclassification analyses to psychosocial research in a pediatric population. The result is a theoretically informed, empirically based algorithm that can adequately estimate the likelihood of physical and sexual TDV perpetration during vulnerable developmental periods. These findings can immediately aid emerging preventive initiatives for this increasing public health concern.
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Affiliation(s)
- Joseph R. Cohen
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, Illinois
| | - Ryan C. Shorey
- Department of Psychology, Ohio University, Athens, Ohio; and
| | - Suvarna V. Menon
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, Illinois
| | - Jeff R. Temple
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
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Youngstrom EA, Halverson TF, Youngstrom JK, Lindhiem O, Findling RL. Evidence-Based Assessment from Simple Clinical Judgments to Statistical Learning: Evaluating a Range of Options Using Pediatric Bipolar Disorder as a Diagnostic Challenge. Clin Psychol Sci 2018; 6:243-265. [PMID: 30263876 PMCID: PMC6152934 DOI: 10.1177/2167702617741845] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Reliability of clinical diagnoses is often low. There are many algorithms that could improve diagnostic accuracy, and statistical learning is becoming popular. Using pediatric bipolar disorder as a clinically challenging example, we evaluated a series of increasingly complex models ranging from simple screening to a supervised LASSO regression in a large (N=550) academic clinic sample. We then externally validated models in a community clinic (N=511) with the same candidate predictors and semi-structured interview diagnoses, providing high methodological consistency; the clinics also had substantially different demography and referral patterns. Models performed well according to internal validation metrics. Complex models degraded rapidly when externally validated. Naïve Bayesian and logistic models concentrating on predictors identified in prior meta-analyses tied or bettered LASSO models when externally validated. Implementing these methods would improve clinical diagnostic performance. Statistical learning research should continue to invest in high quality indicators and diagnoses to supervise model training.
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