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Habibi Asgarabad M, Steinsbekk S, Hartung CM, Wichstrøm L. Reciprocal relations between dimensions of attention-deficit/hyperactivity and anxiety disorders from preschool age to adolescence: sex differences in a birth cohort sample. J Child Psychol Psychiatry 2024. [PMID: 38965813 DOI: 10.1111/jcpp.14038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/04/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Symptoms of anxiety and attention-deficit/hyperactivity disorder (ADHD) are prospectively related from childhood to adolescence. However, whether the two dimensions of ADHD-inattention and hyperactivity-impulsivity-are differentially related to anxiety and whether there are developmental and sex/gender differences in these relations are unknown. METHODS Two birth cohorts of Norwegian children were assessed biennially from ages 4 to 16 (N = 1,077; 49% girls) with diagnostic parent interviews used to assess symptoms of anxiety and ADHD. Data were analyzed using a random intercept cross-lagged panel model, adjusting for all unobserved time-invariant confounding effects. RESULTS In girls, increased inattention, but not hyperactivity-impulsivity, predicted increased anxiety 2 years later across all time-points and increased anxiety at ages 12 and 14 predicted increased inattention but not hyperactivity-impulsivity. In boys, increased hyperactivity-impulsivity at ages 6 and 8, but not increased inattention, predicted increased anxiety 2 years later, whereas increased anxiety did not predict increased inattention or hyperactivity-impulsivity. CONCLUSIONS The two ADHD dimensions were differentially related to anxiety, and the relations were sex-specific. In girls, inattention may be involved in the development of anxiety throughout childhood and adolescence and anxiety may contribute to girls developing more inattention beginning in early adolescence. In boys, hyperactivity-impulsivity may be involved in the development of anxiety during the early school years. Effective treatment of inattention symptoms in girls may reduce anxiety risk at all time-points, while addressing anxiety may decrease inattention during adolescence. Similarly, treating hyperactivity-impulsivity may reduce anxiety risk in boys during late childhood (at ages 8-10).
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Affiliation(s)
| | - Silje Steinsbekk
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Lars Wichstrøm
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Child and Adolescent Psychiatry, St Olav's Hospital, Trondheim, Norway
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Jones JD, Boyd RC, Sandro AD, Calkins ME, Los Reyes AD, Barzilay R, Young JF, Benton TD, Gur RC, Moore TM, Gur RE. The General Psychopathology 'p' Factor in Adolescence: Multi-Informant Assessment and Computerized Adaptive Testing. Res Child Adolesc Psychopathol 2024:10.1007/s10802-024-01223-8. [PMID: 38869751 DOI: 10.1007/s10802-024-01223-8] [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] [Accepted: 06/06/2024] [Indexed: 06/14/2024]
Abstract
Accumulating evidence supports the presence of a general psychopathology dimension, the p factor ('p'). Despite growing interest in the p factor, questions remain about how p is assessed. Although multi-informant assessment of psychopathology is commonplace in clinical research and practice with children and adolescents, almost no research has taken a multi-informant approach to studying youth p or has examined the degree of concordance between parent and youth reports. Further, estimating p requires assessment of a large number of symptoms, resulting in high reporter burden that may not be feasible in many clinical and research settings. In the present study, we used bifactor multidimensional item response theory models to estimate parent- and adolescent-reported p in a large community sample of youth (11-17 years) and parents (N = 5,060 dyads). We examined agreement between parent and youth p scores and associations with assessor-rated youth global functioning. We also applied computerized adaptive testing (CAT) simulations to parent and youth reports to determine whether adaptive testing substantially alters agreement on p or associations with youth global functioning. Parent-youth agreement on p was moderate (r =.44) and both reports were negatively associated with youth global functioning. Notably, 7 out of 10 of the highest loading items were common across reporters. CAT reduced the average number of items administered by 57%. Agreement between CAT-derived p scores was similar to the full form (r =.40) and CAT scores were negatively correlated with youth functioning. These novel results highlight the promise and potential clinical utility of a multi-informant p factor approach.
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Affiliation(s)
- Jason D Jones
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA 19146, USA.
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA.
| | - Rhonda C Boyd
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA 19146, USA
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA
| | - Akira Di Sandro
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA
| | - Monica E Calkins
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA
| | - Andres De Los Reyes
- Department of Psychology, University of Maryland, College Park, Maryland, USA
| | - Ran Barzilay
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA 19146, USA
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA
| | - Jami F Young
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA 19146, USA
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA
| | - Tami D Benton
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA 19146, USA
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA
| | - Ruben C Gur
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA
| | - Tyler M Moore
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA
| | - Raquel E Gur
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA 19146, USA
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA
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Sachs R, Nakonezny PA, Balzen KM, Heerschap J, Kennard BD, Emslie GJ, Stewart SM. The effect of parent-adolescent discrepancies in reports of familial dysfunction and depression on suicidal ideation in adolescents. Suicide Life Threat Behav 2024; 54:515-527. [PMID: 38385782 PMCID: PMC11164646 DOI: 10.1111/sltb.13062] [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: 09/16/2022] [Revised: 11/14/2023] [Accepted: 01/05/2024] [Indexed: 02/23/2024]
Abstract
INTRODUCTION Parents and adolescents are often discrepant in their reports of adolescent psychosocial factors. Few studies have addressed parent-adolescent discrepancies in subjective ratings of familial dysfunction and depression as longitudinal predictor variables, and none have done so in a treatment setting for adolescents with acute suicidality. This study examined how parent-adolescent discrepancies in familial dysfunction and depression impact adolescent treatment response in an intensive outpatient program for suicidality. METHODS Adolescents (N = 315) were assessed at treatment entry and exit for familial dysfunction, depression, and suicidal ideation. Parents received parallel assessments of familial dysfunction and adolescent depression at each time point. A polynomial regression was conducted to determine whether parent-adolescent discrepancies in reports of familial dysfunction and depression at entry related to the treatment outcome of adolescent-reported depression and suicide ideation at exit. RESULTS Significant discrepancies were present with on average adolescents reporting more depression and familial dysfunction than parents. Entry discrepancy in familial dysfunction (but not depression) predicted suicide ideation at exit. CONCLUSIONS Our results suggest that parent-adolescent discrepancies in perception of familial dysfunction is a risk factor for poor outcomes in suicidal youth and might be a fruitful target in treatment programs.
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Affiliation(s)
- Raney Sachs
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX
- Division of Psychology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Paul A. Nakonezny
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX
- Peter O’Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX
| | | | - Jessica Heerschap
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX
- Division of Psychology, University of Texas Southwestern Medical Center, Dallas, TX
- Department of Psychiatry, Children’s Health Children’s Medical Center, Dallas, TX
| | - Betsy D. Kennard
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX
- Division of Psychology, University of Texas Southwestern Medical Center, Dallas, TX
- Department of Psychiatry, Children’s Health Children’s Medical Center, Dallas, TX
| | - Graham J. Emslie
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX
- Department of Psychiatry, Children’s Health Children’s Medical Center, Dallas, TX
| | - Sunita M. Stewart
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX
- Division of Psychology, University of Texas Southwestern Medical Center, Dallas, TX
- Department of Psychiatry, Children’s Health Children’s Medical Center, Dallas, TX
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Connors EH, Childs AW, Douglas S, Jensen-Doss A. Data-Informed Communication: How Measurement-Based Care Can Optimize Child Psychotherapy. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024:10.1007/s10488-024-01372-4. [PMID: 38662178 DOI: 10.1007/s10488-024-01372-4] [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] [Accepted: 03/13/2024] [Indexed: 04/26/2024]
Abstract
Measurement-based care (MBC) research and practice, including clinical workflows and systems to support MBC, are grounded in adult-serving mental health systems. MBC research evidence is building in child and adolescent services, but MBC practice is inherently more complex due to identified client age, the family system and the need to involve multiple reporters. This paper seeks to address a gap in the literature by providing practical guidance for youth-serving clinicians implementing MBC with children and their families. We focus on MBC as a data-informed, client-centered communication process, and present three key strategies to enhance usual care child and adolescent psychotherapy via developmentally-appropriate MBC. These strategies include (1) go beyond standardized measures; (2) lean into discrepancies; and (3) get curious together. Case-based examples drawn from various child-serving settings illustrate these key strategies of MBC in child psychotherapy.
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Affiliation(s)
| | - Amber W Childs
- Yale School of Medicine, Department of Psychiatry, New Haven, CT, USA
| | - Susan Douglas
- Department of Leadership, Policy, and Organizations, Vanderbilt University, Peabody College, Nashville, TN, USA
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Chiu AW, Desai P, Skriner L, Catarozoli C, Sullivan P, Bennett SM. Youth Top Problems in an Acute Psychiatric Sample: Describing Consumer-Nominated Treatment Needs in an Adolescent Partial Hospital Setting. Child Psychiatry Hum Dev 2024; 55:520-530. [PMID: 36074210 DOI: 10.1007/s10578-022-01427-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/27/2022] [Indexed: 11/28/2022]
Abstract
Given the wide range of diagnostic presentations treated in partial hospital programs, finding efficient ways to identify and measure progress on the chief concerns of consumers in these settings is important. The current study uses a self-administered version of the Top Problems Assessment to describe treatment targets identified by youth and their caregivers presenting for care at an adolescent partial hospital setting. Caregiver-youth agreement on these chief concerns upon admission and predictors of agreement were explored. About one-third (34.65%) of caregiver-youth pairs did not match on any target problems. Although anxiety and depression were the most commonly cited top problems in this sample, caregivers and youth exhibited disagreement on these domains. Treatment teams in acute care settings such as a partial hospital program can benefit from careful assessment surrounding the initial goals of treatment as youth and their caregivers may not agree on the referral problems upon entering a program.
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Affiliation(s)
- Angela W Chiu
- Department of Child and Adolescent Psychiatry, Weill Cornell Medicine-New York-Presbyterian Hospital, 315 East 62nd Street, 5th floor, New York, NY, 10065, USA.
| | - Payal Desai
- Department of Child and Adolescent Psychiatry, Columbia University Medical Center, New York, NY, USA
| | - Laura Skriner
- The Center for Stress, Anxiety, and Mood, Summit, NJ, USA
| | - Corinne Catarozoli
- Department of Child and Adolescent Psychiatry, Weill Cornell Medicine-New York-Presbyterian Hospital, 315 East 62nd Street, 5th floor, New York, NY, 10065, USA
| | - Paul Sullivan
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine/NYC Health + Hospitals/Bellevue, New York, NY, USA
| | - Shannon M Bennett
- Department of Child and Adolescent Psychiatry, Weill Cornell Medicine-New York-Presbyterian Hospital, 315 East 62nd Street, 5th floor, New York, NY, 10065, USA
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Haller SP, Archer C, Jeong A, Jaffe A, Jones EL, Harrewijn A, Naim R, Linke JO, Stoddard J, Brotman MA. Changes in Internalizing Symptoms During the COVID-19 Pandemic in a Transdiagnostic Sample of Youth: Exploring Mediators and Predictors. Child Psychiatry Hum Dev 2024; 55:206-218. [PMID: 35794298 PMCID: PMC9816351 DOI: 10.1007/s10578-022-01382-z] [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] [Accepted: 05/21/2022] [Indexed: 01/11/2023]
Abstract
The COVID-19 pandemic is a chronically stressful event, particularly for youth. Here, we examine (i) changes in mood and anxiety symtpoms, (ii) pandemic-related stress as a mediator of change in symptoms, and (ii) threat processing biases as a predictor of increased anxiety during the pandemic. A clinically well-characterized sample of 81 youth ages 8-18 years (M = 13.8 years, SD = 2.65; 40.7% female) including youth with affective and/or behavioral psychiatric diagnoses and youth without psychopathology completed pre- and during pandemic assessments of anxiety and depression and COVID-related stress. Forty-six youth also completed a threat processing fMRI task pre-pandemic. Anxiety and depression significantly increased during the pandemic (all ps < 0.05). Significant symptom change was partially mediated by pandemic stress and worries. Increased prefrontal activity in response to neutral faces pre-pandemic was associated with more intense parent-reported anxiety during the pandemic (all Fs(1.95,81.86) > 14.44, ps < 0.001). The present work extends existing knowledge on the mediating role of psychological stress on symptoms of anxiety and depression in youth.
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Affiliation(s)
- Simone P Haller
- Emotion and Development Branch, National Institutes of Mental Health, 9000 Rockville Pike, Bldg. 15K, Bethesda, MD, 20892-2670, USA.
| | - Camille Archer
- Emotion and Development Branch, National Institutes of Mental Health, 9000 Rockville Pike, Bldg. 15K, Bethesda, MD, 20892-2670, USA
| | - Annie Jeong
- Emotion and Development Branch, National Institutes of Mental Health, 9000 Rockville Pike, Bldg. 15K, Bethesda, MD, 20892-2670, USA
| | - Allison Jaffe
- Emotion and Development Branch, National Institutes of Mental Health, 9000 Rockville Pike, Bldg. 15K, Bethesda, MD, 20892-2670, USA
| | - Emily L Jones
- Emotion and Development Branch, National Institutes of Mental Health, 9000 Rockville Pike, Bldg. 15K, Bethesda, MD, 20892-2670, USA
| | - Anita Harrewijn
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Reut Naim
- Emotion and Development Branch, National Institutes of Mental Health, 9000 Rockville Pike, Bldg. 15K, Bethesda, MD, 20892-2670, USA
| | - Julia O Linke
- Emotion and Development Branch, National Institutes of Mental Health, 9000 Rockville Pike, Bldg. 15K, Bethesda, MD, 20892-2670, USA
| | - Joel Stoddard
- Department of Psychiatry & Neuroscience Program, Children's Hospital Colorado, Pediatric Mental Health Institute, University of Colorado, Anschutz Medical Campus, 13123 East 16th Avenue, Aurora, CO, 80045, USA
| | - Melissa A Brotman
- Emotion and Development Branch, National Institutes of Mental Health, 9000 Rockville Pike, Bldg. 15K, Bethesda, MD, 20892-2670, USA
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Amelio P, Antonacci C, Khosravi P, Haller S, Kircanski K, Berman E, Cullins L, Lewis K, Davis M, Engel C, Towbin K, Stringaris A, Pine DS. Evaluating the development and well-being assessment (DAWBA) in pediatric anxiety and depression. Child Adolesc Psychiatry Ment Health 2024; 18:12. [PMID: 38245769 PMCID: PMC10800067 DOI: 10.1186/s13034-023-00696-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 12/19/2023] [Indexed: 01/22/2024] Open
Abstract
Enhancing screening practices and developing scalable diagnostic tools are imperative in response to the increasing prevalence of youth mental health challenges. Structured lay psychiatric interviews have emerged as one such promising tool. However, there remains limited research evaluating structured psychiatric interviews, specifically their characterization of internalizing disorders in treatment-seeking youth. This study evaluates the relationship between the Development and Well-Being Assessment (DAWBA), a structured psychiatric interview, and established measures of pediatric anxiety and depression, including the Screen for Child Anxiety Related Disorders (SCARED), the Pediatric Anxiety Rating Scale (PARS), and the Mood and Feelings Questionnaire (MFQ). The study comprised two independent clinical samples of treatment-seeking youth: sample one included 55 youth with anxiety and 29 healthy volunteers (HV), while sample two included 127 youth with Major Depressive Disorder and 73 HVs. We examined the association between the DAWBA band scores, indicating predicted risk for diagnosis, the SCARED and PARS (sample one), and the MFQ (sample two). An exploratory analysis was conducted in a subset of participants to test whether DAWBA band scores predicted the change in anxiety symptoms (SCARED, PARS) across a 12-week course of cognitive behavioral therapy. The results revealed that the DAWBA significantly predicted the SCARED, PARS and MFQ measures at baseline; however, it did not predict changes in anxiety symptoms across treatment. These findings suggest that the DAWBA may be a helpful screening tool for indexing anxiety and depression in treatment-seeking youth but is not especially predictive of longitudinal trajectories in symptomatology across psychotherapy.
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Affiliation(s)
- Paia Amelio
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Chase Antonacci
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Parmis Khosravi
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA.
| | - Simone Haller
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Katharina Kircanski
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Erin Berman
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Lisa Cullins
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Krystal Lewis
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Mollie Davis
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Chana Engel
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Kenneth Towbin
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Argyris Stringaris
- Divisions of Psychiatry and Psychology and Language Science, University College London, London, UK
- National and Kapodistrian University of Athens, Athens, Greece
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
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Pivetta E, Costa S, Antonietti JP, Marino C, Billieux J, Canale N. Adolescent problematic gaming and its association with maternal behaviors: A dyadic study focusing on the relational-emotional correlates. Addict Behav 2023; 140:107602. [PMID: 36621044 DOI: 10.1016/j.addbeh.2022.107602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/18/2022] [Accepted: 12/23/2022] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Associations between Problematic Gaming (PG) and the relational-emotional correlates of parenting have been reported in the literature. Previous research mostly collected information from adolescents, however, and suggested that little is known about the perceptions of parents and whether these are shared among parent-adolescent dyads. Therefore, this study aimed to (a) examine multiple informants' reports of adolescent PG and maternal behaviors (i.e., warmth and indifference) and (b) disentangle the associations between the behaviors shared by mothers and adolescents from those unique to each member. METHOD Data were collected by using self-administered online questionnaires from 137 Italian mother-adolescent dyads in Italy. The mean age of adolescents (n = 92 males, n = 42 females, n = 3 nonbinary) was 14.68 (±1.25) years and that of mothers 47.48 (±4.69) years. Descriptive statistics and common fate model (CFM) analyses were conducted. RESULTS Mothers reported higher scores of their offspring's PG. Within-reporter interclass correlations revealed positive associations between maternal indifference and adolescent PG for both informants. CFM indicated that correlations between maternal behaviors and adolescent PG based on shared perceptions did not reach statistical significance, whereas correlations based on unique mothers' perceptions were statistically significant for all the observed relationships. CONCLUSIONS In the context of adolescent PG, mothers may have a heightened motivation to perceive their parenting as crucial. The multi-informant approach allows a more accurate examination of the associations between adolescent PG and maternal behaviors and underscores the need to consider discordant assessment of the same phenomenon between mothers and adolescents.
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Affiliation(s)
- Erika Pivetta
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy.
| | - Sebastiano Costa
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | | | - Claudia Marino
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
| | - Joël Billieux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland; Center for Excessive Gambling, Addiction Medicine, Lausanne University, Hospitals (CHUV), Lausanne, Switzerland
| | - Natale Canale
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
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Sicouri G, March S, Pellicano E, De Young AC, Donovan CL, Cobham VE, Rowe A, Brett S, Russell JK, Uhlmann L, Hudson JL. Mental health symptoms in children and adolescents during COVID-19 in Australia. Aust N Z J Psychiatry 2023; 57:213-229. [PMID: 35411818 PMCID: PMC9896295 DOI: 10.1177/00048674221090174] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE COVID-19 has led to disruptions to the lives of Australian families through social distancing, school closures, a temporary move to home-based online learning, and effective lockdown. Understanding the effects on child and adolescent mental health is important to inform policies to support communities as they continue to face the pandemic and future crises. This paper sought to report on mental health symptoms in Australian children and adolescents during the initial stages of the pandemic (May to November 2020) and to examine their association with child/family characteristics and exposure to the broad COVID-19 environment. METHODS An online baseline survey was completed by 1327 parents and carers of Australian children aged 4 to 17 years. Parents/carers reported on their child's mental health using five measures, including emotional symptoms, conduct problems, hyperactivity/inattention, anxiety symptoms and depressive symptoms. Child/family characteristics and COVID-related variables were measured. RESULTS Overall, 30.5%, 26.3% and 9.5% of our sample scored in the high to very high range for emotional symptoms, conduct problems and hyperactivity/inattention, respectively. Similarly, 20.2% and 20.4% of our sample scored in the clinical range for anxiety symptoms and depressive symptoms, respectively. A child's pre-existing mental health diagnosis, neurodevelopmental condition and chronic illness significantly predicted parent-reported child and adolescent mental health symptoms. Parental mental health symptoms, having a close contact with COVID-19 and applying for government financial assistance during COVID-19, were significantly associated with child and adolescent mental health symptoms. CONCLUSION Our findings show that Australian children and adolescents experienced considerable levels of mental health symptoms during the initial phase of COVID-19. This highlights the need for targeted and effective support for affected youth, particularly for those with pre-existing vulnerabilities.
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Affiliation(s)
- Gemma Sicouri
- Black Dog Institute and School of Psychology, University of New South Wales, Sydney, NSW, Australia,Gemma Sicouri, Black Dog Institute, University of New South Wales, Hospital Rd, Randwick, NSW 2031, Australia.
| | - Sonja March
- School of Psychology and Wellbeing, University of Southern Queensland, Ipswich, QLD, Australia,Centre for Health Research, University of Southern Queensland, Springfield, QLD, Australia
| | | | - Alex C De Young
- Child Health Research Centre, The University of Queensland, Brisbane, QLD, Australia,School of Psychology, The University of Queensland, St Lucia, QLD, Australia
| | - Caroline L Donovan
- School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
| | - Vanessa E Cobham
- School of Psychology, The University of Queensland, St Lucia, QLD, Australia,Children’s Health Queensland, Child and Youth Mental Health Service, Brisbane, QLD, Australia
| | - Arlen Rowe
- School of Psychology and Wellbeing, University of Southern Queensland, Ipswich, QLD, Australia,Centre for Health Research, University of Southern Queensland, Springfield, QLD, Australia
| | - Simon Brett
- Macquarie School of Education, Macquarie University, Sydney, NSW, Australia,School of Psychology and Clinical Language Services, University of Reading, Reading, UK
| | - Jeremy K Russell
- Centre for Health Research, University of Southern Queensland, Springfield, QLD, Australia
| | - Laura Uhlmann
- Children’s Health Queensland, Child and Youth Mental Health Service, Brisbane, QLD, Australia
| | - Jennifer L Hudson
- Black Dog Institute and School of Psychology, University of New South Wales, Sydney, NSW, Australia
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10
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Westrupp EM, Bennett C, Berkowitz T, Youssef GJ, Toumbourou JW, Tucker R, Andrews FJ, Evans S, Teague SJ, Karantzas GC, Melvin GM, Olsson C, Macdonald JA, Greenwood CJ, Mikocka-Walus A, Hutchinson D, Fuller-Tyszkiewicz M, Stokes MA, Olive L, Wood AG, McGillivray JA, Sciberras E. Child, parent, and family mental health and functioning in Australia during COVID-19: comparison to pre-pandemic data. Eur Child Adolesc Psychiatry 2023; 32:317-330. [PMID: 34417875 PMCID: PMC8379590 DOI: 10.1007/s00787-021-01861-z] [Citation(s) in RCA: 61] [Impact Index Per Article: 61.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 08/13/2021] [Indexed: 02/07/2023]
Abstract
The COVID-19 pandemic presents significant risks to population mental health. Despite evidence of detrimental effects for adults, there has been limited examination of the impact of COVID-19 on parents and children specifically. We aim to examine patterns of parent and child (0-18 years) mental health, parent substance use, couple conflict, parenting practices, and family functioning during COVID-19, compared to pre-pandemic data, and to identify families most at risk of poor outcomes according to pre-existing demographic and individual factors, and COVID-19 stressors. Participants were Australian mothers (81%) and fathers aged 18 years and over who were parents of a child 0-18 years (N = 2365). Parents completed an online self-report survey during 'stage three' COVID-19 restrictions in April 2020. Data were compared to pre-pandemic data from four Australian population-based cohorts. Compared to pre-pandemic estimates, during the pandemic period parents reported higher rates of parent depression, anxiety, and stress (Cohen's d = 0.26-0.81, all p < 0.001), higher parenting irritability (d = 0.17-0.46, all p < 0.001), lower family positive expressiveness (d = - 0.18, p < 0.001), and higher alcohol consumption (22% vs 12% drinking four or more days per week, p < 0.001). In multivariable analyses, we consistently found that younger parent age, increased financial deprivation, pre-existing parent and child physical and mental health conditions, COVID-19 psychological and environmental stressors, and housing dissatisfaction were associated with worse parent and child functioning and more strained family relationships. Our data suggest wide-ranging, detrimental family impacts associated with the COVID-19 pandemic; and support policy actions to assist families with financial supports, leave entitlements, and social housing.
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Affiliation(s)
- E M Westrupp
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia.
- Department of Paediatrics, University of Melbourne, Victoria, Australia.
- Judith Lumley Centre, La Trobe University, Victoria, Australia.
| | - C Bennett
- Judith Lumley Centre, La Trobe University, Victoria, Australia
| | - T Berkowitz
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
| | - G J Youssef
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
- Murdoch Children's Research Institute, Victoria, Australia
| | - J W Toumbourou
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
| | - R Tucker
- Deakin HOME Research Hub, Victoria, Australia
| | - F J Andrews
- Deakin HOME Research Hub, Victoria, Australia
| | - S Evans
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
| | - S J Teague
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
| | - G C Karantzas
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
| | - G M Melvin
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
- Centre for Educational Development Research and Appraisal, University of Warwick, Coventry, UK
| | - C Olsson
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
- Department of Paediatrics, University of Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Victoria, Australia
| | - J A Macdonald
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
- Department of Paediatrics, University of Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Victoria, Australia
| | - C J Greenwood
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
| | - A Mikocka-Walus
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
| | - D Hutchinson
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
- Murdoch Children's Research Institute, Victoria, Australia
- The National Drug and Alcohol Research Centre, University of Sydney, New South Wales, Australia
| | - M Fuller-Tyszkiewicz
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
| | - M A Stokes
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
| | - L Olive
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
- IMPACT Institute, School of Medicine, Faculty of Health, Deakin University, Victoria, Australia
| | - A G Wood
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
- College of Health and Life Sciences, Aston University, Birmingham, UK
| | - J A McGillivray
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
| | - E Sciberras
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
- Department of Paediatrics, University of Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Victoria, Australia
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11
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De Los Reyes A, Wang M, Lerner MD, Makol BA, Fitzpatrick OM, Weisz JR. The Operations Triad Model and Youth Mental Health Assessments: Catalyzing a Paradigm Shift in Measurement Validation. 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; 52:19-54. [PMID: 36040955 DOI: 10.1080/15374416.2022.2111684] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Researchers strategically assess youth mental health by soliciting reports from multiple informants. Typically, these informants (e.g., parents, teachers, youth themselves) vary in the social contexts where they observe youth. Decades of research reveal that the most common data conditions produced with this approach consist of discrepancies across informants' reports (i.e., informant discrepancies). Researchers should arguably treat these informant discrepancies as domain-relevant information: data relevant to understanding youth mental health domains (e.g., anxiety, depression, aggression). Yet, historically, in youth mental health research as in many other research areas, one set of paradigms has guided interpretations of informant discrepancies: Converging Operations and the Multi-Trait Multi-Method Matrix (MTMM). These paradigms (a) emphasize shared or common variance observed in multivariate data, and (b) inspire research practices that treat unique variance (i.e., informant discrepancies) as measurement confounds, namely random error and/or rater biases. Several yearsw ago, the Operations Triad Model emerged to address a conceptual problem that Converging Operations does not address: Some informant discrepancies might reflect measurement confounds, whereas others reflect domain-relevant information. However, addressing this problem requires more than a conceptual paradigm shift beyond Converging Operations. This problem necessitates a paradigm shift in measurement validation. We advance a paradigm (Classifying Observations Necessitates Theory, Epistemology, and Testing [CONTEXT]) that addresses problems with using the MTMM in youth mental health research. CONTEXT optimizes measurement validity by guiding researchers to leverage (a) informants that produce domain-relevant informant discrepancies, (b) analytic procedures that retain domain-relevant informant discrepancies, and (c) study designs that facilitate detecting domain-relevant informant discrepancies.
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Affiliation(s)
- Andres De Los Reyes
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland
| | - Mo Wang
- Department of Management, University of Florida
| | | | - Bridget A Makol
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland
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12
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De Los Reyes A, Epkins CC. Introduction to the Special Issue. A Dozen Years of Demonstrating That Informant Discrepancies are More Than Measurement Error: Toward Guidelines for Integrating Data from Multi-Informant Assessments of Youth Mental Health. 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; 52:1-18. [PMID: 36725326 DOI: 10.1080/15374416.2022.2158843] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Validly characterizing youth mental health phenomena requires evidence-based approaches to assessment. An evidence-based assessment cannot rely on a "gold standard" instrument but rather, batteries of instruments. These batteries include multiple modalities of instrumentation (e.g., surveys, interviews, performance-based tasks, physiological readings, structured clinical observations). Among these instruments are those that require soliciting reports from multiple informants: People who provide psychometrically sound data about youth mental health (e.g., parents, teachers, youth themselves). The January 2011 issue of the Journal of Clinical Child and Adolescent Psychology (JCCAP) included a Special Section devoted to the most common outcome of multi-informant assessments of youth mental health, namely discrepancies across informants' reports (i.e., informant discrepancies). The 2011 JCCAP Special Section revolved around a critical question: Might informant discrepancies contain data relevant to understanding youth mental health (i.e., domain-relevant information)? This Special Issue is a "sequel" to the 2011 Special Section. Since 2011, an accumulating body of work indicates that informant discrepancies often contain domain-relevant information. Ultimately, we designed this Special Issue to lay the conceptual, methodological, and empirical foundations of guidelines for integrating multi-informant data when informant discrepancies contain domain-relevant information. In this introduction to the Special Issue, we briefly review the last 12 years of research and theory on informant discrepancies. This review highlights limitations inherent to the most commonly used strategies for integrating multi-informant data in youth mental health. We also describe contributions to the Special Issue, including articles about informant discrepancies that traverse multiple content areas (e.g., autism, implementation science, measurement validation, suicide).
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Affiliation(s)
- Andres De Los Reyes
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland
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13
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Fitzpatrick OM, Holcomb JM, Weisz JR, Langer DA. Shared Decision-Making as a Tool for Navigating Multi-Stakeholder Discrepancies in Youth Psychotherapy. 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; 52:95-107. [PMID: 36190817 PMCID: PMC9898176 DOI: 10.1080/15374416.2022.2127105] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Discrepancies among the key stakeholders in youth psychotherapy (e.g., caregivers, youths) commonly present an obstacle to treatment planning, forcing clinicians to align with one perspective over another and increasing the likelihood of a treatment plan that is not fully responsive to divergent opinions. At the same time, multi-stakeholder discrepancies can also offer opportunities to build an inclusive, effective treatment plan, guided by the integration of numerous sources of domain-specific knowledge related to the concerns for which families seek clinical care. METHOD We aim to: 1) investigate the degree to which multi-stakeholder discrepancies are observed when youths and caregivers are invited to report their treatment priorities, rather than the presence and severity of youth symptoms, 2) describe the rationale for, as well as the promise and challenges of, shared decision-making (SDM)-an approach designed to facilitate multi-stakeholder collaboration during treatment planning, 3) provide a case example illustrating how a clinician, youth, and caregiver could use SDM to navigate discrepancies and identify therapy targets, and 4) propose future directions for exploring the potential value of SDM in youth psychotherapy. RESULTS Different levels of multi-stakeholder agreement were observed when caregivers and youths were asked to identify their treatment priorities, compared to youth symptom presence and severity, revealing nuances in multi-stakeholder agreement in youth psychotherapy. CONCLUSIONS Multi-stakeholder discrepancies can inform treatment planning processes, and SDM may be an effective approach for navigating them and building a treatment plan that integrates the perspective of all stakeholders in youth psychotherapy.
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14
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Spears AP, Gratch I, Nam RJ, Goger P, Cha CB. Future Directions in Understanding and Interpreting Discrepant Reports of Suicidal Thoughts and Behaviors Among 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 2023; 52:134-146. [PMID: 36473063 PMCID: PMC9898197 DOI: 10.1080/15374416.2022.2145567] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Both the quality and utility of youth suicide research depend on how we assess our outcomes of interest: suicidal thoughts and behaviors (STBs). We now have access to more STB assessments than ever before, with measures for youth that vary in what exact experiences are asked about, how such measures elicit information, when and how frequently measures are administered, and who the informants are. This growing armamentarium of assessments has the potential to improve the study and treatment of STBs among youth, but it hinges on meaningful interpretation of assessment responses. Interpretation can be especially challenging when different STB assessments yield conflicting information. Determining how to manage discrepant reports of STBs is a pivotal step toward achieving meaningfully comprehensive STB assessment batteries. Here, we outline several discrepant reporting patterns that have been detected, discuss the potential significance of these observed discrepancies, and present initial steps to formally investigate discrepant reports of STBs among youth. Developing coherent, interpretable, and comprehensive batteries assessing STBs among youth would address a fundamental step to uncovering etiology, improving clinical decision-making and case management, informing intervention development, and tracking prognosis.
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Affiliation(s)
- Angela Page Spears
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Ilana Gratch
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Rachel J Nam
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Pauline Goger
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Christine B Cha
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
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15
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Xavier RM, Calkins ME, Bassett DS, Moore TM, George WT, Taylor JH, Gur RE. Characterizing Youth-Caregiver Concordance and Discrepancies in Psychopathology Symptoms in a US Community Sample. Issues Ment Health Nurs 2022; 43:1004-1013. [PMID: 35839118 PMCID: PMC9709771 DOI: 10.1080/01612840.2022.2099494] [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] [Indexed: 10/17/2022]
Abstract
Evidence shows that reports of psychopathology symptoms by youth and their caregiver informants differ. To quantify youth-caregiver discrepancies in psychopathology symptoms and factors associated with such discrepancies, we investigated differences in how youth and their caregivers rated psychopathology symptoms. The sample (N = 5094) was extracted from the Philadelphia Neurodevelopmental Cohort, a community-based sample of youth and included participants ages 11-17 years old with both youth and caregiver reported symptom scores. Across psychopathology symptoms, youth-caregiver concordance was poor to fair (Cohens kappa for symptom items ranged between 0.03-0.41). Psychosis symptoms had the lowest concordance-Cohen's kappa ranged from 0.03 to 0.17 across psychosis symptoms. Discrepancies between youth and caregiver symptom reports were greater than average for Black youth and for youth of low socioeconomic status; discrepancies were also higher than average in youth with any psychiatric disorder when compared to typically developing youth. Network analysis of difference scores obtained by subtracting youth symptom scores from caregiver reported symptom scores showed that network connectivity (i.e., correlated difference scores) was sparsest for psychosis spectrum compared to other psychiatric disorders. Using a large sample, we show that youth and their caregiver informants tend to report psychopathology symptoms differently. Youth-caregiver discrepancies were the most pronounced for Black youth and youth of low socio-economic status. Race and socioeconomic status contribute to significant differences in how youth and their caregivers report such symptoms and are important factors that should be accounted for to facilitate accurate mental health symptom assessment and evaluation.
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Affiliation(s)
- Rose Mary Xavier
- School of Nursing, University of North Carolina at Chapel Hill, NC, USA
| | - Monica E. Calkins
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Dani S. Bassett
- Departments of Bioengineering, Psychiatry, Neurology, Physics & Astronomy, Electrical & Systems Engineering, University of Pennsylvania, Philadelphia, PA, USA
| | - Tyler M. Moore
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Jerome H. Taylor
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Raquel E. Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
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16
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Anksiyete Bozukluğu Tanılı Ergenlerin Belirtileri Açısından Ergen-Ebeveyn Uyumu. JOURNAL OF CONTEMPORARY MEDICINE 2022. [DOI: 10.16899/jcm.1148404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Aim: Considering the role of the parent in the children and adolescent's access to treatment, it is important that the symptoms are adequately noticed by the parents. In this study, it was aimed to examine the adolescent-parent agreement in terms of symptoms of adolescents with anxiety disorder.
Material and Method: 100 adolescents who applied to the child and adolescent psychiatry outpatient clinic and were diagnosed with anxiety disorder according to the DSM-5 diagnostic criteria were included in the study. In the study, the sociodemographic form and the Revised Child Anxiety and Depression Scale (RCADS) adolescent and parent form were used for data collection.
Results: When the parent and adolescent forms of RCADS were compared, the adolescent scores were significantly higher than the parents in all subscales and scale total scores, except for the separation anxiety subscale. The ICC (95% CI) value between the parent and adolescent forms of RCADS ranged from 0.06 to 0.74.
Conclusion: In our study, it was found that adolescents scored their symptoms higher than their parents, and the correlation between parent-child reporting was low-moderate. Age, gender, comorbidity, and parental psychopathology were among the factors affecting adolescent-parent agreement.
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17
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Casline E, Woodard G, Patel ZS, Phillips DA, Ehrenreich-May J, Ginsburg GS, Jensen-Doss A. Characterizing measurement-based care implementation using therapist report. EVIDENCE-BASED PRACTICE IN CHILD AND ADOLESCENT MENTAL HEALTH 2022; 8:549-559. [PMID: 38031580 PMCID: PMC10683951 DOI: 10.1080/23794925.2022.2124555] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
The effectiveness of measurement-based care (MBC), an evidence-based practice that uses regularly collected assessment data to guide clinical decision-making, is impacted by whether and how therapists use information from MBC tools in treatment. Improved characterization of how therapists use MBC in treatment sessions with youth is needed to guide implementation and understand variability in MBC effectiveness. To meet this need, this study examined therapists' sharing and discussion of MBC in treatment sessions. Thirty therapists were randomly assigned to the MBC condition as part of a comparative effectiveness trail of treatments for adolescent anxiety and depression. A qualitative content analysis was conducted on therapists' written explanations of changes made to the session based on the MBC data. Therapists reported sharing data with youth and caregivers in an average of 34.6% and 27.4% of sessions, respectively. Therapists reported incorporating MBC data in an average of 21.1% of sessions. When data were used, therapists predominately focused changes on short-term (e.g., current symptoms, treatment skill) rather than long-term (e.g., symptom progress, treatment goals) decision-making. Therapists inconsistently used MBC data, highlighting the need for improved training in and monitoring of how therapists use MBC in session to guide collaborative treatment decision-making with youth and caregivers.
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Affiliation(s)
| | - Grace Woodard
- University of Miami Department of Psychology, Coral Gables, FL, USA
| | - Zabin S. Patel
- University of Miami Department of Psychology, Coral Gables, FL, USA
| | | | | | - Golda S. Ginsburg
- University of Connecticut School of Medicine, Department of Psychiatry, Farmington, CT, USA
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18
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De Los Reyes A, Tyrell FA, Watts AL, Asmundson GJG. Conceptual, methodological, and measurement factors that disqualify use of measurement invariance techniques to detect informant discrepancies in youth mental health assessments. Front Psychol 2022; 13:931296. [PMID: 35983202 PMCID: PMC9378825 DOI: 10.3389/fpsyg.2022.931296] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 06/24/2022] [Indexed: 12/13/2022] Open
Abstract
On page 1 of his classic text, Millsap (2011) states, “Measurement invariance is built on the notion that a measuring device should function the same way across varied conditions, so long as those varied conditions are irrelevant [emphasis added] to the attribute being measured.” By construction, measurement invariance techniques require not only detecting varied conditions but also ruling out that these conditions inform our understanding of measured domains (i.e., conditions that do not contain domain-relevant information). In fact, measurement invariance techniques possess great utility when theory and research inform their application to specific, varied conditions (e.g., cultural, ethnic, or racial background of test respondents) that, if not detected, introduce measurement biases, and, thus, depress measurement validity (e.g., academic achievement and intelligence). Yet, we see emerging bodies of work where scholars have “put the cart before the horse” when it comes to measurement invariance, and they apply these techniques to varied conditions that, in fact, may reflect domain-relevant information. These bodies of work highlight a larger problem in measurement that likely cuts across many areas of scholarship. In one such area, youth mental health, researchers commonly encounter a set of conditions that nullify the use of measurement invariance, namely discrepancies between survey reports completed by multiple informants, such as parents, teachers, and youth themselves (i.e., informant discrepancies). In this paper, we provide an overview of conceptual, methodological, and measurement factors that should prevent researchers from applying measurement invariance techniques to detect informant discrepancies. Along the way, we cite evidence from the last 15 years indicating that informant discrepancies reflect domain-relevant information. We also apply this evidence to recent uses of measurement invariance techniques in youth mental health. Based on prior evidence, we highlight the implications of applying these techniques to multi-informant data, when the informant discrepancies observed within these data might reflect domain-relevant information. We close by calling for a moratorium on applying measurement invariance techniques to detect informant discrepancies in youth mental health assessments. In doing so, we describe how the state of the science would need to fundamentally “flip” to justify applying these techniques to detect informant discrepancies in this area of work.
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Affiliation(s)
- Andres De Los Reyes
- Comprehensive Assessment and Intervention Program, Department of Psychology, The University of Maryland at College Park, College Park, MD, United States
- *Correspondence: Andres De Los Reyes,
| | - Fanita A. Tyrell
- Resilient Adaptation Across Culture and Context Lab, Department of Psychology, The University of Maryland at College Park, College Park, MD, United States
| | - Ashley L. Watts
- Department of Psychological Sciences, University of Missouri, Columbia, MO, United States
| | - Gordon J. G. Asmundson
- Anxiety and Illness Behaviour Laboratory, Department of Psychology, University of Regina, Regina, SK, Canada
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19
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Charamut NR, Racz SJ, Wang M, De Los Reyes A. Integrating multi-informant reports of youth mental health: A construct validation test of Kraemer and colleagues’ (2003) Satellite Model. Front Psychol 2022; 13:911629. [PMID: 35967634 PMCID: PMC9371006 DOI: 10.3389/fpsyg.2022.911629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 07/01/2022] [Indexed: 12/26/2022] Open
Abstract
Accurately assessing youth mental health involves obtaining reports from multiple informants who typically display low levels of correspondence. This low correspondence may reflect situational specificity. That is, youth vary as to where they display mental health concerns and informants vary as to where and from what perspective they observe youth. Despite the frequent need to understand and interpret these informant discrepancies, no consensus guidelines exist for integrating informants’ reports. The path to building these guidelines starts with identifying factors that reliably predict the level and form of these informant discrepancies, and do so for theoretically and empirically relevant reasons. Yet, despite the knowledge of situational specificity, few approaches to integrating multi-informant data are well-equipped to account for these factors in measurement, and those that claim to be well-positioned to do so have undergone little empirical scrutiny. One promising approach was developed roughly 20 years ago by Kraemer and colleagues (2003). Their Satellite Model leverages principal components analysis (PCA) and strategic selection of informants to instantiate situational specificity in measurement, namely components reflecting variance attributable to the context in which informants observe behavior (e.g., home/non-home), the perspective from which they observe behavior (e.g., self/other), and behavior that manifests across contexts and perspectives (i.e., trait). The current study represents the first construct validation test of the Satellite Model. A mixed-clinical/community sample of 134 adolescents and their parents completed six parallel surveys of adolescent mental health. Adolescents also participated in a series of simulated social interactions with research personnel trained to act as same-age, unfamiliar peers. A third informant (unfamiliar untrained observer) viewed these interactions and completed the same surveys as parents and adolescents. We applied the Satellite Model to each set of surveys and observed high internal consistency estimates for each of the six-item trait (α = 0.90), context (α = 0.84), and perspective (α = 0.83) components. Scores reflecting the trait, context, and perspective components displayed distinct patterns of relations to a battery of criterion variables that varied in the context, perspective, and source of measurement. The Satellite Model instantiates situational specificity in measurement and facilitates unifying conceptual and measurement models of youth mental health.
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Affiliation(s)
- Natalie R. Charamut
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland, College Park, College Park, MD, United States
| | - Sarah J. Racz
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland, College Park, College Park, MD, United States
| | - Mo Wang
- Department of Management, University of Florida, Gainesville, FL, United States
| | - Andres De Los Reyes
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland, College Park, College Park, MD, United States
- *Correspondence: Andres De Los Reyes,
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20
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Watts AL, Makol BA, Palumbo IM, De Los Reyes A, Olino TM, Latzman RD, DeYoung CG, Wood PK, Sher KJ. How Robust Is the p Factor? Using Multitrait-Multimethod Modeling to Inform the Meaning of General Factors of Youth Psychopathology. Clin Psychol Sci 2022; 10:640-661. [PMID: 36090949 PMCID: PMC9454373 DOI: 10.1177/21677026211055170] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We used multitrait-multimethod (MTMM) modeling to examine general factors of psychopathology in three samples of youth (Ns = 2119, 303, 592) for whom three informants reported on the youth's psychopathology (e.g., child, parent, teacher). Empirical support for the p-factor diminished in multi-informant models compared with mono-informant models: the correlation between externalizing and internalizing factors decreased and the general factor in bifactor models essentially reflected externalizing. Widely used MTMM-informed approaches for modeling multi-informant data cannot distinguish between competing interpretations of the patterns of effects we observed, including that the p-factor reflects, in part, evaluative consistency bias or that psychopathology manifests differently across contexts (e.g., home vs. school). Ultimately, support for the p-factor may be stronger in mono-informant designs, although it is does not entirely vanish in multi-informant models. Instead, the general factor of psychopathology in any given mono-informant model likely reflects a complex mix of variances, some substantive and some methodological.
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Affiliation(s)
- Ashley L Watts
- Department of Psychological Sciences, University of Missouri, Columbia, MO, 65211
| | - Bridget A Makol
- Department of Psychology, University of Maryland, College Park, MD, 20742
| | | | | | - Thomas M Olino
- Department of Psychology, Temple University, Philadelphia, PA, 19122
| | - Robert D Latzman
- Department of Psychology, Georgia State University, Atlanta, GA, 30303
| | - Colin G DeYoung
- Department of Psychology, University of Minnesota, Minneapolis, MN 55455
| | - Phillip K Wood
- Department of Psychological Sciences, University of Missouri, Columbia, MO, 65211
| | - Kenneth J Sher
- Department of Psychological Sciences, University of Missouri, Columbia, MO, 65211
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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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Garcia-Lopez LJ, Espinosa-Fernandez L, Muela-Martinez JA, Piqueras JA. Screening Social Anxiety in Adolescents Through the Eyes of Their Carers. Front Psychol 2021; 12:769006. [PMID: 34925170 PMCID: PMC8676051 DOI: 10.3389/fpsyg.2021.769006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 10/19/2021] [Indexed: 11/13/2022] Open
Abstract
Despite the availability of efficacious treatment and screening protocols, social anxiety disorder (SAD) in adolescents is considerably under-detected and undertreated. Our main study objective was to examine a brief, valid, and reliable social anxiety measure already tested to serve as self-report child measure but administered via Internet aimed at listening to the ability of his or her parent to identify social anxiety symptomatology in his or her child. This parent version could be used as a complementary measure to avoid his or her overestimation of children of social anxiety symptomatology using traditional self-reported measures. We examined the psychometric properties of brief and valid social anxiety measure in their parent format and administered via the Internet. The sample included 179 parents/legal guardians of adolescents (67% girls) with a clinical diagnosis of SAD (mean age: 14.27; SD = 1.33). Findings revealed good factor structure, internal consistency, and construct validity. Data support a single, strength-based factor on the SPAIB-P, being structure largely invariant across age and gender. The limited number of adolescents with a performance-only specifier prevented examining the utility of scale to screen for this recently established specifier. It is crucial to evaluate if these results generalize to different cultures and community samples. The findings suggest that the SPAIB-P evidences performance comparable with child-reported measure. Parents can be reliable reports of the social anxiety symptomatology of the adolescent. The SPAIB-P may be useful for identifying clinically disturbed socially anxious adolescents.
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Reyes ADL, Talbott E, Power TJ, Michel JJ, Cook CR, Racz SJ, Fitzpatrick O. The needs-to-goals gap: How informant discrepancies in youth mental health assessments impact service delivery. Clin Psychol Rev 2021; 92:102114. [DOI: 10.1016/j.cpr.2021.102114] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 10/25/2021] [Accepted: 12/16/2021] [Indexed: 01/24/2023]
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The Discrepancy between Mother and Youth Reported Internalizing Symptoms Predicts Youth’s Negative Self-Esteem. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-019-00501-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Etkin RG, Zilcha-Mano S, Lebowitz ER. Clinical Update: The Role of Family Accommodation in Youth Anxiety Treatment Outcomes. EVIDENCE-BASED PRACTICE IN CHILD AND ADOLESCENT MENTAL HEALTH 2021; 7:295-305. [PMID: 36262867 PMCID: PMC9576190 DOI: 10.1080/23794925.2021.1981175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Over the past several years, family accommodation (FA) has gained increasing recognition for its role in child and adolescent anxiety disorders. Recent clinical trials highlight the importance of assessing and addressing FA within the context of treatment, with findings showing that FA is a significant predictor of treatment success. This clinical update was prompted by such findings, and specifically findings from a study by Zilcha-Mano and colleagues (2020) which suggest that the level of agreement between child- and parent-reports of FA has differential effects on outcomes for child- and parent-based treatments. In this article we aim to provide (1) a brief overview of the research pointing to the reduction of FA as a critical ingredient of youth anxiety treatment, and (2) a summary and in-depth discussion of the study by Zilcha-Mano et al. (2020) that speaks to the potential importance of leveraging multi-informant reports of FA. With regard to the latter aim, we offer preliminary suggestions for how clinicians might incorporate measures of FA into their practice to maximize benefits for anxious youth and their families. We also offer suggestions for how future research can build on these novel findings, advance methods of FA assessment, and promote its clinical utility.
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Affiliation(s)
- Rebecca G. Etkin
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | | | - Eli R. Lebowitz
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
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Etkin RG, Lebowitz ER, Silverman WK. Using Evaluative Criteria to Review Youth Anxiety Measures, Part II: Parent-Report. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2021; 50:155-176. [PMID: 33739908 DOI: 10.1080/15374416.2021.1878898] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
This Evidence Base Update of parent-report measures of youth anxiety symptoms is a companion piece to our update on youth self-report anxiety symptom measures (Etkin et al., 2021). We rate the psychometric properties of the parent-report measures as Adequate, Good, or Excellent using criteria developed by Hunsley and Mash (2008) and Youngstrom et al. (2017). Our review reveals that the evidence base for parent-report measures is considerably less developed compared with the evidence base for youth self-report measures. Nevertheless, several measures, the parent-report Screen for Child Anxiety-Related Emotional Disorders, Multidimensional Anxiety Scale for Children, and Spence Children's Anxiety Scale, were found to have Good to Excellent psychometric properties. We conclude our review with suggestions about which parent-report youth anxiety measures are best suited to perform different assessment functions and directions for additional research to expand and strengthen the evidence base.
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Johnson AM, McCarty CA, Marcynyszyn LA, Zatzick DF, Chrisman SP, Rivara FP. Child- compared with parent-report ratings on psychosocial measures following a mild traumatic brain injury among youth with persistent post-concussion symptoms. Brain Inj 2021; 35:574-586. [PMID: 33733955 DOI: 10.1080/02699052.2021.1889663] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Primary Objective: To compare child- and parent-report ratings on the Health Behavior Inventory, Revised Child Anxiety and Depression Scale-Short Version (anxiety subscale), Patient Health Questionnaire-9, and Pediatric Quality of Life InventoryTM among children with persistent post-concussive symptoms following a sports- or recreation-related concussion, overall and by child age and gender.Research Design: Cross-sectional study examining baseline data from a randomized, comparative effectiveness trial.Methods and Procedures: Inter-rater reliability was assessed using two-way random effects model (absolute agreement) intraclass correlations, correlations were examined using Spearman's rho, mean differences were determined using paired t-tests, and agreement was examined using Bland-Altman plots.Main Outcomes and Results: The final analytic sample was 200 parent-child dyads [child Mage = 14.7 (95% CI: 14.5, 15.0)]. Reliability and correlations were modest overall. When considering child age and gender, reliability ranged from poor to excellent (-1.01-0.95) and correlations ranged from weak to strong (-0.64-0.94). Overall, children reported more symptoms but better functioning than parents, and mean differences in scores were greater among females (versus males) and ages 16-18 (versus younger groups).Conclusions: Findings should inform the use and interpretation of psychosocial measures when developing appropriate youth concussion treatment plans.
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Affiliation(s)
- Ashleigh M Johnson
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, US
| | - Carolyn A McCarty
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, US.,Department of Pediatrics, University of Washington, Seattle, US
| | - Lyscha A Marcynyszyn
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, US
| | - Douglas F Zatzick
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, US.,Harborview Injury Prevention and Research Center, University of Washington, Seattle, USA
| | - Sara Pd Chrisman
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, US.,Department of Pediatrics, University of Washington, Seattle, US
| | - Frederick P Rivara
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, US.,Department of Pediatrics, University of Washington, Seattle, US.,Harborview Injury Prevention and Research Center, University of Washington, Seattle, USA
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Curriculum-Based Animal-Assisted Therapy in an Acute Outpatient Mental Health Setting. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2021. [DOI: 10.1007/s10879-020-09470-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Martin SR, Zeltzer LK, Seidman LC, Allyn KE, Payne LA. Caregiver-Child Discrepancies in Reports of Child Emotional Symptoms in Pediatric Chronic Pain. J Pediatr Psychol 2021; 45:359-369. [PMID: 31886865 DOI: 10.1093/jpepsy/jsz098] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 10/29/2019] [Accepted: 12/02/2019] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE Pediatric chronic pain evaluation includes self-reports and/or caregiver proxy-reports across biopsychosocial domains. Limited data exist on the effects of caregiver-child discrepancies in pediatric pain assessment. In children with chronic pain, we examined associations among discrepancies in caregiver-child reports of child anxiety and depressive symptoms and child functional impairment. METHODS Participants were 202 children (Mage=14.49 ± 2.38 years; 68.8% female) with chronic pain and their caregivers (95.5% female). Children and caregivers completed the Revised Child Anxiety and Depression Scale (RCADS) and RCADS-Parent, respectively. Children also completed the Functional Disability Inventory. Mean difference tests examined caregiver-child discrepancies. Moderation analyses examined whether associations between child self-reported anxiety and depressive symptoms and functional impairment varied as a function of caregiver proxy-report. RESULTS Children reported more anxiety and depressive symptoms compared with their caregivers' proxy-reports (Z = -4.83, p < .001). Both informants' reports of child anxiety and depressive symptoms were associated with child functional impairment (rs = .44, rs = .30, p < .001). Caregiver proxy-report moderated associations between child-reported anxiety and depressive symptoms and functional impairment (B = -0.007, p = .003). When caregiver proxy-report was low, child self-reported anxiety and depressive symptoms were positively related to functional impairment (B = 0.28, SE = 0.07, 95% CI [0.15, 0.41], p < .001). CONCLUSIONS Discrepant caregiver-child perceptions of child anxiety and depressive symptoms may be associated with functioning in children with chronic pain, especially when caregivers report less child internalizing symptoms. These findings highlight the need for further examination of the effects of caregiver-child discrepancies on pediatric chronic pain outcomes and may indicate targets for intervention.
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Affiliation(s)
- Sarah R Martin
- Pediatric Pain and Palliative Care Program, David Geffen School of Medicine at UCLA
| | - Lonnie K Zeltzer
- Pediatric Pain and Palliative Care Program, David Geffen School of Medicine at UCLA
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A latent class analysis of parent-child discrepancies in reports of peer victimization: Associations to child sexual abuse status and psychological adjustment. Dev Psychopathol 2021; 34:889-900. [PMID: 33478619 DOI: 10.1017/s0954579420001522] [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: 11/06/2022]
Abstract
Researchers face an important challenge when assessing peer victimization in children, since self-reports are often discrepant with parent-reports. A latent class analysis identified patterns of response to items assessing peer victimization, which were either divergent or convergent between the parent and the child. Classes were then compared on the child sexual abuse status and on various behavioral and social outcomes. Participants were 720 school-aged child victims of sexual abuse and a comparison group of 173 nonvictims and their caregivers. We identified two discordant subgroups (self-identified and parent-identified) and two concordant groups (nonvictims and concordant victims of peer victimization). Compared to children of the comparison group, sexually abused children were five times more likely to be identified as targets of peer victimization solely by their parent than the contrary. Sexually abused children with concordant reports of peer victimization showed the poorest adjustment on all studied outcomes assessed 6 months later. Children who discounted experiencing peer victimization while their parent reported it were also at risk of maladjustment. Results underscore the importance of supplementing self-reports with other available sources of information, especially in young and vulnerable populations who may be inclined to discount their victimization experiences.
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Adaptive skills and mental health in children and adolescents with neuromuscular diseases. Eur J Paediatr Neurol 2021; 30:134-143. [PMID: 33109477 DOI: 10.1016/j.ejpn.2020.10.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/26/2020] [Accepted: 10/18/2020] [Indexed: 01/11/2023]
Abstract
BACKGROUND Adaptive skills represent the ways that children and adolescents meet their basic needs for self-care, decision making, communication, and learning in their daily life. Having a neuromuscular disease (NMD) not only presents mental health issues, but also impacts these skills. AIMS Our study aimed to compare the adaptive skills and mental health of paediatric patients with the most common NMDs with their healthy peers and assess how NMDs shape the way patients form relationships with others, engage in leisure activities and take care of their daily living needs. METHODS We used the Adaptive Behaviour Assessment System (ABAS-3) and Achenbach Child Behaviour Checklist (CBCL) to compare the adaptive skills and mental health symptoms of 50 NMD patients to a demographically-matched control group of 298 peers. We examined specific outcomes of having myotonic dystrophy (DM), Duchenne muscular dystrophy (DMD), Becker muscular dystrophy (BMD), spinal muscular atrophy (SMA) or a mixed group of other NMDs. RESULTS All NMD patients displayed poor practical adaptive skills. When the disease was more likely to involve the central nervous system (DM, DMD) they also showed additional deficits in their conceptual and social skills. Contrary to previous research no increased rate of psychopathological symptoms was found in NMD patients, with the exception of difficulties in the social domain among patients with DM. CONCLUSIONS Although most children with NMDs displayed more limited practical skills, the specific profile of adaptive skills for each patient group needs to be taken into consideration when planning school support and other psychosocial interventions.
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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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Asbrand J, Foltys L, Ebeling L, Tuschen-Caffier B. Übereinstimmung zwischen Eltern und Kind zur kindlichen Psychopathologie und deren Bedeutung für den Therapieerfolg. VERHALTENSTHERAPIE 2020. [DOI: 10.1159/000511095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
<b><i>Hintergrund:</i></b> Symptome psychischer Störungen werden von Kindern und Jugendlichen häufig anders als von den Eltern eingeschätzt. Als Einflussfaktoren für diese Urteilsdiskrepanzen im externalisierenden und internalisierenden Symptombereich werden kindliches Geschlecht und Alter untersucht. Zudem wird der prädiktive Wert der Diskrepanz für den wahrgenommenen Therapieerfolg analysiert. <b><i>Methode:</i></b> Kinder und Jugendliche (<i>n</i> = 271, 10–21 Jahre) in ambulanter Psychotherapie sowie Eltern gaben Auskunft über den Youth Self Report (YSR) und die Child Behavioral Checklist (CBCL). <b><i>Ergebnisse:</i></b> Neben einer grundsätzlich guten Übereinstimmung zwischen Eltern und Kind berichten Eltern über mehr psychische Symptome als die davon betroffenen Kinder. Mit zunehmendem Alter steigt die von den Kindern selbstberichtete externalisierende Symptomatik an. Mädchen geben mehr internalisierende Symptome als Jungen an. Ein hoher elterlicher Baselinewert (prä-Therapie) zur kindlichen externalisierenden Symptomatik sagt einen höheren Elternbericht nach Abschluss der Psychotherapie des Kindes vorher. Kinder berichten nach der Psychotherapie mehr Symptome, wenn Uneinigkeit zwischen Eltern und Kindern bezüglich der internalisierenden Symptomatik prä-Therapie besteht sowie eine hohe kindberichtete externalisierende bzw. elternberichtete internalisierende Symptomatik berichtet wird. <b><i>Schlussfolgerung:</i></b> Insgesamt zeigen sich einzelne Faktoren prädiktiv für die Symptomatik post-Therapie, jedoch die Eltern-Kind Urteilsdiskrepanz nur in geringem Maß. Beeinflussende Faktoren wie Alter und Geschlecht sollten in zukünftigen Studien standardmäßig aufgenommen werden.
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Norris LA, Kendall PC. Moderators of Outcome for Youth Anxiety Treatments: Current Findings and Future Directions. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2020; 50:450-463. [PMID: 33140992 DOI: 10.1080/15374416.2020.1833337] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objective: To improve outcomes and create more personalized interventions, the field has sought to identify moderators of treatment response (variables that specify which treatments work for whom and under what conditions).Method: The current review examines moderators of youth anxiety treatments.Results: The majority of studies to date have examined variables of convenience, including demographics (age, sex, race, ethnicity, socioeconomic status), pretreatment youth clinical characteristics (anxiety severity, principal diagnosis, comorbidity) and pretreatment parent variables (parent psychopathology, parenting). Findings indicate few consistent moderators.Conclusions: Future directions are discussed, including (a) group to individual generalizability, (b) power considerations, and (c) updates to study design and measure selection.
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Makol BA, De Los Reyes A, Ostrander RS, Reynolds EK. Parent-Youth Divergence (and Convergence) in Reports of Youth Internalizing Problems in Psychiatric Inpatient Care. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 47:1677-1689. [PMID: 30937814 DOI: 10.1007/s10802-019-00540-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
When compared to one another, multiple informants' reports of adolescent internalizing problems often reveal low convergence. This creates challenges in the delivery of clinical services, particularly for severe outcomes linked to internalizing problems, namely suicidal thoughts and behaviors. Clinicians would benefit from methods that facilitate interpretation of multi-informant reports, particularly in inpatient settings typified by high-cost care and high-stakes decision-making. 765 adolescent inpatients (70.3% female; Mage = 14.7) and their parents completed measures of adolescent internalizing problems. We obtained baseline clinical and treatment characteristics from electronic medical records. Latent class analysis revealed four reporting patterns: Parent-Adolescent Low (LL; 49.0%), Parent Low-Adolescent High (PL-AH; 11.5%), Parent High-Adolescent Low (PH-AL; 21.8%), Parent-Adolescent High (HH; 17.6%). Relative to the LL class, adolescents in the PH-AL and PL-AH classes were more likely to be admitted with suicidality. In terms of treatment characteristics and relative to the LL class, HH and PH-AL adolescents were more likely to receive standing antipsychotics, PH-AL adolescents were more likely to be in seclusion, and HH adolescents had longer hospital stays. At discharge and relative to the LL class, HH, PH-AL, and PL-AH adolescents were more likely to receive an anxiety disorder diagnosis. Further, HH, PH-AL, and PL-AH adolescents were more likely to receive partial hospitalization or care in another restrictive environment after inpatient treatment, relative to the LL class. This naturalistic study informs clinical decision-making by aiding our understanding of how multi-informant reports facilitate interpretations of adolescents' clinical presentations as well as predictions about treatment characteristics.
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Affiliation(s)
- Bridget A Makol
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland at College Park, Biology/Psychology Building, Room 3123K, College Park, MD, 20742, USA.
| | - Andres De Los Reyes
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland at College Park, Biology/Psychology Building, Room 3123K, College Park, MD, 20742, USA
| | - Rick S Ostrander
- Department of Psychiatry and Behavioral Science, Division of Child and Adolescent Psychiatry, Bloomberg Children's Center (Level 12), Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD, USA
| | - Elizabeth K Reynolds
- Department of Psychiatry and Behavioral Science, Division of Child and Adolescent Psychiatry, Bloomberg Children's Center (Level 12), Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD, USA
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Tonarely NA, Sherman JA, Grossman RA, Shaw AM, Ehrenreich-May J. Neuroticism as an underlying construct in youth emotional disorders. Bull Menninger Clin 2020; 84:214-236. [PMID: 33000965 DOI: 10.1521/bumc.2020.84.3.214] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Structural research on neuroticism, as indicated by Big Five personality traits and/or internalizing symptoms, has been conducted with youth. However, no structural research has investigated neuroticism as characterized by transdiagnostic risk factors such as distress tolerance (DT), negative affect (NA), and avoidance. No study has investigated whether DT, NA, and avoidance, as a group, are associated with anxiety, depressive, obsessive-compulsive (OC) symptoms, and independent evaluator (lE)-rated symptom severity in a clinical sample of youth. The purpose of the current investigation was to understand the proportion of variance in anxiety, depressive, OC symptoms, and independent evaluator-rated global symptom severity by a latent construct of neuroticism, as indicated by these modifiable features in youth with emotional disorders among a sample of 121 adolescents (ages 13-18, 51.2% female). A latent neuroticism factor was significantly associated with greater youth- and parent-reported anxiety, depressive, and OC symptoms, and greater IE-rated global severity.
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Affiliation(s)
- Niza A Tonarely
- Graduate student, Department of Psychology, University of Miami, Coral Gables, Florida
| | - Jamie A Sherman
- Graduate student, Department of Psychology, University of Miami, Coral Gables, Florida
| | - Rebecca A Grossman
- Graduate student, Department of Psychology, University of Miami, Coral Gables, Florida
| | - Ashley M Shaw
- Postdoctoral fellow, University of Miami, Coral Gables, Florida
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Cvencek D, Greenwald AG, McLaughlin KA, Meltzoff AN. Early implicit-explicit discrepancies in self-esteem as correlates of childhood depressive symptoms. J Exp Child Psychol 2020; 200:104962. [PMID: 32798935 DOI: 10.1016/j.jecp.2020.104962] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 07/13/2020] [Accepted: 07/13/2020] [Indexed: 11/29/2022]
Abstract
This longitudinal study examined early social-cognitive markers that might be associated with the emergence of childhood depression and anxiety. At 5 years of age, 137 children completed an implicit self-esteem measure. At 9 years of age, the same children completed measures of implicit self-esteem, explicit self-esteem, depression, and anxiety. Two novel findings emerged. First, higher implicit self-esteem at age 5 than explicit self-esteem at age 9 (implicit > explicit discrepancy) was associated with depressive symptoms at age 9, but not with symptoms of anxiety. Second, this cross-age implicit > explicit discrepancy was associated with depressive symptoms more strongly than was the same implicit > explicit discrepancy measured concurrently at age 9. The overall pattern suggests that the appearance of depressive symptoms in children is associated with discrepancies between implicit and explicit self-esteem and not just lower levels of implicit self-esteem or lower levels of explicit self-esteem taken alone. It is the direction and discrepancy across time that is particularly informative, such that discrepancies between early implicit representations and later explicit reports of self-worth reflect a developmental pathway associated with elevated risk for depressive symptoms. Taken altogether, this study illustrates the benefits of combining work in developmental, child-clinical, and social psychology to provide a more complete view of the developing child. We believe that combining implicit and explicit measures of self-esteem across developmental time points can be used to examine early markers of depression in children at younger ages than typically possible with explicit measures alone.
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Affiliation(s)
- Dario Cvencek
- Institute for Learning and Brain Sciences, University of Washington, Seattle, WA 98195, USA.
| | | | | | - Andrew N Meltzoff
- Institute for Learning and Brain Sciences, University of Washington, Seattle, WA 98195, USA
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Zilcha-Mano S, Shimshoni Y, Silverman WK, Lebowitz ER. Parent-Child Agreement on Family Accommodation Differentially Predicts Outcomes of Child-Based and Parent-Based Child Anxiety Treatment. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2020; 50:427-439. [PMID: 32401557 DOI: 10.1080/15374416.2020.1756300] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Objectives: Family accommodation is linked to poor treatment outcomes for childhood anxiety. Progress in research on the role of accommodation in treatment has been hindered by the relatively weak association between child and parent reports on accommodation. In this study, we suggest that parent-child agreement on family accommodation may provide a dependable estimation of this construct, and investigated whether the level of parent-child agreement on family accommodation predicts subsequent treatment outcome. We further examined whether the effect was greater in Supportive Parenting for Anxious Childhood Emotions (SPACE), which directly targets family accommodation, than in individual child-focused cognitive behavioral therapy (CBT).Methods: Participants were 104 children (aged 6-15) with anxiety disorders, and their mothers, randomized to SPACE or CBT. Accommodation was rated by mothers and children before treatment, halfway through treatment, and at treatment end, using respective versions of Family Accommodation Scale-Anxiety. To accurately estimate agreement, we conducted multilevel response surface analysis by polynomial regression, with agreement on accommodation at each time point predicting subsequent child anxiety severity, over the course of treatment.Results: Parent-child agreement and disagreement on accommodation were significant predictors of subsequent anxiety symptom severity. Different results were obtained for SPACE and CBT, suggesting potentially distinct underlying mechanisms.Conclusions: The findings suggest treatment-specific roles of accommodation in SPACE vs. CBT. Multiple-informant assessment of accommodation provides important information, which may have important implications for optimal treatment personalization.
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Affiliation(s)
| | - Yaara Shimshoni
- Child Study Center, School of Medicine, Yale University, Child Study Center, School of Medicine
| | - Wendy K Silverman
- Child Study Center, School of Medicine, Yale University, Child Study Center, School of Medicine
| | - Eli R Lebowitz
- Child Study Center, School of Medicine, Yale University, Child Study Center, School of Medicine
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Cannon CJ, Makol BA, Keeley LM, Qasmieh N, Okuno H, Racz SJ, De Los Reyes A. A Paradigm for Understanding Adolescent Social Anxiety with Unfamiliar Peers: Conceptual Foundations and Directions for Future Research. Clin Child Fam Psychol Rev 2020; 23:338-364. [DOI: 10.1007/s10567-020-00314-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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40
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Shain LM, Pao M, Tipton MV, Bedoya SZ, Kang SJ, Horowitz LM, Wiener L. Comparing Parent and Child Self-report Measures of the State-Trait Anxiety Inventory in Children and Adolescents with a Chronic Health Condition. J Clin Psychol Med Settings 2020; 27:173-181. [PMID: 31127422 PMCID: PMC6874919 DOI: 10.1007/s10880-019-09631-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Anxiety symptoms in children and adolescents with a chronic health condition have been estimated as high as 40% lifetime prevalence. Clinicians often rely on parent/caregiver information to supplement or substitute child self-report related to pediatric physical and mental health. We developed a caregiver proxy version (STAI-P) for the State-Trait Anxiety Inventory (STAI) State Anxiety Scale that was compared with a child self-report version in 201 parent-child dyads to evaluate its utility in measuring state anxiety in chronically ill youth. For patients aged 7-12, self-reports of state anxiety were moderately associated with parent distress and health provider-reported functional status, but negatively associated with parent STAI-P scores. For patients aged 13-17, self-reports of state anxiety were significantly associated with STAI-P scores, parent distress, and health provider-reported functional status. The STAI-P parent version may be a useful tool in identifying and addressing anxiety symptoms in youth living with a chronic health condition.
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Affiliation(s)
- Lindsey M Shain
- College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Maryland Pao
- Office of the Clinical Director, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Mary V Tipton
- Office of the Clinical Director, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Sima Zadeh Bedoya
- Pediatric Oncology Branch, National Cancer Institute, Center for Cancer Research, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, 20892, USA
| | - Sun J Kang
- Genetic Epidemiology Branch, National Institute of Mental Health, NIH, Bethesda, MD, USA
| | - Lisa M Horowitz
- Office of the Clinical Director, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Lori Wiener
- Pediatric Oncology Branch, National Cancer Institute, Center for Cancer Research, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, 20892, USA.
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41
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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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42
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De Los Reyes A, Cook CR, Gresham FM, Makol BA, Wang M. Informant discrepancies in assessments of psychosocial functioning in school-based services and research: Review and directions for future research. J Sch Psychol 2019; 74:74-89. [PMID: 31213233 DOI: 10.1016/j.jsp.2019.05.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 04/22/2019] [Accepted: 05/03/2019] [Indexed: 12/15/2022]
Abstract
Psychosocial functioning plays a key role in students' wellbeing and performance inside and outside of school. As such, techniques designed to measure and improve psychosocial functioning factor prominently in school-based service delivery and research. Given that the different contexts (e.g., school, home, community) in which students exist vary in the degree to which they influence psychosocial functioning, educators and researchers often rely on multiple informants to characterize intervention targets, monitor intervention progress, and inform the selection of evidence-based services. These informants include teachers, students, and parents. Across research teams, domains, and measurement methodologies, researchers commonly observe discrepancies among informants' reports. We review theory and research-occurring largely outside of school-based service delivery and research-that demonstrates how patterns of informant discrepancies represent meaningful differences that can inform our understanding of psychosocial functioning. In turn, we advance a research agenda to improve use and interpretation of informant discrepancies in school-based services and research.
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Affiliation(s)
| | | | | | - Bridget A Makol
- University of Maryland at College Park, United States of America
| | - Mo Wang
- University of Florida, United States of America
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43
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Rith-Najarian LR, Mesri B, Park AL, Sun M, Chavira DA, Chorpita BF. Durability of Cognitive Behavioral Therapy Effects for Youth and Adolescents With Anxiety, Depression, or Traumatic Stress:A Meta-Analysis on Long-Term Follow-Ups. Behav Ther 2019; 50:225-240. [PMID: 30661562 DOI: 10.1016/j.beth.2018.05.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 05/25/2018] [Accepted: 05/25/2018] [Indexed: 01/16/2023]
Abstract
Cognitive behavioral therapies (CBT) for youth with anxiety, traumatic stress, and depression have demonstrated strong effects in individual studies and meta-analyses. Relatively more attention has been given to posttreatment effects, though, and assessment of follow-up effects has been limited at the meta-analytic level. The current meta-analysis aimed to (a) examine the effects of youth CBT at posttreatment, 1-month, 3-month, 6-month, 1-year, and long-term (2+ years) follow-up as well as (b) identify research-related variables (e.g., measure respondent type) that relate to effects. Using a random effects model across 110 child and adolescent CBT groups, within-group effect sizes were large at posttreatment (g = 1.24) and from 1-month through long-term follow-up (g = 1.23-1.82), and effect sizes did not significantly differ by treatment target (i.e., anxiety, traumatic stress, depression). However, availability of outcome data for effect sizes diminished across later follow-up assessments. Moreover, effect sizes were significantly associated with outcome respondent type across assessment timing, with outcome measures from caregiver and youth respondents associated with smaller effect sizes (B = -0.97, p < 0.001) relative to outcome measures that were evaluator-reported. Results provide initial support for the durability of treatment effects for youth CBTs and highlight the importance of some confounding variables. Implications for improving treatment research standards and prioritizing assessment of long-term follow-up assessment are discussed.
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44
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De Los Reyes A, Ohannessian CM, Racz SJ. Discrepancies Between Adolescent and Parent Reports About Family Relationships. CHILD DEVELOPMENT PERSPECTIVES 2018. [DOI: 10.1111/cdep.12306] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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45
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Conelea CA, Selles RR, Benito KG, Walther MM, Machan JT, Garcia AM, Sapyta J, Morris S, Franklin M, Freeman JB. Secondary outcomes from the pediatric obsessive compulsive disorder treatment study II. J Psychiatr Res 2017; 92:94-100. [PMID: 28412602 PMCID: PMC5500971 DOI: 10.1016/j.jpsychires.2017.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 03/06/2017] [Accepted: 04/06/2017] [Indexed: 12/29/2022]
Abstract
UNLABELLED The Pediatric Obsessive-Compulsive Disorder Treatment Study II (POTS II) investigated the benefit of serotonin reuptake inhibitor (SRI) augmentation with cognitive behavioral therapy (CBT). Primary outcomes focused on OCD symptom change and indicated benefit associated with a full course of CBT. Given that the majority of youth with OCD suffer from significant comorbid symptoms and impaired quality of life, the current study examined POTS II data for effects on secondary outcomes. Participants were 124 youth ages 7-17 years with a primary diagnosis of OCD who were partial responders to an adequate SRI trial. Participants were randomized to medication management, medication management plus instructions in cognitive behavioral therapy (CBT), or medication management plus full CBT. Acute effects on non-OCD anxiety, depression, inattention, hyperactivity, and quality of life were examined across treatment conditions. Improvement across treatment was observed for non-OCD anxiety, inattention, hyperactivity, and quality of life. Changes were generally significantly greater in the group receiving full CBT. Child-rated depression was not found to change. OCD-focused treatment lead to improvement in other areas of psychopathology and functioning. For youth who are partial responders to SRI monotherapy, augmentation with full CBT may yield the greatest benefit on these secondary outcomes. CLINICAL TRIALS REGISTRATION Treatment of Pediatric OCD for SRI Partial Responders, Clinicaltrials.gov Identifier: NCT00074815, http://clinicaltrials.gov/show/NCT00074815.
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Affiliation(s)
- Christine A. Conelea
- Bradley Hospital Pediatric Anxiety Research Center, Riverside, RI, USA,Alpert Medical School of Brown University, Providence, RI, USA,Corresponding author. Department of Psychiatry, F282/2A West Building, 2450 Riverside Avenue, Minneapolis, MN 55454, USA. (C.A. Conelea)
| | - Robert R. Selles
- Bradley Hospital Pediatric Anxiety Research Center, Riverside, RI, USA,Alpert Medical School of Brown University, Providence, RI, USA
| | - Kristen G. Benito
- Bradley Hospital Pediatric Anxiety Research Center, Riverside, RI, USA,Alpert Medical School of Brown University, Providence, RI, USA
| | - Michael M. Walther
- Bradley Hospital Pediatric Anxiety Research Center, Riverside, RI, USA,Alpert Medical School of Brown University, Providence, RI, USA
| | - Jason T. Machan
- Alpert Medical School of Brown University, Providence, RI, USA,Rhode Island Hospital, Providence, RI, USA
| | - Abbe M. Garcia
- Bradley Hospital Pediatric Anxiety Research Center, Riverside, RI, USA,Alpert Medical School of Brown University, Providence, RI, USA
| | | | - Sarah Morris
- University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Martin Franklin
- University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Jennifer B. Freeman
- Bradley Hospital Pediatric Anxiety Research Center, Riverside, RI, USA,Alpert Medical School of Brown University, Providence, RI, USA
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