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Kirk N, Hirsch E, Alam T, Wakschlag LS, Wiggins JL, Roy AK. A pragmatic, clinically optimized approach to characterizing adolescent irritability: Validation of parent- and adolescent reports on the Multidimensional Assessment Profile Scales-Temper Loss Scale. Int J Methods Psychiatr Res 2023; 32:e1986. [PMID: 37702276 PMCID: PMC10654814 DOI: 10.1002/mpr.1986] [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: 07/03/2023] [Revised: 08/14/2023] [Accepted: 08/17/2023] [Indexed: 09/14/2023] Open
Abstract
OBJECTIVES Heightened irritability in adolescence is an impairing symptom that can lead to negative outcomes in adulthood, but effective screening tools are lacking. This study aimed to derive clinically-optimized cutoff scores using the Multidimensional Assessment Profile Scales-Temper Loss (MAPS-TL) to pragmatically identify adolescents with impairing irritability. METHODS A diverse sample of 79 adolescents and their parents completed the MAPS-TL-Youth version. Stepwise logistic regression analyses were used to determine the items associated with impairment, and receiver operator characteristic (ROC) analyses were conducted to derive optimal cutoff scores. RESULTS Three parent-report items (become frustrated easily, angry/irritable/grouchy throughout the day, difficulty calming down when angry) and two youth-report items (hit/shove/kick when lost temper, difficulty calming down when angry) were strongly associated with impairment. Optimal cutoff scores garnered very good sensitivity (91%, 73%) and specificity (77%, 75%) for the parent- and youth-report versions respectively. Scores above these cutoffs were associated with increased internalizing and externalizing problems and lower overall quality of life. CONCLUSIONS The MAPS-TL clinically optimized irritability scores show preliminary validity for implementation in practical settings to efficiently identify adolescents who need additional evaluation and/or intervention. Further research is important to validate these cutoff scores with larger population-based samples and real-world settings.
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Affiliation(s)
- Nathan Kirk
- Department of PsychologySan Diego State UniversitySan DiegoCaliforniaUSA
- San Diego State University Research FoundationSan DiegoCaliforniaUSA
| | - Emily Hirsch
- Department of PsychologyFordham UniversityBronxNew YorkUSA
| | - Tasmia Alam
- Department of PsychologySan Diego State UniversitySan DiegoCaliforniaUSA
| | - Lauren S. Wakschlag
- Department of Medical Social SciencesFeinberg School of MedicineChicagoIllinoisUSA
- Institute for Innovations in Developmental SciencesNorthwestern UniversityChicagoIllinoisUSA
| | - Jillian Lee Wiggins
- Department of PsychologySan Diego State UniversitySan DiegoCaliforniaUSA
- Joint Doctoral Program in Clinical PsychologySan Diego State University/University of CaliforniaSan DiegoCaliforniaUSA
| | - Amy K. Roy
- Department of PsychologyFordham UniversityBronxNew YorkUSA
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Walker AL, Rujimora J, Swygert A, McNiece Z, Yoon E, Machado M, Myers K, Richardson E, Lenes E, Hebert L, Marchi E, Arthurson-McColl Z, Lagmay J, Puig A. A Novel Palliative Care Peer Support Program for Adolescents and Young Adults: Survey and Factor Analytic Study. J Palliat Med 2023; 26:627-636. [PMID: 36472550 PMCID: PMC10325807 DOI: 10.1089/jpm.2022.0299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2022] [Indexed: 12/12/2022] Open
Abstract
Background: Palliative care literature indicates a dearth of programs addressing the psychosocial needs of adolescents and young adults (AYAs). Objectives: This study assessed patient-reported experiences of a palliative care peer support program, analyzed psychometric qualities of the program evaluation, and examined associations with quality-of-life scores to assess validity and potential impact on aspects of AYA quality of life. Design: This retrospective, cross-sectional study described self-reported Streetlight program evaluation and quality of life of AYA patients, exploratory factor analysis of survey responses, and analysis of associations with quality of life. Setting/Subjects: AYA participants (13-30) enrolled in the Streetlight program for at least six months were recruited during hospital admissions and clinic visits at UF Health Shands Hospital. Results: Participants' (n = 69) scores were high for Youth Quality of Life Instrument-Short Form (YQOL-SF) (82.6 of 100), and Streetlight evaluations (4.47 of 5). Patients endorsed themes of: high-quality friendships with volunteers, transformative impacts to wellbeing, and benefits to mental health and coping in open-ended responses. Analyses identified three factors explaining 61% of variance in Streetlight program evaluation responses: "Friendships and Support" (26%); "Coping, Family, and Providers" (20%); and "Diversion and Respect" (15%). Significant positive associations were found between Streetlight evaluation scores and YQOL-SF Belief in Self and Family factor scores, as well as between Streetlight evaluation Friendships and Support factor scores, and YQOL-SF total and factor-specific scores. Conclusions: Results suggest that the Streetlight program is a viable model to facilitate positive experiences, opportunities for socialization, and meaningful peer support for AYA patients.
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Affiliation(s)
- Andrew L. Walker
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - James Rujimora
- College of Community Innovation and Education, University of Central Florida, Orlando, Florida, USA
| | - Anna Swygert
- Department of Pediatrics, University of Florida Health, Gainesville, Florida, USA
| | - Zachary McNiece
- Department of Counselor Education, College of Education, University of Florida, Gainesville, Florida, USA
| | - Eunhui Yoon
- Department of Educational Psychology, Florida State University, Tallahassee, Florida, USA
| | - Mercedes Machado
- Department of Counselor Education, College of Education, University of Florida, Gainesville, Florida, USA
| | - Kenneth Myers
- Department of Counselor Education, College of Education, University of Florida, Gainesville, Florida, USA
| | - Eric Richardson
- Center for Healthcare Organization and Implementation Research, US Department of Veterans Affairs, Washington, DC, USA
| | - Emilie Lenes
- Department of Counselor Education, College of Education, University of Florida, Gainesville, Florida, USA
| | | | - Emily Marchi
- Department of Pediatrics, University of Florida Health, Gainesville, Florida, USA
| | | | - Joanne Lagmay
- Department of Pediatric Hematology–Oncology, University of Florida Health, Gainesville, Florida, USA
| | - Ana Puig
- Department of Counselor Education, College of Education, University of Florida, Gainesville, Florida, USA
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Karekla M, Nikolaou P, Merwin RM. Randomized Clinical Trial Evaluating AcceptME-A Digital Gamified Acceptance and Commitment Early Intervention Program for Individuals at High Risk for Eating Disorders. J Clin Med 2022; 11:jcm11071775. [PMID: 35407386 PMCID: PMC8999727 DOI: 10.3390/jcm11071775] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/18/2022] [Accepted: 03/20/2022] [Indexed: 12/13/2022] Open
Abstract
Eating disorders (ED) constitute a serious public health issue affecting predominantly women and appearing typically in adolescence or early adulthood. EDs are extremely difficult to treat, as these disorders are ego-syntonic, and many patients do not seek treatment. It is vital to focus on the development of successful early-intervention programs for individuals presenting at risk and are on a trajectory towards developing EDs. This study is a randomized controlled trial evaluating an innovative digital gamified Acceptance and Commitment early-intervention program (AcceptME) for young females showing signs and symptoms of an ED and at high risk for an ED. Participants (n = 92; Mage = 15.30 years, SD = 2.15) received either AcceptME (n = 62) or a waitlist control (n = 30). Analyses indicated that the AcceptME program effectively reduced weight and shape concerns with large effects when compared to waitlist controls. Most participants scored below the at-risk cut-off (WCS score < 52) in the AcceptME at end-of-intervention (57.1%) compared to controls (7.1%), with odds of falling into the at-risk group being 14.5 times higher for participants in the control group. At follow-up, 72% of completers reported scores below the at-risk cut-off in the AcceptME group. The intervention also resulted in a decrease in ED symptomatology and increased body image flexibility. Overall, results suggest that the AcceptME program holds promise for early-intervention of young women at risk for developing an ED.
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Affiliation(s)
- Maria Karekla
- Department of Psychology, University of Cyprus, Nicosia 1678, Cyprus;
- Correspondence: ; Tel.: +357-2289-2100
| | - Patrisia Nikolaou
- Department of Psychology, University of Cyprus, Nicosia 1678, Cyprus;
| | - Rhonda M. Merwin
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA;
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