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Sannes TS, Yusufov M, Amonoo HL, Broden EG, Burgers DE, Bain P, Pozo-Kaderman C, Miran DM, Smith TS, Braun IM, Pirl WF. Proxy ratings of psychological well-being in patients with primary brain tumors: A systematic review. Psychooncology 2023; 32:203-213. [PMID: 36371618 PMCID: PMC10373343 DOI: 10.1002/pon.6063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 10/14/2022] [Accepted: 10/31/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This systematic review examined the agreement of proxy ratings of depression and anxiety in neuro-oncology patients. METHODS Searches were conducted across 4 databases (MEDLINE, Embase, PsycINFO, CINAHL, and Web of Science) to identify studies that compared proxy ratings (non-health care providers) of anxiety and depression in patients with brain cancer. Methodological quality and potential risk of bias were evaluated using the Joanna Briggs Institute Critical Appraisal Checklist. RESULTS Out of the 936 studies that were screened for inclusion, 6 were included for review. The findings were mixed in terms of whether patient and proxy ratings were accurate (e.g., deemed equivalent), with many of the selected studies suggesting moderate level of agreement for several of the selected studies and, when both depression and anxiety were included, depression ratings from proxy raters were more accurate than for anxiety. We identified important limitations across the selected articles, such as low sample size, clarity on defining proxy raters and the different instructions that proxy raters are given when asked to assess patients' mood symptoms. CONCLUSIONS Our findings suggest that proxy ratings of depression and anxiety should be interpreted with caution. While there is some agreement in proxy and patients with brain cancer ratings of depression and anxiety (greater agreement for depression), future work should recruit larger samples, while also remaining mindful of defining proxy raters and the instructions given in collecting these ratings.
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Affiliation(s)
- Timothy S Sannes
- Division of Adult Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Miryam Yusufov
- Division of Adult Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Hermioni L Amonoo
- Division of Adult Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA.,Brigham and Women's Hospital, Mass General Brigham, Boston, Massachusetts, USA
| | - Elizabeth G Broden
- Division of Adult Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, Massachusetts, USA
| | - Darcy E Burgers
- Division of Adult Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Paul Bain
- Countway Library, Harvard Medical School, Boston, Massachusetts, USA
| | - Cristina Pozo-Kaderman
- Division of Adult Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Damien M Miran
- Division of Adult Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Timothy S Smith
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Ilana M Braun
- Division of Adult Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - William F Pirl
- Division of Adult Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
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2
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Muriel AC, Burgers DE, Treyball AN, Vrooman LM, Adolf E, Samsel C. Risk factors for steroid-induced affective disorder in children with leukemia. Pediatr Blood Cancer 2021; 68:e28847. [PMID: 33305874 DOI: 10.1002/pbc.28847] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 10/24/2020] [Accepted: 11/21/2020] [Indexed: 11/06/2022]
Abstract
Corticosteroids are essential to treating childhood acute lymphoblastic leukemia (ALL), and can cause significant neuropsychiatric side effects. This retrospective chart review is a preliminary exploration of characteristics associated with psychiatry consultation and steroid-induced affective disorder (SIAD) during ALL treatment. Of 125 ALL patients (ages 1-10 years), 56 (44.8%) received psychiatry consultation. Thirty-nine (31.2%) of the total cohort were diagnosed with SIAD. SIAD was significantly associated with family psychiatric history, but not with steroid exposure, CNS radiation, sociodemographic factors, developmental delay, Trisomy 21, or prior psychiatric history. Gathering family psychiatric history may help identify children at increased risk of SIAD.
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Affiliation(s)
- Anna C Muriel
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Boston Children's Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Darcy E Burgers
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Boston Children's Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Annika N Treyball
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Tufts University School of Medicine, Boston, Massachusetts
| | - Lynda M Vrooman
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Boston Children's Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Esmeralda Adolf
- Dana-Farber Cancer Institute, Boston, Massachusetts.,University of Colorado Denver, Denver, Colorado
| | - Chase Samsel
- Dana-Farber Cancer Institute, Boston, Massachusetts.,Boston Children's Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
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3
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Yeo KK, Burgers DE, Brodigan K, Fasciano K, Frazier AL, Warren KE, Reardon DA. Adolescent and young adult neuro-oncology: a comprehensive review. Neurooncol Pract 2021; 8:236-246. [PMID: 34055371 DOI: 10.1093/nop/npab001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Adolescent and young adult (AYA; ages 15-39) patients represent a population that experiences significant challenges in cancer care and research, exemplified by poorer clinical outcomes as well as unmet psychosocial and reproductive health needs. Despite central nervous system (CNS) tumors being one of the most common malignancies diagnosed in the age group, there is a clear paucity of AYA CNS tumor-specific publications, especially those related to the unique psychosocial and reproductive health needs of this population of patients. In this review, we examine various aspects of AYA oncological care including tumor biology, clinical outcome, clinical trials enrollment rate, site of care, unique psychosocial needs, and oncofertility. We assess the current state of these issues, highlight areas of deficiencies, and outline the steps needed to address these concerns. We emphasize the importance of comprehensive molecular testing as part of the diagnostic work-up, expansion of clinical trial availability, access to psychosocial care and oncofertility expertise, and the development of AYA-specific clinical research to define best practices and advancing care for this population.
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Affiliation(s)
- Kee Kiat Yeo
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Darcy E Burgers
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts.,Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Katelynn Brodigan
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts
| | - Karen Fasciano
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts
| | - A Lindsay Frazier
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Katherine E Warren
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - David A Reardon
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Medicine, Harvard Medical School, Boston, Massachusetts
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4
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Burgers DE, Tarquini SJ, Kazak AE, Muriel AC. Screening and Assessment in Pediatric Psycho-Oncology. Psychooncology 2021. [DOI: 10.1093/med/9780190097653.003.0086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This chapter provides an overview of current and recommended practices regarding systematic screening and assessment of psychosocial needs in pediatric oncology. The chapter reviews published recommendations from the Psychosocial Standards of Care Project for Childhood Cancer and provides information about validated instruments for brief screening of children and their families. It also describes guidelines for using follow-up symptom-based measures and in-person clinical assessment. It includes a summary of what is known about the current implementation of screening nationally, and possible steps to enhance implementation. There is also special consideration of screening and assessment of unique medical populations within pediatric oncology, children with developmental concerns, and families from different cultures. Future directions include using implementation science to develop models for routine screening and demonstrating the impact of screening on psychosocial outcomes for patients and families and on the system of pediatric oncology care.
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5
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Steinberg Christofferson E, Burgers DE, Buchanan C, Suplee AF, Upshaw N, Ariefdjohan M. Providers' perspectives on substance use among solid organ transplant candidates in a pediatric hospital. Pediatr Transplant 2020; 24:e13668. [PMID: 32043761 DOI: 10.1111/petr.13668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 12/20/2019] [Accepted: 12/30/2019] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Substance use is prevalent among youth and often leads to impairment in multiple domains. Additionally, substance use may pose adverse health issues post-transplant. Yet, practices related to substance use among pediatric patients who require organ transplant remain inconsistent. In this study, providers were surveyed for their perspectives on substance use among solid organ transplant candidates within a pediatric hospital. METHODS An online survey was administered to providers on the heart, kidney, and liver transplant teams at one tertiary pediatric care center located in the intermountain region of the United States (N = 50, 42% response rate). Providers answered questions about the need for a hospital-wide policy across heart, liver, and kidney transplant teams within this transplant center, timing of substance use evaluation, types of substances eliciting concerns based on organ, and recommended interventions. Data were analyzed using descriptive statistics. RESULTS Providers felt strongly about the need for a policy to guide recommendations for substance use among transplant candidates. Providers wanted a hospital-wide substance use policy (84%) and a standardized measure for assessing substance use (98%). Respondents (98%) indicated that substance use should be assessed during the pretransplant evaluation. Respondents expressed varied concerns based on substance and organ type, and recommended interventions for patients to cease substance use prior to transplant listing. CONCLUSIONS This study highlights the need for a clear, directive, hospital-wide policy and standardized procedure for evaluating substance use among adolescent solid organ transplant candidates nationally across pediatric transplant centers.
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Affiliation(s)
- Elizabeth Steinberg Christofferson
- Department of Psychiatry, Child and Adolescent Division, University of Colorado Denver, Aurora, Colorado.,Department of Pediatrics, University of Colorado Denver, Aurora, Colorado.,Pediatric Mental Health Institute, Children's Hospital Colorado, Aurora, Colorado
| | - Darcy E Burgers
- Department of Psychosocial Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Cindy Buchanan
- Department of Psychiatry, Child and Adolescent Division, University of Colorado Denver, Aurora, Colorado.,Pediatric Mental Health Institute, Children's Hospital Colorado, Aurora, Colorado.,Department of Surgery, University of Colorado Denver, Aurora, Colorado
| | - Amanda F Suplee
- Department of Pediatric Psychology, Valley Children's Hospital, Madera, California
| | - Naadira Upshaw
- Department of Pediatrics, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia
| | - Merlin Ariefdjohan
- Department of Psychiatry, Child and Adolescent Division, University of Colorado Denver, Aurora, Colorado.,Pediatric Mental Health Institute, Children's Hospital Colorado, Aurora, Colorado
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6
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Thomas JH, Burgers DE. Sleep is an eye-opener: Behavioral causes and consequences of hypersomnolence in children. Paediatr Respir Rev 2018; 25:3-8. [PMID: 27986503 DOI: 10.1016/j.prrv.2016.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 11/15/2016] [Indexed: 10/20/2022]
Abstract
The most common behavioral cause of hypersomnia in children is insufficient sleep. Behavioral causes of insufficient sleep for children, ages six months through 12 years, include inadequate sleep hygiene, bedtime struggles, prolonged sleep onset latency, nighttime fears, and nightmares. Behavioral interventions are efficacious and should be individualized to meet the needs of the child and family. Insufficient sleep affects many areas of child development, including academic, cognitive, and psychosocial, as well as parents and caregivers. Behavioral causes of sleepiness in children are best identified through a clinical interview, sleep diary, and actigraphy.
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Affiliation(s)
- Jocelyn H Thomas
- Sleep Center, The Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA.
| | - Darcy E Burgers
- Department of Psychology, Temple University, Weiss Hall, 1701N. 13(th) Street, Philadelphia, PA 19122, USA.
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7
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Burgers DE, Drabick DAG. Community Violence Exposure and Generalized Anxiety Symptoms: Does Executive Functioning Serve a Moderating Role Among Low Income, Urban Youth? J Abnorm Child Psychol 2017; 44:1543-1557. [PMID: 26983818 DOI: 10.1007/s10802-016-0144-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Although community violence exposure (CVE) confers risk for generalized anxiety symptoms, not all youth who are exposed to violence exhibit such symptoms, suggesting that other factors moderate this relation. One candidate for moderation is executive functioning (EF), which is linked to both CVE and generalized anxiety symptoms. Nevertheless, little research has examined whether EF moderates the CVE-anxiety relation. To address this gap, we examined associations among CVE (i.e., direct victimization and witnessed violence), EF abilities (i.e., emotional control and shifting), and parent- and child-reported generalized anxiety disorder (GAD) symptoms among low income, urban youth (N = 104, 50 % male, M = 9.93 ± 1.22 years). In terms of main effects, lower levels of emotional control were associated with increased parent-reported GAD symptoms, whereas lower levels of shifting abilities were associated with increased parent- and child-reported GAD symptoms across both subtypes of CVE. EF abilities moderated the relation between direct victimization and both parent- and child-reported GAD symptoms, but did not moderate the relation between witnessed violence and GAD symptoms. Post-hoc probing indicated that when youth were exposed to higher levels of direct victimization, those with lower EF abilities exhibited elevated GAD symptoms. However, the level of direct victimization did not impact the level of GAD symptoms among youth with higher EF abilities. Findings have implications for prevention and intervention programs among at-risk youth who are exposed to community violence.
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Affiliation(s)
- Darcy E Burgers
- Department of Psychology, Temple University, Weiss Hall 1701 N. 13th Street, Philadelphia, PA, 19122-6011, USA.
| | - Deborah A G Drabick
- Department of Psychology, Temple University, Weiss Hall 1701 N. 13th Street, Philadelphia, PA, 19122-6011, USA
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8
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Abstract
Peer rejection and deviant peer affiliation are linked consistently to the development and maintenance of conduct problems. Two proposed models may account for longitudinal relations among these peer processes and conduct problems: the (a) sequential mediation model, in which peer rejection in childhood and deviant peer affiliation in adolescence mediate the link between early externalizing behaviors and more serious adolescent conduct problems; and (b) parallel process model, in which peer rejection and deviant peer affiliation are considered independent processes that operate simultaneously to increment risk for conduct problems. In this review, we evaluate theoretical models and evidence for associations among conduct problems and (a) peer rejection and (b) deviant peer affiliation. We then consider support for the sequential mediation and parallel process models. Next, we propose an integrated model incorporating both the sequential mediation and parallel process models. Future research directions and implications for prevention and intervention efforts are discussed.
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Affiliation(s)
- Diane Chen
- Division of Adolescent Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Avenue, Box 10B, Chicago, IL, 60611-2605, USA.
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
| | | | - Darcy E Burgers
- Department of Psychology, Temple University, Philadelphia, PA, USA
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9
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De Los Reyes A, Augenstein TM, Wang M, Thomas SA, Drabick DAG, Burgers DE, Rabinowitz J. The validity of the multi-informant approach to assessing child and adolescent mental health. Psychol Bull 2015; 141:858-900. [PMID: 25915035 DOI: 10.1037/a0038498n] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Child and adolescent patients may display mental health concerns within some contexts and not others (e.g., home vs. school). Thus, understanding the specific contexts in which patients display concerns may assist mental health professionals in tailoring treatments to patients' needs. Consequently, clinical assessments often include reports from multiple informants who vary in the contexts in which they observe patients' behavior (e.g., patients, parents, teachers). Previous meta-analyses indicate that informants' reports correlate at low-to-moderate magnitudes. However, is it valid to interpret low correspondence among reports as indicating that patients display concerns in some contexts and not others? We meta-analyzed 341 studies published between 1989 and 2014 that reported cross-informant correspondence estimates, and observed low-to-moderate correspondence (mean internalizing: r = .25; mean externalizing: r = .30; mean overall: r = .28). Informant pair, mental health domain, and measurement method moderated magnitudes of correspondence. These robust findings have informed the development of concepts for interpreting multi-informant assessments, allowing researchers to draw specific predictions about the incremental and construct validity of these assessments. In turn, we critically evaluated research on the incremental and construct validity of the multi-informant approach to clinical child and adolescent assessment. In so doing, we identify crucial gaps in knowledge for future research, and provide recommendations for "best practices" in using and interpreting multi-informant assessments in clinical work and research. This article has important implications for developing personalized approaches to clinical assessment, with the goal of informing techniques for tailoring treatments to target the specific contexts where patients display concerns. (PsycINFO Database Record
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Affiliation(s)
- Andres De Los Reyes
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland
| | - Tara M Augenstein
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland
| | - Mo Wang
- Department of Management, University of Florida
| | - Sarah A Thomas
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland
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10
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De Los Reyes A, Augenstein TM, Wang M, Thomas SA, Drabick DA, Burgers DE, Rabinowitz J. The validity of the multi-informant approach to assessing child and adolescent mental health. Psychol Bull 2015; 141:858-900. [PMID: 25915035 PMCID: PMC4486608 DOI: 10.1037/a0038498] [Citation(s) in RCA: 779] [Impact Index Per Article: 86.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Child and adolescent patients may display mental health concerns within some contexts and not others (e.g., home vs. school). Thus, understanding the specific contexts in which patients display concerns may assist mental health professionals in tailoring treatments to patients' needs. Consequently, clinical assessments often include reports from multiple informants who vary in the contexts in which they observe patients' behavior (e.g., patients, parents, teachers). Previous meta-analyses indicate that informants' reports correlate at low-to-moderate magnitudes. However, is it valid to interpret low correspondence among reports as indicating that patients display concerns in some contexts and not others? We meta-analyzed 341 studies published between 1989 and 2014 that reported cross-informant correspondence estimates, and observed low-to-moderate correspondence (mean internalizing: r = .25; mean externalizing: r = .30; mean overall: r = .28). Informant pair, mental health domain, and measurement method moderated magnitudes of correspondence. These robust findings have informed the development of concepts for interpreting multi-informant assessments, allowing researchers to draw specific predictions about the incremental and construct validity of these assessments. In turn, we critically evaluated research on the incremental and construct validity of the multi-informant approach to clinical child and adolescent assessment. In so doing, we identify crucial gaps in knowledge for future research, and provide recommendations for "best practices" in using and interpreting multi-informant assessments in clinical work and research. This article has important implications for developing personalized approaches to clinical assessment, with the goal of informing techniques for tailoring treatments to target the specific contexts where patients display concerns. (PsycINFO Database Record
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Affiliation(s)
- Andres De Los Reyes
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland at College Park, 20742, USA
| | - Tara M. Augenstein
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland at College Park, 20742, USA
| | - Mo Wang
- Department of Management, Warrington College of Business Administration, University of Florida, Gainesville, FL, 32611, USA
| | - Sarah A. Thomas
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland at College Park, 20742, USA
| | | | - Darcy E. Burgers
- Department of Psychology, Temple University, Philadelphia, PA, 19122, USA
| | - Jill Rabinowitz
- Department of Psychology, Temple University, Philadelphia, PA, 19122, USA
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11
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Tyrka AR, Burgers DE, Philip NS, Price LH, Carpenter LL. The neurobiological correlates of childhood adversity and implications for treatment. Acta Psychiatr Scand 2013; 128:434-47. [PMID: 23662634 PMCID: PMC4467688 DOI: 10.1111/acps.12143] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/03/2013] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This article provides an overview of research on the neurobiological correlates of childhood adversity and a selective review of treatment implications. METHOD Findings from a broad array of human and animal studies of early adversity were reviewed. RESULTS Topics reviewed include neuroendocrine, neurotrophic, neuroimaging, and cognitive effects of adversity, as well as genetic and epigenetic influences. Effects of early-life stress on treatment outcome are considered, and development of treatments designed to address the neurobiological abnormalities is discussed. CONCLUSION Early adversity is associated with abnormalities of several neurobiological systems that are implicated in the development of psychopathology and other medical conditions. Early-life stress negatively impacts treatment outcome, and individuals may require treatments that are specific to this condition.
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Affiliation(s)
- Audrey R. Tyrka
- Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI,Address Correspondence to: Audrey R. Tyrka, M.D., Ph.D., Butler Hospital, 345 Blackstone Blvd., Providence, RI 02906. TEL: (401) 455-6520. FAX: (401) 455-6534.
| | - Darcy E. Burgers
- Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI
| | - Noah S. Philip
- Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI
| | - Lawrence H. Price
- Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI
| | - Linda L. Carpenter
- Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI
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