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Freitag GF, Coxe S, Cardinale EM, Furr JM, Herrera A, Comer JS. Phasic Versus Tonic Irritability and Associations with Family Accommodation Among Youth with Selective Mutism: A Latent Profile Analysis. Res Child Adolesc Psychopathol 2024; 52:905-917. [PMID: 38270833 DOI: 10.1007/s10802-023-01161-x] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2023] [Indexed: 01/26/2024]
Abstract
Clinical presentations of selective mutism (SM) vary widely across affected youth. Although studies have explored general externalizing problems in youth with SM, research has not specifically examined patterns of irritability. Relatedly, research has not considered how affected families differentially accommodate the anxiety of youth with SM as a function of the child's temper outbursts (i.e., phasic irritability) and general angry mood (i.e., tonic irritability). Data were drawn from a sample of treatment-seeking children and adolescents with a primary diagnosis of selective mutism (N = 152; Mean age = 6.12 years; 67.11% female), and their caregivers. Latent profile analysis (LPA) was used to identify distinct profiles in SM youth that were characterized by varying levels of phasic and/or tonic irritability. Analyses further examined whether these different profiles were associated with different levels of family accommodation and global impairment. LPA identified 5 profiles: SM with No irritability, SM with Low Phasic Irritability, SM with High Phasic Irritability, SM with High Phasic and Moderate Tonic Irritability, and SM with High Phasic and High Tonic Irritability. Patterns of family accommodation and global impairment were highest among youth belonging to profiles characterized by high phasic irritability. Findings highlight separable patterns of irritability across youth with SM, with phasic irritability (i.e., temper outbursts) appearing particularly linked with increased family accommodation and overall global impairment. Assessing phasic irritability is critical for optimizing treatment in youth with SM and can be useful for flagging possible patterns of family accommodation contributing to overall impairment.
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Affiliation(s)
- Gabrielle F Freitag
- Mental Health Interventions and Technology (MINT) Program, Center for Children and Families, Department of Psychology, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA.
| | - Stefany Coxe
- Mental Health Interventions and Technology (MINT) Program, Center for Children and Families, Department of Psychology, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
| | - Elise M Cardinale
- Department of Psychology, The Catholic University of America, Washington, DC, USA
| | - Jami M Furr
- Mental Health Interventions and Technology (MINT) Program, Center for Children and Families, Department of Psychology, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
| | - Aileen Herrera
- Mental Health Interventions and Technology (MINT) Program, Center for Children and Families, Department of Psychology, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
| | - Jonathan S Comer
- Mental Health Interventions and Technology (MINT) Program, Center for Children and Families, Department of Psychology, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
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Crowley JJ, Cappi C, Ochoa-Panaifo ME, Frederick RM, Kook M, Wiese AD, Rancourt D, Atkinson EG, Giusti-Rodriguez P, Anderberg JL, Abramowitz JS, Adorno VR, Aguirre C, Alves GS, Alves GS, Ancalade N, Arellano Espinosa AA, Arnold PD, Ayton DM, Barbosa IG, Castano LMB, Barrera CN, Berardo MC, Berrones D, Best JR, Bigdeli TB, Burton CL, Buxbaum JD, Callahan JL, Carneiro MCB, Cepeda SL, Chazelle E, Chire JM, Munoz MC, Quiroz PC, Cobite J, Comer JS, Costa DL, Crosbie J, Cruz VO, Dager G, Daza LF, de la Rosa-Gómez A, Del Río D, Delage FZ, Dreher CB, Fay L, Fazio T, Ferrão YA, Ferreira GM, Figueroa EG, Fontenelle LF, Forero DA, Fragoso DTH, Gadad BS, Garrison SR, González A, Gonzalez LD, González MA, Gonzalez-Barrios P, Goodman WK, Grice DE, Guintivano J, Guttfreund DG, Guzick AG, Halvorsen MW, Hovey JD, Huang H, Irreño-Sotomonte J, Janssen-Aguilar R, Jensen M, Jimenez Reynolds AZ, Lujambio JAJ, Khalfe N, Knutsen MA, Lack C, Lanzagorta N, Lima MO, Longhurst MO, Lozada Martinez DA, Luna ES, Marques AH, Martinez MS, de Los Angeles Matos M, Maye CE, McGuire JF, Menezes G, Minaya C, Miño T, Mithani SM, de Oca CM, Morales-Rivero A, Moreira-de-Oliveira ME, Morris OJ, Muñoz SI, Naqqash Z, Núñez Bracho AA, Núñez Bracho BE, Rojas MCO, Olavarria Castaman LA, Balmaceda TO, Ortega I, Patel DI, Patrick AK, Paz Y Mino M, Perales Orellana JL, Stumpf BP, Peregrina T, Duarte TP, Piacsek KL, Placencia M, Prieto MB, Quarantini LC, Quarantini-Alvim Y, Ramos RT, Ramos IC, Ramos VR, Ramsey KA, Ray EV, Richter MA, Riemann BC, Rivas JC, Rosario MC, Ruggero CJ, Ruiz-Chow AA, Ruiz-Velasco A, Sagarnaga MN, Sampaio AS, Saraiva LC, Schachar RJ, Schneider SC, Schweissing EJ, Seligman LD, Shavitt RG, Soileau KJ, Stewart SE, Storch SB, Strouphauer ER, Cuevas VT, Timpano KR, la Garza BTD, Vallejo-Silva A, Vargas-Medrano J, Vásquez MI, Martinez GV, Weinzimmer SA, Yanez MA, Zai G, Zapata-Restrepo LM, Zappa LM, Zepeda-Burgos RM, Zoghbi AW, Miguel EC, Rodriguez CI, Martinez Mallen MC, Moya PR, Borda T, Moyano MB, Mattheisen M, Pereira S, Lázaro-Muñoz G, Martinez-Gonzalez KG, Pato MT, Nicolini H, Storch EA. Latin American Trans-ancestry INitiative for OCD genomics (LATINO): Study protocol. Am J Med Genet B Neuropsychiatr Genet 2024; 195:e32962. [PMID: 37946624 PMCID: PMC11076176 DOI: 10.1002/ajmg.b.32962] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 09/26/2023] [Accepted: 10/06/2023] [Indexed: 11/12/2023]
Abstract
Obsessive-compulsive disorder (OCD) is a debilitating psychiatric disorder. Worldwide, its prevalence is ~2% and its etiology is mostly unknown. Identifying biological factors contributing to OCD will elucidate underlying mechanisms and might contribute to improved treatment outcomes. Genomic studies of OCD are beginning to reveal long-sought risk loci, but >95% of the cases currently in analysis are of homogenous European ancestry. If not addressed, this Eurocentric bias will result in OCD genomic findings being more accurate for individuals of European ancestry than other ancestries, thereby contributing to health disparities in potential future applications of genomics. In this study protocol paper, we describe the Latin American Trans-ancestry INitiative for OCD genomics (LATINO, https://www.latinostudy.org). LATINO is a new network of investigators from across Latin America, the United States, and Canada who have begun to collect DNA and clinical data from 5000 richly phenotyped OCD cases of Latin American ancestry in a culturally sensitive and ethical manner. In this project, we will utilize trans-ancestry genomic analyses to accelerate the identification of OCD risk loci, fine-map putative causal variants, and improve the performance of polygenic risk scores in diverse populations. We will also capitalize on rich clinical data to examine the genetics of treatment response, biologically plausible OCD subtypes, and symptom dimensions. Additionally, LATINO will help elucidate the diversity of the clinical presentations of OCD across cultures through various trainings developed and offered in collaboration with Latin American investigators. We believe this study will advance the important goal of global mental health discovery and equity.
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Affiliation(s)
- James J Crowley
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Carolina Cappi
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Departamento de Psiquiatria, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | | | - Renee M Frederick
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Minjee Kook
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Andrew D Wiese
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Diana Rancourt
- Department of Psychology, University of South Florida, Tampa, Florida, USA
| | - Elizabeth G Atkinson
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Paola Giusti-Rodriguez
- Department of Psychiatry, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Jacey L Anderberg
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Jonathan S Abramowitz
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Victor R Adorno
- Hospital Psiquiátrico de Asunción, Direccion General, Asuncion, Central, Paraguay
| | - Cinthia Aguirre
- Departamento de Psiquiatría, Hospital Psiquiátrico de Asunción, Asuncion, Central, Paraguay
| | - Gilberto S Alves
- Hospital Nina Rodrigues/Universidade Federal do Maranhão (UFMA), Sao Luis do Maranhao, Maranhao, Brazil
| | - Gustavo S Alves
- Hospital Universitário Professor Edgard Santos, Serviço de Psiquiatria, Laboratório de Neuropsicofarmacologia-LANP, Universidade Federal da Bahia, Salvador, Bahia, Brazil
- Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Pós-Graduação em Medicina e Saúde, Salvador, Bahia, Brazil
| | - NaEshia Ancalade
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Paul D Arnold
- The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Daphne M Ayton
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Izabela G Barbosa
- Departamento de Saúde Mental da Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | | | - María Celeste Berardo
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
| | - Dayan Berrones
- Department of Psychology, Rice University, Houston, Texas, USA
| | - John R Best
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tim B Bigdeli
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
- VA New York Harbor Healthcare System, Brooklyn, New York, USA
| | - Christie L Burton
- Department of Neurosciences and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Joseph D Buxbaum
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Maria Cecília B Carneiro
- Departamento de Psiquiatria e Medicina Legal, Universidade Federal do Paraná, Curitiba, Parana, Brazil
| | - Sandra L Cepeda
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Evelyn Chazelle
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
| | - Jessica M Chire
- Instituto Nacional de Salud Mental "Honorio Delgado-Hideyo Noguchi", Dirección de Niños y Adolescentes Lima, Lima, Peru
| | | | | | - Journa Cobite
- Department of Counseling Psychology, University of Houston, Houston, Texas, USA
| | - Jonathan S Comer
- Department of Psychology, Florida International University, Miami, Florida, USA
| | - Daniel L Costa
- Departamento de Psiquiatria, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Jennifer Crosbie
- Department of Neurosciences and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Victor O Cruz
- Instituto Nacional de Salud Mental "Honorio Delgado-Hideyo Noguchi", Oficina Ejecutiva de Investigación, Lima, Lima, Peru
- School of Medicine, Universidad San Martin de Porres, Lima, Lima, Peru
| | - Guillermo Dager
- Corporación Universitaria Rafael Nuñez, Cartagena, Bolivar, Colombia
| | - Luisa F Daza
- Hospital Psiquiátrico Universitario Del Valle, Cali, Valle del Cauca, Colombia
| | - Anabel de la Rosa-Gómez
- Facultad de Estudios Superiores Iztacala, Tlalnepantla de Baz, Universidad Nacional Autónoma de México, Ciudad de Mexico, Mexico
| | | | - Fernanda Z Delage
- Departamento de Medicina Forense e Psiquiatria, Universidade Federal do Paraná, Curitiba, Parana, Brazil
| | - Carolina B Dreher
- Departamento de Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Departamento de Psiquiatria, Clínica Médica, Porto Alegre, Rio Grande do Sul, Brazil
| | - Lucila Fay
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
| | - Tomas Fazio
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
| | - Ygor A Ferrão
- Departamento de Psiquiatria, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Gabriela M Ferreira
- Departamento de Medicina Forense e Psiquiatria, Universidade Federal do Paraná, Curitiba, Parana, Brazil
- Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Parana, Brazil
| | - Edith G Figueroa
- Departamento de Psiquiatría de Adultos, Instituto Nacional de Salud Mental "Honorio Delgado-Hideyo Noguchi", Lima, Lima, Peru
| | - Leonardo F Fontenelle
- Departamento de Psiquiatria e Medicina Legal, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
- Departamento de Psiquiatria, Instituto D'Or de Pesquisa e Ensino, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Diego A Forero
- Fundación Universitaria del Área Andina, Escuela de Salud y Ciencias del Deporte, Bogota, Bogota, Colombia
| | - Daniele T H Fragoso
- Departamento de Medicina Forense e Psiquiatria, Universidade Federal do Paraná, Curitiba, Parana, Brazil
| | - Bharathi S Gadad
- Department of Psychiatry, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
| | | | | | - Laura D Gonzalez
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
| | - Marco A González
- Facultad de Estudios Superiores Iztacala, Tlalnepantla de Baz, Universidad Nacional Autónoma de México, Ciudad de Mexico, Mexico
| | - Polaris Gonzalez-Barrios
- Departamento de Psiquiatría, Universidad de Puerto Rico, San Juan, Puerto Rico, USA
- Universidad de Puerto Rico Campus de Ciências Médicas, San Juan, Puerto Rico, USA
| | - Wayne K Goodman
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Dorothy E Grice
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jerry Guintivano
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Andrew G Guzick
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Matthew W Halvorsen
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Joseph D Hovey
- Department of Psychological Science, The University of Texas Rio Grande Valley, Edinburg, Texas, USA
| | - Hailiang Huang
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Cambridge, Massachusetts, USA
| | - Jonathan Irreño-Sotomonte
- Center for Mental Health-Cersame, School of Medicine and Health Sciences, Universidad del Rosario, Bogota, District of Colombia, Colombia
| | - Reinhard Janssen-Aguilar
- Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suarez, Subdirección de Psiquiatría, Ciudad de México, Ciudad de Mexico, Mexico
| | - Matias Jensen
- Centro de Neurociencias, Universidad de Valparaíso, Valparaiso, Chile
| | | | | | - Nasim Khalfe
- Baylor College of Medicine, School of Medicine, Houston, Texas, USA
| | - Madison A Knutsen
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
- Department of Psychology, Augustana College, Rock Island, Illinois, USA
| | - Caleb Lack
- Department of Psychology, University of Central Oklahoma, Edmond, Oklahoma, USA
| | - Nuria Lanzagorta
- Departamento de Investigación Clínica, Grupo Médico Carracci, Ciudad de México, Ciudad de Mexico, Mexico
| | - Monicke O Lima
- Departamento de Psiquiatria, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Melanie O Longhurst
- Department of Psychiatry, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
| | | | - Elba S Luna
- Instituto Nacional de Salud Mental "Honorio Delgado-Hideyo Noguchi", Oficina Ejecutiva de Investigación, Lima, Lima, Peru
| | - Andrea H Marques
- National Institute of Mental Heatlh (NIMH), Bethesda, Maryland, USA
| | - Molly S Martinez
- DFW OCD Treatment Specialists, Richardson, Texas, USA
- Specialists in OCD and Anxiety Recovery (SOAR), Richardson, Texas, USA
| | - Maria de Los Angeles Matos
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
| | - Caitlyn E Maye
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Joseph F McGuire
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Gabriela Menezes
- Programa de Ansiedade, Obsessões e Compulsões, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Charlene Minaya
- Department of Psychology, Fordham University, New York, New York, USA
| | - Tomás Miño
- Centro de Neurociencias, Universidad de Valparaíso, Valparaiso, Chile
| | - Sara M Mithani
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | | | | | - Maria E Moreira-de-Oliveira
- Programa de Ansiedade, Obsessões e Compulsões, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Olivia J Morris
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Sandra I Muñoz
- Facultad de Estudios Superiores Iztacala, Tlalnepantla de Baz, Universidad Nacional Autónoma de México, Ciudad de Mexico, Mexico
| | - Zainab Naqqash
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | | | | | - Trinidad Olivos Balmaceda
- Centro Interdisciplinario de Neurociencia de Valparaíso, Universidad de Valparaíso, Valparaiso, Valparaiso, Chile
| | - Iliana Ortega
- The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Darpan I Patel
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Ainsley K Patrick
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Mariel Paz Y Mino
- Clínica de Salud Mental USFQ, Universidad San Francisco de Quito, Quito, Pichincha, Ecuador
- Universidad San Francisco de Quito, Quito, Pichincha, Ecuador
| | - Jose L Perales Orellana
- Universidad Tegnológica Privada de Santa Cruz (UTEPSA), Santa Cruz de la Sierra, Andres Ibañez, Bolivia
| | - Bárbara Perdigão Stumpf
- Departamento de Saúde Mental da Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | | | | | - Maritza Placencia
- Departamento Académico de Ciencias Dinámicas, Universidad Nacional Mayor de San Marcos, Lima, Lima, Peru
| | - María Belén Prieto
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
| | - Lucas C Quarantini
- Hospital Universitário Professor Edgard Santos, Serviço de Psiquiatria, Laboratório de Neuropsicofarmacologia-LANP, Universidade Federal da Bahia, Salvador, Bahia, Brazil
- Departamento de Neurociências e Saúde Mental, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Yana Quarantini-Alvim
- Hospital Universitário Professor Edgard Santos, Serviço de Psiquiatria, Laboratório de Neuropsicofarmacologia-LANP, Universidade Federal da Bahia, Salvador, Bahia, Brazil
- Faculdade Santa Casa, Faculdade de Psicologia, Salvador, Bahia, Brazil
| | - Renato T Ramos
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Iaroslava C Ramos
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Psychiatry, Frederick Thompson Anxiety Disorders Centre, Toronto, Ontario, Canada
| | - Vanessa R Ramos
- Departamento de Psiquiatria, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Kesley A Ramsey
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Elise V Ray
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Margaret A Richter
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Juan C Rivas
- Hospital Psiquiátrico Universitario Del Valle, Cali, Valle del Cauca, Colombia
- Departamento de Psiquiatría, Universidad del Valle, Cali, Valle del Cauca, Colombia
- Departamento de Psiquiatria, Universidad ICESI, Cali, Valle del Cauca, Colombia
- Departamento de Psiquiatria, Fundación Valle del Lili, Cali, Valle del Cauca, Colombia
| | - Maria C Rosario
- Departamento de Psiquiatria da, Universidade Federal de São Paulo (UNIFESP), Sao Paulo, Sao Paulo, Brazil
| | - Camilo J Ruggero
- Department of Psychology, University of North Texas, Denton, Texas, USA
| | | | - Alejandra Ruiz-Velasco
- Department of Psychiatry, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
| | - Melisa N Sagarnaga
- Facultad de Psicología, Universidad de Buenos Aires, Buenos Aires, Buenos Aires, Argentina
| | - Aline S Sampaio
- Hospital Universitário Professor Edgard Santos, Serviço de Psiquiatria, Laboratório de Neuropsicofarmacologia-LANP, Universidade Federal da Bahia, Salvador, Bahia, Brazil
- Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Pós-Graduação em Medicina e Saúde, Salvador, Bahia, Brazil
- Departamento de Neurociências e Saúde Mental, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Leonardo C Saraiva
- Departamento de Psiquiatria, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Russell J Schachar
- Department of Neurosciences and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Sophie C Schneider
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Ethan J Schweissing
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Laura D Seligman
- Department of Psychological Science, The University of Texas Rio Grande Valley, Edinburg, Texas, USA
| | - Roseli G Shavitt
- Departamento de Psiquiatria, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Keaton J Soileau
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - S Evelyn Stewart
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
- BC Mental Health and Substance Use Services, Vancouver, British Columbia, Canada
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Shaina B Storch
- Washington University in St. Louis, St. Louis, Missouri, USA
| | | | - Vissente Tapia Cuevas
- Centro Interdisciplinario de Neurociencia de Valparaíso, Universidad de Valparaíso, Valparaiso, Valparaiso, Chile
| | - Kiara R Timpano
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | | | - Alexie Vallejo-Silva
- Center for Mental Health-Cersame, School of Medicine and Health Sciences, Universidad del Rosario, Bogota, District of Colombia, Colombia
| | - Javier Vargas-Medrano
- Department of Psychiatry, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
| | - María I Vásquez
- Hospital Nacional Arzobispo Loayza, Servicio de Salud Mental, Lima, Lima, Peru
| | - Guadalupe Vidal Martinez
- Department of Psychiatry, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
| | - Saira A Weinzimmer
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Mauricio A Yanez
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Gwyneth Zai
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Molecular Brain Sciences, Centre for Addiction and Mental Health, Neurogenetics Section, Toronto, Ontario, Canada
| | - Lina M Zapata-Restrepo
- Departamento de Psiquiatria, Fundación Valle del Lili, Cali, Valle del Cauca, Colombia
- Facultad de Ciencias de la Salud, Universidad ICESI, Cali, Valle, Colombia
- Department of Neurology, Global Brain Health Institute-University of California San Francisco, San Francisco, California, USA
| | - Luz M Zappa
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
- Departamento de Salud Mental, Hospital de Niños Ricardo Gutierrez, Buenos Aires, Buenos Aires, Argentina
- Hospital Universitario Austral, Materno Infantil, Buenos Aires, Buenos Aires, Argentina
| | - Raquel M Zepeda-Burgos
- Centro de Investigación en Ciencias y Humanidades, Universidad Dr. José Matías Delgado, Santa Tecla, La Libertad, El Salvador
| | - Anthony W Zoghbi
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
- Department of Psychiatry, New York State Psychiatric Institute, New York, New York, USA
| | - Euripedes C Miguel
- Departamento de Psiquiatria, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Carolyn I Rodriguez
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
- Department of Psychiatry, Temerty Faculty of Medicine, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | | | - Pablo R Moya
- Universidad de Valparaíso, Instituto de Fisiología Valparaiso, Valparaiso, Chile
- Centro Interdisciplinario de Neurociencia de Valparaiso (CINV), Valparaiso, Chile
| | - Tania Borda
- Instituto Realize, Buenos Aires, Buenos Aires, Argentina
- Facultad de Psicología, Universidad Catolica Argentina, Buenos Aires, Buenos Aires, Argentina
| | - María Beatriz Moyano
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
- Asociación de Psiquiatras Argentinos (APSA), Buenos Aires, Buenos Aires, Argentina
- Asociación de Psiquiatras Argentinos (APSA), Presidente del Capítulo de Investigacion en Psiquiatria, Buenos Aires, Buenos Aires, Argentina
| | - Manuel Mattheisen
- Department of Community Health and Epidemiology & Faculty of Computer Science, Dalhousie University, Halifax, Nova Scotia, Canada
- LMU Munich, Institute of Psychiatric Phenomics and Genomics (IPPG), Munich, Germany
| | - Stacey Pereira
- Baylor College of Medicine, Center for Medical Ethics and Health Policy, Houston, Texas, USA
| | - Gabriel Lázaro-Muñoz
- Center for Bioethics, Harvard University School of Medicine, Boston, Massachusetts, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Michele T Pato
- Department of Psychiatry, Rutgers University-Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
| | - Humberto Nicolini
- Departamento de Psiquiatría, Ciudad de México, Grupo Médico Carracci, Ciudad de Mexico, Mexico
- Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Ciudad de México, Instituto Nacional de Medicina Genómica, Ciudad de Mexico, Mexico
| | - Eric A Storch
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
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3
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Shaw AM, Hare MM, Conroy K, Kehrer SM, Cummings LR, Ramos MC, Comer JS. An exploratory study of service user and clinical outcomes in telehealth-delivered dialectical behavior therapy for adolescents skills groups. Psychol Serv 2024:2024-86045-001. [PMID: 38780559 DOI: 10.1037/ser0000863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
The COVID-19 pandemic led many in-office therapeutic programs to pivot to virtual programming without empirical data supporting the acceptability and efficacy of the remote-delivered adaptations. These adaptations were essential for continuing care and addressing surging youth psychological problems at the time. To serve adolescents with comorbid psychiatric disorders and associated problems (e.g., emotion dysregulation), we adapted and implemented virtual and hybrid formats of a dialectical behavior therapy for adolescents (DBT-A; Rathus & Miller, 2015) program within a public university training clinic, such as separating the traditional multifamily group into adolescent-only and caregiver-only groups. Building on qualitative reports on virtual DBT-A, we explored preliminary service user and clinical outcomes of the virtual and hybrid DBT-A adolescent skills group component in a longitudinal retrospective cohort study for teenagers treated during the first 2 years of the pandemic (N = 21; 81% Hispanic/Latinx; 100% White). Aim 1 described service user outcomes (e.g., retention, group cohesion, client satisfaction) in the remote-delivered skills groups. Most youth completed treatment. Caregiver satisfaction was high, whereas adolescent satisfaction was mild. Aim 2 explored preliminary clinical outcomes of remote-delivered skills group adaptations. Overall anxiety, panic, and two emotion regulation facets (i.e., emotional awareness; goal pursuit when upset) significantly reduced across treatment. There were no significant reductions in depression. No suicide attempts or suicides occurred during the program. Further work is needed to clarify the efficacy of telehealth formats of DBT-A skills groups in larger, more racially diverse samples and to identify which adolescents are most appropriate for virtual and/or hybrid DBT-A. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Ashley M Shaw
- Department of Psychology, Florida International University
| | - Megan M Hare
- Department of Psychology, Florida International University
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4
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Sanchez AL, Javadi N, Comer JS. Family engagement in a behavioral parenting intervention: A randomized comparison of telehealth versus office-based treatment formats. J Consult Clin Psychol 2024:2024-73753-001. [PMID: 38619454 DOI: 10.1037/ccp0000887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
OBJECTIVE Despite effective treatment options, many families-especially those from marginalized backgrounds-lack access to quality care for their children's behavioral difficulties. Since the COVID-19 pandemic, telehealth has become a prominent format for the delivery of outpatient services, with potential to increase access to quality care. Although telehealth-delivered parenting interventions are associated with positive clinical outcomes, limited research has examined whether telehealth formats improve treatment engagement relative to office-based care. The present study is the first controlled comparison of engagement across office-based parent-child interaction therapy (PCIT) and internet-delivered PCIT (iPCIT). METHOD Children ages 3-5 years, and their caregiver(s) (N = 40) participated in a randomized trial comparing iPCIT to office-based PCIT in the treatment of behavioral problems. Analyses examined the effects of treatment format on engagement (i.e., missed sessions, premature treatment discontinuation, homework completion, therapeutic alliance, and treatment satisfaction). Logistic and linear regressions further explored whether treatment format moderated the effects of common predictors of treatment engagement (i.e., family economic means, racial/ethnic background, caregiver stress). RESULTS iPCIT improved attendance rates relative to office-based PCIT, especially for families from minoritized racial/ethnic backgrounds. At the same time, among families with relatively higher levels of caregiver stress, office-based PCIT was associated with lower dropout rates and improved treatment alliance and satisfaction, relative to iPCIT. CONCLUSIONS This study provides the first experimental support that telehealth formats can improve treatment attendance in behavioral parenting interventions. Findings highlight nuances in treatment engagement across treatment formats that reveal limits to the extent telehealth transcends engagement concerns. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
| | - Natalie Javadi
- Department of Psychiatry, Columbia University Medical Center
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5
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Blanchet BH, Hayes T, Gillenson C, Neuman K, Heymann P, Comer JS, Bagner DM. Caregiver Distress and Child Behavior Problems in Children with Developmental Delay from Predominantly Minoritized Backgrounds. J Clin Child Adolesc Psychol 2024:1-12. [PMID: 38512063 DOI: 10.1080/15374416.2024.2317409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
IMPORTANCE Child behavior problems have been shown to contribute to caregiver distress and vice versa among youth with developmental delay (DD). However, studies have not examined these associations among children and caregivers from underrepresented ethnic/racial backgrounds. Furthermore, research has not explored how associations function differently following internet-delivered treatment or based on the level of acculturation and enculturation. OBJECTIVE We examined bidirectional associations between caregiver distress (i.e. symptoms of depression, anxiety, and stress) and externalizing and internalizing behavior problems in 3- to 5-year-old children with DD from underrepresented ethnic/racial backgrounds. We also examined the impact of internet-delivered Parent-Child Interaction Therapy (iPCIT) and the moderating role of acculturation and enculturation on these bidirectional associations. METHOD Children aging out of early intervention services (n = 150) and their primary caregiver were randomized to receive iPCIT or referrals as usual (RAU) in the community. RESULTS Findings provide support for bidirectional associations between child internalizing behavior problems and caregiver depressive symptoms, although there were fewer significant associations among families randomized to iPCIT compared to RAU. Weaker associations were observed among families with higher levels of enculturation, whereas stronger associations were observed among families with higher levels of acculturation. CONCLUSIONS Results highlight a sensitive period from age 3.5 to 4 years old for bidirectional associations between caregiver distress and child behavior problems and highlight the importance of addressing family cultural values during treatment. Findings also suggest the utility of internet-delivered behavioral parenting interventions in weakening the effect of child behavior problems on caregiver distress and vice versa.
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Affiliation(s)
- Brynna H Blanchet
- Department of Psychology, Center for Children and Families, Florida International University
| | - Timothy Hayes
- Department of Psychology, Center for Children and Families, Florida International University
| | - Caroline Gillenson
- Department of Psychology, Center for Children and Families, Florida International University
| | - Keara Neuman
- Department of Psychology, Center for Children and Families, Florida International University
| | - Perrine Heymann
- Department of Psychology, Center for Children and Families, Florida International University
| | - Jonathan S Comer
- Department of Psychology, Center for Children and Families, Florida International University
| | - Daniel M Bagner
- Department of Psychology, Center for Children and Families, Florida International University
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6
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Malloy LC, Dykstra VW, Steen LAR, Filoso D, Salem H, Comer JS, Peris TS, Pincus DB, Ehrenreich-May J, Evans AD. Avoidant Parent-Child Communication About COVID-19: A Longitudinal Investigation of Associations with Youth Adjustment Across the First 6 Months of the Pandemic. Res Child Adolesc Psychopathol 2024; 52:253-266. [PMID: 37801269 DOI: 10.1007/s10802-023-01133-1] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2023] [Indexed: 10/07/2023]
Abstract
In the aftermath of discrete disasters, how families discuss the event has been linked with child well-being. There is less understanding, however, of how family communication affects adjustment to a protracted and ongoing public health crisis such as the COVID-19 pandemic. The present research leveraged a large longitudinal sample of families (N = 1884) across the United States and Canada to investigate factors that predicted family communication styles (active versus avoidant communication) about the COVID-19 pandemic and examined the longitudinal sequelae of mental health outcomes for youth associated with different family communication styles. Parents of youth between 5 to 17 years old completed surveys about their own mental health, their child's mental health, and family communication about the COVID-19 pandemic at two time points 6 months apart. Overall, findings indicated that poorer parental mental health was related to greater use of avoidant communication, and avoidant communication styles were associated with poorer youth mental health over time. Findings suggest potential perils of avoidant family communication about ongoing threats and can help identify families at risk of negative mental health outcomes.
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Affiliation(s)
- Lindsay C Malloy
- Faculty of Social Science and Humanities, Ontario Tech University, Oshawa, ON, Canada.
| | | | | | - Daniella Filoso
- Faculty of Social Science and Humanities, Ontario Tech University, Oshawa, ON, Canada
| | - Hanan Salem
- Department of Counseling, Clinical, & School Psychology, University of California, Santa Barbara, CA, USA
| | - Jonathan S Comer
- Center for Children and Families, Florida International University, Miami, FL, USA
| | - Tara S Peris
- Department of Psychiatry & Biobehavioral Sciences / Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, CA, USA
| | - Donna B Pincus
- Center for Anxiety and Related Disorders, Boston University, Boston, MA, USA
| | | | - Angela D Evans
- Department of Psychology, Brock University, St. Catharine's, ON, Canada
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7
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Sullivan ADW, Bozack AK, Cardenas A, Comer JS, Bagner DM, Forehand R, Parent J. Parenting Practices May Buffer the Impact of Adversity on Epigenetic Age Acceleration Among Young Children With Developmental Delays. Psychol Sci 2023; 34:1173-1185. [PMID: 37733001 PMCID: PMC10626625 DOI: 10.1177/09567976231194221] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 07/26/2023] [Indexed: 09/22/2023] Open
Abstract
This study examined whether children exposed to adversity would exhibit lower epigenetic age acceleration in the context of improved parenting. Children with developmental delays and externalizing behavior problems (N = 62; Mage = 36.26 months; 70.97% boys, 29.03% girls; 71% Latinx, 22.6% Black) were drawn from a larger randomized controlled trial (RCT), which randomized them to receive Internet-delivered parent-child interaction therapy (iPCIT; n = 30) or community referrals as usual (RAU; n = 32). Epigenetic age acceleration was estimated with the pediatric buccal epigenetic clock, using saliva. Adversity was assessed using parent, family, and neighborhood-level cumulative-risk indicators. Adversity interacted with Time 2 (T2) observations of positive and negative-parenting practices to predict epigenetic age acceleration 1.5 years later, regardless of treatment assignment. Children exposed to more adversity displayed lower epigenetic age acceleration when parents evidenced increased positive (b = -0.15, p = .001) and decreased negative (b = -0.12, p = .01) parenting practices.
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Affiliation(s)
- Alexandra D. W. Sullivan
- Department of Psychological Science, University of Vermont
- Department of Psychiatry, Center for Health and Community, University of California, San Francisco
| | - Anne K. Bozack
- Department of Epidemiology and Population Health, School of Medicine, Stanford University
| | - Andres Cardenas
- Department of Epidemiology and Population Health, School of Medicine, Stanford University
- Department of Pediatrics, School of Medicine, Stanford University
| | - Jonathan S. Comer
- Department of Psychology and Center for Children and Families, Florida International University
| | - Daniel M. Bagner
- Department of Psychology and Center for Children and Families, Florida International University
| | - Rex Forehand
- Department of Psychological Science, University of Vermont
| | - Justin Parent
- Bradley-Hasbro Children’s Research Center, E. P. Bradley Hospital, Providence, RI
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University
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8
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Timmons AC, Duong JB, Fiallo NS, Lee T, Vo HPQ, Ahle MW, Comer JS, Brewer LC, Frazier SL, Chaspari T. A Call to Action on Assessing and Mitigating Bias in Artificial Intelligence Applications for Mental Health. Perspect Psychol Sci 2023; 18:1062-1096. [PMID: 36490369 PMCID: PMC10250563 DOI: 10.1177/17456916221134490] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 12/14/2022]
Abstract
Advances in computer science and data-analytic methods are driving a new era in mental health research and application. Artificial intelligence (AI) technologies hold the potential to enhance the assessment, diagnosis, and treatment of people experiencing mental health problems and to increase the reach and impact of mental health care. However, AI applications will not mitigate mental health disparities if they are built from historical data that reflect underlying social biases and inequities. AI models biased against sensitive classes could reinforce and even perpetuate existing inequities if these models create legacies that differentially impact who is diagnosed and treated, and how effectively. The current article reviews the health-equity implications of applying AI to mental health problems, outlines state-of-the-art methods for assessing and mitigating algorithmic bias, and presents a call to action to guide the development of fair-aware AI in psychological science.
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Affiliation(s)
- Adela C. Timmons
- University of Texas at Austin Institute for Mental Health Research
- Colliga Apps Corporation
| | | | | | | | | | | | | | - LaPrincess C. Brewer
- Department of Cardiovascular Medicine, May Clinic College of Medicine, Rochester, Minnesota, United States
- Center for Health Equity and Community Engagement Research, Mayo Clinic, Rochester, Minnesota, United States
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9
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Freitag GF, Grassie HL, Jeong A, Mallidi A, Comer JS, Ehrenreich-May J, Brotman MA. Systematic Review: Questionnaire-Based Measurement of Emotion Dysregulation in Children and Adolescents. J Am Acad Child Adolesc Psychiatry 2023; 62:728-763. [PMID: 36529182 PMCID: PMC10267293 DOI: 10.1016/j.jaac.2022.07.866] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 06/30/2022] [Accepted: 12/08/2022] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Emotion dysregulation, understood as a critical transdiagnostic factor in the etiology and maintenance of psychopathology, is among the most common reasons youth are referred for psychiatric care. The present systematic review examined 2 decades of questionnaires used to assess emotion (dys)regulation in youth. METHOD Using "emotion (dys)regulation," PsycINFO, PubMed, and Web of Science were searched for empirical, peer-reviewed journal studies published before May 2021 in clinical and/or nonclinical youth. A total of 510 studies met selection criteria and were included. RESULTS Across the literature, 115 distinct self-, parent-, or other informant-reported measures of emotion (dys)regulation were used in cross-sectional (67.1%), longitudinal (22.4%), intervention (9.0%), and mixed design (1.6%) studies. Out of 115 different questionnaires, a subset of 5 measures of emotion (dys)regulation were used in most of the literature (ie, 59.6% of studies). Moreover, reviewed studies examined emotion (dys)regulation in more than 20 distinct clinical groups, further supporting emotion dysregulation as a transdiagnostic construct. CONCLUSION Numerous themes emerged. Broadly, measures differed in their ability to capture internal vs external components of emotion dysregulation, the use of adaptive vs maladaptive responses, and subjective experiences more broadly vs particular affective states. These findings serve to guide researchers and clinicians in selecting appropriate measurement tools for assessing specific domains of child and adolescent emotion dysregulation.
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Affiliation(s)
| | | | - Annie Jeong
- National Institutes of Mental Health, Intramural Research Program, Bethesda, Maryland
| | - Ajitha Mallidi
- National Institutes of Mental Health, Intramural Research Program, Bethesda, Maryland
| | | | | | - Melissa A Brotman
- National Institutes of Mental Health, Intramural Research Program, Bethesda, Maryland
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10
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Urcuyo AE, Conroy K, Sanchez AL, Silva K, Furr JM, Bagner DM, Comer JS. Psychometric Evaluation of the Abbreviated Multidimensional Acculturation Scale (AMAS) in a Treatment-Seeking Sample of First-Generation Immigrant Caregivers. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01525-w. [PMID: 36964458 DOI: 10.1007/s10578-023-01525-w] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/01/2023] [Indexed: 03/26/2023]
Abstract
The unique needs of first-generation immigrants and their families have not been prioritized in mental healthcare. Cultural tailoring of child services requires valid, reliable, and efficient assessments of family cultural identity. The Abbreviated Multidimension Acculturation Scale (AMAS) is a self-report of acculturation and enculturation that has been evaluated in community, but not clinical, samples. We offer the first AMAS psychometric evaluation in a treatment-seeking sample of first-generation immigrant caregivers presenting for children's mental healthcare (N = 219). Analyses examined the internal consistency, concurrent validity, and factor structures of the long-form AMAS (42 items, six subscales), AMAS-10 (10 items, four subscales), and AMAS-14 (14 items, six subscales). Findings provide support for the AMAS-10 and AMAS-14, but not the full-length AMAS, in the present sample. Given urgent needs for culturally responsive care for first-generation populations, the AMAS-10 and AMAS-14 can be used in clinical settings to support cultural assessment, case conceptualization, and treatment planning.
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Affiliation(s)
- Anya E Urcuyo
- Center for Children and Families, Department of Psychology, Florida International University, 11200 S.W. 8th Street, Miami, FL, 33199, USA
| | - Kristina Conroy
- Center for Children and Families, Department of Psychology, Florida International University, 11200 S.W. 8th Street, Miami, FL, 33199, USA
| | | | - Karina Silva
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Jami M Furr
- Center for Children and Families, Department of Psychology, Florida International University, 11200 S.W. 8th Street, Miami, FL, 33199, USA
| | - Daniel M Bagner
- Center for Children and Families, Department of Psychology, Florida International University, 11200 S.W. 8th Street, Miami, FL, 33199, USA
| | - Jonathan S Comer
- Center for Children and Families, Department of Psychology, Florida International University, 11200 S.W. 8th Street, Miami, FL, 33199, USA.
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11
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Bagner DM, Berkovits MD, Coxe S, Frech N, Garcia D, Golik A, Heflin BH, Heymann P, Javadi N, Sanchez AL, Wilson MK, Comer JS. Telehealth Treatment of Behavior Problems in Young Children With Developmental Delay: A Randomized Clinical Trial. JAMA Pediatr 2023; 177:231-239. [PMID: 36622653 PMCID: PMC9857733 DOI: 10.1001/jamapediatrics.2022.5204] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 10/15/2022] [Indexed: 01/10/2023]
Abstract
Importance Early behavior problems in children with developmental delay (DD) are prevalent and impairing, but service barriers persist. Controlled studies examining telehealth approaches are limited, particularly for children with DD. Objective To evaluate the efficacy of a telehealth parenting intervention for behavior problems in young children with DD. Design, Setting, and Participants A randomized clinical trial was conducted from March 17, 2016, to December 15, 2020, in which children with DD and externalizing behavior problems were recruited from early intervention and randomly assigned to a telehealth parenting intervention or control group and evaluated through a 12-month follow-up. Most children were from ethnic or racial minoritized backgrounds. Over one-half of children were in extreme poverty or low income-need ratio categories. Interventions Internet-delivered parent-child interaction therapy (iPCIT), which leverages videoconferencing to provide live coaching of home-based caregiver-child interactions. Families received 20 weeks of iPCIT (provided in English or in Spanish) or referrals as usual (RAU). Main Outcomes and Measures Observational and caregiver-report measures of child and caregiver behaviors and caregiving stress were examined at preintervention, midtreatment, and postintervention and at 6- and 12-month follow-ups. Results The sample included a total of 150 children (mean [SD] age, 36.2 [1.0] months; 111 male children [74%]) and their caregivers with 75 each randomly assigned to iPCIT or RAU groups. Children receiving iPCIT relative to RAU displayed significantly lower levels of externalizing problems (postintervention Cohen d = 0.48; 6-month Cohen d = 0.49; 12-month Cohen d = 0.50) and significantly higher levels of compliance to caregiver direction after treatment. Of those children with data at postintervention, greater clinically significant change was observed at postintervention for children in the iPCIT group (50 [74%]) than for those in the RAU group (30 [42%]), which was maintained at the 6-month but not the 12-month follow-up. iPCIT did not outperform RAU in reducing caregiving stress, but caregivers receiving iPCIT, relative to RAU, showed steeper increases in proportion of observed positive parenting skills (postintervention odds ratio [OR], 1.10; 95% CI, 0.53-2.21; 6-month OR, 1.31; 95% CI, 0.61-2.55; 12-month OR, 1.64; 95% CI, 0.70-3.07) and sharper decreases in proportion of observed controlling/critical behaviors (postintervention OR, 1.40; 95% CI, 0.61-1.52; 6-month OR, 1.72; 95% CI, 0.58-1.46; 12-month OR, 2.23; 95% CI, 0.53-1.37). After treatment, iPCIT caregivers also self-reported steeper decreases in harsh and inconsistent discipline than did than RAU caregivers (postintervention Cohen d = 0.24; 6-month Cohen d = 0.26; 12-month Cohen d = 0.27). Conclusions and Relevance Results of this randomized clinical trial provide evidence that a telehealth-delivered parenting intervention with real-time therapist coaching led to significant and maintained improvements for young children with DD and their caregivers. Findings underscore the promise of telehealth formats for expanding scope and reach of care for underserved families. Trial Registration ClinicalTrials.gov Identifier: NCT03260816.
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Affiliation(s)
- Daniel M. Bagner
- Department of Psychology, Florida International University, Miami
- Center for Children and Families, Florida International University, Miami
| | | | - Stefany Coxe
- Department of Psychology, Florida International University, Miami
- Center for Children and Families, Florida International University, Miami
| | - Natalie Frech
- Tulsa Schusterman Center, University of Oklahoma, Tulsa
| | - Dainelys Garcia
- Mailman Center for Child Development, University of Miami, Miami, Florida
| | | | - Brynna H. Heflin
- Department of Psychology, Florida International University, Miami
- Center for Children and Families, Florida International University, Miami
| | - Perrine Heymann
- Department of Psychology, Florida International University, Miami
- Center for Children and Families, Florida International University, Miami
| | - Natalie Javadi
- Department of Psychology, Florida International University, Miami
- Center for Children and Families, Florida International University, Miami
| | - Amanda L. Sanchez
- Department of Psychology, George Mason University, Fairfax, Virginia
| | | | - Jonathan S. Comer
- Department of Psychology, Florida International University, Miami
- Center for Children and Families, Florida International University, Miami
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12
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Freitag GF, Salem H, Conroy K, Busto C, Adrian M, Borba CPC, Brandt A, Chu PV, Dantowitz A, Farley AM, Fortuna L, Furr JM, Lejeune J, Miller L, Platt R, Porche M, Read KL, Rivero-Conil S, Hernandez RDS, Shumway P, Sikov J, Spencer A, Syeda H, McLellan LF, Rapee RM, McMakin D, Pincus DB, Comer JS. The Patient-Reported Outcomes Measurement Information System (PROMIS) pediatric and parent-proxy short forms for anxiety: Psychometric properties in the Kids FACE FEARS sample. J Anxiety Disord 2023; 94:102677. [PMID: 36773484 DOI: 10.1016/j.janxdis.2023.102677] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 07/08/2022] [Revised: 01/27/2023] [Accepted: 02/03/2023] [Indexed: 02/08/2023]
Abstract
There is tremendous need for brief and supported, non-commercial youth- and caregiver-report questionnaires of youth anxiety. The pediatric and parent proxy short forms of the Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety scale (8a v2.0) are free, brief, publicly accessible measures of youth- and caregiver-reported anxiety in children and adolescents. Despite increased use of the PROMIS, no study has evaluated performance of its anxiety scales in a sample of treatment-engaged anxious youth. Analyses were conducted on baseline data from the first 265 families (child MAge=11.14 years, 70% racial/ethnic minoritized youth) to enroll in the Kids FACE FEARS trial, a multisite comparative effectiveness trial of therapist-led vs. self-administered treatment for elevated youth anxiety. Confirmatory factor analysis (CFA) examined factor structure; omega coefficients and regression models examined internal consistency, convergent validity, and cross-informant reliability. CFA supported adjusted single-factor solutions across youth and caregiver reports, and internal consistency was high. Convergent validity was supported by medium-to-large associations with anxiety-related impairment and severity. Moderate cross-informant reliability between reports was found. Results showcase the first psychometric study of the PROMIS Anxiety scale short forms among treatment-engaged youth with elevated anxiety. Findings highlight the PROMIS Anxiety scale's utility in typical care settings for youth anxiety.
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Affiliation(s)
- Gabrielle F Freitag
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA.
| | - Hanan Salem
- University of California Santa Barbara, Santa Barbara, CA, USA
| | - Kristina Conroy
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA
| | - Carolina Busto
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA
| | - Molly Adrian
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA; Seattle Children's Hospital, Seattle, WA, USA
| | - Christina P C Borba
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA; Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Amelia Brandt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - Annie Dantowitz
- Department of Psychological and Brain Sciences, Center for Anxiety and Related Disorders (CARD), Boston University, Boston, MA, USA
| | - Alyssa M Farley
- Department of Psychological and Brain Sciences, Center for Anxiety and Related Disorders (CARD), Boston University, Boston, MA, USA
| | - Lisa Fortuna
- University of California San Francisco, San Francisco, CA, USA
| | - Jami M Furr
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA
| | - Julia Lejeune
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Leslie Miller
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Rheanna Platt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Michelle Porche
- University of California San Francisco, San Francisco, CA, USA
| | - Kendra L Read
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA; Seattle Children's Hospital, Seattle, WA, USA
| | | | | | | | - Jennifer Sikov
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
| | - Andrea Spencer
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA; Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Haniya Syeda
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
| | - Lauren F McLellan
- School of Psychological Sciences, Centre for Emotional Health, Macquarie University, Sydney, Australia
| | - Ronald M Rapee
- School of Psychological Sciences, Centre for Emotional Health, Macquarie University, Sydney, Australia
| | - Dana McMakin
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA; Nicklaus Children's Hospital, Miami, FL, USA
| | - Donna B Pincus
- Department of Psychological and Brain Sciences, Center for Anxiety and Related Disorders (CARD), Boston University, Boston, MA, USA
| | - Jonathan S Comer
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, USA
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Crowley JJ, Cappi C, Ochoa-Panaifo ME, Frederick RM, Kook M, Wiese AD, Rancourt D, Atkinson EG, Giusti-Rodriguez P, Anderberg JL, Abramowitz JS, Adorno VR, Aguirre C, Alves GS, Alves GS, Ancalade N, Espinosa AAA, Arnold PD, Ayton DM, Barbosa IG, Castano LMB, Barrera CN, Prieto MB, Berardo MC, Berrones D, Best JR, Bigdeli TB, Burton CL, Callahan JL, Carneiro MCB, Cepeda SL, Chazelle E, Chire JM, Munoz MC, Quiroz PC, Cobite J, Comer JS, Costa DL, Crosbie J, Cruz VO, Dager G, Daza LF, de la Rosa-Gómez A, Del Río D, Delage FZ, Dreher CB, Fay L, Fazio T, Ferrão YA, Ferreira GM, Figueroa EG, Fontenelle LF, Forero DA, Fragoso DT, Gadad BS, Garrison SR, González A, Gonzalez LD, González MA, Gonzalez-Barrios P, Goodman W, Guintivano J, Guttfreund DG, Guzick AG, Halvorsen MW, Hovey JD, Janssen-Aguilar R, Jensen M, Reynolds AZJ, Lujambio JAJ, Khalfe N, Knutsen MA, Lack C, Lanzagorta N, Lima MO, Longhurst MO, Martinez DAL, Luna ES, Marques AH, Martinez M, de Los Angeles Matos M, Maye CE, McGuire JF, Menezes G, Minaya C, Miño T, Mithani SM, de Oca CM, Morales-Rivero A, Moreira-de-Oliveira ME, Morris OJ, Muñoz SI, Naqqash Z, Bracho AAN, Bracho BEN, Rojas MCO, Castaman LAO, Ortega I, Patel DI, Patrick AK, Mino MPY, Orellana JLP, Stumpf BP, Peregrina T, Duarte TP, Piacsek KL, Placencia M, Quarantini LC, Quarantini-Alvim Y, Ramos RT, Ramos IC, Ramos VR, Ramsey KA, Ray EV, Richter MA, Riemann BC, Rivas JC, Rosario MC, Ruggero CJ, Ruiz-Chow AA, Ruiz-Velasco A, Sampaio AS, Saraiva LC, Schachar RJ, Schneider SC, Schweissing EJ, Seligman LD, Shavitt RG, Soileau KJ, Stewart SE, Storch SB, Strouphauer ER, Timpano KR, Treviño-de la Garza B, Vargas-Medrano J, Vásquez MI, Martinez GV, Weinzimmer SA, Yanez MA, Zai G, Zapata-Restrepo LM, Zappa LM, Zepeda-Burgos RM, Zoghbi AW, Miguel EC, Rodriguez CI, Mallen MCM, Moya PR, Borda T, Moyano MB, Mattheisen M, Pereira S, Lázaro-Muñoz G, Martinez-Gonzalez KG, Pato MT, Nicolini H, Storch EA. Latin American Trans-ancestry INitiative for OCD genomics (LATINO): Study Protocol. medRxiv 2023:2023.02.23.23286373. [PMID: 37131804 PMCID: PMC10153323 DOI: 10.1101/2023.02.23.23286373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Obsessive-compulsive disorder (OCD) is a debilitating psychiatric disorder. Worldwide, its prevalence is ~2% and its etiology is mostly unknown. Identifying biological factors contributing to OCD will elucidate underlying mechanisms and might contribute to improved treatment outcomes. Genomic studies of OCD are beginning to reveal long-sought risk loci, but >95% of the cases currently in analysis are of homogenous European ancestry. If not addressed, this Eurocentric bias will result in OCD genomic findings being more accurate for individuals of European ancestry than other ancestries, thereby contributing to health disparities in potential future applications of genomics. In this study protocol paper, we describe the Latin American Trans-ancestry INitiative for OCD genomics (LATINO, www.latinostudy.org). LATINO is a new network of investigators from across Latin America, the United States, and Canada who have begun to collect DNA and clinical data from 5,000 richly-phenotyped OCD cases of Latin American ancestry in a culturally sensitive and ethical manner. In this project, we will utilize trans-ancestry genomic analyses to accelerate the identification of OCD risk loci, fine-map putative causal variants, and improve the performance of polygenic risk scores in diverse populations. We will also capitalize on rich clinical data to examine the genetics of treatment response, biologically plausible OCD subtypes, and symptom dimensions. Additionally, LATINO will help elucidate the diversity of the clinical presentations of OCD across cultures through various trainings developed and offered in collaboration with Latin American investigators. We believe this study will advance the important goal of global mental health discovery and equity.
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Affiliation(s)
- James J Crowley
- University of North Carolina at Chapel Hill, Department of Genetics, Chapel Hill, North Carolina, United States of America
- University of North Carolina at Chapel Hill, Department of Psychiatry, Chapel Hill, North Carolina, United States of America
| | - Carolina Cappi
- Icahn School of Medicine at Mount Sinai, Department of Psychiatry, New York City, New York, United States of America
- Universidade de São Paulo, Departamento de Psiquiatria, São Paulo, São Paulo, Brasil
| | | | - Renee M Frederick
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
| | - Minjee Kook
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
| | - Andrew D Wiese
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
| | - Diana Rancourt
- University of South Florida, Department of Psychology, Tampa, Florida, United States of America
| | - Elizabeth G Atkinson
- Baylor College of Medicine, Department of Molecular and Human Genetics, Houston, Texas, United States of America
| | - Paola Giusti-Rodriguez
- University of Florida College of Medicine, Department of Psychiatry, Gainesville, Florida, United States of America
| | - Jacey L Anderberg
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
| | - Jonathan S Abramowitz
- University of North Carolina at Chapel Hill, Department of Psychology and Neuroscience, Chapel Hill, North Carolina, United States of America
| | - Victor R Adorno
- Hospital Psiquiátrico de Asunción, Direccion General, Asunción, Central, Paraguay
| | - Cinthia Aguirre
- Hospital Psiquiátrico de Asunción, Departamento de Psiquiatría, Asunción, Central, Paraguay
| | - Gustavo S Alves
- Universidade Federal da Bahia, Hospital Universitário Professor Edgard Santos, Serviço de Psiquiatria, Laboratório de Neuropsicofarmacologia - LANP, Salvador, Bahia, Brasil
- Universidade Federal da Bahia, Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Salvador, Bahia, Brasil
| | - Gilberto S Alves
- Hospital Nina Rodrigues/Universidade Federal do Maranhão (UFMA), Sao Luis do Maranhão, Maranhão, Brasil
| | - NaEshia Ancalade
- University of North Carolina at Chapel Hill, Department of Genetics, Chapel Hill, North Carolina, United States of America
| | | | - Paul D Arnold
- University of Calgary, The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Calgary, Alberta, Canada
| | - Daphne M Ayton
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
| | - Izabela G Barbosa
- Universidade Federal de Minas Gerais, Departamento de Saúde Mental da Faculdade de Medicina, Belo Horizonte, Minas Gerais, Brasil
| | | | | | - María Belén Prieto
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
| | - María Celeste Berardo
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
| | - Dayan Berrones
- Rice University, Department of Psychology, Houston, Texas, United States of America
| | - John R Best
- University of British Columbia, Department of Psychiatry, Vancouver, British Columbia, Canada
| | - Tim B Bigdeli
- SUNY Downstate Health Sciences University, Department of Psychiatry and Behavioral Sciences, Brooklyn, New York, United States of America
- VA New York Harbor Healthcare System, Brooklyn, New York, United States of America
| | - Christie L Burton
- Hospital for Sick Children, Department of Neurosciences and Mental Health, Toronto, Ontario, Canada
| | - Jennifer L Callahan
- University of North Texas, Department of Psychology, Denton, Texas, United States of America
| | - Maria Cecília B Carneiro
- Universidade Federal do Paraná, Departamento de Psiquiatria e Medicina Legal, Curitiba, Paraná, Brasil
| | - Sandra L Cepeda
- University of Miami, Department of Psychology, Coral Gables, Florida, United States of America
| | - Evelyn Chazelle
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
| | - Jessica M Chire
- Instituto Nacional de Salud Mental ""Honorio Delgado-Hideyo Noguchi"", Dirección de Niños y Adolescentes, Lima, Lima, Perú
| | | | | | - Journa Cobite
- University of Houston, Department of Counseling Psychology, Houston, Texas, United States of America
| | - Jonathan S Comer
- Florida International University, Department of Psychology, Miami, Florida, United States of America
| | - Daniel L Costa
- Universidade de São Paulo, Departamento de Psiquiatria, São Paulo, São Paulo, Brasil
| | - Jennifer Crosbie
- Hospital for Sick Children, Department of Neurosciences and Mental Health, Toronto, Ontario, Canada
- University of Toronto, Department of Psychiatry, Toronto, Ontario, Canada
| | - Victor O Cruz
- Instituto Nacional de Salud Mental ""Honorio Delgado-Hideyo Noguchi"", Oficina Ejecutiva de Investigación, Lima, Lima, Perú
- Universidad San Martin de Porres, School of Medicine, Lima, Lima, Perú
| | - Guillermo Dager
- Corporación Universitaria Rafael Nuñez, Cartagena, Bolivar, Colombia
| | - Luisa F Daza
- Hospital Psiquiátrico Universitario Del Valle, Cali, Valle del Cauca, Colombia
| | - Anabel de la Rosa-Gómez
- Universidad Nacional Autónoma de México, Facultad de Estudios Superiores Iztacala, Tlalnepantla de Baz, Ciudad de México, México
| | | | - Fernanda Z Delage
- Universidade Federal do Paraná, Departamento de Medicina Forense e Psiquiatria, Curitiba, Paraná, Brasil
| | - Carolina B Dreher
- Universidade Federal do Rio Grande do Sul, Departamento de Psiquiatria, Porto Alegre, Rio Grande do Sul, Brasil
- Universidade Federal de Ciências da Saúde de Porto Alegre, Departamento de Psiquiatria - Clínica Médica, Porto Alegre, Rio Grande do Sul, Brasil
| | - Lucila Fay
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
| | - Tomas Fazio
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
| | - Ygor A Ferrão
- Universidade Federal do Paraná de Porto Alegre, Departamento de Psiquiatria, Porto Alegre, Rio Grande do Sul, Brasil
| | - Gabriela M Ferreira
- Universidade Federal do Paraná, Departamento de Medicina Forense e Psiquiatria, Curitiba, Paraná, Brasil
- Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Parana, Brasil
| | - Edith G Figueroa
- Instituto Nacional de Salud Mental ""Honorio Delgado-Hideyo Noguchi"", Departamento de Psiquiatría de Adultos, Lima, Lima, Perú
| | - Leonardo F Fontenelle
- Universidade Federal do Rio de Janeiro, Departamento de Psiquiatria e Medicina Legal, Rio de Janeiro, Rio de Janeiro, Brasil
- Instituto D'Or de Pesquisa e Ensino, Departamento de Psiquiatria, Rio de Janeiro, Rio de Janeiro, Brasil
| | - Diego A Forero
- Fundación Universitaria del Área Andina, Escuela de Salud y Ciencias del Deporte, Bogotá, Bogotá, Colombia
| | - Daniele Th Fragoso
- Universidade Federal do Paraná, Departamento de Medicina Forense e Psiquiatria, Curitiba, Paraná, Brasil
| | - Bharathi S Gadad
- Texas Tech University Health Sciences Center El Paso, Department of Psychiatry, El Paso, Texas, United States of America
| | - Sheldon R Garrison
- Rogers Behavioral Health, Oconomowoc, Wisconsin, United States of America
| | | | - Laura D Gonzalez
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
| | - Marco A González
- Universidad Nacional Autónoma de México, Facultad de Estudios Superiores Iztacala, Tlalnepantla de Baz, Ciudad de México, México
| | - Polaris Gonzalez-Barrios
- Universidad de Puerto Rico, Departamento de Psiquiatría, San Juan, Puerto Rico, Los Estados Unidos
- Universidad de Puerto Rico Campus de Ciências Médicas, San Juan, Puerto Rico, Los Estados Unidos
| | - Wayne Goodman
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
| | - Jerry Guintivano
- University of North Carolina at Chapel Hill, Department of Psychiatry, Chapel Hill, North Carolina, United States of America
| | | | - Andrew G Guzick
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
| | - Matthew W Halvorsen
- University of North Carolina at Chapel Hill, Department of Genetics, Chapel Hill, North Carolina, United States of America
| | - Joseph D Hovey
- The University of Texas Rio Grande Valley, Department of Psychological Science, Edinburg, Texas, United States of America
| | - Reinhard Janssen-Aguilar
- Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suarez, Subdirección de Psiquiatría, Ciudad de México, Ciudad de México, México
| | - Matias Jensen
- Universidad de Valparaíso, Centro de Neurociencias, Valparaíso, Valparaíso, Chile
| | - Alexandra Z Jimenez Reynolds
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
| | | | - Nasim Khalfe
- Baylor College of Medicine, School of Medicine, Houston, Texas, United States of America
| | - Madison A Knutsen
- Augustana College, Department of Psychology, Rock Island, Illinois, United States of America
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
| | - Caleb Lack
- University of Central Oklahoma, Department of Psychology, Edmond, Oklahoma, United States of America
| | - Nuria Lanzagorta
- Grupo Médico Carracci, Departamento de Investigación Clínica, Ciudad de México, Ciudad de México, México
| | - Monicke O Lima
- Universidade de São Paulo, Departamento de Psiquiatria, São Paulo, São Paulo, Brasil
| | - Melanie O Longhurst
- Texas Tech University Health Sciences Center El Paso, Department of Psychiatry, El Paso, Texas, United States of America
| | | | - Elba S Luna
- Instituto Nacional de Salud Mental ""Honorio Delgado-Hideyo Noguchi"", Oficina Ejecutiva de Investigación, Lima, Lima, Perú
| | - Andrea H Marques
- National Institute of Mental Heatlh (NIMH), Bethesda, Maryland, United States of America
| | - Molly Martinez
- DFW OCD Treatment Specialists, Richardson, Texas, United States of America
- Specialists in OCD and Anxiety Recovery (SOAR), Richardson, Texas, United States of America
| | - Maria de Los Angeles Matos
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
| | - Caitlyn E Maye
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
| | - Joseph F McGuire
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, Maryland, United States of America
| | - Gabriela Menezes
- Universidade Federal do Rio de Janeiro, Programa de Ansiedade, Obsessões e Compulsões, Rio de Janeiro, Rio de Janeiro, Brasil
| | - Charlene Minaya
- Fordham University, Department of Psychology, New York City, New York, United States of America
| | - Tomás Miño
- Universidad de Valparaíso, Centro de Neurociencias, Valparaíso, Valparaíso, Chile
| | - Sara M Mithani
- University of Texas Health Science Center at San Antonio, School of Nursing, San Antonio, Texas, United States of America
| | | | | | - Maria E Moreira-de-Oliveira
- Universidade Federal do Rio de Janeiro, Programa de Ansiedade, Obsessões e Compulsões, Rio de Janeiro, Rio de Janeiro, Brasil
| | - Olivia J Morris
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
| | - Sandra I Muñoz
- Universidad Nacional Autónoma de México, Facultad de Estudios Superiores Iztacala, Tlalnepantla de Baz, Ciudad de México, México
| | - Zainab Naqqash
- University of British Columbia, Department of Psychiatry, Vancouver, British Columbia, Canada
| | | | | | | | | | - Iliana Ortega
- University of Calgary, The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Calgary, Alberta, Canada
| | - Darpan I Patel
- University of Texas Health Science Center at San Antonio, School of Nursing, San Antonio, Texas, United States of America
| | - Ainsley K Patrick
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, Maryland, United States of America
| | - Mariel Paz Y Mino
- Universidad San Francisco de Quito, Clínica de Salud Mental USFQ, Quito, Pichincha, Ecuador
- Universidad San Francisco de Quito, Quito, Pichincha, Ecuador
| | - Jose L Perales Orellana
- Universidad Tegnológica Privada de Santa Cruz (UTEPSA), Santa Cruz de la Sierra, Andres Ibañez, Bolivia
| | - Bárbara Perdigão Stumpf
- Universidade Federal de Minas Gerais, Departamento de Saúde Mental da Faculdade de Medicina, Belo Horizonte, Minas Gerais, Brasil
| | | | | | - Kelly L Piacsek
- Rogers Behavioral Health, Oconomowoc, Wisconsin, United States of America
| | - Maritza Placencia
- Universidad Nacional Mayor de San Marcos, Departamento Académico de Ciencias Dinámicas, Lima, Lima, Perú
| | - Lucas C Quarantini
- Universidade Federal da Bahia, Departamento de Neurociências e Saúde Mental, Faculdade de Medicina da Bahia, Salvador, Bahia, Brasil
- Universidade Federal da Bahia, Hospital Universitário Professor Edgard Santos, Serviço de Psiquiatria, Laboratório de Neuropsicofarmacologia - LANP, Salvador, Bahia, Brasil
| | - Yana Quarantini-Alvim
- Universidade Federal da Bahia, Hospital Universitário Professor Edgard Santos, Serviço de Psiquiatria, Laboratório de Neuropsicofarmacologia - LANP, Salvador, Bahia, Brasil
- Faculdade Santa Casa, Faculdade de Psicologia, Salvador, Bahia, Brasil
| | - Renato T Ramos
- Sunnybrook Health Sciences Centre, Department of Psychiatry, Toronto, Ontario, Canada
- University of Toronto, Department of Psychiatry, Toronto, Ontario, Canada
| | - Iaroslava C Ramos
- Sunnybrook Health Sciences Centre, Department of Psychiatry, Toronto, Ontario, Canada
- Frederick Thompson Anxiety Disorders Centre, Department of Psychiatry, Toronto, Ontario, Canada
| | - Vanessa R Ramos
- Universidade de São Paulo, Departamento de Psiquiatria, São Paulo, São Paulo, Brasil
| | - Kesley A Ramsey
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, Maryland, United States of America
| | - Elise V Ray
- University of North Carolina at Chapel Hill, Department of Genetics, Chapel Hill, North Carolina, United States of America
| | - Margaret A Richter
- Sunnybrook Health Sciences Centre, Department of Psychiatry, Toronto, Ontario, Canada
- University of Toronto, Department of Psychiatry, Temerty Faculty of Medicine, Toronto, Ontario, Canada
| | - Bradley C Riemann
- Rogers Behavioral Health, Oconomowoc, Wisconsin, United States of America
| | - Juan C Rivas
- Hospital Psiquiátrico Universitario Del Valle, Cali, Valle del Cauca, Colombia
- Universidad del Valle, Departamento de Psiquiatría, Cali, Valle del Cauca, Colombia
- Universidad ICESI, Departamento de Psiquiatria, Cali, Valle del Cauca, Colombia
- Fundación Valle del Lili, Departamento de Psiquiatria, Cali, Valle del Cauca, Colombia
| | - Maria C Rosario
- Departamento de Psiquiatria da Universidade Federal de São Paulo (UNIFESP), São Paulo, São Paulo, Brasil
| | - Camilo J Ruggero
- University of North Texas, Department of Psychology, Denton, Texas, United States of America
| | | | - Alejandra Ruiz-Velasco
- Texas Tech University Health Sciences Center El Paso, Department of Psychiatry, El Paso, Texas, United States of America
| | - Aline S Sampaio
- Universidade Federal da Bahia, Departamento de Neurociências e Saúde Mental, Faculdade de Medicina da Bahia, Salvador, Bahia, Brasil
- Universidade Federal da Bahia, Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Salvador, Bahia, Brasil
- Universidade Federal da Bahia, Hospital Universitário Professor Edgard Santos, Serviço de Psiquiatria, Laboratório de Neuropsicofarmacologia - LANP, Salvador, Bahia, Brasil
| | - Leonardo C Saraiva
- Universidade de São Paulo, Departamento de Psiquiatria, São Paulo, São Paulo, Brasil
| | - Russell J Schachar
- Hospital for Sick Children, Department of Neurosciences and Mental Health, Toronto, Ontario, Canada
- University of Toronto, Department of Psychiatry, Toronto, Ontario, Canada
| | - Sophie C Schneider
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
| | - Ethan J Schweissing
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
| | - Laura D Seligman
- The University of Texas Rio Grande Valley, Department of Psychological Science, Edinburg, Texas, United States of America
| | - Roseli G Shavitt
- Universidade de São Paulo, Departamento de Psiquiatria, São Paulo, São Paulo, Brasil
| | - Keaton J Soileau
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
| | - S Evelyn Stewart
- University of British Columbia, Department of Psychiatry, Vancouver, British Columbia, Canada
- BC Mental Health and Substance Use Services, Vancouver, British Columbia, Canada
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Shaina B Storch
- Washington University in St. Louis, St. Louis, Missouri, United States of America
| | - Emily R Strouphauer
- Baylor College of Medicine, School of Medicine, Houston, Texas, United States of America
| | - Kiara R Timpano
- University of Miami, Department of Psychology, Coral Gables, Florida, United States of America
| | | | - Javier Vargas-Medrano
- Texas Tech University Health Sciences Center El Paso, Department of Psychiatry, El Paso, Texas, United States of America
| | - María I Vásquez
- Hospital Nacional Arzobispo Loayza, Servicio de Salud Mental, Lima, Lima, Perú
| | - Guadalupe Vidal Martinez
- Texas Tech University Health Sciences Center El Paso, Department of Psychiatry, El Paso, Texas, United States of America
| | - Saira A Weinzimmer
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
| | - Mauricio A Yanez
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
| | - Gwyneth Zai
- Centre for Addiction and Mental Health, Neurogenetics Section, Molecular Brain Sciences Department, Toronto, Ontario, Canada
- University of Toronto, Department of Psychiatry, Temerty Faculty of Medicine, Toronto, Ontario, Canada
| | - Lina M Zapata-Restrepo
- Fundación Valle del Lili, Departamento de Psiquiatria, Cali, Valle, Colombia
- Universidad ICESI, Facultad de Ciencias de la Salud, Cali, Valle, Colombia
- Global Brain Health Institute - University of California San Francisco, Department of Neurology, San Francisco, California, United States of America
| | - Luz M Zappa
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
- Hospital de Niños Ricardo Gutierrez, Departamento de Salud Mental, Buenos Aires, Buenos Aires, Argentina
- Hospital Universitario Austral, Materno Infantil, Buenos Aires, Buenos Aires, Argentina
| | - Raquel M Zepeda-Burgos
- Universidad Dr. José Matías Delgado, Centro de Investigación en Ciencias y Humanidades, Santa Tecla, La Libertad, El Salvador
| | - Anthony W Zoghbi
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
- New York State Psychiatric Institute, Department of Psychiatry, New York City, New York, United States of America
| | - Euripedes C Miguel
- Universidade de São Paulo, Departamento de Psiquiatria, São Paulo, São Paulo, Brasil
| | - Carolyn I Rodriguez
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, Stanford, California, United States of America
- Veterans Affairs Palo Alto Health Care System, Department of Psychiatry, Temerty Faculty of Medicine, Palo Alto, California, United States of America
| | | | - Pablo R Moya
- Universidad de Valparaíso, Instituto de Fisiología, Valparaíso, Valparaíso, Chile
- Centro Interdisciplinario de Neurociencia de Valparaiso (CINV), Valparaíso, Valparaíso, Chile
| | - Tania Borda
- Instituto Realize, Buenos Aires, Buenos Aires, Argentina
- Universidad Catolica Argentina, Facultad de Psicologia, Buenos Aires, Buenos Aires, Argentina
| | - María Beatriz Moyano
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
- Asociacion de Psiquiatras Argentinos (APSA), Buenos Aires, Buenos Aires, Argentina
- Asociacion de Psiquiatras Argentinos (APSA), Presidente del Capitulo de Investigacion en Psiquiatria, Buenos Aires, Buenos Aires, Argentina
| | - Manuel Mattheisen
- Dalhousie University, Department of Community Health and Epidemiology & Faculty of Computer Science, Halifax, Nova Scotia, Canada
- LMU Munich, Institute of Psychiatric Phenomics and Genomics (IPPG), Munich, Germany
| | - Stacey Pereira
- Baylor College of Medicine, Center for Medical Ethics and Health Policy, Houston, Texas, United States of America
| | - Gabriel Lázaro-Muñoz
- Harvard University School of Medicine, Center for Bioethics, Boston, Massachusetts, United States of America
- Massachusetts General Hospital, Department of Psychiatry, Boston, Massachusetts, United States of America
| | | | - Michele T Pato
- Rutgers University- Robert Wood Johnson Medical School, Department of Psychiatry, Piscataway, New Jersey, United States of America
| | - Humberto Nicolini
- Grupo Médico Carracci, Departamento de Psiquiatría, Ciudad de México, Ciudad de México, México
- Instituto Nacional de Medicina Genómica, Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Ciudad de México, Ciudad de México, México
| | - Eric A Storch
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
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De Los Reyes A, Epkins CC, Asmundson GJG, Augenstein TM, Becker KD, Becker SP, Bonadio FT, Borelli JL, Boyd RC, Bradshaw CP, Burns GL, Casale G, Causadias JM, Cha CB, Chorpita BF, Cohen JR, Comer JS, Crowell SE, Dirks MA, Drabick DAG, DuPaul GJ, Ehrlich KB, Evans SC, Evans SW, Felton JW, Fite PJ, Gadow KD, Galán CA, Garbacz SA, Gaylord-Harden N, Humphreys KL, Gerber AH, Hogue A, Ivanova MY, Jarrett MA, Jensen-Doss A, Kang E, Kendall PC, Laird RD, Langberg JM, Langer DA, Lee SS, Lerner MD, Lippold MA, Luebbe AM, Makol BA, McLeod BD, McMahon RJ, Miller M, Ohannessian CM, Ollendick TH, Piña A, Prinstein MJ, Rabinowitz J, Reynolds EK, Salekin RT, Schleider JL, Scott JC, Tackett JL, Talbott E, Silverman WK, Spears AP, von der Embse N, Wakschlag LS, Wang M, Watts AL, Weisz JR, White BA, White SW, Youngstrom EA. Editorial Statement About JCCAP's 2023 Special Issue on Informant Discrepancies in Youth Mental Health Assessments: Observations, Guidelines, and Future Directions Grounded in 60 Years of Research. J Clin Child Adolesc Psychol 2023; 52:147-158. [PMID: 36652590 DOI: 10.1080/15374416.2022.2158842] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Andres De Los Reyes
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland
| | | | | | | | | | - Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati
| | | | | | - Rhonda C Boyd
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia
| | | | | | - Gino Casale
- Institute for Educational Research, University of Wuppertal
| | | | - Christine B Cha
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | | | | | - Jonathan S Comer
- Center for Children and Families, Department of Psychology, Florida International University
| | | | | | | | | | | | | | | | | | - Paula J Fite
- Clinical Child Psychology Program, University of Kansas
| | | | | | | | | | | | | | | | | | | | | | - Erin Kang
- Department of Psychology, Montclair State University
| | | | - Robert D Laird
- Department of Human Development and Family Studies, University of Alabama
| | - Joshua M Langberg
- Graduate School of Applied and Professional Psychology, Rutgers University
| | | | - Steve S Lee
- Department of Psychology, University of California
| | | | | | | | | | - Bryce D McLeod
- Department of Psychology, Virginia Commonwealth University
| | - Robert J McMahon
- Department of Psychology, Simon Fraser University.,B.C. Children's Hospital
| | - Meghan Miller
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California
| | | | - Thomas H Ollendick
- Department of Psychology, Virginia Polytechnic Institute and State University
| | - Armando Piña
- Department of Psychology, Arizona State University
| | | | | | | | | | | | - Judith C Scott
- Clinical Department, School of Social Work, Boston University
| | | | | | | | - Angela Page Spears
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | | | - Lauren S Wakschlag
- Department of Medical Social Sciences, Feinberg School of Medicine & Institute for Innovations in Developmental Sciences, Northwestern University
| | - Mo Wang
- Department of Management, University of Florida
| | - Ashley L Watts
- Department of Psychological Sciences, University of Missouri
| | | | | | | | - Eric A Youngstrom
- Department of Psychology and Neuroscience, University of North Carolina.,Helping Give Away Psychological Science
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15
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Georgiadis C, Bose D, Wolenski R, Javadi N, Coxe S, Pettit JW, Comer JS. How Flexible are Treatments for Youth Internalizing Disorders? Examining Modification Guidelines Included across Supported Treatments. J Clin Child Adolesc Psychol 2022; 51:593-609. [PMID: 36007223 DOI: 10.1080/15374416.2022.2109649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Treatment protocols for youth-internalizing disorders have been developed, however these protocols have yielded mixed findings in routine care settings. Despite increased recognition of the importance of flexibility when delivering evidence-based treatments (EBTs), little is known about the extent to which protocols offer guidance to providers in flexible EBT implementation. The current study examined the extent to which supported EBTs for youth internalizing disorders explicitly incorporate guidance for treatment modification. METHODS Supported treatment protocols for youth internalizing disorders were identified (N = 44), from which 4,021 modification guidelines were extracted and coded using a structured coding system to classify modification strategies (i.e., the forms that recommended modifications take), and associated tailoring factors (i.e., the rationale for which modifications are recommended). RESULTS Across all EBTs, modification guidelines were quite common, with the average protocol including almost 91 text passages providing guidance for modification. The majority of modification guidelines functionally increase session or treatment length by recommending the addition or repetition of material, whereas less than 5% of modification guidelines provided strategies for condensing or streamlining care. Strikingly, less than 2% of modification guidelines in EBT protocols address patient cultural factors, and rarely address provider or setting issues that can challenge standard implementation. CONCLUSIONS Findings highlight critical gaps in the available guidance to modify EBTs for youth internalizing disorders, and suggest EBT protocols may not be optimally poised to flexibly address the broad diversity of children and adolescents across varied settings in need of mental health care.
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Affiliation(s)
- Christopher Georgiadis
- Center for Children and Families, Department of Psychology, Florida International University
| | - Deepika Bose
- Center for Children and Families, Department of Psychology, Florida International University
| | - Rebecca Wolenski
- Center for Children and Families, Department of Psychology, Florida International University
| | - Natalie Javadi
- Center for Children and Families, Department of Psychology, Florida International University
| | - Stefany Coxe
- Center for Children and Families, Department of Psychology, Florida International University
| | - Jeremy W Pettit
- Center for Children and Families, Department of Psychology, Florida International University
| | - Jonathan S Comer
- Center for Children and Families, Department of Psychology, Florida International University
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16
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Phillips KE, Conroy K, Pinney EL, Comer JS, Kendall PC. School-based supports and accommodations among anxious youth in treatment. J Anxiety Disord 2022; 90:102603. [PMID: 35944449 DOI: 10.1016/j.janxdis.2022.102603] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 06/29/2022] [Accepted: 07/04/2022] [Indexed: 11/16/2022]
Abstract
Within pediatric anxiety, accommodation describes ways caregivers modify their behavior in an effort to alleviate distress shown by anxious youth. In schools, accommodation refers to school-based supports (SBS) placed to increase academic success for students with disabilities. The present study, using school documents provided at treatment, examined the types of SBS provided to youth (N = 76; ages 7-17; mean age 11.07; 47.4 % female) diagnosed with an anxiety disorder. SBS were rated by a panel of youth anxiety experts on the degree to which each SBS promoted (a) approach or (b) avoidance. School documents were coded for the presence of SBS and each SBS received a (a) total approach and (b) total avoidance score. Analyses revealed (a) approach and (b) avoidance promoting SBS were differentially associated with diagnostic status: youth with social anxiety disorder were more likely to be recommended SBS promoting avoidance and youth with a specific phobia were more likely to be recommended SBS promoting approach. Overall, the present study characterizes types of SBS being received by anxious youth and finds that SBS recommended to anxious youth vary in type and quality. Discussion considers the need for observations in schools to further address the merits/demerits of anxiety-related SBS.
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17
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Hong N, Herrera A, Furr JM, Georgiadis C, Cristello J, Heymann P, Dale CF, Heflin B, Silva K, Conroy K, Cornacchio D, Comer JS. Remote Intensive Group Behavioral Treatment for Families of Children with Selective Mutism. Evid Based Pract Child Adolesc Ment Health 2022; 8:439-458. [PMID: 38155719 PMCID: PMC10752620 DOI: 10.1080/23794925.2022.2062688] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2023]
Abstract
Selective mutism (SM) is a relatively rare, but highly interfering, child anxiety disorder characterized by a consistent failure to speak in certain situations, despite demonstrating fluent speech in other contexts. Exposure-based cognitive behavioral therapy and Parent-Child Interaction Therapy adapted for SM can be effective, but the broad availability and accessibility of such specialty care options remains limited. Stay-at-home guidelines to mitigate the spread of COVID-19 further limited the accessibility of office-based specialty care for SM. Building on separate lines of research supporting intensive treatments and telehealth service delivery models, this paper is the first to describe the development, preliminary feasibility, acceptability, and efficacy of a Remote Intensive Group Behavioral Treatment (IGBT) for families of young children with SM (N=9). Treatment leveraged videoconferencing technology to deliver caregiver training sessions, lead-in sessions, 5 consecutive daily IGBT sessions, and an individualized caregiver coaching session. Remote IGBT was found to be both feasible and acceptable. All families (100%) completed diagnostic assessments and caregiver-report questionnaires at four major study timepoints (i.e., intake, pre-treatment, post-treatment, 4-month follow-up) and participated in all treatment components. Caregivers reported high treatment satisfaction at post-treatment and 4-month follow-up and low levels of burden associated with treatment participation at post-treatment. Approximately half of participating children were classified as treatment responders by independent evaluators at post-treatment and 4-month follow-up. Although these pilot results should be interpreted with caution, the present work underscores the potential utility of using videoconferencing to remotely deliver IGBT to families in their natural environments.
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18
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Farhat LC, Vattimo EFQ, Ramakrishnan D, Levine JLS, Johnson JA, Artukoglu BB, Landeros-Weisenberger A, Asbahr FR, Cepeda SL, Comer JS, Fatori D, Franklin ME, Freeman JB, Geller DA, Grant PJ, Goodman WK, Heyman I, Ivarsson T, Lenhard F, Lewin AB, Li F, Merlo LJ, Mohsenabadi H, Peris TS, Piacentini J, Rosa-Alcázar AI, Rosa-Alcázar À, Rozenman M, Sapyta JJ, Serlachius E, Shabani MJ, Shavitt RG, Small BJ, Skarphedinsson G, Swedo SE, Thomsen PH, Turner C, Weidle B, Miguel EC, Storch EA, Mataix-Cols D, Bloch MH. Systematic Review and Meta-analysis: An Empirical Approach to Defining Treatment Response and Remission in Pediatric Obsessive-Compulsive Disorder. J Am Acad Child Adolesc Psychiatry 2022; 61:495-507. [PMID: 34597773 DOI: 10.1016/j.jaac.2021.05.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 05/05/2021] [Accepted: 09/21/2021] [Indexed: 02/01/2023]
Abstract
OBJECTIVE A lack of universal definitions for response and remission in pediatric obsessive-compulsive disorder (OCD) has hampered the comparability of results across trials. To address this problem, we conducted an individual participant data diagnostic test accuracy meta-analysis to evaluate the discriminative ability of the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) in determining response and remission. We also aimed to generate empirically derived cutoffs on the CY-BOCS for these outcomes. METHOD A systematic review of PubMed, PsycINFO, Embase and CENTRAL identified 5,401 references; 42 randomized controlled clinical trials were considered eligible, and 21 provided data for inclusion (N = 1,234). Scores of ≤2 in the Clinical Global Impressions Improvement and Severity scales were chosen to define response and remission, respectively. A 2-stage, random-effects meta-analysis model was established. The area under the curve (AUC) and the Youden Index were computed to indicate the discriminative ability of the CY-BOCS and to guide for the optimal cutoff, respectively. RESULTS The CY-BOCS had sufficient discriminative ability to determine response (AUC = 0.89) and remission (AUC = 0.92). The optimal cutoff for response was a ≥35% reduction from baseline to posttreatment (sensitivity = 83.9, 95% CI = 83.7-84.1; specificity = 81.7, 95% CI = 81.5-81.9). The optimal cutoff for remission was a posttreatment raw score of ≤12 (sensitivity = 82.0, 95% CI = 81.8-82.2; specificity = 84.6, 95% CI = 84.4-84.8). CONCLUSION Meta-analysis identified empirically optimal cutoffs on the CY-BOCS to determine response and remission in pediatric OCD randomized controlled clinical trials. Systematic adoption of standardized operational definitions for response and remission will improve comparability across trials for pediatric OCD.
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Affiliation(s)
- Luis C Farhat
- Faculdade de Medicina FMUSP, Universidade de São Paulo, Brazil
| | | | - Divya Ramakrishnan
- Yale Child Study Center, Yale School of Medicine, New Haven, Connecticut
| | - Jessica L S Levine
- Yale Child Study Center, Yale School of Medicine, New Haven, Connecticut
| | - Jessica A Johnson
- Columbia University New York, New York; Columbia School of Nursing, New York
| | | | | | | | | | - Jonathan S Comer
- Center for Children and Families, Florida International University, Miami, Florida
| | - Daniel Fatori
- Faculdade de Medicina FMUSP, Universidade de São Paulo, Brazil
| | - Martin E Franklin
- University of Pennsylvania, Philadelphia; Rogers Memorial Hospital, Oconomowoc, Wisconsin
| | - Jennifer B Freeman
- Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Daniel A Geller
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | | | | | - Isobel Heyman
- Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
| | - Tord Ivarsson
- Regional Center for Child and Youth Mental Health and Child Welfare, Faculty of Medicine and Health Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Fabian Lenhard
- Centre for Psychiatry Research, Karolinska Institutet, Stockholm Health Care Services, Region Stockholm, Sweden
| | - Adam B Lewin
- University of South Florida, Hillsborough County
| | - Fenghua Li
- Yale Child Study Center, Yale School of Medicine, New Haven, Connecticut
| | | | - Hamid Mohsenabadi
- Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, IR
| | - Tara S Peris
- Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles
| | - John Piacentini
- Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles
| | | | | | | | | | - Eva Serlachius
- Centre for Psychiatry Research, Karolinska Institutet, Stockholm Health Care Services, Region Stockholm, Sweden
| | - Mohammad J Shabani
- Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, IR
| | | | - Brent J Small
- School of Aging Studies, University of South Florida, Hillsborough County
| | | | | | - Per Hove Thomsen
- Regional Center for Child and Youth Mental Health and Child Welfare, Faculty of Medicine and Health Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Aarhus University Hospital, Skejby, Denmark
| | - Cynthia Turner
- Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Bernhard Weidle
- Regional Center for Child and Youth Mental Health and Child Welfare, Faculty of Medicine and Health Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; St. Olav's University Hospital, Trondheim, Norway
| | | | | | - David Mataix-Cols
- Centre for Psychiatry Research, Karolinska Institutet, Stockholm Health Care Services, Region Stockholm, Sweden
| | - Michael H Bloch
- Yale Child Study Center, Yale School of Medicine, New Haven, Connecticut.
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19
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La Greca AM, Tarlow N, Brodar KE, Danzi BA, Comer JS. The stress before the storm: Psychological correlates of hurricane-related evacuation stressors on mothers and children. Psychol Trauma 2022; 14:S13-S22. [PMID: 34435819 DOI: 10.1037/tra0001052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Natural disasters, such as hurricanes, can contribute to the development of posttraumatic stress symptoms (PTSS), anxiety, and depression. Furthermore, mothers and children are especially vulnerable postdisasters. Despite the rise in the frequency of climate-related disasters and also the threat of disasters (e.g., storms that threaten but do not make landfall), little is known about how predisaster experiences are associated with mothers' and children's postdisaster psychological functioning. This study examined evacuation-related stressors as predictors of mothers' and youths' psychological functioning 3 months after Hurricane Irma. METHOD Mothers (N = 535; 33% ethnic/racial minorities) from South Florida counties most affected by Hurricane Irma completed an online survey that assessed evacuation-related stressors (both pre- and posthurricane), hurricane exposure (i.e., life threat, loss/disruption), and posthurricane social support and mental health symptomatology (i.e., PTSS, anxiety, depression). Mothers of children aged 7-17 years (n = 226) also reported on their child's psychological functioning. RESULTS Using a risk and resilience model, evacuation stressors significantly predicted mothers' and youths' PTSS and symptoms of anxiety and depression, even after accounting for demographic factors, hurricane exposure, and availability of social support. Mothers of older children also reported significantly higher levels of PTSS, anxiety, and depression than mothers who only had young children (aged 6 or younger) at home. CONCLUSIONS Evacuation experiences represent significant stressors that may put mothers and children at risk for PTSS and psychological distress. Resilience-building efforts should include efforts to better prepare families for prestorm evacuations, thereby reducing risk in mothers and youth and ultimately contributing to better psychosocial functioning. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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20
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Comer JS, Conroy K, Cornacchio D, Furr JM, Norman SB, Stein MB. Psychometric evaluation of a caregiver-report adaptation of the Overall Anxiety Severity and Impairment Scale (OASIS) for use with youth populations. J Affect Disord 2022; 300:341-348. [PMID: 34979182 PMCID: PMC8828693 DOI: 10.1016/j.jad.2021.12.113] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 07/22/2021] [Revised: 11/24/2021] [Accepted: 12/30/2021] [Indexed: 01/09/2023]
Abstract
Background Despite progress in youth anxiety assessment, there is need for a measure that is simultaneously (a) free, (b) brief, (c) focused broadly on anxiety and avoidance severity, frequency, and interference, and (d) concerned with the past week. The adult overall anxiety severity and impairment scale (OASIS) was adapted to yield a caregiver-report of past week youth anxiety and interference (OASIS-Y). Methods In a sample of diverse youth seeking anxiety services (N = 132; 67% racial/ethnic minority) and their caregivers, analyses examined the OASIS-Y factor structure, internal consistency, and convergent and divergent validity. Hierarchical linear modeling in a participant subset examined OASIS-Y sensitivity to treatment-related change. Results OASIS-Y internal consistency was high and confirmatory factor analysis supported a single-factor structure similar to that found in adults. OASIS-Y convergent validity was supported by a medium-sized association with an established, commercially available measure of youth anxiety, and divergent validity was supported by the absence of unique associations with measures of youth attention and externalizing problems. In a sample subset, session-by-session OASIS-Y scores significantly declined across treatment, and declined at a steeper rate among treatment "responders" versus "non-responders," providing evidence of OASIS-Y sensitivity to treatment-related change. Limitations This study focused on a clinical sample and cannot speak to OASIS-Y performance in community settings. Shared method-variance may have also influenced findings. Conclusions This study offers the first psychometric evaluation of the OASIS-Y, and underscores the promising clinical utility of the measure for assessing past week youth anxiety and impairment and for supporting routine outcome monitoring.
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Affiliation(s)
- Jonathan S. Comer
- Center for Children and Families, Department of Psychology, Florida International University
| | - Kristina Conroy
- Center for Children and Families, Department of Psychology, Florida International University
| | | | - Jami M. Furr
- Center for Children and Families, Department of Psychology, Florida International University
| | - Sonya B. Norman
- Department of Psychiatry, University of California, San Diego
| | - Murray B. Stein
- Department of Psychiatry, University of California, San Diego
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21
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Sanchez AL, Jent J, Aggarwal NK, Chavira D, Coxe S, Garcia D, La Roche M, Comer JS. Person-Centered Cultural Assessment Can Improve Child Mental Health Service Engagement and Outcomes. J Clin Child Adolesc Psychol 2022; 51:1-22. [PMID: 34905434 DOI: 10.1080/15374416.2021.1981340] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Disparities in child mental health service engagement suggest traditional evidence-based practices do not properly consider cultural and contextual factors relevant for marginalized families. We propose a person-centered approach to improve the cultural responsiveness of services. Preliminary research supports broadening standard assessments to include a person-centered evaluation of patient cultural factors, however, controlled studies have not been conducted in the context of children's mental health care. METHODS Participants included families (N = 89; 89% racial/ethnic minority) receiving services for child externalizing problems. Prior to intake, caregivers were randomized to receive either Assessment as Usual (AAU) or AAU augmented with the Cultural Formulation Interview (CFI+AAU), a brief caregiver assessment of cultural factors affecting their child's problems and family help-seeking. RESULTS Implementation data showed strong provider fidelity and clinical utility. Following assessments, CFI+AAU caregivers (relative to AAU caregivers) reported feeling better understood by their provider, and providers reported better understanding CFI+AAU families' values. Caregiver satisfaction was rated highly overall, yet providers reported being more satisfied with the assessment when the CFI was incorporated. Engagement outcomes found CFI+AAU families were significantly more likely than AAU families to subsequently complete the first phase of treatment. Further, among families receiving services in Spanish, CFI+AAU, relative to AAU, was associated with significantly higher treatment attendance, homework completion, and treatment response. CONCLUSIONS The results underscore the utility of incorporating a brief cultural assessment in pretreatment assessments. To improve the cultural responsiveness of services, efforts may do well to promote the uptake of person-centered approaches such as cultural assessment into usual care. Registered at clinicaltrials.gov (NCT03499600).
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Affiliation(s)
- Amanda L Sanchez
- Penn Center for Mental Health, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | - Jason Jent
- Mailman Center for Child Development, University of Miami Miller School of Medicine
| | | | - Denise Chavira
- Department of Psychology, University of California Los Angeles
| | - Stefany Coxe
- Center for Children and Families and Department of Psychology, Florida International University
| | - Dainelys Garcia
- Mailman Center for Child Development, University of Miami Miller School of Medicine
| | - Martin La Roche
- Harvard Medical School, Boston Children's Hospital at Martha Eliot
| | - Jonathan S Comer
- Center for Children and Families and Department of Psychology, Florida International University
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22
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Sullivan ADW, Forehand R, Acosta J, Parent J, Comer JS, Loiselle R, Jones DJ. COVID-19 and the Acceleration of Behavioral Parent Training Telehealth: Current Status and Future Directions. Cogn Behav Pract 2021; 28:618-629. [PMID: 34629838 PMCID: PMC8488182 DOI: 10.1016/j.cbpra.2021.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 05/12/2021] [Accepted: 06/19/2021] [Indexed: 02/01/2023]
Abstract
The SARS-COV-2 (COVID-19) pandemic and associated social distancing guidelines have accelerated the telehealth transition in mental health. For those providing Behavioral Parent Training (BPT), this transition has called for moving sessions that are traditionally clinic-based, active, and directive to engaging, supporting, and treating families of children with behavior disorders remotely in their homes. Whereas many difficulties accompany this transition, the lessons learned during the current public health crisis have the potential to transform BPT service delivery on a large scale in ways that address many of its long-standing limitations. We describe both challenges and opportunities and consider the possibilities inherent in a large scale BPT service delivery model capable of increasing the reach and impact of evidence-based treatment for all families.
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Affiliation(s)
| | | | - Juliana Acosta
- Center for Children and Families, Florida International University
| | - Justin Parent
- Center for Children and Families, Florida International University
| | - Jonathan S Comer
- Center for Children and Families, Florida International University
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23
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Danzi BA, La Greca AM, Green JG, Comer JS. What's in a name? Comparing alternative conceptualizations of posttraumatic stress disorder among preadolescent children following the Boston Marathon bombing and manhunt. Anxiety Stress Coping 2021; 34:545-558. [PMID: 33661034 DOI: 10.1080/10615806.2021.1894330] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 10/12/2020] [Accepted: 02/02/2021] [Indexed: 05/23/2023]
Abstract
BACKGROUND AND OBJECTIVES New diagnostic criteria for posttraumatic stress disorder (PTSD) were introduced by DSM-5 and ICD-11. It remains unclear how well these new definitions of PTSD capture the posttrauma responses of children, particularly when using parent report. This study compared different conceptual models of PTSD in children following the Boston Marathon bombing and manhunt. DESIGN AND METHODS Parents/caretakers (N = 254) reported on PTSD symptoms of their children (ages 4-11) following the Boston Marathon bombing and manhunt. Algorithms compared criteria from ICD-11, DSM-IV, and DSM-5 (specifically the "Preschool" criteria). RESULTS DSM-5 Preschool criteria identified twice as many children as ICD-11, and over four times as many as DSM-IV. DSM-5 Preschool criteria identified all cases detected by ICD-11 and DSM-IV. Across models, all identified cases had greater trauma exposure than non-identified children. DSM-5 Preschool and ICD-11 (but not DSM-IV) cases had greater clinical decline than non-identified children. The Avoidance cluster showed the most variability in identifying cases. CONCLUSIONS Newer models of PTSD are likely to identify more children than DSM-IV, mostly related to changes in the Avoidance criteria. The DSM-5 Preschool definition is the most inclusive model. ICD-11 may provide a balance between inclusivity and stringency in detecting childhood PTSD.
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Affiliation(s)
- BreAnne A Danzi
- Department of Psychology, University of South Dakota, Vermillion, SD, USA
| | | | - Jennifer Greif Green
- Wheelock College of Education & Human Development, Boston University, Boston, MA, USA
| | - Jonathan S Comer
- Department of Psychology, Florida International University, Miami, FL, USA
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24
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Comer JS, Furr JM, Del Busto C, Silva K, Hong N, Poznanski B, Sanchez A, Cornacchio D, Herrera A, Coxe S, Miguel E, Georgiadis C, Conroy K, Puliafico A. Therapist-Led, Internet-Delivered Treatment for Early Child Social Anxiety: A Waitlist-Controlled Evaluation of the iCALM Telehealth Program. Behav Ther 2021; 52:1171-1187. [PMID: 34452671 DOI: 10.1016/j.beth.2021.01.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 12/17/2020] [Accepted: 01/16/2021] [Indexed: 12/14/2022]
Abstract
Despite recent advances in the treatment of early child social anxiety, the broad accessibility of brick-and-mortar services has been limited by traditional barriers to care, and more recently by new obstacles related to efforts to slow the spread of COVID-19. The present waitlist-controlled trial examined the preliminary efficacy of a family-based behavioral parenting intervention (i.e., the iCALM Telehealth Program) that draws on Parent-Child Interaction Therapy and videoconferencing to remotely deliver clinician-led care for anxiety in early childhood. Young children (3-8 years) with a diagnosis of social anxiety disorder (N = 40; 65% from ethnic/racial minority backgrounds) were randomly assigned to iCALM or waitlist. Intent-to-treat analyses found that at post, independent evaluators classified roughly half of the iCALM-treated children, but only 6% of waitlist children, as "Responders" (Wald test = 4.51; p = .03). By Post, iCALM led to significantly greater reductions than waitlist in child anxiety symptoms, fear, discomfort, and anxiety-related social impairment, and also led to greater improvements in child soothability. By 6-month follow-up, the percentage of iCALM-treated children classified as "Responders" rose to roughly 60%. Exploratory moderation tests found iCALM was particularly effective in reducing life impairments and parental distress among families presenting with higher, relative to lower, levels of baseline parental accommodation. The present findings add to a growing body of research supporting the promise of technology-based strategies for broadening the portfolio of options for delivering clinician-led mental health services.
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Conroy K, Salem H, Georgiadis C, Hong N, Herrera A, Furr JM, Greif Green J, Comer JS. Gauging Perceptions and Attitudes About Student Anxiety and Supports Among School-Based Providers. School Mental Health 2021. [DOI: 10.1007/s12310-021-09470-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Conroy K, Frech N, Sanchez AL, Hagan MB, Bagner DM, Comer JS. Caregiver stress and cultural identity in families of preschoolers with developmental delay and behavioral problems. Infant Ment Health J 2021; 42:573-585. [PMID: 33961711 PMCID: PMC8363575 DOI: 10.1002/imhj.21923] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 11/10/2022]
Abstract
INTRODUCTION Research on families of young children with developmental delay and disruptive behavior problems has failed to examine caregiver stress in the context of cultural factors. METHODS Families of 3-year-old children with developmental delay and behavior problems were recruited from Early Intervention sites. All caregivers in the current analysis (n = 147) were from immigrant and/or cultural minority backgrounds. Regarding income-to-needs, most families (57.8%) fell into the extreme poverty, poor, or low-income categories. Caregivers reported on their own experiences of acculturation and enculturation as well as their child's problems. RESULTS Path analyses revealed that higher caregiver acculturation was associated with less parenting-specific stress, and higher caregiver enculturation was associated with less caregiver general stress. Severity of child problems was associated with more parenting-specific stress and general stress. Exploratory analysis yielded significant differences in associations between acculturation, enculturation, and caregiver stress in Black/African American caregivers versus Hispanic White caregivers. CONCLUSION Findings suggest that among cultural minority caregivers of young children with developmental and behavioral problems, acculturation and enculturation may influence caregiver stress. While the cross-sectional nature of the study precludes causal conclusions, clinicians should consider how cultural factors can be harnessed to strengthen caregiver resiliency and improve engagement in parenting interventions.
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Affiliation(s)
- Kristina Conroy
- Center for Children and Families, Department of Psychology, Florida International University, Miami, Florida, USA
| | - Natalie Frech
- Center for Children and Families, Department of Psychology, Florida International University, Miami, Florida, USA
| | - Amanda L. Sanchez
- Penn Center for Mental Health, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mary B. Hagan
- Center for Children and Families, Department of Psychology, Florida International University, Miami, Florida, USA
| | - Daniel M. Bagner
- Center for Children and Families, Department of Psychology, Florida International University, Miami, Florida, USA
| | - Jonathan S. Comer
- Center for Children and Families, Department of Psychology, Florida International University, Miami, Florida, USA
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Wilson MK, Cornacchio D, Brotman MA, Comer JS. Measuring Irritability in Early Childhood: A Psychometric Evaluation of the Affective Reactivity Index in a Clinical Sample of 3- to 8-Year-Old Children. Assessment 2021; 29:1473-1481. [PMID: 34060361 DOI: 10.1177/10731911211020078] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The parent-report Affective Reactivity Index (ARI-P) is the most studied brief scale specifically developed to assess irritability, but relatively little is known about its performance in early childhood (i.e., ≤8 years). Support in such populations is particularly important given developmental shifts in what constitutes normative irritability across childhood. We examined the performance of the ARI-P in a diverse, treatment-seeking sample of children ages 3 to 8 years (N = 115; mean age = 5.56 years; 58.4% from ethnic/racial minority backgrounds). In this sample, confirmatory factor analysis supported the single-factor structure of the ARI-P previously identified with older youth. ARI-P scores showed large associations with another irritability index, as well as small-to-large associations with aggression, anxiety, depression, and attention problems, supporting the convergent and concurrent validity of the ARI-P when used with children in this younger age range. Findings support the ARI-P as a promising parent-report tool for assessing irritability in early childhood, particularly in clinical samples.
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Sanchez AL, Comer JS, LaRoche M. Enhancing the Responsiveness of Family-Based CBT Through Culturally Informed Case Conceptualization and Treatment Planning. Cognitive and Behavioral Practice 2021. [DOI: 10.1016/j.cbpra.2021.04.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Conroy K, Hong N, Poznanski B, Hart KC, Ginsburg GS, Fabiano GA, Comer JS. Harnessing Home-School Partnerships and School Consultation to Support Youth With Anxiety. Cognitive and Behavioral Practice 2021; 29:381-399. [PMID: 35812004 PMCID: PMC9267952 DOI: 10.1016/j.cbpra.2021.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Youth with anxiety often experience significant impairment in the school setting. Despite the relevance and promise of addressing anxiety in schools, traditional treatment approaches to school-based anxiety often do not adequately address generalization to the school setting, or they require removing the student from the classroom to deliver time- and staff-intensive programs. Such programs often leave teachers and caregivers feeling ill-equipped to support the student with anxiety throughout the natural course of the school day. Given the heavy demands placed on teachers and documented burnout among school professionals, providing effective school supports requires collaborative partnerships among outpatient therapists/specialists, school personnel, and caregivers. Drawing from literature on collaborative models for externalizing problems, we offer recommendations for outpatient therapists and specialists working to implement evidence-based supports in school settings and promote home-school partnerships to benefit youth with anxiety in the school setting. Our recommendations touch upon several components of such school consultation, including (a) identification of key parties involved, (b) conducting a needs assessment, (c) collaborative goal setting and development of a fear hierarchy, (d) plan development and implementation (e.g., facilitating a school-based exposure mindset, promoting home-school communication, enhancing school relationships), and (e) progress monitoring and ongoing support. We conclude with a case example to bring these recommendations to life.
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Zemestani M, Didehban R, Comer JS, Kendall PC. Psychometric Evaluation of the Intolerance of Uncertainty Scale for Children (IUSC): Findings From Clinical and Community Samples in Iran. Assessment 2021; 29:993-1004. [PMID: 33682479 DOI: 10.1177/1073191121998769] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The present study examined the psychometric properties of a Persian version of the Intolerance of Uncertainty Scale for Children (IUSC; Comer et al, 2009). METHOD Participating youth (n = 346) 8 to 18 years of age were nonreferred community youth (n = 279) or youth who met diagnostic criteria for an anxiety disorder (n = 67) and their parents. RESULTS Across child- and parent-report data, confirmatory factor analysis supported a shortened 12-item version of the IUSC, and the confirmatory factor analysis also confirmed a theory-driven correlated two-factor structure of the IUSC-12. (i.e., prospective/inhibitory IU). Results further supported reliability and validity of parent- and child-reports of the Persian IUSC-12 via evidence of internal consistency, 4-week retest, significant associations with established measures of internalizing problems, and the ability of the measure to reliably distinguish the clinical sample from the community sample. CONCLUSION Findings demonstrate sound psychometric properties of the Persian version of the IUSC-12 and provide additional support for the reliability and validity of the measure and its use in non-Western cultures. Findings are discussed in terms of implications for assessment, treatment, and study of anxiety and related internalizing problems in Iranian youth.
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Carl JR, Jones DJ, Lindhiem OJ, Doss BD, Weingardt KR, Timmons AC, Comer JS. Regulating digital therapeutics for mental health: Opportunities, challenges, and the essential role of psychologists. Br J Clin Psychol 2021; 61 Suppl 1:130-135. [PMID: 33650131 DOI: 10.1111/bjc.12286] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 12/30/2022]
Abstract
With so many promising digital therapeutics for anxiety and obsessive-compulsive (OC) spectrum problems, there is an urgent need to consider how evolving regulatory oversight of digital therapeutics is poised to shift how these tools are developed, evaluated, reimbursed, and delivered. In this commentary, we discuss both opportunities and potential pitfalls associated with emerging government regulations of digital therapeutics for mental health, and we consider how applying the traditional 'prescription-based' medical approval paradigm to digital therapeutics for mental health could ultimately undermine and limit the broad accessibility of these software-based innovations that have been explicitly designed to expand the accessibility of care. For example, the vast majority of behavioural and mental health providers do not have 'prescription privileges' (a term originally rooted in pharmacologic practices), and as a result, under current regulations in the U.S. would not be authorized to make FDA-cleared digital therapeutics available to their patients. This is particularly concerning given that most digital therapeutics for mental health are directly rooted in psychological and behavioural science, yet psychologists would not be authorized to incorporate these innovations into their practice. We consider how synchronizing regulatory standards across countries may prove useful, and we conclude by arguing that multidisciplinary teams making regulatory decisions concerning digital therapeutics for mental health must include representation from the discipline and practice of psychology. PRACTITIONER POINTS: Emerging government regulations of digital therapeutics for mental health present both opportunities and potential pitfalls Applying the traditional 'prescription-based' medical approval paradigm to digital therapeutics for mental health could ultimately undermine the broad accessibility of these software-based innovations. Synchronizing regulatory standards across countries may prove useful. Multidisciplinary teams making regulatory decisions concerning digital therapeutics for mental health must include representation from the field of psychology.
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Affiliation(s)
- Jenna R Carl
- Big Health Inc., San Francisco, California, USA.,Big Health Inc., London, UK
| | - Deborah J Jones
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, North Carolina, USA
| | - Oliver J Lindhiem
- Department of Psychiatry, University of Pittsburgh, Pennsylvania, USA
| | - Brian D Doss
- Department of Psychology, University of Miami, Florida, USA
| | | | - Adela C Timmons
- Department of Psychology, Florida International University, Miami, Florida, USA
| | - Jonathan S Comer
- Department of Psychology, Florida International University, Miami, Florida, USA
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Peverill M, Dirks MA, Narvaja T, Herts KL, Comer JS, McLaughlin KA. Socioeconomic status and child psychopathology in the United States: A meta-analysis of population-based studies. Clin Psychol Rev 2021; 83:101933. [PMID: 33278703 PMCID: PMC7855901 DOI: 10.1016/j.cpr.2020.101933] [Citation(s) in RCA: 107] [Impact Index Per Article: 35.7] [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] [Received: 05/08/2020] [Revised: 09/26/2020] [Accepted: 10/13/2020] [Indexed: 12/31/2022]
Abstract
Children raised in families with low socioeconomic status (SES) are more likely to exhibit symptoms of psychopathology. However, the strength of this association, the specific indices of SES most strongly associated with childhood psychopathology, and factors moderating the association are strikingly inconsistent across studies. We conducted a meta-analysis of 120 estimates of the association between family SES and child psychopathology in 13 population-representative cohorts of children studied in the US since 1980. Among 26,715 participants aged 3-19 years, we observed small to moderate associations of low family income (g = 0.19), low Hollingshead index (g = 0.21), low subjective SES (g = 0.24), low parental education (g = 0.25), poverty status (g = 0.25), and receipt of public assistance (g = 0.32) with higher levels of childhood psychopathology. Moderator testing revealed that receipt of public assistance showed an especially strong association with psychopathology and that SES was more strongly related to externalizing than internalizing psychopathology. Dispersion in our final, random effects, model suggested that the relation between SES and child psychopathology is likely to vary in different populations of children and in different communities. These findings highlight the need for additional research on the mechanisms of SES-related psychopathology risk in children in order to identify targets for potential intervention.
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Affiliation(s)
- Matthew Peverill
- University of Washington, Department of Psychology, Seattle, WA, United States of America; Harvard University, Department of Psychology, Cambridge, MA, United States of America.
| | - Melanie A Dirks
- McGill University, Department of Psychology, Montreal, Canada
| | - Tomás Narvaja
- University of Washington, School of Medicine, Seattle, WA, United States of America
| | - Kate L Herts
- Weill Cornell Medicine, Department of Psychiatry, White Plains, NY, United States of America
| | - Jonathan S Comer
- Florida International University, Department of Psychology, Miami, FL, United States of America
| | - Katie A McLaughlin
- Harvard University, Department of Psychology, Cambridge, MA, United States of America
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Heflin BH, Comer JS, Bagner DM. Predicting BMI in Young Children with Developmental Delay and Externalizing Problems: Links with Caregiver Depressive Symptoms and Acculturation. J Pediatr Psychol 2020; 45:1084-1092. [PMID: 32929475 PMCID: PMC7522297 DOI: 10.1093/jpepsy/jsaa074] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 07/27/2020] [Accepted: 07/28/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Caregiver depression is associated with increased risk for childhood obesity. However, studies assessing the relation between caregiver depression and childhood obesity have focused primarily on typically developing, school-aged children and have not examined the influence of cultural factors. OBJECTIVES To evaluate the association between caregiver depressive symptoms and body mass index (BMI) scores in young children with developmental delay (DD) and externalizing behavior problems, as well as the moderating role of acculturation and enculturation on this association. METHODS We examined the association between caregiver depressive symptoms and child BMI scores in 147 3-year-old children with DD and elevated levels of externalizing behavior problems. Caregivers of all participating children self-identified as coming from cultural minority backgrounds. We also examined the association between caregiver depressive symptoms and child BMI across levels of caregiver acculturation and enculturation. RESULTS Higher levels of caregiver depressive symptoms were associated with higher child BMI scores (b = .189, p = .001). Acculturation significantly moderated the association between caregiver depressive symptoms and child BMI scores (b = .21, p = .01), such that the association was stronger for more acculturated caregivers. Enculturation was not a significant moderator. CONCLUSIONS Caregiver depressive symptoms may confer elevated risk for child obesity when caregivers are highly acculturated to the United States, suggesting clinicians should consider levels of acculturation to optimize services for children and families from cultural minority backgrounds.
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Affiliation(s)
- Brynna H Heflin
- Department of Psychology, Center for Children and Families, Florida International University
| | - Jonathan S Comer
- Department of Psychology, Center for Children and Families, Florida International University
| | - Daniel M Bagner
- Department of Psychology, Center for Children and Families, Florida International University
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O'Connor EE, Langer DA, Comer JS, Tompson MC. A randomized-controlled examination of the effect of cognitive reappraisal instruction on maternal accommodation of child anxiety symptoms. J Anxiety Disord 2020; 74:102260. [PMID: 32603994 DOI: 10.1016/j.janxdis.2020.102260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 05/24/2020] [Accepted: 06/11/2020] [Indexed: 11/17/2022]
Abstract
Parental accommodation plays a key role in the maintenance of child anxiety, yet much of the research to date has been correlational, making it difficult to draw conclusions about underlying mechanisms. Given preliminary evidence that parental beliefs play a role in parental accommodation, the present study sought to experimentally reduce accommodation by targeting parental attitudes about child anxiety. Mothers of children ages 4-9 (N = 47) were randomly assigned to either receive brief instruction in cognitive reappraisal (EXP) or to a control intervention in which they received no instruction (CON). At pre- and post-intervention mothers were presented with bogus information that their child was experiencing varying levels of distress while completing a task in a nearby room. Maternal distress, negative affect and perceived likelihood of accommodation in the context of child distress were measured pre- and post-intervention. EXP mothers reported greater pre- to post-intervention decreases in distress and perceived likelihood of accommodation, compared to CON mothers. EXP and CON mothers showed similar changes in negative affect. Findings from this study provide preliminary experimental evidence that targeting maternal beliefs about child anxiety can result in changes in maternal distress and behavior following exposure to child distress. Implications for prevention and treatment are discussed.
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Affiliation(s)
- Erin E O'Connor
- Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Ave. #2, Boston, MA, 02215, United States
| | - David A Langer
- Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Ave. #2, Boston, MA, 02215, United States
| | - Jonathan S Comer
- Department of Psychology, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, United States
| | - Martha C Tompson
- Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Ave. #2, Boston, MA, 02215, United States
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Lorenzo NE, Cornacchio D, Chou T, Kurtz SM, Furr JM, Comer JS. Expanding Treatment Options for Children With Selective Mutism: Rationale, Principles, and Procedures for an Intensive Group Behavioral Treatment. Cognitive and Behavioral Practice 2020. [DOI: 10.1016/j.cbpra.2020.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Gurwitch RH, Salem H, Nelson MM, Comer JS. Leveraging parent-child interaction therapy and telehealth capacities to address the unique needs of young children during the COVID-19 public health crisis. Psychol Trauma 2020; 12:S82-S84. [PMID: 32538646 DOI: 10.1037/tra0000863] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
COVID-19 and related efforts to mitigate its spread have dramatically transformed the structure and predictability of modern childhood, resulting in growing concerns children may be particularly vulnerable to serious mental health consequences. Worldwide stay-at-home directives and emergency changes in healthcare policy and reimbursement have smoothed the trail for broad implementation of technology-based remote mental health services for children. Parent-Child Interaction Therapy (PCIT) is particularly well-positioned to address some of the most pressing child and parental needs that arise during stressful times, and telehealth formats of PCIT, such as Internet-delivered PCIT (iPCIT), have already been supported in controlled trials. This commentary explores PCIT implementation during the COVID-19 public health crisis and the challenges encountered in the move toward Internet-delivered services. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Fleming GE, Kimonis ER, Furr JM, Comer JS. Internet-Delivered Parent Training for Preschoolers with Conduct Problems: Do Callous-Unemotional Traits Moderate Efficacy and Engagement? J Abnorm Child Psychol 2020; 48:1169-1182. [PMID: 32533295 DOI: 10.1007/s10802-020-00660-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 01/17/2023]
Abstract
Recent efforts to improve access to evidence-based parent training programs using online delivery have largely neglected findings that young children with callous-unemotional (CU)-type conduct problems receive less benefit from parent training than children with conduct problems alone. The current study aimed to examine the moderating effect of child CU traits on efficacy and engagement outcomes associated with Internet-delivered Parent-Child Interaction Therapy (iPCIT) versus standard, clinic-based PCIT. Forty families (57.6% non-Hispanic Caucasian) with a 3-5 year-old (M = 3.95 years, SD = 0.9; 83.5% boys) child with a disruptive behavior disorder were randomized to either iPCIT or clinic-based PCIT. Families participated in four assessments across time; child conduct problems, global functioning and treatment responder status, and parent-rated treatment satisfaction were measured. Analyses revealed that the negative influence of CU traits on functional gains was not uniform across treatment formats. Specifically, the detrimental effect of CU traits on functional gains was significantly more pronounced among children treated with iPCIT than clinic-based PCIT. CU traits also predicted lower parental treatment satisfaction across delivery formats, but this effect was more pronounced among iPCIT parents. In contrast, CU traits did not moderate differential effects across iPCIT and clinic-based PCIT for conduct problem severity or treatment response status. Findings suggest that iPCIT is a promising treatment option for early conduct problems, particularly when access-to-care barriers exist, but that further research is needed to determine whether strategic adaptations to online programs can more optimally address the distinct needs of children with clinically significant CU traits.
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Affiliation(s)
- Georgette E Fleming
- School of Psychology, The University of New South Wales, Sydney, New South Wales, Australia.
| | - Eva R Kimonis
- School of Psychology, The University of New South Wales, Sydney, New South Wales, Australia
| | - Jami M Furr
- Center for Children and Families, Florida International University, Miami, Florida, USA
| | - Jonathan S Comer
- Center for Children and Families, Florida International University, Miami, Florida, USA
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Douglas S, Jensen-Doss A, Ordorica C, Comer JS. Strategies to enhance communication with telemental health measurement-based care (tMBC). Pract Innov (Wash D C) 2020; 5:143-149. [PMID: 34888414 DOI: 10.1037/pri0000119] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Telehealth has always held great promise to increase access to mental health care, never more so than in the age of COVID-19, when clients can't or won't come to the clinician's physical location. A feasible and effective alternative to traditional in-person care, telemental health requires that clinicians adopt new strategies to build and maintain communication and the therapeutic relationship. This can be particularly troublesome for clinicians new to the modality, who may feel the loss of the "in-session" experience more acutely. As an evidence-based practice that is transtheoretical and transdiagnostic, telemental health measurement-based care (tMBC) is the ideal complement to enhance systematic ongoing monitoring, treatment engagement, and therapeutic alliance in the context of the virtual encounter. While tMBC mechanisms of actions are still being explored, there is promising evidence that tMBC improves clinician responsivity to acute client concerns. By using client-reported measures, tMBC provides an important pathway for clients to systematically communicate with their clinicians, which can guide therapeutic actions and contribute to shared understanding. This brief report summarizes the evidence for tMBC as a patient-centered communication tool and provides recommendations for evidence-based and practice-informed strategies to integrate tMBC into telehealth solutions, with suggestions for monitoring new concerns related to the COVID-19 crisis.
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Conroy K, Greif Green J, Phillips K, Poznanski B, Coxe S, Kendall PC, Comer JS. School-Based Accommodations and Supports for Anxious Youth: Benchmarking Reported Practices Against Expert Perspectives. J Clin Child Adolesc Psychol 2020; 51:419-427. [PMID: 32078389 DOI: 10.1080/15374416.2020.1723601] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: Although research has examined negatively reinforcing patterns of parental accommodation of youth anxiety, limited research considers school staff-led accommodations for students with anxiety. Further, the extent to which patterns of school staff-led accommodations/supports for anxiety align with anxiety expert perspectives remains unclear.Method: School staff across elementary, middle, and high schools who identified anxiety as their top student concern (N = 134) were surveyed about their use of 23 anxiety-focused accommodations/supports, as well as their own mental health literacy and emotional exhaustion. A youth anxiety expert panel (N = 28) independently rated the extent to which each of the 23 school-based accommodations/supports could (1) promote youth avoidance of anxiety, and (2) promote youth approach toward anxiety-provoking situations/experiences.Results: School staff reported using a broad range of accommodations/supports to address student anxiety, but these accommodations were mixed in alignment with anxiety expert perspectives. Although the two most commonly endorsed school-based accommodations/supports were rated by the expert panel as highly approach-oriented, 92.5% of school staff reported using at least one accommodation or support rated by the expert panel as highly avoidance-oriented. Higher emotional exhaustion among school staff predicted greater use of avoidance-oriented supports whereas higher mental health literacy predicted greater use of approach-oriented supports.Conclusions: Strategies may be needed to reduce the use of avoidance-oriented accommodations/supports with anxious students in school settings. In addition to promoting school staff awareness of expert perspectives on anxiety-focused accommodations/supports, efforts to curb staff burnout may have indirect effects on the quality of anxiety-focused accommodations and supports in school settings.
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Affiliation(s)
| | | | | | | | - Stefany Coxe
- Department of Psychology, Florida International University
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Sanchez AL, Comer JS, Coxe S, Albano AM, Piacentini J, Compton SN, Ginsburg GS, Rynn MA, Walkup JT, Sakolsky DJ, Birmaher B, Kendall PC. The Effects of Youth Anxiety Treatment on School Impairment: Differential Outcomes Across CBT, Sertraline, and their Combination. Child Psychiatry Hum Dev 2019; 50:940-949. [PMID: 31087216 DOI: 10.1007/s10578-019-00896-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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] [Indexed: 10/26/2022]
Abstract
Youth anxiety disorders are highly prevalent and are associated with considerable school impairment. Despite the identification of well-supported strategies for treating youth anxiety, research has yet to evaluate the differential effects of these treatments on anxiety-related school impairment. The present study leveraged data from the Child/Adolescent Anxiety Multimodal Study to examine differential treatment effects of CBT, sertraline, and their combination (COMB), relative to placebo (PBO), on anxiety-related school impairment among youth (N = 488). Latent growth modeling revealed that all three active treatments demonstrated superiority over PBO in reducing anxiety-related school impairment over time, with COMB showing the most robust effects. According to parent report, medication strategies may have stronger effects on anxiety-related school impairment among males than among females. Results were discrepant across parents and youth. Findings are discussed in terms of clinical implications for anxious youth and the need for continued research to examine treatment effects on anxiety-related school impairment.
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Affiliation(s)
- Amanda L Sanchez
- Center for Children and Families and Department of Psychology, Florida International University, Miami, FL, USA.
| | - Jonathan S Comer
- Center for Children and Families and Department of Psychology, Florida International University, Miami, FL, USA
| | - Stefany Coxe
- Center for Children and Families and Department of Psychology, Florida International University, Miami, FL, USA
| | - Anne Marie Albano
- Division of Child & Adolescent Psychiatry, Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York, NY, USA
| | - John Piacentini
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA
| | - Scott N Compton
- Department of Psychiatry and Biobehavioral Sciences, Duke University, Durham, NC, USA
| | - Golda S Ginsburg
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Moira A Rynn
- Department of Psychiatry and Biobehavioral Sciences, Duke University, Durham, NC, USA
| | - John T Walkup
- Anne and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Dara J Sakolsky
- Western Psychiatric Institute and Clinic-University of Pittsburgh Medical Center, Pittsburgh, USA
| | - Boris Birmaher
- Western Psychiatric Institute and Clinic-University of Pittsburgh Medical Center, Pittsburgh, USA
| | - Philip C Kendall
- Department of Psychology, Temple University, Philadelphia, PA, USA
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Comer JS, Timmons AC. The other side of the coin: Computer‐mediated interactions may afford opportunities for enhanced empathy in clinical practice. Clinical Psychology: Science and Practice 2019. [DOI: 10.1111/cpsp.12308] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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43
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Keller AE, Langer DA, Pincus DB, Elkins RM, Kerns CE, Comer JS. A Psychometric Evaluation of the Distress Intolerance Index for Youth. J Psychopathol Behav Assess 2019; 41:447-455. [PMID: 31452578 PMCID: PMC6709990] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Distress Intolerance (DI), defined as the perceived inability to tolerate negative mood states and experiential discomfort, has been posited as a vulnerability factor for several anxiety and emotional disorders. There is a relative paucity of research on DI in youth samples, in large part due to the absence of a psychometrically sound measure of DI in youth. The current study evaluated the psychometric properties of the Distress Intolerance Index for Youth (DII-Y) and the Distress Intolerance Index for Youth-Parent Report (DII-Y-P), which are downward extension adaptations of the adult-oriented Distress Intolerance Index (McHugh & Otto, 2012). Participants were 176 youth (ages 9-17) and their parents who were seeking treatment for child anxiety problems. The DII-Y and DII-Y-P demonstrated good-to-excellent internal consistency. Convergent validity of the DII-Y and the DII-Y-P was supported by large, significant associations with measures of intolerance of uncertainty, as well as with anxiety sensitivity in the case of the DII-Y. Discriminant validity of the DII-Y and the DII-Y-P was supported by the absence of significant direct relationships with a measure of defiant behavior. Results support the use of DII-Y and DII-Y-P as reliable and valid instruments for the assessment of youth DI, providing a practical and efficient tool to study DI as a potential factor in the etiology and maintenance of youth anxiety and emotional disorders.
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Affiliation(s)
- Alex E. Keller
- Department of Psychological and Brain Sciences, Boston University
| | - David A. Langer
- Department of Psychological and Brain Sciences, Boston University
| | - Donna B. Pincus
- Department of Psychological and Brain Sciences, Boston University
| | - R. Meredith Elkins
- Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School
| | | | - Jonathan S. Comer
- Mental Health Interventions and Technology (MINT) Program, Florida International University
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Comer JS, Conroy K, Timmons AC. Ensuring wearable devices don’t wear out their welcome: Cautions for the mental health care road ahead. Clinical Psychology: Science and Practice 2019. [DOI: 10.1111/cpsp.12297] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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45
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Cornacchio D, Furr JM, Sanchez AL, Hong N, Feinberg LK, Tenenbaum R, Del Busto C, Bry LJ, Poznanski B, Miguel E, Ollendick TH, Kurtz SMS, Comer JS. Intensive group behavioral treatment (IGBT) for children with selective mutism: A preliminary randomized clinical trial. J Consult Clin Psychol 2019; 87:720-733. [PMID: 31294589 PMCID: PMC6629469 DOI: 10.1037/ccp0000422] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [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: 01/17/2023]
Abstract
OBJECTIVE Very few controlled trials have evaluated targeted treatment methods for childhood selective mutism (SM); the availability of evidence-based services remains limited. This study is the first controlled trial to evaluate an intensive group behavioral treatment (IGBT) for children with SM. METHOD Twenty-nine children with SM (5-9 years; 76% female; 35% ethnic minority) were randomized to immediate SM 5-day IGBT or to a 4-week waitlist with psychoeducational resources (WLP), and were assessed at Week 4 and again 8 weeks into the following school year. RESULTS IGBT was associated with high satisfaction and low perceived barriers to treatment participation. At Week 4, 50% of the immediate IGBT condition and 0% of the WLP condition were classified as "clinical responders." Further, Time × Condition interactions were significant for social anxiety severity, verbal behavior in social situations, and global functioning (but not for SM severity, verbal behavior in home settings, or overall anxiety). School-year follow-up assessments revealed significant improvements across all outcomes. Eight weeks into the following school year, 46% of IGBT-treated children were free of an SM diagnosis. In addition, teachers in the post-IGBT school year rated less school impairment and more classroom verbal behavior relative to teachers in the pre-IGBT school year. CONCLUSIONS Findings provide the first empirical support for the efficacy and acceptability of IGBT for SM. Further study is needed to examine mechanisms of IGBT response, and other effective SM treatment methods, in order to clarify which treatment formats work best for which affected children. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Danielle Cornacchio
- Florida International University, Center for Children and Families, Mental Health Interventions and Technology (MINT) Program
| | - Jami M. Furr
- Florida International University, Center for Children and Families, Mental Health Interventions and Technology (MINT) Program
| | - Amanda L. Sanchez
- Florida International University, Center for Children and Families, Mental Health Interventions and Technology (MINT) Program
| | - Natalie Hong
- Florida International University, Center for Children and Families, Mental Health Interventions and Technology (MINT) Program
| | - Leah K. Feinberg
- Florida International University, Center for Children and Families, Mental Health Interventions and Technology (MINT) Program
| | - Rachel Tenenbaum
- Florida International University, Center for Children and Families, Mental Health Interventions and Technology (MINT) Program
| | - Cristina Del Busto
- Florida International University, Center for Children and Families, Mental Health Interventions and Technology (MINT) Program
| | - Laura J. Bry
- Florida International University, Center for Children and Families, Mental Health Interventions and Technology (MINT) Program
| | - Bridget Poznanski
- Florida International University, Center for Children and Families, Mental Health Interventions and Technology (MINT) Program
| | - Elizabeth Miguel
- Florida International University, Center for Children and Families, Mental Health Interventions and Technology (MINT) Program
| | | | | | - Jonathan S. Comer
- Florida International University, Center for Children and Families, Mental Health Interventions and Technology (MINT) Program
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46
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Comer JS, Hong N, Poznanski B, Silva K, Wilson M. Evidence Base Update on the Treatment of Early Childhood Anxiety and Related Problems. J Clin Child Adolesc Psychol 2019; 48:1-15. [PMID: 30640522 DOI: 10.1080/15374416.2018.1534208] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The controlled evaluation of treatments for early childhood anxiety and related problems has been a relatively recent area of investigation, and accordingly, trials examining early childhood anxiety treatment have not been well represented in existing systematic reviews of youth anxiety treatments. This Evidence Base Update provides the first systematic review of evidence supporting interventions specifically for the treatment of early childhood anxiety and related problems. Thirty articles testing 38 treatments in samples with mean age < 7.9 years (N = 2,228 children) met inclusion criteria. We applied Southam-Gerow and Prinstein's (2014) review criteria, which classifies families of treatments according to one of five levels of empirical support-Well-Established, Probably Efficacious, Possibly Efficacious, Experimental, and of Questionable Efficacy. We found family-based cognitive-behavioral therapy (CBT) to be a Well-Established treatment, and Group Parent CBT and Group Parent CBT + Group Child CBT to both be Probably Efficacious treatments. In contrast, play therapy and attachment-based therapy are still only Experimental treatments for early childhood anxiety, relaxation training has Questionable Efficacy, and there is no evidence to date to speak to the efficacy of individual child CBT and/or medication in younger anxious children. All 3 currently supported interventions for early childhood anxiety entail exposure-based CBT with significant parental involvement. This conclusion meaningfully differs from conclusions for treating anxiety in older childhood that highlight the well-established efficacy of individual child CBT and/or medication and that question whether parental involvement in treatment enhances outcomes.
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Affiliation(s)
- Jonathan S Comer
- a Mental Health Interventions and Technology (MINT) Program, Center for Children and Families , Florida International University
| | - Natalie Hong
- a Mental Health Interventions and Technology (MINT) Program, Center for Children and Families , Florida International University
| | - Bridget Poznanski
- a Mental Health Interventions and Technology (MINT) Program, Center for Children and Families , Florida International University
| | - Karina Silva
- a Mental Health Interventions and Technology (MINT) Program, Center for Children and Families , Florida International University
| | - Maria Wilson
- a Mental Health Interventions and Technology (MINT) Program, Center for Children and Families , Florida International University
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47
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Keller AE, Langer DA, Pincus DB, Meredith Elkins R, Kerns CE, Comer JS. A Psychometric Evaluation of the Distress Intolerance Index for Youth. J Psychopathol Behav Assess 2018. [DOI: 10.1007/s10862-018-9711-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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48
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Wiltsey Stirman S, Comer JS. What are we even trying to implement? Considering the relative merits of promoting evidence‐based protocols, principles, practices, or policies. Clinical Psychology: Science and Practice 2018. [DOI: 10.1111/cpsp.12269] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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49
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Crum KI, Cornacchio D, Coxe S, Green JG, Comer JS. A latent profile analysis of co-occurring youth posttraumatic stress and conduct problems following community trauma. J Child Fam Stud 2018; 27:3638-3649. [PMID: 31824130 PMCID: PMC6904109 DOI: 10.1007/s10826-018-1205-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Although most research with youth exposed to violent manmade disasters has focused on internalizing problems, recent work suggests conduct problems (CPs) may also manifest in exposed youth. However, the extent to which youth postevent CPs present independently, versus co-present in conjunction with PTSD symptoms, remains unclear. The present study examined PTS and CP symptom profiles among affected Boston-area youth following the 2013 Boston Marathon bombing. This study used latent profile analysis to identify distinct PTS and CP symptom profiles among Boston-area youth ages 4-19 years (N=344) affected by the Boston Marathon bombing events. PTS and CPs were measured using the UCLA-PTSD-RI and the SDQ parent reports, respectively. Analyses identified 3 distinct profiles: presentations characterized by (a) low PTS, low CPs, (b) moderate PTS, low CPs, and (c) high PTS, elevated CPs. The profile characterized by the highest PTS was the only profile with elevated CPs; hyperarousal and emotional numbing/avoidance symptoms showed the greatest distinguishing properties among profiles with and without elevated CP. Types of traumatic exposure experienced by youth were differentially associated with profiles. Specifically, direct (but not relational) exposure distinguished youth classified in the profile showing elevated CPs. Findings suggest interventions following violent manmade disasters may do well to incorporate CP modules when working with youth showing the greatest hyperarousal and emotional numbing, and/or who have directly witnessed the most violence.
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Affiliation(s)
- Kathleen I Crum
- Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, National Crime Victims Research and Treatment Center; 67 President St, MSC 861, Charleston, SC 29414
| | | | - Stefany Coxe
- Florida International University, Department of Psychology, Miami, FL
| | | | - Jonathan S Comer
- Florida International University, Department of Psychology, Miami, FL
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50
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Carpenter AL, Pincus DB, Furr JM, Comer JS. Working From Home: An Initial Pilot Examination of Videoconferencing-Based Cognitive Behavioral Therapy for Anxious Youth Delivered to the Home Setting. Behav Ther 2018; 49:917-930. [PMID: 30316490 PMCID: PMC6190606 DOI: 10.1016/j.beth.2018.01.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 01/07/2018] [Accepted: 01/20/2018] [Indexed: 12/17/2022]
Abstract
Progress in evidence-based treatments for child anxiety has been hampered by limited accessibility of quality care. This study utilized a multiple baseline design to evaluate the pilot feasibility, acceptability, and preliminary efficacy of real-time, Internet-delivered, family-based cognitive-behavioral therapy for child anxiety delivered to the home setting via videoconferencing. Participants included 13 anxious youth (mean age = 9.85) with a primary/co-primary anxiety disorder diagnosis. Eleven participants (84.6%) completed treatment and all study procedures. Consistent with hypotheses, the intervention was feasible and acceptable to families (i.e., high treatment retention, high client satisfaction, strong therapeutic alliance, and low barriers to participation). Moreover, the novel videoconferencing treatment format showed preliminary efficacy: 76.9% of the intention-to-treat (ITT) sample and 90.9% of treatment completers were treatment responders (i.e., Clinical Global Impressions-Improvement Scale = 1 or 2 at posttreatment), and 69.2% of the ITT sample and 81.8% of treatment completers were diagnostic responders (as per the Anxiety Disorders Interview for Children). Gains were largely maintained at 3-month follow-up evaluation. Outcome patterns within and across subjects are discussed, as well as limitations and the need for further controlled evaluations. With continued support, videoconferencing treatment formats may serve to meaningfully broaden the reach of quality care for youth anxiety disorders.
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Affiliation(s)
| | - Donna B Pincus
- Center for Anxiety and Related Disorders, Boston University
| | - Jami M Furr
- Center for Children and Families, Florida International University
| | - Jonathan S Comer
- Center for Children and Families, Florida International University
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