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Executive function challenges are linked to important outcomes in adulthood, including mental and physical health and employment. Executive function skills can be taught but require support for generalization into home and school settings. The present study examined the feasibility of a series of brief videos (e.g., animations, expert and caregiver interviews) for caregivers of children with symptoms consistent with a neurodevelopmental disorder and flexibility or planning/organization problems. Caregivers (n = 102) viewed 12 videos over a four-month time period that describe ways to support and model executive function skills for their children. Quantitative and qualitative feedback suggest caregivers found the videos acceptable, feasible, and that they changed their view of their child's EF challenges. In addition, caregiver knowledge of key executive function strategies and concepts improved. Results suggested these videos show promise to reduce caregiver-reported sense of strain and child executive function problems; however, caregiver competence did not improve from pre- to post-video review. These findings suggest even brief, online, and asynchronous caregiver-oriented instructional videos on executive function supports may improve caregiver and child outcomes. Moreover, they raise the possibility that low-cost, highly accessible caregiver support tools may yield important benefits for a common and potent childhood difficulty. Given the present study is a preliminary feasibility study of the caregiver support videos, future randomized controlled trials are necessary to fully examine caregiver- and child-related outcomes. Highlights: We aimed to both develop and deliver executive function support videos to caregivers of children with executive function challenges. Videos were iteratively developed in partnership with a community advisory board and research participants. As a preliminary study of the video suite, we evaluated the feasibility and acceptability of videos for caregivers. Caregivers found the videos helpful, informative, efficacious, acceptable, and feasible to use. The videos show promise to reduce caregiver-reported strain and child executive function challenges. This study implies that brief, low-cost support tools are acceptable and feasible for caregivers to use and may benefit caregivers and their children with executive function challenges. [ABSTRACT FROM AUTHOR]

Following the United States' recent engagements in military conflicts, the impact of parent deployment on child adaptation has become an increased focus of research. This study examined the contributions of maternal depressive affect and parenting stress to young children's (ages 3 to 7) internalizing and externalizing symptomatology. In order to examine how these maternal factors contribute to child well-being, mean level differences and path analysis with group level modelling examined differences between military, single-parent and two-parent civilian families. Mean level differences reflected higher rates of difficulty for military homefront mothers in terms of depressive affect than either single or two-parent families and similar levels of parenting stress with single mothers. Military children demonstrated higher rates of internalizing or externalizing symptoms than children in single or two-parent families. Path analysis results indicated group level differences in links between maternal depressive affect and internalizing symptoms, with military families having stronger associations than single parent families. No group level differences were found between maternal depressive affect and externalizing symptoms. Associations between parenting stress and internalizing symptoms were stronger for military families than two parent families but weaker than single parent families, while the links between parenting stress and externalizing symptoms were the same for military and for single-parent families. These findings have important implications regarding potential intervention/prevention approaches for military families, suggesting that it may be particularly beneficial to target homefront mothers' depressive affect and parenting stress during deployment as a means for promoting positive child outcomes. Highlights: Homefront mothers exhibit higher rates of depressive affect than civilian mothers (i.e. single or two-parent), and more emotion dysregulation and parenting stress than civilian two-parent mothers. Young children from military families demonstrated higher rates of internalizing and externalizing symptoms than children from either group of civilian families. Different patterns of prediction from maternal depressive affect and parenting stress to children's internalizing and externalizing symptoms were found based on family type. Findings suggest the importance of easily available mental health services, targeting maternal depressive affect and parenting stress for homefront mothers. [ABSTRACT FROM AUTHOR]

This longitudinal study examined the psychosocial health trajectories of children following reunification from residential care and the associated contextual factors. Data were drawn from a randomised controlled trial evaluating the effects of a parenting programme on the successful reunification and reintegration of 1–13-year-old children with their families, in nine districts in Uganda. Families were randomised to receive either a basic reintegration package consisting of a reunification grant and case management (standard intervention) or an enhanced package consisting of the basic package plus 13 bi-weekly training sessions of a parenting programme (enhanced intervention). Data were collected from caregivers at home and the residential care facilities, as well as the children (n = 55 dyadic pairs) through prospective interviews at baseline (before reunification), and at 6- and 12-months post-reunification. Predictive growth curve analyses assessed longitudinal changes in child psychosocial problems (externalizing, internalizing, total behavioural problems) and associated contextual factors. In age, sex, and study arm stratified analyses, we found declining linear trajectories in children's psychosocial problem scores at 6 and 12 months post-reunification. Taking covariates into account, persistent externalizing, internalizing, and total behavioural problems at endline were associated with children's depressive symptoms, caregiver characteristics and quality of caregiving. Our findings suggest that children who are reunified from residential to family-based care have fewer psychosocial problems post-reunification compared to their time in residential care. These findings did not differ by age and sex of the child or type of reintegration package received. Although findings from our small single study have limited generalizability and should be interpreted with caution for policy and programming, they underscore the potential benefits of reunification programmes for children's psychosocial well-being. Highlights: This study examined the psychosocial health trajectories of children reunified from residential to family-based care and associated factors. Reunified children had fewer psychosocial problems at 6 and 12 months after reunification compared with their baseline when in residential care. Findings did not differ with child age, sex or type of reintegration package received. Persistent psychosocial problems were associated with caregiver unemployment, child depressive symptoms, poorer caregiver health, and low-quality caregiving. Larger studies with longer follow-up periods are required to validate our findings in a resource-limited setting. [ABSTRACT FROM AUTHOR]

This pilot study examined associations between transdiagnostic symptoms and parent-perceived parent-child relationship quality in treatment-seeking families of children with neurodevelopmental disabilities, and interactions among clinical symptoms and cognitive functioning. Sixty-three children between 8 to 13 years of age and their caregivers were assessed at baseline while seeking cognitive behaviour therapy for emotion regulation and mental health difficulties. Diagnoses included autism, ADHD, cerebral palsy, and learning disability, with 52% of children having multiple diagnoses. Parent-perceived parent-child relationship quality was assessed by the Positive Affect Index, autism symptoms (e.g., social communication, repetitive behaviours) by the Social Responsiveness Scale, Second Edition, mental health (i.e., internalizing problems, externalizing problems, behavioural symptoms) by the Behaviour Assessment Scale for Children, Third Edition, and IQ by the Weschler Abbreviated Scale of Intelligence, Second Edition. Results revealed that higher IQ scores and greater social communication challenges, externalizing problems, and behavioural symptoms, were associated with lower parent-child relationship quality. Interaction effects were found between IQ and social communication challenges, reflecting significantly stronger relationships between social communication challenges and lower parent-child relationship quality in the context of higher IQ. Understanding the interactions between cognitive functioning and social communication challenges can help to inform individualized supports, and advocate for a transdiagnostic approach to intervention. Highlights: We examined associations between transdiagnostic symptoms and parent-perceived parent-child relationship quality in families of children with neurodevelopmental disabilities. Social communication challenges, IQ, externalizing problems, and behavioural symptoms were negatively associated with parent-child relationship quality. The strength of the relationship between social communication challenges and parent-child relationship quality was inversely related to IQ levels. [ABSTRACT FROM AUTHOR]

Social Anxiety Disorder is highly prevalent among children and leads to poor long-term outcomes if left untreated. Theoretical models of anxiety differ in whether children with Social Anxiety Disorder experience objective social skills deficits, negative self-interpretation biases, or some combination of the two. This pilot study evaluated evidence in support of the "deficit" and "bias" models. Approval was obtained from the ethics committee of a large private university in Cambridge, MA, USA, and data collection was completed in 2015. We recruited 68 parent-child dyads for a study in which anxious children (with Social Anxiety Disorder) and non-anxious children underwent a child-adapted version of the Trier Social Stress Test. Children were aged 8-14, 67.6% male, and self-identified as 54.4% White, 7.4% Black, 4.4% Latinx, 13.2% Asian, 14.7% multiethnic, and 5.9% "other" or no response. Performance ratings were obtained from children, their parents, and external observers. We found evidence of both specific social skills deficits and self-appraisal biases in anxious children. Anxious children struggled with signs of physical discomfort but not with actual speech content. Although children were generally able to accurately evaluate their social performance, older anxious children were most self-critical. Parents were similarly accurate in appraisals of their children's social performance. Anxious children responded favorably to positive feedback with improved self-evaluations of performance and decreased anxiety. Findings suggest that a comprehensive "integrated" theoretical model of Social Anxiety Disorder should include both skills deficits and self-appraisal biases. Highlights: This parent-child dyadic study utilized a behavioral paradigm – the Trier Social Stress Test – to examine social skills deficits and self-appraisal biases in anxious children from the perspective of multiple reporters (child, parent, and external observer). We found evidence of both specific social skills deficits and self-appraisal biases in anxious children. Parents of anxious children were not hypercritical or inaccurate in appraisal of their children's social skills. Our study supports a comprehensive "integrated" theoretical model of anxiety. [ABSTRACT FROM AUTHOR]

Developing psychometric instruments for understanding childhood mental illness stigma is challenging due to the complexity of the stigma concept. The objective of the present study was to validate a novel measure of childhood mental illness stigma from the perceiver´s perspective using modern psychometric techniques and to critically reflect on the insights generated by the results. A convenience sample of 290 Brazilian elementary schoolteachers was investigated for the presence of personal stigma (PS) and perceived public stigma (PPS). The items of each stigma type were analyzed using Item Response Theory. A 20-item Likert instrument was developed and validated allowing comparison of levels of PS and PPS. Although all items showed good potential for discriminating individuals with different levels of stigma, the items dangerousness, fear and intellectual disability exhibited greatest discriminative power. The difference in an individual's perceived behavior/attitude of others compared to their own was observed and described as the distance between PS and PPS. We report important insights into the novel measure of childhood mental illness stigma from the stigmatizer´s perspective which can help plan topics to be addressed and new approach strategies for anti-stigma campaigns in child mental health. Highlights: New assessment measure of the stigma from the stigmatizer´s perspective was proposed. The most relevant items were violence, incompetence and non-recovery. Different responses were observed in first or third person. Personal stigma and perceived public stigma were quantified. [ABSTRACT FROM AUTHOR]

Comorbid psychiatric presentations, defined as those who present with more than one mental and/or behavioral health diagnosis at the same time, during adolescence are on the rise. Mindfulness-based interventions can alleviate psychological symptoms and improve emotion regulation in youth. Mindfulness is a multifaceted phenomenon, with five underlying facets (Observing, Describing, Acting with Awareness, Non-Judgment and Non-Reactivity of Inner Experience). Little evidence has documented which facets produce pronounced psychiatric symptom reduction for adolescents. This pilot study examined the efficacy of an online mindfulness-based intervention delivered to adolescents undergoing mental health treatment during COVID-19 to reduce psychiatric outcomes. Fifty-six adolescents (m = 14.5 years, 66.1% female) categorized as moderate-risk (treatment histories of outpatient therapy only) or high-risk (treatment histories with intensive service participation) participated in the 8-session mindfulness-based intervention. Significant reductions in psychiatric symptoms and increases in adaptive coping strategies were observed at post-test, particularly for those at moderate-risk. Multivariate stepwise regression found significant associations between mindfulness facet use and anxiety, depression, and somatic symptoms (R2 ranging from 42.5 to 52.8%). Results indicate preliminary efficacy for an online mindfulness-based intervention for adolescents, particularly those at moderate-risk, due to the introduction of new coping skills, given their history of less intense treatment. Further investigation is warranted to understand which mindfulness facet intervention components produce the most prominent outcomes. Highlights: Preliminary efficacy for an online MBI for adolescents deemed moderate- and high-risk (outpatient only versus outpatient plus intensive care). Significant reduction in psychiatric symptoms and increases in adaptive coping strategies observed at post-test. Pre-test mindfulness facet use explained 42.5–52.8% of the variance in anxiety, depression and somatic symptoms. [ABSTRACT FROM AUTHOR]

Coping with a child's psychiatric disorder involves various challenges for parents that can result in family burden. One factor related to family burden, which has been examined in previous studies, involves the interaction of the parent with the child diagnosed with the disorder. The current study, expanding on this notion, examined the interactions between parents and two of their children, one with a disorder and one without, by assessing parental expressed emotion (EE). The study also assessed the relations between the interactions with each child, examining whether these two interactions were positively or negatively-related: the "spillover hypothesis" and the "compensation hypothesis," respectively. In addition, the current study examined a mediation model whereby parental competence would mediate the association between parental EE towards each child and perceived family burden. 41 parents, whose children were treated at a mental health center, participated in the study. The Five Minute Speech Sample was administered to the parents to assess parental EE, as well as scales of parental competence and family burden. Results showed positive correlations between parental EE towards the two children (in the relationship and warmth subscales). The mediation model was confirmed only with regard to parental EE (relationship subscale) towards the child with the disorder. These findings support the spillover hypothesis, according to which feelings and cognitions are transferred from one family subsystem to another. Findings also highlight the importance of sense of competence in parenting a child with a psychiatric disorder, as it reduces family burden. Highlights: Parental expressed emotion (EE) towards child with a disorder and healthy child were positively-related. The finding supports the "spillover hypothesis"—transferring emotions from one child to the other. More warmth and less emotional over-involvement towards the healthy child were observed. We found negative association between parents competence and family burden. Parental competence is a key factor in reducing family burden for a child with a disorder. [ABSTRACT FROM AUTHOR]

Oppositional defiant disorder (ODD) is a common mental health concern and is particularly prevalent among children living in poverty-impacted communities. A family strengthening/parent management training (PMT)-based multiple family group (MFG) program entitled, the 4 Rs and 2 Ss for Strengthening Families, focuses on the following family process variables: rules, responsibilities, relationships, respectful communication, social support, and stress. While evidence supports effectiveness of this treatment program, less is known about the specific relationship between the family process variables and mental health outcomes of children and caregivers. The current study examined these relationships among a sample of 287 caregiver/child dyads who participated in a NIMH-funded Type II hybrid effectiveness-implementation study in New York City. Data were analyzed using SPSS 27 and Mplus 8. Results indicated that two of the six family process variables related to one or more child and caregiver mental health outcome. Caregiver stress significantly related to child inattention (b = 0.034, SE = 0.01, p < 0.001), child ODD (b = 0.053, SE = 0.02, p < 0.01), and caregiver depression (b = 0.049, SE = 0.02, p < 0.01). Family rules significantly related to caregiver depression (b = 0.228, SE = 0.11, p < 0.05) over time. Findings point towards the substantial role of caregiver stress in child and caregiver mental health, in addition to the impact of inconsistent discipline with difficulty establishing rules on caregiver depression. Examinations of treatment components in relation to improvements in child and caregiver mental health can guide practitioners towards utilizing models that result in positive therapeutic outcomes and/or making adaptations with added content that has been shown to be effective. Highlights: Oppositional defiant disorder is a prevalent mental health concern among youth relating to negative outcomes in adulthood. The 4 Rs and 2 Ss for Strengthening Families is a family strengthening/parent management training program targeting family rules, responsibilities, relationships, respectful communication, social support, and stress. Two of the six family process variables (Rules & Stress) related to one or more child and caregiver mental health outcome. Findings point towards the substantial role of caregiver stress in child and caregiver mental health. Examinations of treatment components and targets are essential to inform practice and both utilization and adaptation of interventions. [ABSTRACT FROM AUTHOR]

This systematic review aimed to examine sleep associations in a) typically developing children and their parents, and b) children with neurodevelopmental disorders and their parents. Literature search was conducted on PubMed, PsycINFO, EMBASE and Scopus databases for articles examining sleep associations between parents and children. Thirty studies were included in the final review. Based on the first aim, sleep associations between parents and typically developing children were observed for sleep quality, sleep duration and sleep efficiency. However, evidence for associations between sleepiness levels in parents and children and sleep schedules related to bedtime or waketime was limited. Based on the second aim, children with neurodevelopmental disorders and their parents reported greater sleep disturbances in comparison to typically developing children and their parents. The review concluded that sleep in parents and children is interrelated across a number of sleep parameters. It also revealed some preliminary evidence on bidirectionality in parent-child sleep, which warrants further examination. The review highlights the need to examine the mediating role of environmental factors on the interactions between parent-child sleep. Rigorous, longitudinal designs should be employed to explore the pathways through which parents may impact their children's sleep and functioning and vice-versa. Highlights: Sleep quality, insomnia symptoms and objectively measured sleep duration and sleep efficiency are associated between parents and their children. Children's sleep disturbances are linked to poor sleep quality, greater insomnia symptoms and increased pre-sleep arousal in parents. Daily fluctuations in children's sleep can have an impact on their mothers' sleep and vice-versa, indicating potential bidirectionality in mother and child sleep. Parents of children with neurodevelopmental disorders have greater sleep disturbances than parents of typically developing children. Future research should consider the importance of family context when examining sleep disturbances in adults and children. [ABSTRACT FROM AUTHOR]

There is some scientific evidence to support the applicability and preliminary effects of ACT as a parent intervention but more research is needed. In this pilot research, Acceptance and Commitment Therapy (ACT) is provided as a parent counseling therapy in order to increase psychological flexibility which in turn helps parents to choose attuned parenting behavior, invest in a helpful parent-child relationship, deal with feelings of incompetence, and cope with their own psychopathology. ACT parent counseling is developed for parents of children (3–18 years old) with psychiatric problems. The mean age of the parents (n = 101) was 47.1 years (range = 30–66). A repeated measures design was used including pretreatment, posttreatment, and 6-month follow-up measurements. The main outcomes were ACT measures (psychological flexibility, parental psychological inflexibility, and cognitive fusion). Secondary outcomes included parenting behavior, the quality of the parent-child interaction, parental competence, parental psychopathology, and the satisfaction with the treatment program. This is the first study we know of that showed statistically significant improvements on parental psychological flexibility, parenting behavior (except behavioral control), parent-child relations, parental competence, and parental internalizing psychopathology directly after treatment. At 6-month follow-up, significantly less conflicts, more parental competence, and less parental psychopathology was found. However, the improvements were not clinically significant, as calculated with the RCI. No control group was used in this uncontrolled pilot study but preliminary findings indicate that ACT parent counseling can help parents to increase psychological flexibility in order to choose more flexible and effective parenting behavior. Highlights: This is the first pilot study that investigates Acceptance and Commitment Therapy (ACT) as parent counseling in parents with children with various psychopathology. Improvements on parental psychological flexibility, parenting behavior, parent-child relations, parental competence, and parental psychopathology were found. These preliminary findings indicate that ACT as parent counseling is a feasible and acceptable intervention for parents of children with various psychopathology. [ABSTRACT FROM AUTHOR]

As a clinical intervention, Mindful Parenting has positive effects on parental stress and psychopathology, as well as child psychopathology. However, previous studies have not considered what characterizes parents and families who receive this type of intervention. The current study utilized a quasi-experimental design to determine the characteristics that distinguish parents seeking or referred to a mindful parenting intervention in community child mental health care centers. Two groups of parents were recruited to the study: treatment-seeking parents (n = 89), and a comparison group of parents from a community population (n = 66). All parents completed measures relating to their child's psychopathology, their own psychopathology, general mindful awareness, and parenting measures of stress, over-reactivity, experiential avoidance and mindful parenting. A cross-sectional comparison confirmed that the treatment-seeking parents reported significantly higher psychopathology in their child (d = 0.91–1.19) and in themselves (d = 0.99–1.21), lower general mindful awareness, and higher parenting stress, over-reactivity, parental experiential avoidance and lower mindful parenting than the community parents. Across all outcomes, group differences in mindful parenting indicated the largest effect (d = 1.77), followed by parenting stress (d = 1.42), general mindfulness (d = 1.34), parental over-reactivity (d = 1.32), and parental experiential avoidance (d = 1.21). Hierarchical binary logistic regression analyses indicated that, next to higher child internalizing problems, lower mindful parenting distinguished treatment-seeking parents from community parents. Those parents seeking or referred to a mindful parenting intervention may benefit most from improvements in the very construct that the intervention targets: cultivating mindful parenting. Highlights: Characteristics of parents seeking or referred to a mindful parenting intervention were compared to those of parents from the community. Treatment-seeking parents reported higher psychopathology in their child and themselves compared to community parents. Treatment-seeking parents were distinguished from community parents by lower mindfulness and mindful parenting, higher parental stress, overreactivity and experiential avoidance. Higher internalizing child problems and lower mindful parenting mostly distinguished treatment-seeking parents. [ABSTRACT FROM AUTHOR]

Over the last decades, ambulatory psychosocial interventions aimed at treating child externalized behavior problems have been developed and tested. In recent years, however, it has become clear that the reported effects of psychotherapies have been considerably overestimated due to publication bias. In addition, previous meta-analyses of psychosocial interventions aimed at treating child disruptive behaviors have not accounted for potential interaction effects among moderators. The purpose of this meta-analysis was to examine the effects of interventions while accounting for publication bias and dependencies among moderators. We searched electronic databases to identify randomized controlled trials targeting child externalized behavior problems treated in ambulatory settings. A total of 111 randomized controlled trials with 11,623 participating children were analyzed. Interventions targeting children with symptom severity below the clinical range demonstrated a non-significant effect (adjusted g = 0.12), while interventions targeting children with symptom severity within the clinical range demonstrated a small to moderate effect size (adjusted g = 0.38) that was sustained at follow-up (adjusted g = 0.27). We found the highest pooled effect size for individually administered treatments involving both the parent and the child (g = 1.11; no indication of publication bias). No other differences were found between delivery formats, including assisted self-help interventions. Publication bias was relatively smaller in high-quality studies. These findings suggest that the most effective treatment regime involves both the parent and the child, however, only when they are treated in an individual setting. Our results highlight the importance of accounting for interaction effects, publication bias and trial quality in future meta-analyses. Highlights: Interventions for children with symptoms within the clinical range are effective. Individual treatments involving both the parent and child had the highest effect. Child involvement was not associated with better outcome in group administered interventions. Analysis indicates that high quality studies reduce the risk of publication bias. [ABSTRACT FROM AUTHOR]

Child maltreatment and involvement in the child welfare system are linked to numerous adverse health and behavioral outcomes for children. However, there is some variability in children's health, suggesting that protective factors may attenuate child maltreatment risks. Specific protective factors, such as social support networks and receipt of health services, may be important for children in the child welfare system. Further study is needed on how these protective factors can mitigate salient risks associated with child welfare involvement, including caregiver substance use, mental health, and physical health that are linked to children's long-term health and behavioral outcomes. Using the National Survey for Child and Adolescent Well-Being II (NSCAW II) dataset (N = 5872), this longitudinal study uses three successive step-wise multiple and ordered logistic regression models to investigate the relative effects of the timing of social supports and receipt of health services in the relationship between exposure to caregiver risk characteristics and children's internalizing and externalizing problems, and health outcome among children investigated for maltreatment. Results revealed social support mitigated effects of poor physical and mental health on children's internalizing and externalizing behaviors in wave 1 and mitigated poor physical health on internalizing behaviors at wave 3. Social support also mitigated effects of poor mental health on children's health outcomes at wave 1. Results suggest the need for timely and responsive health services in the child welfare system. Highlights: The results showed greatest mitigating effects of social supports on behavioral outcomes. The mitigating effects were most robust for protective factors integrated closest to risk and expected outcomes. [ABSTRACT FROM AUTHOR]

Objectives: Although research investigating Mindfulness-based interventions (MBIs) for adults has increased exponentially, the evidence of the effects of MBIs on adolescents with mental health problems is only beginning to emerge. Our aim is to systematically review the current state of the MBI research literature across the range of mental health conditions in adolescents, and to identify some key research questions yet unanswered. Methods: MEDLINE, CINAHL, PsycINFO and Scopus were searched, as well as the references of retrieved articles. Of 754 articles, 17 met the inclusion criteria. Of these, only a few studies implemented a manualized intervention for adolescents, five featured interventions adapted from the classical Mindfulness models (MBSR and MBCT), while the remaining studies used a combination between these models while incorporating also other components. In terms of research design, only three of the studies were RCTs, seven pilot studies, five design studies and the rest were feasibility studies. Moreover, only three of the seventeen studies used validated measures of mindfulness in gauging the impact of the interventions. Results: We identified the following four categories of mental health conditions in studies of MBIs among adolescents: Neurodevelopmental and Behavioral Disorders; Mood and Anxiety Disorders; Substance Abuse Disorders, and Heterogeneous Disorders. Conclusions: The evidence so far suggests that MBIs are both feasible and well accepted, although study populations and methods varied so much that precise estimates of impact on clinical outcomes needs further research. Guided by our systematic review, we summarize ways to adapt MBIs for adolescents with mental health problems. [ABSTRACT FROM AUTHOR]

Impairment of adaptive functioning is a critical criterion in the diagnostic process for mental disorders, as well as clinicians’ preferred target when treating clients. At the same time, clinical research with youth overemphasizes mental health symptoms and undervalues measures of adaptive functioning. Moreover, there is a dearth of comprehensive assessments of functioning that are practical and validated for use with both youth and parents in clinical outpatient settings. The current study addresses these issues by examining the factor structure of both youth and parent versions of a measure of functional impairment. This study used an archival dataset of adolescents aged 11-19 years (87% Caucasian, 50% female) receiving services at a semi-rural community mental health clinic in Northwest Ohio. To determine the factor structure of functional impairment, exploratory and confirmatory factor analyses were conducted separately on youth and parent versions of the Ohio Scales Functioning Scale. Prior to analyses, the final sample of 1080 adolescents was randomly split in half in order to perform principal axis factoring on one half and confirmatory factor analysis on the other half. Overall, youth and parent Functioning Scales tapped into five domains encompassing youths’ school, social-emotional, recreation, self-care, and responsible behavior. However, there were slight differences in the item compositions of some domains, suggesting that youth and parents view certain behaviors as indicators of different aspects of functioning. Results support that youth adaptive functioning is a multi-dimensional construct, and the Ohio Scales may offer a more comprehensive assessment of functional impairment than other measures. [ABSTRACT FROM AUTHOR]

Adolescents who engage in aggression, hyperactivity, and delinquency experience a host of negative outcomes, including poor academic performance, peer rejection, and substance use. Previous researchers have linked somatization, such as pain, to behavioral problems. The purpose of this study was to examine whether resilience moderates the influence of somatization on externalizing problems by gender. We surveyed the parents of 195 adolescents, ages 14 to 17, while the adolescents were being treated in the pediatric emergency department of a large urban hospital. Parents answered questions about their adolescent’s somatic symptoms, resilience, and externalizing problems. Moderation models were conducted to test whether the influence of somatization on aggression, hyperactivity, conduct problems, and an externalizing behavior composite was dependent upon level of resilience, and whether these relationships differed by gender. Resilience lessened the impact of somatization on aggression and conduct problems, but these relationships did not differ by gender. The influence of somatization on hyperactivity as well as the externalizing composite index was buffered by high levels of resilience only for girls. These results are compatible with the Diathesis-Stress Model, suggesting that girls with low or average levels of resilience may engage in hyperactivity when they experience a level of somatic symptoms that exceeds the threshold within which they can manage stress. Future research should examine these constructs within longitudinal study designs in order to determine directionality of the relationships reported and advance the science of risk factors and potential intervention targets in the prevention of externalizing behaviors. [ABSTRACT FROM AUTHOR]

International adoptees are at an increased risk of emotional and behavioral problems, especially those who are adopted at an older age. We took a new approach in our study of the network structure and predictability of emotional and behavioral problems in internationally adopted children in Finland. Our sample was from the on-going adoption study and comprised 778 internationally adopted children (387 boys and 391 girls, mean age 10.5 (SD 3.4) years). Networks were estimated using Gaussian graphical models and lasso regularization for all the children, and separately for those who were adopted at different ages. The results showed that anxiety/depressive symptoms, social problems, and aggressiveness were the most central symptom domains. Somatic symptoms were the least central and had the weakest effect on the other domains. Similarly, aggressiveness, social problems, and attention problems were high in terms of predictability (73-65%), whereas internalizing problems were relatively low (28-56%). There were clear but local age-group differences in network structure, symptom centrality, and predictability. According to our findings, network models provide important additional information about the centrality and predictability of specific symptom domains, and thus may facilitate targeted interventions among international adoptees. [ABSTRACT FROM AUTHOR]

Parents’ frequent destructive conflicts may lead children to respond to these disputes in maladaptive ways and these distressing and maladaptive responses, in turn, may lead to psychopathology in children. Child behavioral dysregulation was examined as a mediator between marital conflict and child internalizing and externalizing symptoms as well as parents’ future conflicts in a sample of 235 children and their parents. Parents reported on study variables over three annual measurement occasions beginning when their children were 6 years old and autoregressive controls were included for destructive marital conflict and initial levels of children’s symptoms of psychopathology. Results based on structural equation modeling showed that behavioral dysregulation mediated the relationship between destructive marital conflict and children’s internalizing and externalizing symptoms. In addition, children’s behavioral dysregulation mediated the relationship between parents’ initial levels of destructive conflict and their later conflicts, indicating that children’s responses did not serve to reduce parents’ future conflicts, but were in fact related to an increase in destructive disputes over time. Findings of the current study suggest that children’s behavioral dysregulation is a maladaptive response to marital conflict, associated with risk for children’s development of internalizing and externalizing symptoms and heightened destructive marital conflict. Discussion makes suggestions for future research regarding children’s responses to marital conflict. [ABSTRACT FROM AUTHOR]

This study investigated associations between parental and child psychopathology with parenting stress as a possible mediator, in order to get more insight in mothers’ and fathers’ roles in the development of psychopathology in children. Parents of 272 clinically referred (aged 6-20, 66% boys) reported about their own and their child’s behavioral problems, and about parenting stress. Data were analyzed using Structural Equation Modeling. Outcomes of path models demonstrated that mothers’ higher internalizing and externalizing problems were associated with respectively children’s higher internalizing and externalizing problems. Fathers’ higher externalizing problems were associated with both children’s higher internalizing and externalizing problems, but fathers’ internalizing problems were only associated with children’s lower externalizing problems. Parenting stress fully mediated the relation between mothers’ and children’s externalizing problems, and partly mediated the relation between mothers’ and children’s internalizing problems. For fathers, parenting stress partly mediated the relation between fathers’ internalizing problems and children’s externalizing problems. Findings indicate that for mothers, the association between parental and child psychopathology is specific, whereas for fathers it is non-specific. Furthermore, results suggest that reducing parenting stress may decrease child problem behavior. Longitudinal studies are needed in order to gain more insight in the direction and underlying mechanisms of the relation between parental and child psychopathology, including parental stress. [ABSTRACT FROM AUTHOR]

The study aimed to examine the psychometric properties of the Chinese revision of the Emotional and Behavioral Screener (EBS), and to extend its application to preschoolers (4–7 years old). Teachers and parents of 216 preschoolers (age M = 5.11, SD = 0.9) were invited to complete the EBS, and some of the teachers were also asked to complete the Preschool Behavioral and Emotional Rating Scale (PreBERS) (N = 80) and the Strength and Difficulties Questionnaires (SDQ) (N = 90). Results of confirmatory factor analysis suggested that the original single-factor model of the EBS didn’t fit the data well. Based on the results of a series of exploratory factor analyses, we proposed a two-factor model instead, representing externalizing and internalizing problems respectively. The Chinese revision demonstrated satisfactory internal reliability, inter-rater reliability, convergent validity and divergent validity. All these evidences supported its use among Chinese preschoolers to identify those who will be at risk of suffering from emotional and behavioral disturbances. [ABSTRACT FROM AUTHOR]

Early detection and treatment promote positive outcomes in mental health problems among infants. This study developed a simple and reliable screening inventory for infants' mental health. Participants were 579 primary caregivers who had Japanese infants aged 2-6 years. Participants evaluated their children using the Mental Health Inventory for Infants (MHII; developed in this study), which contains 24 items. Exploratory factorial analysis identified the MHII factor structure; confirmatory factorial analysis examined its factorial validity. Internal consistency and criterion-related validity were also examined. Irritability (8 items), somatic symptoms (6 items), and signs of insecurity (4 items) were identified as factors in the MHII; each of these factors measures a critical aspect of infants' mental health. The MHII's internal consistency and scale homogeneity were acceptable; its criterion-related validity was supported. In this study, male infants exhibited greater irritability and less insecurity than females. The present results support the MHII's reliability and validity; additionally, they indicate that caregivers may use the MHII to quickly screen for three critical aspects of infants' mental health. We expect that the MHII will be used for early detection of mental health difficulties in infants to facilitate treatment. [ABSTRACT FROM AUTHOR]

Compared to non-Hispanic whites, Hispanic adolescents in the U.S. report higher rates of several mental, emotional, and behavioral problems such as substance use, sexual risk behaviors, and internalizing and externalizing problems. There is evidence of common pathways in the development of mental, emotional, and behavioral problems with certain subgroups of Hispanic adolescents being at greater risk. In the present article, we report analysis of baseline data for 959 Hispanic adolescents who participated in one of two randomized controlled trials evaluating a family-based preventive intervention. Utilizing latent class analysis, we identified subgroups of Hispanic adolescents based on socio-ecological risk and protective factors (e.g., parent-adolescent communication, parental involvement in school). Three distinct socio-ecological risk subgroups (high, medium, and low risk) were identified and exhibited significant differences from each other across a majority of socio-ecological risk and protective factors. Adolescents in higher socio-ecological risk subgroups reported greater mental, emotional, and behavioral problems across all outcomes. Individual comparisons revealed significant differences between the low socio-ecological risk group and both the medium and high socio-ecological risk group in lifetime alcohol use, smoking, and sex, as well as internalizing and externalizing problems. Implications for intervention include focusing on specific risk subgroups and targeting shared risk and protective factors rather than specific mental, emotional, and behavioral outcomes. [ABSTRACT FROM AUTHOR]

Wraparound is a team-based care coordination strategy for children and youth with complex behavioral health needs and their families. Despite widespread adoption, a review of the literature pertaining to Wraparound has not previously been conducted. To address this gap, we conducted a comprehensive review, ultimately identifying 206 unique Wraparound-related publications in peer-reviewed outlets. We then coded and analyzed the publications' methods, main foci, measures, and findings. Eighty-three publications (40%) were non-empirical, most of which focused on defining Wraparound and advocating for its use, largely based on its alignment with the System of Care philosophy. Among empirical studies ( n = 123; 60%), 22 controlled studies were found, most finding positive or mixed evidence for Wraparound's effectiveness. Other empirical studies examined implementation issues such as necessary system conditions and measurement and influence of fidelity. Major gaps include rigorous tests of Wraparound's change mechanisms, workforce development models, peer support, and the use of specific treatments. We conclude that literature produced to date has provided useful information about Wraparound's core components, program-level and system-level implementation supports, and applicability across systems and populations, as well as preliminary information about effectiveness and cost-effectiveness. The Wraparound research base would, however, benefit from additional studies of the model's intervention and implementation components, as well as more rigorous effectiveness studies. [ABSTRACT FROM AUTHOR]

This study examined the role of anxiety sensitivity as an explanatory variable in the link between two temperamental dimensions (i.e., behavioral inhibition and negative affect) and anxiety disorder symptom severity in a sample of children with anxiety disorders. Forty-four children (52 % African American) between 8 and 12 years of age and their mothers participated in this study. An assessment battery consisting of diagnostic interviews, questionnaires, and behavioral assessment of behavioral inhibition was administered. Findings revealed that anxiety sensitivity was a significant explanatory variable linking child self-reports of behavioral inhibition and negative affect to anxiety disorder symptom severity. For parent-completed measures, only direct effects of behavioral inhibition on anxiety disorder symptom severity were found. The clinical implications of our findings, including the importance and feasibility of anxiety sensitivity and behavioral inhibition assessments as part of routine clinical care of children with anxiety disorders are discussed, along with the limitations of our study. [ABSTRACT FROM AUTHOR]

We used questionnaire data collected at intake from 979 parents and guardians of 6-year-old children to 18-year-old children referred to a private outpatient mental health clinic to build on and extend current views of caregiver strain and its relationship to children's behavioral and emotional problems. First, we offered evidence for the validity of a measure of attachment strain, referring to strains in caregivers' positive feelings towards their child; and second, we assessed whether parent-child interactions might help to account for robust relationships between child problems and caregiver strain identified in prior studies. Findings were consistent with our conceptualization of attachment strain as distinct from but related to dimensions of strain identified in prior research, and as an especially severe, outwardly directed form of subjective strain associated with caring for a child with especially severe problems in behavioral and emotional regulation. Multiple regression analysis showed that child problems and parent-child interactions accounted for 31 to 42 % of the total variance in caregiver strain. Commonality analysis indicated that approximately half of the explained variance in each dimension was 'shared.' The unique contribution of child problems, however, overshadowed the unique contribution of parent-child interactions in predicting objective and subjective internalized strain whereas the opposite was true for subjective externalized and attachment strain. We suggest that child-problem-focused treatment strategies may be especially helpful in addressing caregivers' objective and subjective internalized strain whereas strategies designed to improve the quality of parent-child interactions may be especially helpful in alleviating caregivers' subjective, outwardly directed experiences of strain. [ABSTRACT FROM AUTHOR]

The current initiative and program evaluation study is a demonstration of the research to practice process in youth-focused psychotherapy. We collaborated within a community-university partnership to create practice and research infrastructure in order to develop, implement, and evaluate two new models of service founded on evidence-based psychotherapeutic practice parameters. The two new service models incorporated validated interventions to address behavior problems in elementary age children, and depression in adolescents, which were delivered in separate but similarly run intensive outpatient programs within a mental health setting. We utilized a rigorous training, technical assistance, fidelity monitoring, and outcome measurement strategy to promote the integrity and quality of services provided. The resultant programs were delivered with acceptable to high fidelity and effects on youth and parenting measures collected during program and from pre to post showed a decrease in targeted problems in youth and positive benefits for families. This initiative and program evaluation adds to the accumulating research-to-practice literature in children's mental health. [ABSTRACT FROM AUTHOR]

Research to date on child and adolescent anxiety and depression have focused predominantly on major ethnic groups. Very few studies to date have been conducted on specific ethnic minority groups and the relatively few studies on these ethnic minority samples have produced mixed findings. The following question therefore still remains: Do specific ethnic subgroups differ with respect to their expression of anxiety and depression? And do these differences differ as a function of reporter type (i.e., youth versus parent)? If the expression of internalizing symptoms differs across specific ethnic subgroups, these differences could inform approaches to assessing and treating these populations. In the current study, we therefore examined ethnic differences in anxiety and depression symptoms in ethnic subgroups. A total of 629 children and adolescents from various public and private schools, aged 8-18 years ( M = 12.37, SD = 2.8) and their caregivers completed anxiety and depression scales. Multiple indicators, multiple causes confirmatory factor analysis revealed that the following specific ethic subgroups were associated with significantly greater anxiety and depression relative to Caucasian youth: Chinese American, Filipino American, Japanese American, and Native Hawaiian. These results were found only among parent (but not youth) reports. Age and low SES status was also associated with more internalizing problems among Chinese, Filipino, and Japanese American youth. Implications related to ethnic minority subgroup differences and the role of multi-informant reports in understanding the relationship between anxiety, depression and ethnic minority subgroups are discussed. [ABSTRACT FROM AUTHOR]

This paper examines whether family structure and its transitions are associated with internalizing and externalizing psychiatric disorders among Puerto Rican-origin children. It uses longitudinal data (three waves) from the Boricua Youth Study, which includes probability samples of children in the South Bronx (New York) and San Juan (Puerto Rico) (n = 2,142). We also examine factors which may explain how family structure and transitions may be related to child psychiatric disorders. Our results show that for both internalizing and externalizing disorders there were no significant differences between children of cohabiting (biological or step) parents or of single parents compared to children of married biological parents. In Puerto Rico only, transitioning once from a two-parent family to a single-parent family was related to child internalizing disorders. Family transitions were not associated with externalizing disorders at either site. Context may be an important factor shaping the risk that family dissolution is followed by an internalizing disorder among children. [ABSTRACT FROM AUTHOR]

Self-stigma detracts from the wellbeing, self-esteem, and social connectedness of adults with mental health disorders. Although emerging research has indicated that self-stigma may have similar consequences for parents of children with mental health disorders, currently we lack a comprehensive description of how parents experience self-stigma. To address this, we investigated parents' lived experiences of self-stigma using a descriptive qualitative approach. Directed by interview questions informed by a parent-based participatory action research group ( n = 4), we conducted individual semi-structured interviews with 12 parents of children (aged 5-13) diagnosed with emotional and/or behavioural disorders. Data obtained from interviews with 11 mothers was coded and thematically analysed. Five themes were found: (1) the 'good parent' ideal, (2) awareness of external stigma, (3) outcomes of external stigma (social avoidance and self-doubt), (4) self-stigma (believing self-doubt and external stigma), and (5) refuting self-stigma. Our findings show that parents of children with mental health disorders experience self-stigma. However, because it leads to a diminished sense of being a good parent, the self-stigma is of a different type to that which has been described for adults with mental illness. This has important implications for the conceptualisation and assessment of parent self-stigma as research in this area moves forward. [ABSTRACT FROM AUTHOR]

Emotional and behavioral (EB) problems in children are associated with increased perceptions of strain in parenting. Among children receiving services, parenting stress has been linked to initiating services for their children, and may strain the relationship between parent and child. In contrast, parental engagement and empowerment in services is an important quality indicator for positive treatment outcomes. However, no known studies have examined the association between parent empowerment in their child's services and their perceptions of stress related to parenting a child with significant mental health needs. Further, no studies have explored whether empowerment moderates the relationship between the child's symptoms and parental perceptions of stress. The current study examined the impact of child EB problems and parent empowerment on parenting stress. Among a sample of 525 parents of children receiving school-based services for disruptive behavior disorders, child EB problems significantly predicted parenting stress. Parent empowerment also correlated with lower parenting stress, as hypothesized. Although parent empowerment was not found to moderate the relationship between child symptomatology and parenting stress, the relationship between parent empowerment and parenting stress differed based on child gender and age. Parent empowerment was associated with lower parenting stress more for parents of females and younger children than for parents of males and older children. [ABSTRACT FROM AUTHOR]

Psychologists can contribute considerably to decision making in family law proceedings. The mental health of the parents and the children forms an important factor in psychological evaluation. It is the overall aim of this study to specifically examine the occurrence of mental disorders in evaluated family members in cases of termination of parental rights as opposed to cases of child custody and visitation rights. This data are based on 297 psychological evaluations completed between 2008 and 2012 at an evaluator association in Bremen, Germany. In this retrospective content analysis, evaluation reports were examined for indications of mental disorders in children, mothers and fathers. The data were assessed in bivariate analyses and logistic regression models. A total rate above 39 % indicates a comparatively high exposure to mental disorders of children and adolescents in this sample. A mental disorder of the mother and a mental disorder of the father occur significantly more often in cases of termination of parental rights than in cases of child custody/visitation rights. Children and adolescents who showed aggressive-dissocial behavior and aggressive-oppositional behavior were significantly more likely to be evaluated in legal issues of termination of parental rights as opposed to child custody/visitation rights. Restrictions in parental mental health and parenting capacity should be carefully weighed against restrictions in the mental health of the children and their developmental needs when conducting psychological evaluation. [ABSTRACT FROM AUTHOR]

Early recognition of childhood mental-health problems can help minimise long-term negative outcomes. Recognition of mental-health problems, needed for referral and diagnostic evaluation, is largely dependent on health-care professionals' (HCPs) judgement of symptoms presented by the child. This study aimed to establish whether HCPs recognition of mental-health problems varies as a function of three child-related factors (type of problem, number of symptoms, and demographic characteristics). In an online survey, HCPs ( n = 431) evaluated a series of vignettes describing children with symptoms of mental-health problems. Vignettes varied by problem type (Attention-Deficit/Hyperactivity Disorder (ADHD), Generalised Anxiety Disorder (GAD), Autism Spectrum Disorder (ASD), Conduct Disorder (CD) and Major Depressive Disorder), number of symptoms presented (few and many), and child demographic characteristics (ethnicity, gender, age and socio-economic status (SES)). Results show that recognition of mental-health problems varies by problem type, with ADHD best recognised and GAD worst. Furthermore, recognition varies by the number of symptoms presented. Unexpectedly, a child's gender, ethnicity and family SES did not influence likelihood of problem recognition. These results are the first to reveal differences in HCPs' recognition of various common childhood mental-health problems. HCPs in practice should be advised about poor recognition of GAD, and superior recognition of ADHD, if recognition of all childhood mental-health problems is to be equal. [ABSTRACT FROM AUTHOR]

The parent-child relationship has been recognized as an important micro-ecological context that is thought to influence child anxiety and depression. Much contemporary research has examined child-reports of broad parenting behaviors (e.g., rejection, overprotection) and has overwhelmingly focused on the mother-child relationship. Little research has examined specific parenting behaviors that may be associated with child anxiety and depression, and whether these processes are similar for mothers and fathers and boys and girls. Using a parent-child interaction task, we examined associations among specific mother and father behaviors and child-reported general anxiety, social anxiety, and depression, and explored whether these associations were moderated by child gender. Participants were 90 children (50 % female) aged 9-12 years ( Mage = 10.28, SD = 1.22), 90 fathers ( Mage = 43.78, SD = 6.31) and 90 mothers ( Mage = 40.67, SD = 4.97). Children completed measures of social anxiety, general anxiety, and depression. Families participated in a video-recorded blindly rated interaction task that provided indices of verbal and nonverbal rejection and controlling behaviors. Mothers' physical takeovers (unsolicited physical assistance) were associated with greater child social anxiety and mothers' denial of requests for reassurance were associated with greater child general anxiety. Fathers' critical statements were associated with child-reported depression. Several child gender differences were noted. Findings from our study suggest that mothers' and fathers' specific parenting behaviors are differentially associated with children's social anxiety, general anxiety and depression-and these processes may vary by child gender. [ABSTRACT FROM AUTHOR]

This purpose of this paper is to review the literature on the treatment of Oppositional Defiant Disorder, with a specific focus on cost analyses. In general the literature shows that while there has been substantial research on Oppositional Defiant Disorder there has been little focus on the costs involved. A search of the major databases in psychology and the social sciences yielded only seven articles even marginally appropriate for a review of costs associated with Oppositional Defiant Disorder and related disruptive behavior. Interestingly, only two of these studies investigated treatment costs specifically associated with Oppositional Defiant Disorder. These studies showed that the treatment of Oppositional Defiant Disorder is much less expensive than the treatment of Conduct Disorder and family therapy is the most cost effective approach. Overall, the review showed that there is a dearth of literature related to treatment costs, which leads to the conclusion that much more research is needed on the cost of treating Oppositional Defiant Disorder. [ABSTRACT FROM AUTHOR]

This study aimed to discover the relationship between parental self-reports of ADHD symptoms and the diagnosis of ADHD in offspring, to demonstrate the extent to which parental ADHD symptoms predict ADHD diagnosis in offspring, to examine the contribution of adult ADHD scales to ADHD diagnosis, and to provide findings on the psychometric utility of adult ADHD scales. The sample consisted of 6-12-year-old boys diagnosed with ADHD (n = 149), boys in the control group (n = 47) and both parents (n = 392). Amongst the many exclusion criteria was the comorbidity of neurological and psychiatric disorders. Parental self-reports of current ADHD symptoms were obtained using the Adult Attention Deficit Hyperactivity Disorder Scale (ADD/ADHD Scale), and past symptoms were retrospectively obtained using the Wender-Utah Rating Scale (WUR Scale). For children diagnosed with ADHD, the frequency of parents with ADHD symptoms was higher than the parents without ADHD symptoms; the significance was derived from the group in which both parents displayed ADHD symptoms. The ADHD symptom scores of the parents led to a high accuracy level when predicting ADHD in children (sensitivity) but led to a low accuracy level when classifying children without any diagnosis in the control group (specificity). The study disclosed the psychometric strengths and weaknesses of the ADD/ADHD and WUR scales for measuring parental ADHD symptoms and provided original findings on their psychometric properties. [ABSTRACT FROM AUTHOR]

It is known that youth engaged in the juvenile justice system show high rates of psychiatric disorders. However, little is known about the course of those disorders over time, or about mental health service use on the part of children and families during justice system involvement. Boys and girls recruited from their first contact with juvenile court (n = 75), at a mean age of 13.6 years, completed three waves of interviews, each consisting of a structured clinical interview and questionnaires regarding service use, family functioning, parental burden, and parental psychopathology. High rates of psychiatric disorders were evident. Three quarters (n = 56) met criteria for a mood, anxiety or behavioral disorder by parent or child report. Despite the high prevalence of mental health concerns, relatively few youth (approximately 20 %) were involved in mental health services in follow-up waves. The presence of ODD and higher levels of family communication problems were associated with involvement in mental health services. Although parents experienced burden associated with their child's mental health problems, burden was not a strong correlate of help-seeking. Mental health problems declined from the point of initial involvement with juvenile justice; only ODD symptoms showed stability over time. Low rates of engagement in mental health services are found for juveniles subsequent to their first contact with juvenile justice. ODD and family communication problems most influenced service engagement, while burden due to mental health problems did not. The results provide potential targets for efforts to enhance parental motivation towards service engagement. [ABSTRACT FROM AUTHOR]

This study developed a model linking maternal and offspring antisocial behavior, with particular emphasis on whether this link is especially strong in teenage mother-child dyads. Data were taken from a longitudinal government dataset; structural equation modeling and invariance testing was used to test the hypotheses. Good model fit indicated that maternal and offspring antisociality are linked, and antisocial behavior persists across childhood, but that these relationships are not dependent on the mother's age at primiparity. These results suggest that although maternal behavior predicts offspring antisociality, being the child of a teenage mother is not an independent risk factor for the development of antisociality. Given that mothers in general tend to transmit their antisocial behavior patterns, intervention for antisocial behavior patterns in females before or during adolescence should contribute to a significant lessening of not only their own behavior problems, but also the incidence of antisocial behavior in their future offspring. [ABSTRACT FROM AUTHOR]

There is growing evidence to suggest that children with mental health problems have difficulties in emotion understanding, including particular biases in their processing of emotion information. However, less is known about the specific developmental and socialization processes that may contribute to difficulties in emotion understanding in young children with emotional and behavioral problems. The present study examines the roles of child receptive language and maternal depressive symptoms in predicting emotion understanding in clinically referred preschoolers. Participants were 79 preschool-aged children (3-5 years of age) who were admitted to a psychiatric day treatment program for young children and their families. Children participated in assessments of receptive language skills and emotion understanding and mothers completed self-report measures of depressive symptoms and child behavior problems. Children's receptive language skills were positively associated with accuracy in identifying happy, sad, angry, and scared emotions, whereas maternal depressive symptoms were specifically linked to children's biased perceptions of sadness. Findings underscore the role of both child and family factors as related to individual differences in emotion understanding in clinically referred preschoolers, with implications for developmentally informed and emotion-focused approaches to treatment of early childhood psychopathology. [ABSTRACT FROM AUTHOR]

The main objective of this study is to explore the relationship of psychotropic medication use patterns and clinician-reported maltreatment status in Medicaid-insured youth. This cross-sectional study analyzed computerized outpatient claims for youth aged 2-17 years who were continuously enrolled for ≥10 months in a mid-Atlantic state Medicaid program in 2006. Bivariate analyses and multivariable logistic modeling were employed to assess patterns of any psychotropic drug use, and specifically for antipsychotics, antidepressants, and stimulants by clinician-reported maltreatment status and according to other study covariates. Child maltreatment status was assessed using ICD-9 codes for maltreatment. Other covariates included age group, gender, race/ethnicity, region, Medicaid-eligibility categories, and clinician-reported psychiatric diagnostic groups. Among 274,490 youth, 901 had a clinician-reported child maltreatment indicator for a prevalence of 3.3 per 1,000. These youth were more likely to be older, female, African American, and Medicaid eligible by foster care or disability. Youth with clinician-reported maltreatment compared to youth without identified maltreatment had a significantly higher prevalence of antipsychotic use (14.1 vs. 3.4 %), antidepressant use (12.1 vs. 3.4 %) and stimulant use (15.8 vs. 7.8 %). After adjusting for the study covariates, the odds of antipsychotic use (2.6 [2.0, 3.2]), antidepressant use (2.0 [1.6, 2.6]), and any psychotropic use (1.5 [1.3, 1.9]) were comparatively higher among youth with clinician-reported maltreatment. By contrast, the adjusted-odds of stimulant use was comparable between the groups. The findings from this exploratory study from one state's Medicaid outpatient data suggest that youth with maltreatment indicators have an increased likelihood of antipsychotic and antidepressant medication dispensings. [ABSTRACT FROM AUTHOR]

The current study utilized a Delphic poll to identify significant problems regarding children and families in which psychologists can assist. The Delphic poll methodology combines both qualitative and quantitative methodologies to obtain information and predictions about the future from a panel of knowledgeable experts. Thirty-one professionals participated in the first round of the survey, and 26 participants (83.9 % of the round 1 participants) chose to complete the second-round survey. Several themes emerged consistently across questions as important issues to be addressed in the future of childhood mental health. For example, participants frequently identified access, advocacy, research and research dissemination, prevention/early intervention, and integration of services as important issues. Implications and recommendations are drawn for organizations and individual psychologists as advocates for improving children's mental health in the United States. [ABSTRACT FROM AUTHOR]

In this study the long-terms outcomes of children and youth with severe mental health problems receiving residential treatment (RT) or an intensive home-based treatment (IHT) were reported. RT is 24-hour mental health intervention in a highly supervised and structured group living setting where individualized and related therapies are provided. Youths attend a day school within the residential environment. IHT developed as an alternative to residential treatment for youth and comprises the same therapeutic interventions provided in the home as opposed to the residential setting. Youths attend their regular school which could be within a specialized setting, such as a day school. At discharge, there were statistically and clinically significant improvements in psychosocial functioning for children and youth in RT and IHT. There were also statistically significant improvements in scores on symptom severity from admission to 12 to 18 months post-discharge, and these improvements were maintained at 36 to 40 months post-discharge. Differences in demographic data between the two groups suggest that the programs may serve two different populations, and that both programs are important components of a comprehensive mental health plan for children and youth. [ABSTRACT FROM AUTHOR]

Fire setting is one of the most challenging behaviors for the child welfare system. However, existing knowledge about its prevalence and correlates has been limited to research on single programs. The Illinois Department of Children and Family Services initiated a uniform assessment process at entry into state custody using a trauma-informed version of the Child and Adolescent Needs and Strengths (CANS). By using information from these assessments it is possible to establish an estimate of the prevalence of fire setting behavior and identify clinical and functional correlates. A review of 4,155 children and youth entering state custody reveals an overall prevalence rate of 1.35%. However, the rate for children and youth, 10 years and older was 3.5%. The rate was higher for boys than girls but there was no relationship to race. In general, the children and youth who engaged in fire setting behaviors had much higher levels of needs, fewer strengths, and were lower functioning. Within group analysis suggests the children and youth who set fires represent a relatively homogeneous group. [ABSTRACT FROM AUTHOR]

We examined the associations between parent and child anxious and depressive symptoms controlling for co-occurring symptoms in both. One hundred and four families participated, including 131 9-15 year old children considered at risk for anxiety and/or depression due to a history of depression in a parent. Parents and children completed questionnaires assessing depressive and anxious symptoms. Linear Mixed Models analyses controlling for the alternate parent and child symptoms indicated that both parent and child depressive symptoms and parent and child anxious symptoms were positively associated. Parental depressive symptoms were not positively associated with child anxious symptoms, and parental anxious symptoms were not positively associated with child depressive symptoms. The findings provide evidence for positive specific links between parent and child development of same-syndrome, but not cross-syndrome, symptoms when a caregiver has a history of depression. [ABSTRACT FROM AUTHOR]

Using multiple informants from a clinical setting, potential associations between inter-parental agreement and age, gender, and child diagnosis were explored in the current study. Archival data from psychological evaluations conducted on 174 children ages 5–18 through a hospital-affiliated outpatient psychology clinic were analyzed, focusing on mothers’ and fathers’ scores on the syndrome and index scales of the Child Behavior Checklist (CBCL). Although inter-parent correspondence levels on each of the subscales were found to be moderately high (averaging r = .50), significant discrepancies between the severity levels of parent reports were found on nine of 11 subscales, with mothers’ ratings consistently being slightly higher. Data from this clinical sample suggest that although single-informant ratings of child behavior may be generally representative of reports from both parents on many of the CBCL narrow-band scales, age, gender, and child diagnosis were related to several patterns of agreement on specific syndrome scales. Therefore, it is important to include fathers, because they provide a unique perspective on social problems, delinquency, and attention problems, in particular. Both correspondence and discrepancies between parent reports of specific child problems can provide valuable clinical information that is useful for child assessment and treatment. [ABSTRACT FROM AUTHOR]

We describe the development of a parent empowerment program (PEP) using a community-based participatory research approach. In collaboration with a group of dedicated family advocates working with the Mental Health Association of New York City and state policy makers, academic researchers took an iterative approach to crafting and refining PEP to better prepare family advocates to help bridge the gaps in service access among children with emotional and behavioral problems. Despite the growth of family-led, family support programs nationally, research that demonstrates the positive benefits of such programs is scarce in the children’s mental health literature. The PEP model is based on research data about barriers families face in mental health service utilization (e.g., stigma, perceptions of providers, attitudes towards mental illness, service availability, etc.). PEP is premised on (a) the concept of empowerment as a process, (b) the need to engage parents in becoming active agents of change, and (c) the application of an integrated framework to empower parents, called the Parents as Agents of Change model. Our paper focuses on describing the application of a Unified Theory of Behavior Change as a theoretical framework to help activate parents as change agents in meeting their children’s mental health needs. Based on an integrated model of grassroots driven Principles of Parent Support and research-based Unified Theory of Behavior Change, PEP’s Parents as Agents of Change model provides a conceptual framework for testing the effectiveness of family support services in children’s mental health, a much-needed area for future research. [ABSTRACT FROM AUTHOR]

Research examining the links between disorganized attachment and clinical symptoms largely has neglected middle childhood due to lack of available measurement tools. The few studies that have examined these links in other developmental phases have found higher clinical symptoms in disorganized individuals. Our study extended this research by using a recently-developed attachment interview measure ideally suited to evaluate disorganized attachment in middle childhood. We examined concurrent associations among disorganized attachment in 8–12 year old children and symptoms of psychopathology theoretically hypothesized for their links with disorganized attachment. Using child- and parent-reports, we measured symptoms of depression, social anxiety, shyness, inattention, and thought problems. During our two-session study, 97 children completed the Child Attachment Interview, and children and parents completed clinical questionnaires. Results suggested that disorganized attachment was associated with higher child reports of depressive symptoms and shyness, and with parent-reports of social anxiety, inattention, and thought problems, and that disorganized children are more likely to have symptoms that meet clinical criteria. Implications for the relation of attachment to psychopathology are discussed. [ABSTRACT FROM AUTHOR]

We developed predicted change trajectories and a warning system designed to identify psychotherapy cases at risk for treatment failure as observed in archival Youth Outcome Questionnaire data (parent/guardian-report) from 363 children and adolescents (ages 4–17) served in an outpatient community mental health system. We used multilevel modeling procedures to develop models of predicted change based on demographic information. Controlling for the effects of age on intercept, no other variables were significant in the model. The warning system we created from half of the sample ( n = 181) correctly identified 71% of treatment failures in the other half of the sample ( n = 182), defined as cases whose symptoms were significantly higher at the end of treatment compared to symptoms at intake. As over half of youth cases in this usual care setting did not demonstrate reliable improvement in symptoms, these results further emphasize the value of patient-focused research in monitoring patient progress and prompting changes in the treatment approach if suitable progress is not observed. [ABSTRACT FROM AUTHOR]

We examined parent participation in the context of a going-to-scale implementation trial of the evidence-based, multi-component Early Risers conduct problems prevention program. In this study we examine the participation of parents in two parent/family-focused components of Early Risers that were delivered over 2 years across 21 rural school sites with 155 primarily Caucasian families. One component is a standardized “Parent Skills” curriculum delivered at participating schools and the second component delivers “Family Support” via tailored case management services through school and non-school site contacts. The study examines predictors of parent participation for each parent-focused component using multilevel modeling analyses. Previous research is extended by examining parent participation within the context of a going-to-scale trial and by looking at a broader array of child/parent/family and implementation context predictors. Parent participation in Parent Skills is predicted by higher level of parent’s frustration in parent–child relationships, while their participation in Family Support is related to lower family income. Implementers with higher previous work experience with children/families and lower education levels, as well as those manifesting more extroverted and less agreeable personality characteristics, elicit more participation in Parent Skills. Greater participation in Family Support is also predicted by lower levels of implementer neuroticism. Finally, implementers who achieve higher quality of delivery fidelity have greater participation in Parent Skills and a lower level of adherence fidelity predicts more participation in Family Support. The results are discussed within the context of going-to-scale service provision and in terms of implications for future prevention efforts. [ABSTRACT FROM AUTHOR]

Although a developing body of literature suggests that depressive symptoms in fathers are related to child psychopathology, little evidence suggests that paternal depression plays a unique role in children¿s symptoms. We used a high-risk design involving children of mothers with and without histories of depression to test the unique mediating role of father¿child conflict in the relations between fathers¿ depressive symptoms and child externalizing and internalizing symptoms. In all regression analyses, mothers¿ history of depression and current depressive symptoms were controlled. Depressive symptoms in fathers were associated with child externalizing and internalizing symptoms, and father¿child conflict. Father¿child conflict mediated relations between fathers¿ depressive symptoms and child externalizing symptoms above and beyond the effects of maternal depression history and depressive symptoms. The results suggest that negative interpersonal consequences of parental depression on child psychopathology may not be limited to mothers. [ABSTRACT FROM AUTHOR]