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Background: Hurricane Harvey struck southeast Texas in August 2017 resulting in widespread destruction and significant emotional distress. Objective: We examined the effectiveness of a transdiagnostic psychotherapeutic intervention delivered to youth with emotional disorders in a large, community health system following this hurricane. Methods: One hundred forty-nine youth aged 5 to 17 years with a history of hurricane exposure and emotional difficulties received an average of 6.4 (SD = 3.4) psychotherapy sessions using the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents. Youth-caregiver dyads completed measures of disaster exposure and impact at baseline as well as anxiety and depression at baseline and each therapy session. Symptom severity and level of functioning were rated by the clinician. Latent growth curve modeling was used to examine symptom change over time. Results: Children and adolescents began treatment with moderate levels of anxiety and depressive symptoms, symptom severity, and difficulties in daily functioning. Anxiety and depressive symptoms and symptom severity declined significantly over the treatment period. Clinician ratings of functionality evidenced significant improvement over time. Older age was correlated with more depressive symptoms at baseline and superior functioning at baseline with fewer completed treatment sessions. Conclusion: In this naturalistic, community-based effectiveness study we found significant improvement on measures of anxiety, depression, symptom severity, and daily functioning. Findings suggest that a transdiagnostic intervention may be effective for addressing a range of emotional concerns in the aftermath of a natural disaster. These results can be used to inform and refine evidence-based interventions that improve the mental health and wellbeing of disaster-exposed youth.

Background: Anxiety and depressive disorders in adolescents have an enormous burden worldwide due to their high prevalence and disability. Despite the high comorbidity between these disorders, preventive interventions have often been developed separately for anxiety and depression. Objective: The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A; Ehrenreich-May et al. in Unified protocols for transdiagnostic treatment of emotional disorders in children and adolescents, Oxford University Press, New York, 2018), a transdiagnostic treatment that targets core dysfunctions associated with anxiety and depression within a single protocol, was adapted as a universal preventive anxiety and depression program for the purposes of this investigation. The subsequent study of this adapted protocol evaluated pre- to post-intervention changes across a range of primary and secondary outcome measures. The secondary aims of this study were to assess the acceptability and feasibility of the adapted UP-A. Methods: Twenty-eight students (mean age = 14.67; SD = 0.87) participated in this uncontrolled trial conducted in Madrid, Spain. The program included nine weekly 55-min sessions administered in a school setting by an advanced doctoral student in clinical psychology to two groups of 15 and 13 students, respectively. Results: Intent-to-treat analyses revealed significant declines in self-reported anxiety symptoms, interference of anxiety and depression, and top problems' mean severity. Moderate to high participant satisfaction was indicated. Conclusions: The initial promising findings suggest that future trials of the UP-A adapted as a school-based universal anxiety and depression prevention program using a larger sample size are warranted. However, the results of this study should be interpreted cautiously due to limitations regarding the small sample size as well as the lack of a control group and a follow-up period. Suggestions are provided as to how the intervention might be refined in content and delivery.

Objective: Misophonia is a psychiatric condition characterized by strong emotional and/or behavioral responses to auditory stimuli, leading to distress and functional impairment. Despite previous attempts to define and categorize this condition, misophonia is not currently included in the Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases. The lack of formal diagnostic consensus presents challenges for research aimed at assessing and treating this clinical presentation. Methods: The current study presents clinical characteristics of youth (N = 47) with misophonia in the largest treatment‐seeking sample to date. We examined demographic characteristics of the sample, frequency of comorbid disorders, frequency of specific misophonia symptoms (i.e., triggers, emotional and behavioral responses, and impairments), and caregiver‐child symptom agreement. Misophonia symptoms were evaluated using a multimodal assessment including clinician, youth, and caregiver reports on empirically established misophonia measures, and concordance among measures was assessed. Results: Youth seeking treatment for misophonia presented with marked misophonia symptoms and an array of comorbid conditions. Youth and caregivers identified various triggers of misophonia symptoms (e.g., chewing sounds, breathing sounds), as well as a wide range of emotional (e.g., anger, annoyance, disgust) and behavioral (e.g., aggression, avoidance) responses to triggers. Youth and caregivers exhibited high agreement on misophonia triggers but lower agreement on symptom severity and associated impairment. Compared to younger children (aged 8−13), older children (aged 14+) appeared to report symptom severity and associated impairment more reliably. Conclusion: Misophonia is a heterogenous and impairing clinical condition that warrants future investigation and evidence‐based treatment development. [ABSTRACT FROM AUTHOR]

Background: Social anxiety disorder (SAD) and depression are common among adolescents, frequently comorbid, and resistant to change. Prevention programs for adolescent SAD are scant, and depression prevention programs do not fully address peer-risk factors. One critical peer-risk factor for SAD and depression is peer victimization. We describe the development and initial evaluation of a transdiagnostic school-based preventive intervention for adolescents with elevated symptoms of social anxiety and/or depression and elevated peer victimization. We modified Interpersonal Psychotherapy-Adolescent Skills Training for depression, incorporating strategies for dealing with social anxiety and peer victimization. Objective: Our open trial assessed the feasibility, acceptability, and preliminary benefit of the modified program (called UTalk) for adolescents at risk for SAD or depression and who also reported peer victimization. Method: Adolescents (N = 14; 13-18 years; 79% girls; 86% Hispanic) were recruited and completed measures of peer victimization, social anxiety, and depression both pre- and post-intervention and provided ratings of treatment satisfaction. Independent evaluators (IEs) rated youths' clinical severity. The intervention (3 individual and 10 group sessions) was conducted weekly during school. Results: Regarding feasibility, 86% of the adolescents completed the intervention (M attendance = 11.58 sessions). Satisfaction ratings were uniformly positive. Intention-to-treat analyses revealed significant declines in adolescent- and IE-rated social anxiety and depression and in reports of peer victimization. Additional secondary benefits were observed. Conclusions: Although further evaluation is needed, the UTalk intervention appears feasible to administer in schools, with high satisfaction and preliminary benefit. Implications for research on the prevention of adolescent SAD and depression are discussed.

Effectiveness trials aim to increase the generalizability and public health impact of interventions. However, challenges associated with this design present threats to external and internal validity. This paper illustrates these challenges using data from a two-site randomized effectiveness trial, the Community Study of Outcome Monitoring for Emotional Disorders in Teens (COMET) and presents recommendations for future research. COMET was a randomized effectiveness trial conducted in 19 community mental health clinics in two states comparing three interventions: treatment as usual (TAU), TAU with measurement-based care (TAU+), and the Unified Protocol forTransdiagnostic Treatment of Emotional Disorders in Adolescents with MBC (UPA). Participants included 176 clinicians (mean age = 35.5; 85.8% cisgender female; 53.0% racially and/or ethnically minorized) and 196 adolescents (mean age = 14.7; 65.3% cisgender female; 69.4% racially and/or ethnically minorized). Analyses outlined participant flow from recruitment to study completion, described participant characteristics, and examined site differences. Analysis of participant flow suggested that recruitment and retention of clinicians and adolescents was challenging, raising questions about whether participants were representative of participating clinics. Both the clinician and adolescent samples were racially and ethnically diverse and adolescents were low income and clinically complex. Significant site differences were observed in clinician and adolescent characteristics. While this study was successful in recruiting a diverse and historically under-represented sample, difficulties in recruitment and retention raise questions about external validity and site differences present challenges to internal validity of study findings. Suggestions for future effectiveness studies, drawing from implementation science approaches, are discussed. [ABSTRACT FROM AUTHOR]

High rates of anxiety and depression are reported among youth with autism spectrum disorders. These conditions are generally assessed using measures validated for typically developing youth. Few studies have investigated their validity for autism spectrum disorders, which is crucial for accurate assessment and the provision of proper treatment. The Revised Children's Anxiety and Depression Scale was evaluated with 67 youth with autism spectrum disorders to examine its utility in measuring anxiety and depression in this population. Parents and children (aged 11-15 years) referred to a multisite intervention study completed the Pediatric Anxiety Rating Scale, Multidimensional Anxiety Scale for Children, Anxiety Disorders Interview Schedule, Child Behavior Checklist, and Revised Children's Anxiety and Depression Scale. Results suggest acceptable internal consistency of the Revised Children's Anxiety and Depression Scale. Modest convergent validity was found among the Revised Children's Anxiety and Depression Scale and other standardized measures of anxiety and depression. There were stronger correlations between Revised Children's Anxiety and Depression Scale Total scores and subscales of measures expected to correlate significantly than those not expected to correlate. One exception was a significant association between the Revised Children's Anxiety and Depression Scale and Child Behavior Checklist Attention subscale, calling into question the divergent validity in separating anxiety from attention problems. Overall, results suggest preliminary support for the Revised Children's Anxiety and Depression Scale in youth with high-functioning autism spectrum disorders.