Search

Psychiatric symptoms are commonly comorbid in childhood. The ability to disentangle unique and shared correlates of comorbid symptoms facilitates personalized medicine. Cognitive control is implicated broadly in psychopathology, including in pediatric disorders characterized by anxiety and irritability. To disentangle cognitive control correlates of anxiety versus irritability, the current study leveraged both cross-sectional and longitudinal data from early childhood into adolescence.For this study, 89 participants were recruited from a large longitudinal research study on early-life temperament to investigate associations of developmental trajectories of anxiety and irritability symptoms (from ages 2 to 15) as well as associations of anxiety and irritability symptoms measured cross-sectionally at age 15 with neural substrates of conflict and error processing assessed at age 15 using the flanker task.Results of whole-brain multivariate linear models revealed that anxiety at age 15 was uniquely associated with decreased neural response to conflict across multiple regions implicated in attentional control and conflict adaptation. Conversely, irritability at age 15 was uniquely associated with increased neural response to conflict in regions implicated in response inhibition. Developmental trajectories of anxiety and irritability interacted in relation to neural responses to both error and conflict.Our findings suggest that neural correlates of conflict processing may relate uniquely to anxiety and irritability. Continued cross-symptom research on the neural correlates of cognitive control could stimulate advances in individualized treatment for anxiety and irritability during child and adolescent development.

Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder with onset as early as preschool and impairment across the lifespan. Temperament factors, specifically those that theoretically map onto ADHD symptoms, may be early markers of risk for developing later childhood ADHD that could be identifiable in infancy or toddlerhood. This meta-analysis examined the associations between these early temperamental factors and later symptoms and diagnosis of ADHD and mapped early temperament constructs onto the three ADHD symptom dimensions.A systemic review of the literature was conducted to identify prospective longitudinal studies that included theoretically relevant temperament constructs (sustained attention, activity level, inhibition, and negative emotionality) examined from birth to 36 months old and ADHD (symptoms or diagnosis) in preschool or childhood. The association between each temperament construct and ADHD outcomes was examined using pooled standardized estimates in meta-analyses.Forty-eight articles (n = 112,716 infants/toddlers) prospectively examined temperament and the relation to childhood ADHD symptoms or diagnosis. Activity level (k = 18) in infancy and toddlerhood was moderately associated with childhood ADHD (r = .39, CI = 0.27, 0.51, p .001). Moderate effect sizes were also observed for sustained attention (k = 9; r = -.28, CI = -0.42, -0.12, p .001) and negative emotionality (k = 33; r = .25, CI = 0.16, 0.34, p .001) with ADHD. The specificity of each temperament construct for later ADHD symptom dimensions was such that activity level and negative emotionality were predictive of all three symptom dimensions (i.e., inattention, hyperactivity/impulsivity, and combined), whereas sustained attention was only associated with combined symptoms.Infant and toddler temperament is an early risk factor for the development of childhood ADHD that could be utilized for early intervention identification. Yet, this systematic review found that relatively few prospective longitudinal studies have examined sustained attention (k = 9) and inhibition (k = 15) in infancy and toddlerhood in relation to later ADHD highlighting the need for further research.

College students with ADHD are at elevated risk for problem drinking behaviors and depression symptoms relative to their peers without ADHD. However, mechanisms underlying these constructs are unclear. This cross-sectional study examines two models: (1) alcohol-related negative consequences account for the covariation between ADHD symptom severity and depression symptoms and (2) depression symptoms account for the covariation between ADHD symptom severity and alcohol-related negative consequences. The sample included 106 college student drinkers with ADHD ( Mage = 19.86, SD = 1.4). Results indicated that depression symptoms partially accounted for the covariation between ADHD symptom severity and alcohol-related negative consequences. Additionally, alcohol-related negative consequences partially accounted for the covariation between ADHD symptom severity and depression symptoms. Future directions and clinical implications are discussed such as understanding the bidirectional nature of these relationships longitudinally, improving alcohol and depression-related outcomes, and developing transdiagnostic treatments to address these comorbidities among young adults with ADHD.

Objective: Neurobiological models suggest links between maternal cortisol reactivity and parenting; however, no studies have examined cortisol reactivity and parenting in mothers of school-age children with ADHD. Method: We examined the relationship between observed parenting and maternal cortisol reactivity in two laboratory contexts: the Trier Social Stress Task (TSST) and parenting-child interaction (PCI). Mothers of children with ( N = 24) and without ( N = 36) ADHD participated. Results: During the TSST, greater cortisol output and increase were associated with decreased positive and increased negative parenting. However, during the PCI, cortisol output was associated with increased self-reported and observed positive parenting, and decreased observed negative parenting. Cortisol change during the PCI was associated with decreased observed positive parenting and increased self-reported negative parenting. Among mothers of children with ADHD, cortisol output during the PCI was negatively associated with negative, inconsistent parenting. Change in cortisol predicted more inconsistent discipline and corporal punishment. Conclusion: Findings contribute to an integrative biological, psychological, and cognitive process model of parenting in families of children with ADHD.

The current multimethod longitudinal study examines how parents' distress reactions to adolescents' negative emotions may shape youths' own perceptions of negative life events and subsequent increases in depressive symptomology. Ninety adolescents (41 girls, 49 boys, average age = 16.5 years old) and their parents were assessed over three timepoints. We found that greater parent-reported distress reactions to adolescents' emotions predicted subsequent increase in youths' own self-reported negative reactions to stressful experiences over a two-week period, which in turn predicted steeper increases in youth-reported depressive symptoms across this same two-week period. Moreover, youths' negative reactions mediated the relation between parent emotion socialization and increases in adolescent depressive symptoms. These findings support the use of interventions that simultaneously target parent and child distress to prevent the onset of adolescent depression.

OBJECTIVE: It is estimated that childhood ADHD remits by adulthood in approximately 50% of cases; however, this conclusion is typically based on single endpoints, failing to consider longitudinal patterns of ADHD expression. We investigated the extent to which children with ADHD experience recovery and variable patterns of remission by adulthood. METHOD: Children with ADHD (N=558) in the Multimodal Treatment Study of ADHD (MTA) were administered eight assessments from 2-year (M age=10.44) to 16-year follow-up (M age=25.12). We identified participants with fully remitted, partially remitted, and persistent ADHD at each timepoint based on parent, teacher, and self-reports of ADHD symptoms and impairment, treatment utilization, and substance use and mental disorders. Longitudinal patterns of remission and persistence were identified that considered context and timing. RESULTS: Approximately 30% of children with ADHD experienced full remission at some point during the 14-year follow-up period; however, a majority (60% of these) experienced recurrence of ADHD after the initial period of remission. Only 9.1% of the sample demonstrated recovery (sustained remission) by study endpoint and only 10.8% demonstrated stable ADHD persistence across study timepoints. Instead, most participants with ADHD (63.8%) had fluctuating periods of remission and recurrence over time. CONCLUSIONS: The MTA findings challenge the notion that approximately 50% of children with ADHD outgrow the disorder by adulthood. Most cases demonstrated fluctuating symptoms between childhood and young adulthood. Although intermittent periods of remission can be expected in most cases, 90% of children with ADHD continued to struggle with residual ADHD through young adulthood. Clinical Trial Number: NCT00000388, Multimodal Treatment Study of Children with Attention Deficit and Hyperactivity Disorder (MTA). https://clinicaltrials.gov/ct2/show/NCT00000388

Background: Social reticence in early childhood is characterized by shy and anxiously avoidant behavior, and it confers risk for pediatric anxiety disorders later in development. Aberrant threat processing may play a critical role in this association between early reticent behavior and later psychopathology. The goal of this longitudinal study is to characterize developmental trajectories of neural mechanisms underlying threat processing and relate these trajectories to associations between early-childhood social reticence and adolescent anxiety. Methods: In this 16-year longitudinal study, social reticence was assessed from 2 to 7 years of age; anxiety symptoms and neural mechanisms during the dot-probe task were assessed at 10, 13, and 16 years of age. The sample included 144 participants: 71 children provided data at age 10 (43 girls, meanage = 10.62), 85 at age 13 (46 girls, meanage = 13.25), and 74 at age 16 (36 girls, meanage = 16.27). Results: A significant interaction manifested among social reticence, anxiety symptoms, and time, on functional connectivity between the left amygdala and the left dorsolateral prefrontal cortex, voxelwise p < .001, clusterwise familywise error p < .05. Children with high social reticence showed a negative association between amygdala–dorsolateral prefrontal cortex connectivity and anxiety symptoms with age, compared to children with low social reticence, suggesting distinct neurodevelopmental pathways to anxiety. Conclusions: These findings were present across all conditions, suggesting task-general effects in potential threat processing. Additionally, the timing of these neurodevelopmental pathways differed for children with high versus low social reticence, which could affect the timing of effective preventive interventions.

The high school years are a challenging developmental period for adolescents with attention-deficit/hyperactivity disorder (ADHD), their families, and those who work with them in the school system. Moreover, racially minoritized families and schools in low-resource, urban settings often experience additional adverse experiences that can make access to evidence-based mental health care particularly difficult. This qualitative investigation into the experiences of Black high school students with ADHD, their caregivers, teachers, and school mental health providers (SMHPs) aimed to understand this community’s experiences with ADHD across development and to explore the barriers/facilitators to adequate services. Through focus group interviews with stakeholders (i.e., 6 adolescents with a diagnosis of ADHD, 5 caregivers of adolescents with ADHD, 6 teachers, 5 school mental health providers), themes emerged related to (1) developmental changes observed in ADHD presentation in high school students and (2) contextual factors (including barriers/facilitators to optimal school and home functioning). These themes led to the development of an ecological model that show various contextual factors influencing the experiences of Black adolescents with ADHD in under-resourced urban public high schools (e.g., adolescents’ coping strategies, caregiver involvement, teacher burden or lack of ADHD-knowledge, socioeconomic status, access to care). This qualitative study represents the first step of a treatment development project assessing the implementation of a depression prevention intervention for Black adolescents with ADHD in urban public-school settings. Clinical implications (e.g., coordination of care between home and schools, increasing attention to social determinants of health, ensuring culturally competent discussion of ADHD and its treatment) are discussed.

INTRODUCTION: Research suggests that certain parenting behaviors are best suited to promote optimal child development, depending on a child’s distinctive temperamental presentation. This multi-method, longitudinal study examines the interactive effect of parenting and temperament in early childhood on the developmental trajectory of social anxiety in adolescence. METHODS: Longitudinal growth modeling was used to examine the developmental trajectory of child social anxiety from age 9–15 and the interactive effect of parenting and child temperament at 36-months on the developmental trajectory of child social anxiety from age 9–15. RESULTS: The slope of social anxiety from age 9–15 suggested a decrease in social anxiety throughout early adolescence. Furthermore, 36-month behavioral inhibition predicted the trajectory of child social anxiety from age 9–15 when parents displayed low and high levels of dismissive and supportive parenting (at 36-months). CONCLUSIONS: Results support an interactive effect of infant temperament and parenting in early childhood (at 36-months) on the developmental trajectory of child social anxiety from age 9–15. Specifically, results suggest that engaging highly inhibited children with high supportive and low dismissive parenting may help reduce social anxiety over time in adolescence. Furthermore, parenting needs may differ for children high or low in behavioral inhibition in order to impact the developmental trajectory of social anxiety in adolescence, such that children who are high BI seem to benefit from low dismissive and high supportive parenting, and children who are low in BI seem to benefit more from high dismissive parenting.

BACKGROUND: Depression is a highly prevalent, debilitating disorder that runs in families. Yet, empirical support for bidirectional mechanisms linking mother-adolescent depression symptoms remains limited. This study examined longitudinal bidirectional relations among emotion regulation (ER) constructs and depressive symptoms among mother-adolescent dyads over time. Pathways for girls and boys were explored separately, given extant research on sex differences in the intergenerational transmission of depression. METHODS: Adolescent (n=232; M=15.02 years, SD=0.95; 44% female)-mother dyads, drawn from a longitudinal study on the development of risky behaviors, completed annual assessments of depressive symptoms and facets of ER over 4 years. Panel modeling examined lagged and cross-lagged effects of mother-adolescent depressive symptoms and ER constructs over time, in a multigroup model of boys and girls. RESULTS: Among girls, higher baseline maternal depression scores predicted increased adolescent ER difficulties (std. est.=−.42, p.001, .19]) for girls, but not boys. CONCLUSIONS: Implications for interrupting intergenerational cycles of depressive symptoms and emotion dysregulation are discussed.

Objective: College is a high-risk period for the initiation and escalation of problem alcohol use. College students with attention-deficit/hyperactivity disorder (ADHD) are at particularly high risk for experiencing alcohol-related negative consequences relative to typically developing peers. Despite this, the best therapeutic approach for addressing alcohol problems in college students with ADHD has not been identified. Behavioral activation (BA) may augment the effects of gold-standard College drinking interventions [i.e., brief motivational intervention (BMI)] for students with ADHD who are engaging in problem drinking. Method: 113 college students with ADHD (Mean age = 19.87, SD = 1.44; 49.1% male) were randomized to either BMI + BA or BMI plus supportive counseling (BMI + SC). Both groups received ADHD psychoeducation delivered in MI style. Outcomes were assessed using the Brief Young Adult Alcohol Consequences Questionnaire, Daily Drinking Questionnaire, Barkley Functional Impairment Scale, and Beck Depression Inventory. Results: There were no significant differences in outcomes for the sample as a whole; in both conditions, participants showed significant reductions in their alcohol-related negative consequences, alcohol use, and depressive symptoms at 1- and 3-month follow-ups. Exploratory moderation analyses revealed that participants with elevated depressive symptoms at baseline evidenced greater reductions in alcohol-related negative consequences in the BMI + BA condition compared to BMI + SC at the 3-month follow-up. Those low in depressive symptoms evidenced greater reductions of alcohol-related negative consequences in BMI + SC compared to BMI + BA. Conclusions: For college students with ADHD who reported elevated baseline depressive symptoms, the inclusion of BA with BMI resulted in significantly greater decreases in alcohol-related negative consequences, compared to BMI + SC. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

This special issue consists of 23 articles focusing on parent socialization of emotion in children and adolescents as a transdiagnostic factor for the development of psychopathology. The papers in this special issue span various emotion socialization domains, methodologies, ages, and clinical and non-clinical populations, highlighting the promise, as well as complexities of, such transactional work. Our goals for this commentary include synthesizing the articles, highlighting common themes, and suggesting future research initiatives involving measurement, developmental, and cultural considerations. It is our hope that the research presented in this special issue will inspire future, high-quality research on this topic and ultimately improve outcomes for children and adolescents at risk for poor emotion regulation and psychopathology.

In this article, we provide definitional clarity for the construct of social withdrawal as it was originally construed, and review the original theoretical and conceptual bases that led to the first research program dedicated to the developmental study of social withdrawal (the Waterloo Longitudinal Project). We also describe correlates (e.g., social and social-cognitive incompetence), precursors (e.g., dispositional characteristics, parenting, insecure attachment), and consequences (e.g., peer rejection and victimization, negative self-regard, anxiety) of social withdrawal, and discuss how the study of this type of withdrawal led to a novel intervention that targets risk factors that predict social withdrawal and its negative consequences.

We examined the longitudinal relation between behavioral inhibition (BI) and social anxiety symptoms and behavior and the mediating role of emotion regulation (ER). Moreover, we investigated the influence of parenting behavior on the development of ER strategies. Participants were 291 children (135 male) followed longitudinally from 2 to 13 years. Mothers were predominantly well educated and non-Hispanic Caucasian. Children were screened for BI using maternal report and observational measures (ages 2 and 3), parenting behavior was observed while children and their mothers participated in a fear-eliciting task (age 3), ER strategies were observed while children completed a disappointment task (age 5), and socially anxious behavior was measured via multimethod assessment at 10 and 13 years. Children who exhibited high BI in early childhood exhibited more socially anxious behavior across ages 10 and 13, and there was a significant indirect effect of BI on socially anxious behavior through ER strategies. Children who were high in BI demonstrated less engaged ER strategies during the disappointment task, which in turn predicted more socially anxious behavior. Furthermore, parenting behavior moderated the pathway linking early BI and ER strategies to social anxiety outcomes such that children who exhibited high BI and who received more affectionate/oversolicitous behavior from their mother displayed less engaged ER strategies and more socially anxious behavior than children low in BI or low in oversolicitous parenting behaviors. These findings expand on our understanding of the role that ER strategies and parenting play in the developmental pathway linking early BI to future social anxiety outcomes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

News of a videogame that received FDA clearance to treat youth with attention-deficit hyperactivity disorder (ADHD) garnered a great deal of media attention and raised questions about the role of d...

Depression in early childhood increases risk of psychopathology and impairment across the lifespan. Parent-Child Interaction Therapy-Emotion Development (PCIT-ED) effectively treats depression and improves functioning in preschoolers. Parental depression has been associated with inconsistent parenting, depression onset and maintenance in offspring, and decreased treatment efficacy for youth. Given the intensity of parent involvement in PCIT-ED, this secondary data analysis aimed to evaluate parental depression severity (i.e., Beck Depression Inventory-II Total Score; BDI-II) as a moderator and predictor of child, parenting, and engagement outcomes, within the context of a randomized trial. Children (N = 229; ages 3-6.11) with early childhood depression and a consenting caregiver were randomly assigned to receive PCIT-ED or Waitlist (WL). Moderation results supported the superiority of PCIT-ED over WL on child and parenting outcomes, independent of parent-reported BDI-II at baseline (p ≥ 0.684 and p ≥ 0.476, respectively). BDI-II did not significantly predict child (p ≥ 0.836), parenting (p ≥ 0.114) or engagement (p ≥ 0.114) outcomes. Finally, BDI-II did not surpass chance in predicting whether children would maintain a depression diagnosis after PCIT-ED (AUC = 0.530) or prematurely terminate treatment (AUC = 0.545). Our results suggest that PCIT-ED is not contraindicated by minimal-to-moderate symptoms of depression in parents. Taken together with previous reports, PCIT-ED may indeed be a particularly beneficial treatment choice for this population. Further research in samples with more severe parental depression is needed. ClinicalTrials.gov identifier: NCT02076425.

Objective The COVID-19 pandemic has brought unprecedented changes to young adults’ lives, resulting in mental health difficulties for many; however, some individuals are particularly prone to heightened anxiety. Little is known about the early life predictors of anxiety during the pandemic. We examined a developmental pathway from behavioral inhibition (BI), a temperament characterized by fearful responses toward novelty, to changes in young adults’ anxiety during the initial period of the pandemic. We hypothesized that a stable pattern of BI across early childhood would predict greater adolescent worry dysregulation, which in turn would predict increases in young adult anxiety during a stressful phase of the pandemic. Method Participants (N = 291; 54% female) were followed from toddlerhood to young adulthood. BI was observed at ages 2 and 3 years. Social wariness was observed at age 7 years. Participants rated their worry dysregulation in adolescence (age 15) and anxiety in young adulthood (age 18) at 2 assessments during the COVID-19 pandemic, 1 month apart. Results A significant moderated mediation, in which a stable pattern of BI from toddlerhood to childhood, as compared to the absence of this pattern, predicted greater worry dysregulation in adolescence. Worry dysregulation predicted elevated young adult anxiety in the second assessment during COVID-19, even after accounting for the first assessment. Conclusion This study identifies a developmental pathway from toddlerhood BI to young adults’ elevated anxiety during the COVID-19 pandemic. Findings have implications for early identification of individuals at risk for dysregulated worry and the prevention of anxiety during stressful life events in young adulthood., The current study leveraged a prospective longitudinal sample to characterize developmental pathways from early temperamental risk to elevated young adult anxiety during the COVID-19 pandemic. The rapid spread of COVID-19 has led governments to implement measures such as home quarantine, school closures, and social distancing. These measures have caused significant changes in everyday social life and educational routines.1,2 Although these changes have been associated with heightened anxiety1 for the population in general, some individuals are more prone to experiencing heightened anxiety during stressful life events than are others.3 As such, examining specific developmental pathways from childhood temperament to heightened anxiety during the COVID-19 pandemic is critical for advancing our understanding of the mechanistic pathways that contribute to elevated anxiety during stressful life events.

The COVID-19 pandemic is an unprecedented social-emotional stressor significantly impacting intervention services for at-risk college students with attention-deficit/hyperactivity disorder (ADHD). ...

College students with ADHD are at risk for a host of negative outcomes in academic, social, and emotional domains. However, the majority of college campuses do not provide comprehensive and individ...

Behavioral inhibition (BI) is a temperamental style that poses risk for later anxiety. Efficacious interventions have been developed for inhibited children, but their success depends on parent enga...

Objective: Symptoms of ADHD place adolescents at increased risk for depression. The transition from middle to high school may magnify depression risk. This study examined whether changes in adolescents’ negative relationship quality with their mothers and best friends from eighth to 12th grades mediated the longitudinal relations between ADHD and depressive symptoms. Method: 368 adolescents (48.5% male) were initially recruited. Results: Boys with elevated ADHD symptoms in the eighth grade reported steeper increases in negative relationship quality with their mothers relative to girls, and that this trajectory mediated the relation between ADHD and depressive symptoms. ADHD symptoms were also associated with increases in negative friendship quality across high school for boys; however, this did not mediate the relation between ADHD and depressive symptoms for either sex. Conclusion: Growth in mother–adolescent negative relationship quality may be one mechanism that explains the development of depressive symptoms in adolescent boys with elevated ADHD symptoms.

Maternal emotional functioning and emotion socialization practices can facilitate or hinder children’s emotional development, and youth with symptoms of attention-deficit/hyperactivity disorder (ADHD) are at increased risk for emotion lability. However, little is known about the independent and interactive effects of maternal emotion dysregulation and adolescent ADHD symptoms on maternal emotion socialization and adolescent emotion lability over time. Using secondary data analyses of a longitudinal community sample of youth and their mothers (N(baseline) = 247; 43.7% female), the current study examined direct and indirect effects of maternal emotion dysregulation on adolescent emotion lability via supportive and non-supportive emotion socialization practices as mediators, and the extent to which adolescent ADHD symptoms moderated these longitudinal pathways. Mothers reported on all study constructs. Results showed that non-supportive parenting responses to adolescents’ negative emotional expressions partially mediated the association between maternal emotion dysregulation and adolescent emotion lability, and the effect was stronger at higher levels of youth ADHD symptom severity. Results suggest that parent- and youth-level characteristics interact to confer risk for non-supportive emotion socialization practices and adolescent emotion lability. This research contributes uniquely to theory and research on ADHD and emotional functioning across adolescence. Future research should extend this work by utilizing multi-modal assessment.

Symptoms of ADHD and anxiety often co-occur, yet we are limited in our understanding of which children with ADHD symptoms are more likely to develop anxiety symptoms in adolescence. This longitudinal study examined the role of behavioral inhibition (BI) and peer relationships (i.e., peer support and peer victimization) in relation to childhood ADHD and adolescent anxiety symptoms in a community sample, which was oversampled for reactivity. Data were drawn from a larger longitudinal study (N = 291) examining trajectories of BI. For the current analyses, we used behavioral observations of BI at ages 2 and 3, parent report of their child's ADHD symptoms at age 7, child report of peer support and peer victimization at age 12, and adolescent report of anxiety symptoms at age 15. Using structural equation modeling, results indicated that BI and peer support moderated the relation between ADHD and anxiety symptoms, such that ADHD symptoms predicted later anxiety symptoms only for youth who displayed low BI in toddlerhood and reported experiencing lower levels of peer support in early adolescence. Findings highlight the role of early temperament and peer relationships on the relation between childhood ADHD and adolescent anxiety symptoms, and underscore the importance of evaluating multiple risk factors when examining the development of psychopathology.

This is a commentary on Hinshaw, Nguyen, O'GradyRosenthal's 'ADHD in Girls and Women: Underrepresentation, Longitudinal Processes, and Key Directions', which reviews the empirical literature on female-specific impairments, mechanisms and developmental pathways. Having conducted one of the most prominent and informative longitudinal investigations of girls with and without ADHD, Hinshaw et al. (2021) provide a compelling synthesis of their findings, highlighting research and clinical priorities. In this commentary, I highlight the pernicious effects of unrecognized and untreated ADHD in girls and women, challenges of making an accurate differential diagnosis and the need to raise awareness among health professionals, educators and parents about the clinical presentation of girls with ADHD in order to achieve earlier identification and intervention that can interrupt the developmental trajectory to widespread impairment, comorbidity and, in some cases, devastating outcomes.

Aims Contemporary theories of attention-deficit/hyperactivity disorder (ADHD) and alcohol use disorder (AUD) emphasize core dysfunctions in reward-related processes and behaviors as pathognomonic characteristics. However, to date, it is unclear which domains of reward functioning are unique to ADHD versus AUD symptom dimensions, and which represent underlying shared correlates. Methods The current study employed secondary data analyses from a large community sample of emerging adults (N = 602; 57.3% female) and novel transdiagnostic modeling (i.e. bi-factor confirmatory factor analyses and structural equation modeling) of ADHD, AUD and shared symptom dimensions to identify unique and common reward-related dimensions: environmental suppressors, reward probability, hedonic capacity, proportionate substance-related reinforcement and delay discounting. Results The presence of environmental suppressors was the only reward-related construct that correlated with the underlying ADHD-AUD shared dimension. The AUD symptom dimension was uniquely associated with proportionate substance-related reinforcement, whereas the ADHD symptom dimension was uniquely associated with limited reward probability. No significant associations were found for delay discounting or hedonic capacity. Conclusions These novel findings highlight specific aspects of reward-related functioning in ADHD, AUD and shared symptom dimensions. In so doing, this work meaningfully advances theoretical conceptualizations of these two commonly co-occurring presentations and suggests future directions for research on transdiagnostic correlates. Future longitudinal studies should include clinical samples with diagnoses of AUD and ADHD to further identify underlying correlates over time.

Although the COVID-19 pandemic caused significant stress and anxiety among many, individuals’ experiences varied. We examined if specific forms of anxiety predicted distinct trajectories of anxiety, perceived stress, and COVID-related worries during three early months of the pandemic. In a longitudinal study (N = 291), adolescents’ (n = 194) social and generalized anxiety levels were assessed via parent- and self-reports and clinical diagnostic interviews. In young adulthood (n = 164), anxiety, stress, and COVID-related worries were assessed thrice during the pandemic. Pre-pandemic generalized anxiety predicted higher initial levels and maintenance of anxiety, stress, and COVID-related worries during the pandemic. In contrast, pre-pandemic social anxiety predicted lower initial levels of anxiety, stress, and COVID-related worries, but this initial effect on anxiety and stress was offset over time by social anxiety’s positive effect on the slope. Our results highlight the importance of understanding how pre-pandemic factors influence individuals’ experiences during the pandemic.

Objective: ADHD and depression co-occur at higher than chance levels in adolescence, but moderators of this association are not well understood. Consistent with a developmental–transactional framework, one such moderator may be maternal emotion regulation (ER) difficulties. Using latent growth curve modeling, the current study examined the independent and interactive effects of adolescent ADHD symptoms and maternal ER difficulties on the trajectory of depressive symptoms across adolescence. Method: This study included a community sample of 247 adolescents ( Mage = 13.06 years) assessed annually over a 6-year period. Results: Findings suggested that youth with greater ADHD symptoms whose mothers evidenced more ER difficulties demonstrated steeper increases in depressive symptoms over time relative to their peers with lower ADHD symptoms or whose mothers reported fewer ER difficulties. Conclusion: This work highlights the importance of maternal ER difficulties in predicting the trajectory of depressive symptoms among adolescents with ADHD symptomatology.

Despite gaining admission to college, many students with attention-deficit/hyperactivity disorder (ADHD) struggle to achieve academic, social, and occupational success. Additionally, college students with ADHD experience higher rates of problem drinking and comorbid psychology (e.g., depression). This paper describes the development of the Students Understanding College Choices: Encouraging and Executing Decisions for Success (SUCCEEDS) program for college students diagnosed with ADHD who are engaging in problem drinking. SUCCEEDS combines ADHD psychoeducation, behavioral activation, and brief motivational intervention treatment elements to help college students with ADHD achieve healthier and more fulfilling lifestyles. SUCCEEDS aims to decrease problem drinking by increasing substance-free, goal-directed behavior allowing for success in college. The iterative treatment development process, two SUCCEEDS illustrative case examples, and reliable change indices are presented. Preliminary results suggest that SUCCEEDS may be effective in reducing problem drinking and functional impairment in areas relevant to college students (e.g., academics).

Objective: Recent studies suggest attention-deficit/hyperactivity disorder (ADHD) may emerge post-childhood. We integrate qualitative methods to systematically characterize contextual factors that may (a) delay identification of ADHD in childhood and (b) inform why ADHD symptoms emerge post-childhood. Method: Suspected late-onset ADHD cases from the local normative comparison group of the Multimodal Treatment Study of ADHD completed a qualitative interview (14 young adults and 7 caregivers). Interviews were qualitatively analyzed. Results: We identified five themes. Three themes may attenuate or delay identification of childhood ADHD: external factors (e.g., supportive adults), internal factors (e.g., strong intellectual functioning), and other factors (e.g., dismissive attitudes toward ADHD). Two themes may accompany an increase in ADHD symptoms post-childhood: external factors (e.g., increased external demands) and internal factors (e.g., perceived stress). Conclusion: Clinicians should probe these factors in suspected late-onset cases to address (a) whether, how, and to what extent ADHD was attenuated in childhood and (b) why symptoms emerge post-childhood.

Objective: To examine recurrence and timing of maternal depression as predictors of depressive and conduct symptoms in children with and without ADHD. Method: Children aged 4 to 6 years (125 ADHD, 122 comparison) were followed over 8 years. Maternal depression was assessed annually. Youth depressive and conduct symptoms were assessed at ages 12 to 14. Results: Recurrence of maternal depression predicted youth depressive and conduct symptoms at ages 12 to 14; child ADHD moderated relations between recurrence of maternal depression and youth depressive (but not conduct) symptoms. Early adolescent exposure to maternal depression predicted age 12 to 14 depressive symptoms for all children. Exposure to maternal depression during early childhood, childhood, and early adolescence each independently predicted youth conduct symptoms. Conclusion: Recurrence and timing of maternal depression predict comorbid symptoms in early adolescents, particularly for youth with ADHD. Findings inform the prevention of comorbidities in children with ADHD where maternal depression is present. (J. of Att. Dis. XXXX; XX(X) XX-XX)

High and stable behavioral inhibition (BI) during early childhood have been associated with an increased risk of later anxiety disorders and peer difficulties. Developing evidence-based early interventions to prevent these unhealthy developmental trajectories has become a major focus of interest. However, these interventions are not yet available in Europe. This study aimed to explore the perceptions of Portuguese psychologists about the acceptability of the child component of the Turtle Program, before its dissemination in Portugal. Eighteen psychologists were distributed into three focus groups. Each group was moderated by a trained psychologist, using a semi-structured interview guide. The thematic analysis revealed that Portuguese psychologists acknowledged that the intervention needs to go beyond social skills training and enhance children’s positive self-perceptions. Overall, psychologists perceived the structure, contents, activities, and materials of the intervention to be acceptable. However, participants recommended minor modifications to strengthen the connection with naturalistic contexts, broaden the focus on emotional expressiveness and social interaction, and introduce creative activities and materials. These findings are consistent with previous research with LatinX practitioners, who typically agree with the acceptability of evidence-based child intervention principles and only report the need to introduce minor changes related to the way how interventions are delivered to children.

BACKGROUND: Social anxiety is amongst the most prevalent adolescent mental health problems; however, it is often unrecognized due to its comorbidity with other anxiety problems such as generalized anxiety (Kashdan & Herbert, 2001). Thus, understanding the unique developmental pathways to social anxiety is critical for improving its prevention. We examined the pathway from maternal shyness, when children were 4 years old, to adolescents’ social anxiety at age 15 through social wariness at age 7. We hypothesized that childhood social wariness would mediate the association between maternal shyness and social anxiety in adolescence. METHODS: Participants (N=291; 54% female) were followed from early childhood to adolescence. Mothers reported on their own shyness when children were 4 years old. Social wariness toward unfamiliar peers was observed in the laboratory at ages 4 and 7. Adolescent social anxiety and generalized anxiety were assessed via self-report, parent-report and clinical diagnoses at age 15. RESULTS: Maternal shyness was positively associated with adolescent social anxiety but not generalized anxiety at age 15. Higher levels of maternal shyness at age 4 predicted greater social wariness at age 7, which in turn predicted greater social anxiety but not generalized anxiety at age 15. Social wariness at age 7 partially mediated the association between maternal shyness and adolescent social anxiety. CONCLUSIONS: This study identifies a unique developmental pathway from maternal shyness to adolescent social anxiety. Findings suggest that childhood social wariness connects maternal shyness to adolescent social anxiety.

BACKGROUND Children classified as behaviorally inhibited (BI) are at risk for social anxiety. Risk for anxiety is moderated by both parental behavior and social-emotional competence. Grounded in developmental-transactional theory, the Turtle Program involves both parent and child treatment components delivered within the peer context. Our pilot work demonstrated beneficial effects of the Turtle Program ('Turtle') over a waitlist control group. Herein, we report results of a rigorous randomized controlled trial (RCT) comparing Turtle to the best available treatment for young children high in BI, Cool Little Kids (CLK). METHODS One hundred and fifty-one parents and their 3.5- to 5-year-old children selected on the basis of BI were randomly assigned to Turtle or CLK, delivered in group format over 8 weeks. Effects on child anxiety, life interference, BI, and observed parenting were examined at post-treatment and 1-year follow-up. ClinicalTrials.gov registration: NCT02308826. RESULTS No significant main effect differences were found between Turtle and CLK on child anxiety; children in both programs evidenced significant improvements in BI, anxiety severity, family accommodation, and child impairment. However, Turtle yielded increased observed warm/engaged parenting and decreased observed negative control, compared with CLK. Parental social anxiety moderated effects; parents with higher anxiety demonstrated diminished improvements in child impairment, and parent accommodation in CLK, but not in Turtle. Children of parents with higher anxiety demonstrated more improvements in child BI in Turtle, but not in CLK. CONCLUSIONS Turtle and CLK are both effective early interventions for young children with BI. Turtle is more effective in improving parenting behaviors associated with the development and maintenance of child anxiety. Turtle also proved to be more effective than CLK for parents with social anxiety. Results suggest that Turtle should be recommended when parents have social anxiety; however, in the absence of parent anxiety, CLK may offer a more efficient treatment model.

Extensive research has demonstrated the transactional nature of parent-child psychopathology, with limited studies examining these effects during late adolescence and none, to our knowledge, longitudinally during the COVID-19 pandemic. The current study examined the cross-lagged effects of parent and adolescent internalizing symptoms during the COVID-19 pandemic and the moderating role of avoidant coping. A sample of 291 adolescents (Age mean = 18.27; 53% female; 61% White) and their parents rated their own anxiety and depressive symptoms and coping during the first two months following stay-at-home orders during the COVID-19 pandemic. Parent internalizing symptoms at the first assessment predicted adolescent internalizing symptoms at the second assessment. Adolescent avoidant coping style moderated this effect of parent internalizing symptoms on adolescent internalizing symptoms in the subsequent month, such that parent internalizing symptoms predicted child internalizing symptoms only among adolescents with moderate to high rates of avoidant coping. Follow-up analyses indicated different patterns when examining depressive and anxiety symptoms separately. The results highlight complex family dynamics between adolescents and their parents and begin to differentiate how individual characteristics impact the response to a significant life event such as the COVID-19 pandemic.

Background The COVID-19 pandemic has created increased stress and anxiety for many; however, some individuals are particularly prone to heightened anxiety. It is unclear if and how prestress neurocognitive factors moderate risk for anxiety during high-stress situations. Enhanced error monitoring and a cognitive control strategy of more instantaneous (reactive) control have both been independently related to anxiety. We examined if a specific neurocognitive profile characterized by heightened error monitoring and a more reactive cognitive control strategy in adolescence predicts young adults’ anxiety trajectories across 3 early months of the COVID-19 pandemic. Methods As part of a longitudinal study (N = 291), data were acquired in adolescence (13 years) on error monitoring (n = 124) and cognitive control strategy (n = 119). In young adulthood (18 years), anxiety was assessed three times during the COVID-19 pandemic (n = 162). Results On average, participants experienced greater anxiety in the first COVID-19 pandemic assessment, then anxiety decreased in the following months. Error monitoring and cognitive control strategy interacted to predict anxiety trajectories, such that among adolescents with an increased reliance on reactive control, error monitoring predicted greater anxiety in the first assessment but greater decreases the following months as stay-at-home orders were lifted and families adapted to the restrictions. Conclusions Results suggest that neurocognitive profiles in adolescence predict young adults’ anxiety responses during a highly stressful period, such as the initial months of the COVID-19 pandemic. Our findings have implications for the early identification of individuals at greater risk for anxiety.

High and stable behavioral inhibition during early childhood is a risk factor for later anxiety disorders. The few available interventions targeted at behavioral inhibition have not yet been implemented in European countries. Evaluating intervention acceptability is essential when introducing interventions in new cultures. This study aimed to explore the perceptions of parents about the acceptability of the multicomponent Turtle Program in Portugal. Participants were 12 parents (from seven families) of children with a positive screening on the Behavioral Inhibition Questionnaire and no diagnoses of developmental disorders/selective mutism. Children's mean age was 55.86 months and most children were female and first-born. Parents and children participated in the eight-sessions Turtle Program. After each session, parents completed weekly satisfaction checklists. Following completion of the full intervention, parents were invited to participate in individual qualitative in-depth interviews. The thematic analysis revealed that both parents perceived the intervention objectives and contents as relevant. Both parents suggested the introduction of follow-up sessions, the discussion of practical experiences, the need to be sensitive to cultural differences in positive language, and the provision of more feedback about children's activities. These findings support prior research on the acceptability and cultural tailoring needed for parenting and child socioemotional learning interventions.Una alta y estable conducta de inhibición durante la temprana niñez es un factor de riesgo para posteriores trastornos de ansiedad. Las pocas intervenciones disponibles que se enfocan en la inhibición de la conducta no se han implementado aún en países europeos. Evaluar el nivel de aceptación de la intervención es esencial cuando las intervenciones se introducen en nuevas culturas. Este estudio se propuso explorar las percepciones de los progenitores acerca del nivel de aceptación del multi-compuesto Programa Tortuga en Portugal. Los participantes fueron 12 progenitores (de siete familias) de niños con una positiva detección en el Cuestionario de Inhibición de la Conducta y sin diagnóstico de trastornos de desarrollo/mutismo selectivo. La edad promedio de los niños fue 55.86 meses y la mayoría eran niñas y primogénitas. Los progenitores y los niños participaron en las ocho sesiones del Programa Tortuga. Después de cada sesión, los progenitores completaron listas semanales de chequeo de la satisfacción. Luego de completar la intervención en su totalidad, se invitó a los progenitores a participar en entrevistas cualitativas individuales para profundizar. Los análisis temáticos revelaron que ambos progenitores percibieron como relevantes los objetivos y el contenido de la intervención. Ambos progenitores sugirieron introducir sesiones de seguimiento, la discusión de experiencias prácticas, la necesidad de mostrarse sensible a las diferencias culturales en lenguaje positivo y la provisión de más información sobre las actividades de los niños. Estos resultados apoyan la investigación anterior sobre el nivel de aceptación y la adaptación cultural necesarias en las intervenciones sobre la crianza y el aprendizaje socioemocional del niño.L'inhibition comportementale élevée et stable durant la petite enfance est un facteur de risque pour des troubles de l'anxiété plus tard. Quelques interventions disponibles ciblant l'inhibition comportementale n'ont pas encore été mises en œuvre dans les pays européens. Evaluer l'acceptabilité de l'intervention est essentiel lorsqu'on introduit des interventions dans de nouvelles cultures. Cette étude s'est donnée pour but d'explorer les perceptions des parents à propos de l'acceptabilité du Programme Tortue à composants multiples au Portugal. Les participants ont consisté en 12 parents (de sept familles) d'enfants ayant eu un dépistage positif au Questionnaire d'Inhibition Comportementale et aucun diagnostic de troubles développementaux / mutisme sélectif. L’âge moyen des enfants était de 55,86 mois et la plupart des enfants étaient des filles et des premières nées. Les parents et les enfants ont participé au Programme Tortue de huit séances. Après chaque séance les parents ont rempli des checklists de satisfaction hebdomadaires. Après avoir terminé l'intervention totale les parents ont été invité à participer à des entretiens individuels en profondeur et qualitatifs. L'analyse thématique a révélé que les deux parents percevaient les objectifs d'intervention et les contenus comme étant pertinents. Les deux parents ont suggéré l'introduction de séances de suivi, la discussion d'expériences pratiques, le besoin d’être sensible aux différences culturelles dans le langage positif et le besoin de plus de commentaires sur les activités des enfants. Ces résultats soutiennent les recherches précédentes sur l'acceptabilité et l'adaptation culturelle nécessaire pour le parentage et les interventions pour le développement socioémotionnel de l'enfant.Wahrnehmung portugiesischer Eltern hinsichtlich der Akzeptanz einer Mehrkomponentenintervention zur Verhaltensinhibition in der frühen Kindheit Eine hohe und stabile Verhaltensinhibition in der frühen Kindheit ist ein Risikofaktor für spätere Angststörungen. Die wenigen verfügbaren Interventionen zu Verhaltensinhibition wurden in europäischen Ländern noch nicht implementiert. Wenn Interventionen in neue Kulturkreise eingeführt werden sollen, ist es wichtig, deren Akzeptanz zu evaluieren. Ziel dieser Studie war es, die elterliche Wahrnehmung hinsichtlich der Akzeptanz des Mehrkomponenten-Schildkrötenprogramms in Portugal zu untersuchen. 12 Elternteile (aus sieben Familien) von Kindern mit einem positiven Screening auf den Fragebogen zur Verhaltensinhibition und ohne Diagnose von Entwicklungsstörungen / selektivem Mutismus nahmen an der Studie teil. Das Durchschnittsalter der Kinder betrug 55,86 Monate und die meisten Kinder waren weiblich und erstgeboren. Eltern und Kinder nahmen an acht Sitzungen des Schildkröten-Programms teil. Nach jeder Sitzung füllten die Eltern wöchentliche Zufriedenheitschecklisten aus. Nach Abschluss der vollständigen Intervention wurden die Eltern eingeladen, an individuellen qualitativen Tiefeninterviews teilzunehmen. Die thematische Analyse ergab, dass beide Elternteile die Interventionsziele und -inhalte als relevant empfanden. Beide Elternteile schlugen eine Einführung von Follow-up-Sitzungen, eine Diskussion praktischer Erfahrungen, die Notwendigkeit, auf kulturelle Unterschiede in der positiven Sprache zu achten, und mehr Feedback zu den Aktivitäten der Kinder zu geben, vor. Diese Ergebnisse stützen bisherige Forschungsarbeiten zur Akzeptanz und kulturellen Anpassung, die für sozioemotionale Lerninterventionen von Eltern und Kindern erforderlich sind.乳幼児期における行動抑制を対象とした複数構成要素からなる介入への受容性に ついてのポルトガル人両親の認識 乳幼児期の行動抑制が高い割合で変化することなく生じている時、それは後の不 安障害の危険因子となる。行動抑制を対象としたいくつかの利用可能な介入は、 ヨーロッパ諸国ではまだ実施されていない。新しい文化において介入を導入する 場合、その介入の受容性を評価することが不可欠である。本研究は、ポルトガル における複数構成要素からなるTurtle Programの受容性についての両親の認識を 調査することを目的とした。参加者は、行動抑制質問紙で陽性のスクリーニング を受け、発達障害/場面緘黙症の診断を受けていない子どもの (7家族からの) 12 人の親であった。子どもの平均年齢は55.86ヶ月で、ほとんどの子どもは女子で 長子であった。親子で8セッションのTurtle Programに参加した。各セッション 後、両親は満足度チェックリストに毎週答えた。全ての介入の完了後、両親は質 的で詳細なインタビューを受けることを勧められた。主題分析により、両親は介 入の目的と内容が適切であると認識していることが明らかとなった。両親は共に、 フォローアップセッションの紹介、実践的な体験の議論、肯定的な言葉を使って 文化の違いに繊細であることの必要性、そして子どもたちの活動についてのより 多くのフィードバックの提供、を提案した。これらの調査結果は、子育て及び子 どもの社会情緒的な学習介入に必要な受容性と文化的な調整に関する先行研究を 支持する。.幼儿期明显而持续的行为抑制是未来焦虑症的一个危险因素。欧洲国家尚未实施针对行为抑制的少数可用干预措施。在新文化中引入干预措施时, 评估干预措施的可接受性是至关重要的。本研究旨在探讨葡萄牙家长对多因素“海龟计划”可接受性的看法。参与者为12名 (来自7个家庭) 行为抑制问卷筛查阳性, 且未诊断为发育障碍或选择性缄默症的儿童家长。儿童的平均年龄为55.86个月, 且多为女性和头胎。父母和儿童参与了八期“海龟计划”。每期干预结束后, 父母都要填写每周的满意度检查清单。在完成全面干预后, 父母被邀请参加个性化的深入访谈。主题分析显示, 父母双方都认为干预目标和内容是相关的。父母双方都建议采取跟进干预活动, 讨论实践经验, 需要对正面语言中的文化差异保持敏感, 并提供更多关于儿童活动的反馈意见。这些发现支持了先前对育儿和儿童社会情感学习干预所需的可接受性和文化适应性的研究。.تصورات الآباء والأمهات البرتغاليين حول قبول تدخل متعدد المكونات يستهدف الكبت السلوكي خلال مرحلة الطفولة المبكرة الكبت السلوكي خلال مرحلة الطفولة المبكرة هو عامل خطر يؤدي لاضطرابات القلق في وقت لاحق. ولم تنفذ بعد في البلدان الأوروبية التدخلات القليلة المتاحة التي تستهدف الكبت السلوكي. إن تقييم مقبولية التدخل أمر ضروري عند إدخال التدخلات في الثقافات الجديدة. تهدف هذه الدراسة إلى استكشاف تصورات الآباء والأمهات حول قبول برنامج Turtle متعدد المكونات في البرتغال. وكان المشاركون 12 من الآباء والأمهات (من سبع عائلات) وأطفالهم الذين أظهروا نتيجة إيجابية على استبيان الكبت السلوكي ولم يتم تشخيصهم باضطرابات النمو. وكان متوسط عمر الأطفال 655.8 شهراً، ومعظم الأطفال كانوا من الإناث. شارك الآباء والأطفال في برنامج Turtle الذي امتد ثماني جلسات. وبعد كل جلسة، أكمل الآباء قوائم التحقق الأسبوع عن القبول والرضا. وبعد الانتهاء من التدخل الكامل، دُعي الآباء إلى المشاركة في مقابلات فردية متعمقة نوعية. وكشف التحليل المواضيعي أن كلا الوالدين كانا يعتبران أهداف التدخل ومحتوياته ذات صلة بهم. واقترح الوالدان إدخال جلسات متابعة، ومناقشة التجارب العملية، وضرورة مراعاة الاختلافات الثقافية من خلال استخدام لغة إيجابية، وتقديم مزيد من المعلومات عن أنشطة الأطفال. وتدعم هذه النتائج البحوث السابقة بشأن المقبولية والتكييف الثقافي اللازمين لتدخلات التنشئة الأبوية والتعلم الاجتماعي العاطفي للأطفال.

Individuals with a behaviorally inhibited (BI) temperament are more likely to develop social anxiety. However, the mechanisms by which socially anxious behavior emerges from BI are unclear. Variation in different forms of top-down control, specifically executive functions (EF), may play distinct roles and characterize differential pathways to social anxiety. Here 291 children were assessed for BI in toddlerhood (ages 2 and 3), parent-reported inhibitory control and set shifting during middle childhood (age 7), and multidimensional assessment of socially anxious behavior completed during late childhood and early adolescence (ages 9 and 12). Structural equation modeling revealed that early variation in BI predicted the development of socially anxious behavior through either higher levels of parent-reported inhibitory control or lower levels of parent-reported set shifting. These data reinforce the notion that top-down control does not uniformly influence relations between temperament and socially anxious behavior. These data suggest novel approaches to thinking about the role of EFs and social anxiety outcomes as children approach adolescence.