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The aim of the present study was to examine the additive effect of elements of cognitive behavioral therapy (CBT) on the video game Mindlight in decreasing anxiety of children with an autism spectrum disorder (ASD). A non-concurrent multiple baseline design with 8 children with ASD in the age of 8-12 was used. CBT did not have the hypothesized additive effect on Mindlight in decreasing anxiety of children with ASD. Instead, multiple participants already experienced a decrease in anxiety during the Mindlight sessions. Yet, several participants did experience a stabilization in anxiety at a low level during the CBT sessions. For now, it can be concluded that CBT does not have an additive effect on Mindlight.

Adolescent depression is a major concern for public health and is associated with negative consequences and outcomes. Identifying adolescent characteristics that might relate to the risk for developing depression is crucial. This study investigated bidirectional associations between coping strategies and depressive symptoms over time. The participants were 1,341 secondary school students from the Netherlands (X-bar = 13.91, SD = 0.55, 47.5% girls) who completed self-report questionnaires at six waves over 2.5 years. Cross-lagged models were used to investigate the associations between coping strategies and depressive symptoms. Coping strategies did not predict depressive symptoms over time. However, there was an indication of the reverse relationship. When adolescents experienced elevated depressive symptoms, they used fewer adaptive techniques to target stress. Gender differences were found in the use of avoidance. The inconsistencies of these findings with earlier studies are discussed and provide new directions for future research on working mechanisms underlying depression prevention programs.

We examined cognitive deficits in problematic drinkers with and without mild to borderline intellectual disability (MBID). Problematic drinkers were expected to show a significantly lower estimated performance IQ (PIQ), but not a lower estimated verbal IQ (VIQ), compared to light drinkers. Participants (N = 474) were divided into four groups based on IQ and severity of alcohol use-related problems. IQ was estimated using (a short form of) the Wechsler Adult Intelligence Scale third edition. Severity of alcohol use-related problems was assessed using the Alcohol Use Disorder Identification Test. Overall, there were no significant differences between light and problematic drinkers on estimated VIQ. Within the group without MBID, estimated PIQ was significantly lower. Estimated PIQ was not lower in problematic drinkers with MBID compared to light drinkers with MBID. The results are indicative of cognitive deficits in problematic drinkers without MBID. Screening for cognitive deficits with additional instruments is advised.

Background: The goal of this study was to examine the relationship between drinking motives and interpretation bias (interpreting ambiguous stimuli in an alcohol-related way) in problematic drinkers with and without mild to borderline intellectual disability (MBID). Method: Participants (N = 178) were divided into 4 groups based on severity of alcohol use-related problems and full-scale IQ. They completed a word-association task and the Drinking Motives Questionnaire Revised (DMQ-R). Results: Problematic drinkers showed an interpretation bias towards alcohol. Participants with MBID had a relatively strong interpretation bias. The DMQ-R coping motive predicted the strength of the bias in negative scenarios, whereas the DMQ-R coping and social motives predicted the strength of the bias in positive scenarios. Conclusions: The activation of this bias might depend on individual differences in drinking motives, which provides implications for the assessment and treatment of problematic alcohol use in individuals with and without MBID.

Background: Problematic alcohol use is associated with neuropsychological consequences, including cognitive biases. The goal of the study was to explore the moderating role of executive control and readiness to change on the relationship between alcohol use and cognitive biases in light and problematic drinkers with and without mild to borderline intellectual disability (MBID). Method: Participants (N = 112) performed the visual dot probe task to measure the strength of the cognitive biases. Executive control was measured using two computerised tasks for working memory capacity (Corsi block-tapping task) and inhibitory control (Go/No-go task). Readiness to change was measured using the Readiness to Change Questionnaire. Results: No cognitive biases or executive dysfunctions were found in problematic drinkers. Working memory capacity and inhibitory control were impaired among individuals with MBID, irrespective of severity of alcohol use-related problems. Executive control and readiness to change did not moderate the relationship between alcohol use and cognitive biases. Conclusion: The results fail to support the dual-process models of addiction, but results need to be treated with caution given the problematic psychometric qualities of the visual dot probe task. Implementing a neurocognitive assessment and protocols in the treatment of substance use disorders seems premature.

The present study evaluated long-term effects of a home-based smoking prevention program targeting smoking-specific parenting in families with children with and without asthma. A total of 1398 non-smoking children ("mean age" 10.1) participated, of which 197 (14.1%) were diagnosed with asthma. Families were blinded to group assignment. The intervention group (n = 684) received booklets with assignments that actively encouraged parents to engage in smoking-specific parenting strategies. Control families (n = 714) received booklets containing basic information about youth smoking. Latent growth curve modeling was used to calculate intercepts and slopes to examine whether there was change in the different parenting aspects over the study period. Regression analyses were used to examine whether a possible change was different for intervention and control condition families with and without a child with asthma. For those smoking-specific parenting aspects that changed over time, families in the intervention and control condition increased similarly. Families with a child with asthma did not engage in parenting at higher levels due to the intervention program than parents of non-asthmatic children. This prevention program did not affect smoking-specific parenting in the Netherlands. Future prevention research could focus on other risk factors for smoking initiation among adolescents with asthma.

Background: Problematic alcohol use is characterized by disrupted associative processing of environmental clues, where problematic drinkers interpret ambiguous, alcohol-relevant clues in an alcohol-related way. The present study examined the strength of this interpretation bias in a large sample (N = 230) of light and problematic drinkers with and without mild to borderline intellectual disability (MBID, IQ 50-85). Method: All participants were asked to finish 24 open-ended, ambiguous scenarios with their first, spontaneous response. Results: Consistent with the hypothesis, problematic drinkers with and without MBID were found to have an interpretation bias toward alcohol. The difference in the strength of the bias between light and problematic drinkers was strongest for negative scenarios. Participants with MBID showed a stronger interpretation bias compared to participants without MBID, especially on the negative scenarios. Conclusion: Problematic drinkers tend to interpret ambiguous, alcohol-relevant clues in an alcohol-related way and this tendency increases with higher levels of alcohol use-related problems. These results extend our knowledge on substance use disorder and provide new lines of inquiry for the assessment and treatment of problematic alcohol use in individuals with MBID.

The main aim of the present study was to examine state levels of loneliness in adolescence. Both concurrent associations and temporal dynamics between social contexts and state levels of loneliness were examined. Data were collected from 286 adolescents (M[subscript age] = 14.19 years, 59% girls) by using the Experience Sampling Method. Results showed that adolescents had higher levels of state loneliness when they were alone, compared with being with company. When adolescents were with others, they were most lonely at school and with classmates. Adolescents showed a relief effect when they entered the company of friends after being alone, whereas a spillover effect of solitude was found when adolescents entered the company of family after being alone. Our findings show the dynamics of state loneliness, in that being with classmates increases state loneliness, whereas being with friends reduces loneliness after being alone.

Background: Childhood internalizing and externalizing problems are closely related and often co-occur. Directional models have been employed to test how these problems are related, while few studies have tested a third variables model. Objective: This study investigates whether internalizing and externalizing problems are reciprocally or unidirectionally related, whether these relations can be explained by third variables, and how these relations are associated with onset and stability. Methods: A community sample of 1,434 children aged 5.08 (SD = 1.25) and their mothers participated in two 1-year interval data waves. Internalizing and externalizing problems were examined with the Strengths and Difficulties Questionnaire. Results: Using latent cross-lagged modeling, externalizing problems were found not be related to subsequent internalizing problems, or vice versa. These results were also found when controlling for inadequate parenting, parenting stress, maternal health and social preference. When taking problem level into account, externalizing problems were related to stability of clinical level internalizing problems, even when controlling for third variables inadequate parenting, parenting stress, maternal mental health and social preference. Conclusions: Strong autoregressive paths for internalizing and externalizing problems were found. Internalizing and externalizing problems do not seem to influence each other over time in the community sample. When investigating relations among internalizing and externalizing problems, it seems to be important to take problem level into account.

Background: The purpose of this study was to examine the association between adolescents' body mass index (BMI) z-scores and their subsequent level of schooling, extending previous longitudinal research by using objectively measured weight and height data. Methods: A longitudinal study with 3 study waves (1-year intervals) involving 1248 Dutch adolescents (49% girls; mean age = 13.7 years) at schools providing different educational levels was used to determine adolescents who moved and did not move to a lower educational level in the first year, or in the second year, and to examine whether this movement could be predicted by BMI z-scores (zBMI), after controlling for a large range of potential confounding factors. Results: A total of 1164 Dutch adolescents continued in the same level of education, whereas 84 adolescents moved to a lower educational level (43 moved in the first and 41 in the second year). A higher zBMI significantly increased the risk of a general transition to a lower educational level, and of a transition in the first year, but not in the second year, after controlling for potential demographic, behavioral, and psychological confounds. Conclusions: Findings suggest that a higher zBMI during adolescence immediately lowers educational achievement level during general secondary education.

Background: While child self-reports of psychopathology are increasingly accepted, little standardized instruments are utilized for these practices. The Berkeley Puppet Interview (BPI) is an age-appropriate instrument for self-reports of problem behavior by young children. Objective: Psychometric properties of the Dutch version of the BPI will be reported, specifically, test-retest reliability, intra-class correlations, congruent and concurrent validity. Methods: In a sample of 300 children (M[subscript age] = 7.04 years, SD = 1.15), the BPI was administered twice, with a 1-year interval. Parents and teachers filled out questionnaires about their children's problem behavior. Results: Findings from the analyses indicate that the BPI subscales have sufficient test-retest reliability and can be reliably coded. Furthermore, findings suggest adequate congruent validity. More support for concurrent validity is found among externalizing problems in comparison to internalizing problems. Conclusions: With regard to the present study, the BPI seems to have adequate psychometric properties. As such, the BPI enables interviewing young children about their psychopathology-related symptoms in a standardized way. The BPI could be applied in clinical practice as a complement to the diagnostic cycle, allowing children's self-reports to play an increasingly important role.

During adolescence, teenagers try a range of risk behaviors including smoking, drinking, and the use of soft drugs. Because substance use contributes to an unhealthy lifestyle of teenagers on the short term and can lead to serious health problems on the longer term, prevention in this target group is important. This chapter provides an overview of the determinants of substance use on the one hand, and primary and secondary prevention opportunities on the other hand, especially in the school context. At the end, future directions and recommendations for school, youth, and family are discussed.

Cross-sectional studies have shown a positive association between expressive suppression and depressive symptoms. These results have been interpreted as reflecting the impact of emotion regulation efforts on depression. However, it is also possible that depression may alter emotion regulation tendencies. The goal of the present study was to prospectively examine the bidirectional association between habitual use of suppression and depressive symptoms in young adolescents. Participants were 1,753 adolescents (mean age = 13.8 years) who reported their use of suppression and depressive symptoms at two time points with a 1-year interval. Suppression and depressive symptoms were correlated within each time point. Depressive symptoms preceded increased use of suppression 1 year later, but suppression did not precede future depressive symptoms. Overall, the findings suggest depressive symptoms may be a potential precursor of habitual use of suppression during adolescence. (Contains 1 table and 1 figure.)

Background: Children and youths' self-report of mental health problems is considered essential but complicated. Objective: This study examines the psychometric properties of the Dominic Interactive, a computerized DSM-IV based self-report questionnaire and explores informant correspondence. Methods: The Dominic Interactive was administered to 214 Dutch children, 6-11 year old, 122 attended special education schools and 92 children attended public schools. Within 2 weeks 155 children were reassessed. Parents of 211 children completed a paper version of the Dominic Interactive. Results: The findings showed moderate to good internal consistency and test-retest reliability, although stability increased with age. Factor structure concerning generalized anxiety disorder and major depressive disorder displayed ambiguous results. Comparing special education with public school children revealed that both parents and children in special education reported significantly more problems on almost all scales. The results on informant correspondence revealed that discrepancies in reports were not consistent across individual pairs; they were due to a few extreme cases. Eliminating these cases increased the agreement in reports. Conclusions: Although more research is needed to determine the value of the Dominic Interactive, the Dominic Interactive has the potential to contribute with its unique features to the existing self-report instruments for screening and assessing child mental health.

Cognitive Behavioral Therapy (CBT) was dismantled into four modules of three sessions each: cognitive restructuring (Think), behavioral activation (Act), problem solving (Solve) and relaxation (Relax). We investigated the modules' relative effectiveness in indicated depression prevention for adolescents and examined variations in sequencing of these modules. We performed a pragmatic cluster-randomized microtrial with four parallel conditions: (1) Think-Act-Relax-Solve (n = 14 clusters, n = 81 participants); (2) Act-Think-Relax-Solve (n = 13, n = 69); (3) Solve-Act-Think-Relax (n = 13, n = 77); and (4) Relax-Solve-Act-Think (n = 12, n = 55). The sample consisted of 282 Dutch adolescents with elevated depressive symptoms (Mage = 13.8; 55.7% girls, 92.9% Dutch). In total 52 treatment groups were randomized as a cluster. Assessments were conducted at baseline, after each module and at 6-month follow-up with depressive symptoms as primary outcome. None of the modules (Think, Act, Solve, Relax) was associated with a significant decrease in depressive symptoms after three sessions and no significant differences in effectiveness were found between the modules. All sequences of modules were associated with a significant decrease in depressive symptoms at post-intervention, except the sequence Relax-Solve-Act-Think. At 6-month follow-up, all sequences showed a significant decrease in depressive symptoms. No significant differences in effectiveness were found between the sequences at post-intervention and 6-month follow-up. Regardless of the CBT technique provided, one module of three sessions may not be sufficient to reduce depressive symptoms. The sequence in which the CBT components cognitive restructuring, behavioral activation, problem solving and relaxation are offered, does not appear to significantly influence outcomes at post- intervention or 6-month follow-up. CDI-2:F: Children's Depression Inventory-2 Full-length version; CDI-2:S: Children's Depression Inventory-2 Short version; STARr: Solve, Think, Act, Relax and repeat. [ABSTRACT FROM AUTHOR]

Background: By interacting with children, group care workers shape daily living environments to influence treatment. Current literature provides little knowledge about the content of youth residential care. Objective: In this study, a questionnaire called the Group care worker Intervention Checklist was developed. Method: Group care workers completed the questionnaires for 212 children placed in youth residential care in the Netherlands. Results: Factor analyses revealed three constructs: controlling, warmth/support, and autonomy granting. Reliability of these scales proved to be good. Controlling was associated with Externalizing Behavior Problems while both Warmth/Support and Autonomy Granting were associated with Internalizing Behavior Problems. Conclusions: These findings imply that group care worker interventions can be reliably measured and are related to child problem behavior.

More than 50% of Dutch 12-year olds already started drinking. Since it is known that delaying the onset of alcohol use results in a lower risk of alcohol-related problems, the recently developed "In control: No alcohol!" prevention program is targeted at elementary school children and their mothers. In this pilot study, the success of program implementation and impact of the program on quality of alcohol-specific communication, rules and monitoring were evaluated, using a randomized controlled design. A total of 108 children (11-12 years) and their mothers participated in the prevention program, while the control group consisted of 105 dyads. Families participating in the experimental condition showed an increase in frequency of alcohol-specific communication and 75% of the dyads reported that they took part in at least 3 of 5 magazines, suggesting implementation was successful. The program led to an increase in quality of communication but only for those dyads in which mothers' alcohol use was above average. The program led parents to set up a non-drinking contract with their children and to monitor their children more closely. Results are promising but need to be replicated in a larger longitudinal study.

In scientific literature, early pubertal timing emerges as a risk factor of adolescents' drinking, whereas alcohol-specific rules (the degree to which parents permit their children to consume alcohol in various situations) showed to protect against adolescents' drinking. This study investigated whether alcohol-specific rules mediate and/or moderate the effect that early pubertal and psychosocial timing (personal, relational, socio-institutional) has on adolescents' alcohol use. Mediation and moderation models were tested conducting ordinal logistic structural equation modeling in a cross-sectional sample of 1,893 Dutch adolescents (49% males), aged 13-15 years. Findings showed that early pubertal, relational and socio-institutional timers were at greater risk to initiate alcohol use and for heavy episodic drinking. Alcohol-specific rules more often mediated, rather than moderated, the effect of early timing on alcohol use. Alcohol-specific rules are mostly relaxed when adolescents mature, rather than reinforced, indicating that parents partly facilitate adolescents' drinking.

Parental support and parental depressive feelings are found to be associated with depressive feelings in adolescent boys and girls, but results are inconsistent. In addition, the "5-HTTLPR" genotype has been found to interact with environmental stressors in predicting adolescents' depressive feelings, but this has not been examined longitudinally. Therefore, the present study examined the relationships between parental support, parental depressive feelings, and adolescent depressive feelings. In addition, the relationships between the "5-HTTLPR" genotype and adolescent depressive feelings were explored, as well as gene-environment interactions. Adolescents (N = 306; Girls = 53.3%; M[subscript age T1] = 13.4) filled out questionnaires at five annual waves and provided saliva samples for DNA. Latent growth curve modelling (LGCM) was used to examine the baseline level and the change in depressive feelings over time. Maternal support was related to baseline levels of depressive feelings in girls, whereas paternal support was related to baseline levels in boys. Paternal depressive feelings were only related to boys' depressive feelings at baseline, and maternal depressive feelings were not related to any outcome measures. Furthermore, no associations were found between "5-HTTLPR" genotype and adolescent depressive feelings, and no gene-environment interactions emerged. Limitations of the study and implications of the findings are discussed. (Contains 3 tables.)

Sibling relationships and parental support are important for adolescents' development and well-being, yet both are likely to change during adolescence. Since adolescents participate in both the sibling relationship and the parent-child relationship, we can expect sibling relationships and parental support to be associated with each other. Theoretically, it can be expected that there is either a spillover from one relationship to another (congruence hypothesis) or that one relationship can compensate for the other (compensation hypothesis). However, research examining these associations in adolescence is limited. The present study longitudinally investigated the bidirectional associations between sibling relationships and parental support during adolescence. For five consecutive years, data were collected using self-reports of 428 families, consisting of a father, a mother, and two adolescent siblings. The mean ages of the first-born (52.8% males) and second-born (47.7% males) were 15 and 13 years at T1, respectively. For the second-born siblings, prospective associations were found between sibling relationships and adolescent-reported parental support in early adolescence, with no differences between same-sex and mixed-sex dyads. These associations were not found for first-born siblings or for parents' reports of support. The findings suggest a spillover from the sibling relationship to adolescent-reported parental support only in early adolescence. Findings and implications are discussed in terms of the congruence/spillover and the compensation hypothesis. (Contains 1 figure and 4 tables.)

The present study examined whether a sample of 214 (52.8% male, M age = 15.76, SD = 1.29) institutionalized adolescents could be classified into subgroups based on psychopathic traits. Confirmatory Factor Analyses revealed a relationship between the subscales of the Youth Psychopathic traits Inventory (YPI) and the three latent constructs of the original model on which it is based. Latent Class Analyses showed that adolescents showing psychopathic traits could be classified into three subgroups. The first group showed low scores on the grandiose/manipulative dimension, the callous/unemotional dimension, and the impulsive/irresponsible dimension (normal group). The second group scored moderate on the grandiose/manipulative dimension and the callous/unemotional dimension and high on the impulsive/irresponsible dimension (impulsive, non-psychopathic-like group). The third group scored high on all three dimensions (psychopathy-like group). The findings revealed that the impulsive, non-psychopathic like group scored significantly higher on internalizing problem behavior compared to the normal group, while the psychopathy-like and the impulsive, non-psychopathic-like group both scored higher on externalizing problem behavior compared to the normal group. Based on a self-report delinquency measure, it appeared that the psychopathy-like group had the highest delinquency rates, except for vandalism. Both the impulsive and psychopathy-like group had the highest scores on the use of soft drugs. (Contains 3 tables, 2 figures, and 1 footnote.)

In this three-wave longitudinal survey, we investigated bi-directional longitudinal associations between best friends and adolescents' alcohol consumption. Additionally, since the relation between best friends and adolescents' drinking may be stronger if adolescents have not consumed alcohol yet, we examined this relation not only with regard to continuation but also with regard to the initiation of adolescent drinking. We also hypothesized that low levels of self-esteem and self-control in youths would be related to a higher susceptibility to the impact of their best friends' drinking. Data were used from 433 adolescents and their best friends. Results of SEM analyses did not provide evidence for bi-directional associations between best friends and adolescents' alcohol use over time. Nevertheless, the results of additional growth curve analyses indicated that adolescents and best friends' drinking does seem to develop in a similar fashion over time. Adolescents' self-esteem, self-control, and gender did not moderate longitudinal associations between best friends and adolescents' drinking. The discussion focuses on methodological and theoretical explanations for the absence of significant longitudinal relations between best friends and adolescents' drinking. (Contains 2 tables and 2 figures.)