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© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.Background: With few RCTs having compared active treatments for paediatric PTSD, little is known about whether or which baseline (i.e. pre-randomization) variables predict or moderate outcomes in the evaluated treatments. Objective: To identify predictors and moderators of paediatric PTSD outcomes for Eye Movement Desensitization and Reprocessing Therapy (EMDR) and Cognitive Behavioural Writing Therapy (CBWT). Method: Data were obtained as part of a multi-centre, randomized controlled trial of up to six sessions (up to 45 minutes each) of either EMDR therapy, CBWT, or wait-list, involving 101 youth (aged 8–18 years) with a PTSD diagnosis (full/subthreshold) tied to a single event. The predictive and moderating effects of the child’s baseline sociodemographic and clinical characteristics, and parent’s psychopathology were evaluated using linear mixed models (LMM) from pre- to post-treatment and from pre- to 3- and 12-month follow-ups. Results: At post-treatment and 3-month follow-up, youth with an index trauma of sexual abuse, severe symptoms of PTSD, anxiety, depression, more comorbid disorders, negative posttraumatic beliefs, and with a parent with more severe psychopathology fared worse in both treatments. For children with more severe self-reported PTSD symptoms at baseline, the (exploratory) moderator analysis showed that the EMDR group improved more than the CBWT group, with the opposite being true for children and parents with a less severe clinical profile. Conclusions: The most consistent finding from the predictor analyses was that parental symptomatology predicted poorer outcomes, suggesting that parents should be assessed, supported and referred for their own treatment where indicated. The effect of the significant moderator variables was time-limited, and given the large response rate (>90%) and brevity (

Objective: This study investigates the psychometric properties of the Dutch version of the Ghent University Classroom Coding Inventory (GUCCI-NL) by comparing children with (subthreshold) ADHD to typically developing peers. The advantage of the GUCCI is that it measures the proportion of time ADHD behavior was displayed and length of such intervals in a continuous manner that allows for more detailed assessment of behavior, such as on-task span, compared to traditional time sampling methods.Method: We coded the scales Attention Problems, Motor and Verbal Hyperactivity, and Oppositional Behavior in a sample of 57 children with (subthreshold) ADHD and 34 controls (aged 6–12). Construct validity (i.e., group differences, convergent and divergent validity), predictive validity (including ROC curves), and inter-observer reliability were investigated. Outcome measures were percentage of time and interval span. Results: The GUCCI-NL discriminated between the ADHD and control group for all scales (small to very large effects), with largest effects on percentage of time. Convergent validity against questionnaire and interview scores was confirmed for Verbal Hyperactivity and Oppositional Behavior, although divergent validity was weak. The Attention Problems scale was most sensitive to group membership (AUC = .79). Inter-observer reliability was sufficient (r >.82). Group differences on span length were found for Attention Problems but not for Hyperactivity, confirming the additional value of continuous coding.Conclusion: The GUCCI-NL is a valid objective measure for ADHD symptoms in the classroom, which may be of added value in scientific practice, although for diagnostic purposes additional instruments should be used.

The current COVID-19 virus crisis is creating unprecedented challenges at every level of society. Individuals with neurodevelopmental disorders such as Attention-Deficit/Hyperactivity Disorder (ADHD) are particularly vulnerable and may display increased behavioural problems. The current crisis also poses several important questions for their clinicians on how best to deliver care within the new restrictions. This document provides a summary of the guidance on the assessment and management of ADHD during the COVID-19 virus pandemic, developed by the European ADHD Guidelines Group (EAGG). The full guidance is reported in the Appendix.

Adolescents with an Autism Spectrum Disorder diagnosis (ASD) show executive functioning (EF) difficulties that are crucial to succeed in secondary school, but evidence-based EF interventions are lacking. However, for adolescents with an ADHD diagnosis such an intervention was developed, called Plan My Life (PML), which focused on enhancement of planning skills and in which motivational interviewing was integrated. We explored the applicability of PML in a sample of 12 adolescents with ASD (12-17 years). Pre- to post intervention parent-reported data were collected on EF problems, planning problems, and ASD characteristics. Also, qualitative analyses were conducted on therapist evaluations to investigate whether PML in its present form is suitable for adolescents with ASD and how the PML should be adjusted to better serve their needs. Reliable Change Indices showed that in general adolescents with ASD did not improve, suggesting that in its current form PML is not suitable for adolescents with ASD. However, attrition was low (N = 1), adolescents and parents evaluated PML positively, and a feasible list of therapist recommendations was formulated for adjustment of PML to the needs of this particular group. These recommendations seem specific to autistic teens and may be applicable to other non-pharmacological interventions that will be developed for teens with ASD to improve their care and outcomes.

ACHTERGROND Jongeren en volwassenen met adhd en autismespectrumstoornis (ass) worden regelmatig geconfronteerd met stigmatisering. Dit werd reeds uitvoerig aangetoond wat betreft publiek stigma, maar veel minder voor negatieve berichtgeving in de media, een vorm van structureel stigma. DOEL Exploreren van (verschillen in) structureel stigma in de berichtgeving over adhd en ass in Vlaamse dagbladen. METHODE Op basis van de onlinedatabestanden van 7 Vlaamse dagbladen werden artikelen, gepubliceerd tussen 2010 en 2014, over adhd (n = 772) en ass (n = 1940) geselecteerd. Deze artikelen werden gecategoriseerd wat betreft domein van berichtgeving (bijv. symptomen, epidemiologie of medicamenteuze behandeling) en strekking (nl. positief, neutraal en negatief). RESULTATEN Er kon significant meer negatieve dan neutrale/positieve berichtgeving vastgesteld worden over adhd dan over ass (or 2,1). Deze bevinding was het meest uitgesproken in de domeinen symptomen (or 8,42), diagnostiek (or 2,28) en medicamenteuze behandeling (or 9,40). Bovendien werd – uitsluitend voor adhd – vastgesteld dat de titel negatiever was dan het eigenlijke artikel (χ2(2) = 22,454; p < 0,001). CONCLUSIE Deze bevindingen tonen de noodzaak aan om negatieve en al zeker foutieve berichtgeving over symptomen, diagnostiek en medicamenteuze behandeling van adhd en – in mindere mate – ass bij te sturen en te corrigeren met het oog op zowel de media als hun lezers.

BACKGROUND: Children and adults with adhd and autism spectrum disorder (asd) often find themselves being stigmatised. There is ample evidence of public stigma, but much less is known about negative coverage in the media, a phenomenon that can be regarded as a form of structural stigma. AIM: To explore the different types of structural stigma that characterise the coverage of adhd and asd in Flemish newspapers. METHOD: We used the online databases of seven Flemish newspapers in order to select articles on adhd (n=772) and asd (n=1940) published between 2010 and 2014. We divided these articles into separate categories relating to the domain of coverage (e.g. symptomatology, epidemiology, medical treatment) and valence (i.e. positive, neutral and negative). RESULTS: We found significantly more negative than neutral/positive coverage of adhd than of asd (or 2.1). This finding was most striking in the domains of symptomatology (or 8.42), diagnostics (or 2.28) and medical treatment (or 9.40). Furthermore, with respect to articles specifically on adhd, the title of the article was significantly more negative than the actual message in the main article itself (χ2(2)=22.454, p < 0.001). CONCLUSION: These findings show that Flemish newspapers need to adjust and correct their negative and inaccurate portrayal of symptomatology, diagnostics and treatment of adhd and, to a lesser extent, of asd. Readers of these newspapers also need to be given a less negative impression of adhd and asd. ispartof: Tijdschrift voor Psychiatrie vol:59 issue:5 pages:269-277 ispartof: location:Netherlands status: published

There are few studies assessing moderation and mediation of behavioral treatment and cognitive training outcome in children with ADHD. Only two studies have assessed moderation of treatment outcome. For behavioral treatment outcome, comorbid anxiety, parental self-efficacy, paternal ADHD, and no or single comorbidity are significant moderators. Parents with high self-efficacy, fathers with high levels of ADHD symptoms, and children with comorbid anxiety and only one or no comorbid condition are most likely to benefit from behavioral interventions. The few mediation studies showed ineffective and negative parenting as a significant mediator of behavioral treatment outcome: the more reduction of negative and ineffective parenting, the more effective the treatment is. For cognitive training there is no empirical research on moderation and mediation of treatment outcome within ADHD samples. Given the documented heterogeneity within ADHD and ADHD treatments, more research is needed into moderation and mediation of treatment outcome.

Het werkboek Zelf oplossingen bedenken is speciaal ontwikkeld voor jongeren die ergens tegenaan lopen en niet weten hoe ze dat handig op kunnen lossen. In dit werkboek wordt een duidelijk systeem gebruikt om te leren hier zelf oplossingen voor te bedenken.

Zelf Oplossingen Bedenken is een wetenschappelijk onderzochte oplossingsgerichte training in combinatie met motiverende gespreksvoering om (minder gemotiveerde) jongeren oplossingsvaardigheden aan te leren, waarmee ze meer grip op hun leven kunnen krijgen.

Psychological models of mental disorders guide research into psychological and environmental factors that elicit and maintain mental disorders as well as interventions to reduce them. This paper addresses four areas. (1) Psychological models of mental disorders have become increasingly transdiagnostic, focusing on core cognitive endophenotypes of psychopathology from an integrative cognitive psychology perspective rather than offering explanations for unitary mental disorders. It is argued that psychological interventions for mental disorders will increasingly target specific cognitive dysfunctions rather than symptom‐based mental disorders as a result. (2) Psychotherapy research still lacks a comprehensive conceptual framework that brings together the wide variety of findings, models and perspectives. Analysing the state‐of‐the‐art in psychotherapy treatment research, “component analyses” aiming at an optimal identification of core ingredients and the mechanisms of change is highlighted as the core need towards improved efficacy and effectiveness of psychotherapy, and improved translation to routine care. (3) In order to provide more effective psychological interventions to children and adolescents, there is a need to develop new and/or improved psychotherapeutic interventions on the basis of developmental psychopathology research taking into account knowledge of mediators and moderators. Developmental neuroscience research might be instrumental to uncover associated aberrant brain processes in children and adolescents with mental health problems and to better examine mechanisms of their correction by means of psychotherapy and psychological interventions. (4) Psychotherapy research needs to broaden in terms of adoption of large‐scale public health strategies and treatments that can be applied to more patients in a simpler and cost‐effective way. Increased research on efficacy and moderators of Internet‐based treatments and e‐mental health tools (e.g. to support “real time” clinical decision‐making to prevent treatment failure or relapse) might be one promising way forward. Copyright © 2013 John Wiley & Sons, Ltd.

Objective: Children with attention deficit hyperactivity disorder (ADHD) who participated in a randomized clinical trial, which compared a brief intensive multimodal behaviour therapy combined with optimally titrated methylphenidate to optimally titrated methylphenidate alone (n?=?45), were re-assessed at adolescence in a naturalistic follow-up 4.5 to 7.5?years after treatment. Also a matched normal control group was recruited (n?=?23). Methods: Assessments at follow-up included diagnostic status, ADHD symptoms, oppositional and conduct behaviour, substance abuse symptoms and parenting stress. Results: Of the 24 adolescents participating in the follow-up study, 50% still met diagnostic criteria for ADHD. There were no significant differences between adolescents at follow-up and those lost for follow-up. At follow-up, adolescents in the combined treatment condition used significantly less medication than children in the methylphenidate condition; there were no other significant differences between the treatment conditions. The adolescents showed a significant decline in hyperactivity/impulsivity, oppositional and conduct disorder symptoms from post-test to follow-up. Only inattention symptoms increased from post-test to follow-up but not to pre-test levels. The adolescents originally diagnosed with ADHD fared significantly worse than the matched controls on all outcomes, except on conduct disorder and substance abuse symptoms. Conclusions: Our study shows in adolescents, diagnosed with ADHD in childhood, age-dependent decline of ADHD symptoms, although they still fared significantly worse than matched normal controls. Implications of results are restricted by small samples size, and the results may be subject to chance findings and need replication before firm conclusions can be drawn. Copyright (c) 2011 John Wiley & Sons, Ltd

Eveneens een op de ouders gerichte behandeling is de Nanny-thuisbehandeling, wel bekend van de TV, maar nu aangepast voor toepassing binnen de GGZ. Zij beschrijven deze effectieve behandelmethode in hun artikel ‘Kort maar krachtig’ op een heldere wijze. Het lijkt een veelbelovende methode, die hopelijk breed navolging zal gaan vinden. Het zou interessant zijn om de verschillen en overeenkomsten met de welbekende Videohome trainingen te onderzoeken.

Sacha Lucassen en Saskia van Oort hebben ‘Writejunior’ ontwikkeld: een gedragstherapeutische schrijftherapie, waarbij jongeren die een traumatische ervaring hebben meegemaakt en als gevolg daarvan PTSS ontwikkelen, samen met de therapeut het verhaal van het trauma in zeven stappen schrijven. De behandeling bevat allerlei componenten, zoals exposure, cognitieve herstructurering en social sharing. Tijdens de behandeling wordt intensief gebruik gemaakt van de computer.

Terwijl bij volwassenen met een posttraumatische stress-stoornis (PTSS) de effectiviteit van cognitief gedragstherapeutische schrijftherapie veelvuldig is aangetoond, is die behandeling bij kinderen met PTSS nog helemaal niet onderzocht. In het huidige onderzoek werden 23 kinderen (8-18 jaar) met PTSS, als gevolg van verschillende traumatische gebeurtenissen (o.a. verlies van belangrijke anderen, seksueel misbruik, ongeluk), behandeld door middel van cognitief gedragstherapeutische schrijftherapie. Deze therapie maakt gebruik van verschillende elementen, namelijk exposure, cognitieve herstructurering en social sharing. Voor en na behandeling werden PTSS-klachten, depressie, traumagerelateerde cognities, internaliserende en externaliserende problemen en algemeen probleemgedrag gemeten. De kinderen verbeterden significant op alle uitkomstmaten en kinderen én ouders waren tevreden over de behandeling. De gemiddelde behandelduur was 5,5 sessies. Uit dit eerste onderzoek blijken aanwijzingen voor de effectiviteit van deze kortdurende cognitief gedragstherapeutische schrijftherapie. De volgende stap is evaluatie van deze behandeling in een gerandomiseerde klinische trial.

‘Diagnosis and Treatment Combinations and Stepped Care in Mental Health Care for Children and Teenagers’ The role is examined of diagnosis and treatment combinations and stepped care in mental health care for children and teenagers. They are defined and the problems they entail are examined. There are systematic difficulties since diagnosis and treatment combinations are not well suited to the nature and severity of the problems that arise in outpatient mental health care for children and teenagers. There is no scientific evidence to back the basic principles such as the stepped care model for diagnosis and treatment combinations in mental health care for children and teenagers. Due to increasing numbers of clients, how the market operates and the resulting rise in pressures at work, it is becoming increasingly difficult for care personnel to adhere to the ethical codes of their own professional group.