Journal of Abnormal Child Psychology最新文献

A prior cluster randomized controlled trial (RCT) compared outcomes for a comprehensive school intervention (schoolMAX) to typical educational programming (services-as-usual [SAU]) for 103 children with autism spectrum disorder (ASD) without intellectual disability. The schoolMAX intervention was superior to SAU in improving social-cognitive understanding (emotion-recognition), social/social-communication skills, and ASD-related impairment (symptoms). In the current study, a range of demographic, clinical, and school variables were tested as potential moderators of treatment outcomes from the prior RCT. Moderation effects were not evident in demographics, child IQ, language, or ASD diagnostic symptoms, or school SES. Baseline externalizing symptoms moderated the outcome of social-cognitive understanding and adaptive skills moderated the outcome of ASD-related symptoms (no other comorbid symptoms or adaptive skills ratings moderated outcomes on the three measures). Overall, findings suggest that the main effects of treatment were, with two exceptions, unaffected by third variables.

Psychiatric diagnoses are important resources in helping young people and families make sense of emotional or behavioural difficulties. However, the poor reliability of diagnoses in childhood means many young service-users experience their diagnosis being removed, revised or supplemented over time. No previous research has investigated how young service-users experience, understand or respond to alteration of their original diagnosis. The current study adopted a qualitative approach to explore the lived experience of diagnostic shifts in youth mental health contexts. Narrative interviews were conducted with families living in Ireland, who had direct experience of diagnostic shifts. Participants included 21 parents (19 female) and 14 young people (8 female, mean age = 14). Thematic analysis explored the range of interpretations and implications of diagnostic shifts in families' lives, identifying three themes that underpinned participants' narratives. Diverse Trajectories & Experiences outlined the variety of contexts for diagnostic shifts, ways they were communicated to parents and young people, and their clinical consequences. A Process of Readjustment captured processes of emotional and conceptual adaptation that followed a diagnostic shift. Finally, Social Repositioning explored how diagnostic shifts could prompt changes to interpersonal relations, social identity and stigma experiences. The study shows that diagnostic shifts carry significant emotional, social and practical repercussions. While diagnostic shifts may threaten the therapeutic relationship and service-user understanding, they also offer opportunities to enhance young people's self-concept, social relationships and therapeutic engagement. Clinician awareness of the socio-emotional implications of diagnostic shifts is vital to inform sensitive communication and support strategies.

Children involved with Child Protective Services (CPS) often show worse emotion regulation than non-involved children, with downstream effects on adaptive functioning. The current study uses two randomized control trials, one conducted with foster caregivers and one conducted with birth parents, to investigate the longitudinal effects of caregiver type (foster versus birth parent) and a home-visiting parenting intervention on emotion regulation among young children referred to CPS. Participants were 211 children referred to CPS during infancy or toddlerhood, of whom 120 remained with their birth parents and 91 were placed in foster care. Caregivers were randomly assigned to receive Attachment and Biobehavioral Catch-Up (ABC), a 10-session intervention designed to promote nurturing, sensitive, and non-intrusive caregiving, or a control intervention. Caregiver type moderated the effects of ABC on young children's observed anger dysregulation during a frustrating task at age 2 to 3 years. Among children remaining with their birth parents, children whose caregivers received ABC showed lower anger dysregulation than children whose caregivers received the control intervention. Children placed in foster care showed lower anger dysregulation than children with birth parents regardless of parenting intervention, and additionally showed higher adaptive regulation than children remaining with their birth parents. Adaptive regulation was not significantly associated with parenting intervention or the caregiver by intervention interaction. Results suggest that foster care placement may be protective for emerging emotion regulation skills among young children referred to CPS, and an attachment-based parenting intervention buffers risks of remaining in the home for young children's emotion dysregulation.

Anxiety and irritability symptoms frequently co-occur in children with Attention-Deficit/Hyperactivity Disorder (ADHD). This study aims to investigate whether irritability and anxiety are uniquely associated with performance on measures of cognitive functioning in children with ADHD and whether these associations hold when accounting for confounding variables. Baseline data was used from a randomised controlled trial of cognitive behavioural therapy for anxiety in children with ADHD (N = 219, 8-13 years). Anxiety was assessed using the child- and parent-reported Spence Children's Anxiety Scale, while irritability was assessed using the parent-reported Affective Reactivity Index. Children completed the National Institutes of Health Toolbox - Cognition Battery. Higher symptoms of anxiety were uniquely associated with performance on the Dimensional Card Change Sort Test (β = -2.75, confidence interval (CI) [-4.97, -.52], p = .02) and the List Sort Working Memory Test (β = -2.57, CI [-4.43, -.70], p = .01), while higher symptoms of irritability were negatively associated with Picture Vocabulary Test (β = -2.00, CI [-3.83, -.16], p = .03). These associations did not survive correction for multiple comparisons. There was little evidence of an association between anxiety or irritability symptoms and cognitive functioning. Frequent co-occurrence of anxiety and irritability suggests clinicians working with children with ADHD should assess co-morbid symptom profiles to inform the provision of optimum care.

Trait impulsivity is an established risk factor for externalizing behavior problems in adolescence, but little is understood about the cognitive mechanisms involved. Negative automatic thoughts are associated with externalizing behaviors and impulsivity is associated with less cognitive reappraisal. This study sought to adapt the bioSocial Cognitive Theory (bSCT) of impulsivity and substance use (an externalizing behavior) for externalizing behavior in general. It was predicted that only the component of impulsivity characterized by lack of forethought (rash impulsiveness; RI) would be associated with (non-substance use-related) externalizing behaviors, not reward sensitivity/drive. Further, this association would be mediated by negative automatic thoughts. Participants were 404 (226 female, 63%) adolescents from 6 high schools across South-East Queensland (age = 13-17 years, mean age = 14.97 years, SD = 0.65 years) of mostly Australian/New Zealand (76%) or European (11%) descent. Participants completed self-report measures of impulsivity, negative automatic thoughts, and externalizing behaviors. Path analysis revealed that, as predicted, only RI was uniquely associated with negative automatic thoughts and externalizing behaviors. However, only negative automatic thoughts centered around hostility mediated the positive association between RI and externalizing behaviors, with the indirect mediation effect being smaller than the direct association. In contrast to substance use, only one component of impulsivity, RI, was associated with general adolescent externalizing behavior. Hostile automatic thoughts may be an important mechanism of risk, supporting a role for cognitive-behavioral interventions. Other biopsychosocial mechanisms are clearly involved and the bSCT may provide a useful framework to guide future research.

The mental health toll of common school problems that many children encounter every day is not well understood. This study examined individual differences in mood reactivity to naturally occurring school problems using daily diaries, and assessed their prospective associations with youth mental health, three years later. At baseline, 47 children ages 8 to 13 years described common problems at school and mood on a daily basis, for 8 weeks. Thirty-three youth returned for follow-up three years later at ages 11 to 17 years. Children and parents also completed one-time questionnaires about youth mental health at baseline and follow-up. There were individual differences in the within-person associations between school problems and same-day and next-day mood. A greater tendency to react to school problems with more negative mood or less positive mood on the same day predicted more parent-rated internalizing and externalizing problems and child ratings of depression symptoms three years later, relative to baseline levels of symptoms. Daily diaries can help to identify specific targets of psychosocial interventions in real world settings.

Difficulty using reparative behaviors (i.e., prosocial behaviors that individuals use after they have transgressed to cause another's distress) has been concurrently associated with poorer social functioning and both internalizing and externalizing disorders in children and adults. Despite these associations, no study has examined social and psychological outcomes of children who display consistently low levels of reparative behaviors across childhood. This study used established developmental trajectories of reparative behaviors that span preschool through early adolescence (low-stable, moderate-stable, and high-stable) to predict social and psychological outcomes in adolescence (N = 129). Membership in trajectories characterized by lower levels of reparative behaviors predicted greater social rejection, social withdrawal, aggression, and symptoms of depression in adolescence, even when controlling for baseline levels of each outcome. Membership in the low-stable reparative trajectory also significantly mediated the relationship between high levels of guilt in preschool and greater depression severity in adolescence. Findings suggest that children who display persistently low levels of reparative behaviors may be at-risk for a variety of poorer social and emotional outcomes. Further, preschoolers who display both high levels of guilt and low levels of reparative behaviors may be at particularly high risk for depression recurrence in adolescence. Thus, interventions that teach young children reparative skills and/or promote approach rather than avoidance after transgressions may have important implications for preventing a wide range of poorer social and emotional outcomes in adolescence.

Heightened reward sensitivity has been proposed as a risk factor for developing behavioral disorders whereas heightened punishment sensitivity has been related to the development of anxiety disorders in youth. Combining a cross-sectional (n = 696, mean age = 16.14) and prospective (n = 598, mean age = 20.20) approach, this study tested the hypotheses that an attentional bias for punishing cues is involved in the development of anxiety disorders and an attentional bias for rewarding cues in the development of behavioral disorders. A spatial orientation task was used to examine the relation between an attentional bias for punishing cues and an attentional bias for rewarding cues with anxiety and behavioral problems in a subsample of a large prospective population cohort study. Our study indicates that attentional biases to general cues of punishment and reward do not seem to be important risk factors for the development of anxiety or behavioral problems respectively. It might be that attentional biases play a role in the maintenance of psychological problems. This remains open for future research.

Anxiety disorders tend to onset early in development and often result in chronic impairment across the lifespan. Thus, there is substantial interest in identifying early neural markers of anxiety and leveraging these markers to better understand processes leading to anxiety. The late positive potential (i.e., LPP) indexes sustained attention to motivationally relevant stimuli; and the LPP to negative images is increased in individuals with anxiety. In the current study, we examined how parental presence impacts the LPP to threatening images in children (52.6% male) between 5 and 7 years-old (N = 78). Moreover, we explored interactions with parental sensitivity to child anxiety symptoms. Results suggest that when children are in the presence of their parent (compared to the presence of an experimenter), they displayed a larger LPP to threatening images. LPP activity was modulated by parental response to their child's anxiety symptoms, such that children with parents who were overly reactive to their children's anxiety symptoms had the greatest LPP response when viewing threatening stimuli in their parent's presence. Additionally, exploratory analyses indicated that children with clinical and subclinical anxiety were characterized by an increased LPP to negative images, but only when the LPP was measured with parents in the room. Findings are novel and extend previous work by suggesting that parents who react strongly when observing their children's anxiety symptoms in turn increase their child's engagement with threatening stimuli, thereby placing them at greater risk for anxiety.

The original version of this article unfortunately contained a mistake.