Journal of Clinical Child and Adolescent Psychology最新文献

Objective: While daring-impulsive (DI) traits have been deemed an important concept in subtyping youth with conduct disorder (CD) as part of a multispecifier model, no work has examined whether DI traits add to the existing practice of designating youth with CD beyond co-occurring attention-deficit/hyperactivity disorder (ADHD).

Method: This study examined the utility of DI traits (versus ADHD features) in a sample of 322 justice-involved adolescent boys (ages 16-17 years). In addition to a diagnostic interview to determine severity of CD, adolescents completed measures of DI, ADHD, as well as other relevant characteristics.

Results: Findings revealed differential associations between DI and ADHD in relation to indices of CD, externalizing psychopathology (i.e. reactive aggression, proactive aggression, substance use), internalizing psychopathology (i.e. anxiety, depression), and domains of impulsivity (i.e. positive urgency, negative urgency, sensation seeking, premeditation, perseverance). Additionally, over and above ADHD, DI contributed incremental information in explaining CD, externalizing psychopathology, positive urgency, sensation seeking, and lack of premeditation, but not internalizing psychopathology nor negative urgency and lack of perseverance. Of the 286 adolescents with CD, 114 (39.9%) were in the DI group and only 81 (28.3%) were in the ADHD group. Finally, differential correlates emerged between adolescents exhibiting CD alone, high CD and high DI traits, and high CD and high ADHD features.

Conclusions: Findings tentatively suggest DI traits and ADHD features are empirically distinct from each other in relation to CD and relevant characteristics and, therefore, improved clinical care for adolescents with CD will likely require differential consideration of DI and ADHD.

Objective: We examined the longitudinal effects of internet-delivered PCIT (iPCIT) on caregiver and child imitation in young Hispanic/Latine children with developmental delay (DD). We also examined the moderating roles of acculturation and enculturation on such treatment effects.

Method: Three-year-old, Hispanic/Latine children aging out of early intervention services for developmental delay (n = 98) and their primary caregivers were randomized to receive iPCIT or referrals as usual (RAU) in the community. Caregiver and child imitation were observationally coded during a 5-min child-directed play situation, which occurred during home-based evaluations at four timepoints - i.e. Baseline, Post, 6-month follow-up, and 12-month follow-up.

Results: Treatment effects were significantly moderated by caregiver acculturation. Specifically, iPCIT was associated with greater caregiver and child imitation among families reporting higher, but not lower, levels of caregiver acculturation. However, caregiver enculturation did not moderate the effects of iPCIT on either caregiver or child imitation.

Conclusions: Findings suggest parenting intervention effects on levels of imitation were particularly strong for Hispanic/Latine caregivers reporting higher levels of acculturation. This highlights the promotive role acculturative identity can play in boosting parenting intervention effects, particularly those of caregiver and child imitation. Findings also underscore the importance of assessing cultural factors to better inform personalized care and skill acquisition among Hispanic/Latine samples. Future research is needed to identify mechanisms that help explain precisely how cultural identity factors, such as acculturation and enculturation, can boost treatment-related imitation gains for Hispanic/Latine children with DD and their families.

Objective: To determine the proportion and profile of preschoolers on the autism spectrum who do not acquire spoken language despite receiving evidence-supported interventions that target spoken language.

Methods: We examined an aggregate dataset comprising 707 preschoolers on the autism spectrum who had received evidence-supported interventions to determine the proportion and profile of those who experienced limited progress in spoken language. Interventions were delivered through programs affiliated with university research settings and ranged in duration from 6 to 24 months. Spoken language outcomes were determined from parent-report measures, which were validated against direct assessments and natural language samples.

Results: Approximately two-thirds of children who were non-speaking at baseline were using single words or more complex spoken language by intervention exit. Those who remained non-speaking had lower baseline motor imitation scores, derived mainly from parent reports. Approximately half of the children who were minimally speaking (i.e. had single words or no words) at baseline were combining words by intervention exit. Those who did not acquire word combinations had lower baseline scores in cognitive, social, adaptive and motor imitation measures, and shorter intervention duration. Age at intervention start influenced spoken language advancement differently depending on the initial spoken language level. The odds of acquiring spoken language did not differ based on the intervention received.

Conclusions: Approximately one-third of children who had limited or no spoken language at baseline did not advance to spoken language stages following intervention. Development of spoken language was associated with modifiable factors at the child and intervention level.

Objective: While suicidal behaviors among adolescents declined from 1991 to 2017, suicides among Black youth increased. There is limited research on suicidal help-seeking behaviors among Black adolescents, which is essential for effective suicide prevention and intervention. This study examined suicidal help-seeking behaviors and treatment preferences among Black youth and caregivers, using the Psychological Framework of Radical Hope to explore strategies for fostering hope and healing.

Methods: This qualitative study included Black youth (ages 14-19), caregivers, health and mental health providers, and community members (N = 55). Participants were predominantly Black (96%) and female (53%), with ages ranging from 14 to 68 years. Semi-structured interviews, conducted in 60-90-min virtual focus groups, explored experiences with suicidal help-seeking, service needs, and support preferences. Constant comparative methodology was employed to organize and categorize data into themes.

Results: Youth balanced ideas of faith and agency toward help-seeking behaviors. In contrast, caregivers, providers, and community members were less optimistic about the service needs of Black youth being met largely due to historical and current experiences with systemic barriers. Participant groups discussed how collective memory informs their experiences and inspires them to have hope for positive change.

Discussion: Suicide-specific interventions should integrate strategies for fostering hope, faith, and agency individually and collectively with diverse groups to support Black youth suicidal help-seeking behaviors. Clinical strategies are provided to support the design of interventions to effectively address suicidal help-seeking behaviors for Black youth and their caregivers.

Objective: Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) youth experience known inequities in mental health outcomes, including depression and suicidality. The Promoting Wellbeing & Resilience (PWR) class is an interactive, developmentally tailored group that provides strength-based, practical skills to LGBTQ+ teenagers with depression. It is designed to be implemented by paraprofessionals to increase community-based access to care.

Method: Investigators developed and piloted an eight-session cognitive-behavioral class for LGBTQ+ youth (N = 21) ages 12 to 17 (M = 14.8 years, 81% Caucasian, 57% gender diverse, 100% non-heterosexual) with depression symptoms. The youth received training in mood regulation, communication skills, stress management, and goal setting in a small group format (5-8 youth per group). Outcomes were youth-reported depression (primary), anxiety, and trauma symptoms at pre-treatment and post-treatment. Paired sample (dependent) one-tailed t-tests were used to examine treatment effects. Focus groups were also conducted with participants to assess satisfaction and collect qualitative feedback regarding class content and format.

Result: The resilience class was associated with reductions in depression symptoms post-treatment (t(17) = 3.3, p = .002, d = 0.5) but not anxiety (t(17) = 1.8, p = .049, d = 0.3) or trauma symptoms (t(17) = 1.2, p = .118, d = 0.1). Completion rates for all group sessions were high (95%), and the majority (57%) of participants returned for an optional review session.

Conclusion: Preliminary results suggest a manualized 8-week skills-based cognitive-behavioral group intervention designed to be delivered by paraprofessionals may be effective at reducing depression symptoms in actively depressed LGBTQ+ youth.

Objective: To examine differences in parenting factors among caregivers with children with and without externalizing behavior problems (EBP) in a community homeless shelter sample versus a stable housing sample.

Method: Nine hundred and fourteen children (ages = 2.01-7.49 years, SD = 1.45 years, 40.8% female, 54.3% Black, 46.7% Hispanic) were recruited from a service-driven research project in a shelter setting (n = 638) and a longitudinal/clinical study (n = 276). Primary caregivers (97% mothers) completed a parenting stress questionnaire and an observational measure of parent-child interactions.

Results: Logistic regression indicated that children who were Black and/or of Hispanic background were less likely to be identified as having elevated EBP but only in the homeless shelter sample. Multivariate analyses indicated that the homeless shelter-EBP group reported the highest levels of overall stress compared to the homeless shelter-typically developing (TD), stable housing-EBP and stable housing-TD groups. Mothers from the homeless shelter-EBP group exhibited a higher proportion of negative verbalizations relative to caregivers from all other groups while mothers from the homeless shelter-TD group exhibited a higher proportion of positive verbalizations relative to the caregivers from the homeless shelter-EBP group and the stable housing TD group. Both homeless shelter groups engaged in less total verbalizations relative to both stable housing samples, with the stable housing-EBP group exhibiting the most verbalizations.

Conclusions: High levels of parenting stress and negative parent-child interactions within a homeless shelter sample are exacerbated by having a child with EBP. Embedding universal parenting programs in a homeless shelter setting to reduce parenting stress would be valuable to address health disparities in this vulnerable population.

Objective: Although a growing body of work has found that parents' experiences of racial and socioeconomic (SES) based discrimination are directly related to their children's behavior problems , more work is needed to understand possible pathways by which these factors are related and to identify potential targets for prevention and/or intervention.

Method: Using a large (N = 572), longitudinal sample of low-income families from diverse racial backgrounds, the current study explored whether caregivers' experiences of racial and SES discrimination during their children's middle childhood (i.e. ages 7.5-9.5) predicted youth-reported antisocial behavior during adolescence and potential factors mediating these associations (e.g. caregiver depressive symptoms and positive parenting practices).

Results: We found that higher levels of caregiver experiences of discrimination at child ages 7.5-9.5 predicted higher levels of caregiver depressive symptoms at child age 10.5, which were related to lower levels of caregiver endorsement of positive parenting practices at child age 14.5, which in turn, predicted higher levels of youth-reported antisocial behavior at age 16.

Conclusion: The findings highlight the adverse effects of racism and discrimination in American society. Second, the findings underscore the need to develop interventions which mitigate racism and discrimination among perpetrators and alleviate depressive symptoms among caregivers.

Objective: The current study investigated sex differences in longitudinal associations among youth depression, conduct problems, and peer rejection from ages 11 to 16. We hypothesized that girls would follow the irritable depression model, which posits that depression leads to conduct problems, and that peer rejection would mediate this relationship. We hypothesized that boys would follow the cumulative failure model, which suggests that conduct problems predict future depression, mediated by peer rejection.

Method: We used integrative data analysis to combine three datasets, creating an aggregate sample of 2,322 adolescents, 58.4% of an ethnic minority group, and 51.3% boys. Using random-intercept cross-lagged panel modeling with data from ages 11-16, we conducted a nested model comparison.

Results: Results indicated that a model which allowed paths to differ by sex demonstrated better model fit than a constrained model. While depression, conduct problems, and peer rejection were relatively stable over time and had correlated random intercepts, there were few crossover paths between these domains for either sex. When the strengths of individual crossover pathways were compared based on sex, only the path from conduct problems at age 13 to depression at age 14 was significantly different, with this path being stronger for girls.

Conclusions: These results suggest that stable, between-person effects largely drive relationships between depression, conduct problems, and peer rejection during adolescence, whereas there are few transactional, within-person pathways between these domains. This pattern of findings demonstrates the utility of random intercept cross-lagged panel modeling for disentangling between- and within-person effects.

Importance: Child behavior problems have been shown to contribute to caregiver distress and vice versa among youth with developmental delay (DD). However, studies have not examined these associations among children and caregivers from underrepresented ethnic/racial backgrounds. Furthermore, research has not explored how associations function differently following internet-delivered treatment or based on the level of acculturation and enculturation.

Objective: We examined bidirectional associations between caregiver distress (i.e. symptoms of depression, anxiety, and stress) and externalizing and internalizing behavior problems in 3- to 5-year-old children with DD from underrepresented ethnic/racial backgrounds. We also examined the impact of internet-delivered Parent-Child Interaction Therapy (iPCIT) and the moderating role of acculturation and enculturation on these bidirectional associations.

Method: Children aging out of early intervention services (n = 150) and their primary caregiver were randomized to receive iPCIT or referrals as usual (RAU) in the community.

Results: Findings provide support for bidirectional associations between child internalizing behavior problems and caregiver depressive symptoms, although there were fewer significant associations among families randomized to iPCIT compared to RAU. Weaker associations were observed among families with higher levels of enculturation, whereas stronger associations were observed among families with higher levels of acculturation.

Conclusions: Results highlight a sensitive period from age 3.5 to 4 years old for bidirectional associations between caregiver distress and child behavior problems and highlight the importance of addressing family cultural values during treatment. Findings also suggest the utility of internet-delivered behavioral parenting interventions in weakening the effect of child behavior problems on caregiver distress and vice versa.

Objective: Many adolescents feel pressure to be constantly available and responsive to others via their smartphones and social media. This phenomenon has been understudied using quantitative methods, and no prior study has examined adolescents' specific stress about meeting digital availability expectations within a best friendship, or entrapment. The present study offers an important preliminary examination of this unique digital stressor in a developmental context by examining prospective associations between digital entrapment, psychosocial adjustment, and health in adolescence.

Method: Students in a rural, lower-income school district in the southeastern US (n = 714; 53.8% female; 45.9% White, 22.7% Black, 24.0% Hispanic/Latino) completed self-report measures of digital entrapment, perceived general health, friendship conflict, and depressive symptoms at two timepoints, one year apart.

Results: Digital entrapment, which 76.3% of the sample reported experiencing, was associated prospectively with higher levels of friendship conflict and worse perceived general health one year later among boys, but not girls. Findings suggest that digital entrapment is an extremely common experience for adolescents that may disproportionally affect boys. Entrapment was not prospectively associated with depressive symptoms.

Conclusions: Results offer insight into how boys may have different social media experiences significant to their development and health, while much work exploring gender differences in social media use thus far has elucidated negative effects for girls. Boys may perceive and respond to novel social norms of digital environments differently such that digital entrapment has the potential to be detrimental to their friendships and health.