Journal of Clinical Child and Adolescent Psychology最新文献

Objective: The need to understand and treat childhood chronic irritability (CI; i.e. frequent temper loss and angry/irritable mood) is imperative. CI predicts impairment across development and complex comorbidities with both internalizing and externalizing disorders. Research has emphasized frustration reactivity as a key mechanism of CI. However, there are understudied components of frustrative non-reward, particularly regulation-oriented frustration recovery, frustration tolerance, and cognitive control, that may further explain impairments specific to CI beyond comorbid symptoms.

Method: Sixty-three community children (N = 25 CI/38 non-CI) and a parent completed surveys and the computerized Frustration Go/No-Go (FGNG) and Mirror Tracing Persistence Task (MTPT). Analyses compared task performance and self-rated affect across youth with or without CI, with further comparison based on negative/positive screen for ADHD (N = 45-/18+).

Results: In mixed effects models assessing change across task, the CI group did not demonstrate more intense frustration on the MTPT or rigged FGNG block but exhibited persisting frustration and inhibitory control difficulties into the FGNG recovery period; the CI+ADHD subgroup drove recovery effects. In GEE and logistic regression models including dimensional symptom clusters, only internalizing symptoms predicted child frustration intolerance and reactivity across tasks. ADHD severity was also associated with higher MTPT frustration reactivity, while oppositional behavior predicted lower frustration. Better frustration recovery was associated with lower irritability, but higher internalizing symptoms.

Conclusions: Co-occurring symptoms may better explain some frustration-related difficulties among youth with CI. Difficulties with postfrustration affect and inhibitory control recovery suggest the importance of characterizing CI by self-regulation impairments.

Objective: Research on the role of affect in childhood aggression motives has largely focused on domain-level affective traits. Lower-order affective facets may show more distinct relationships with instrumental and reactive aggression - at both the variable and individual levels - and offer unique insights into whether and how several forms of affect are involved in aggression motives.

Method: Caregivers (98% mothers) of 342 children (M_age = 9.81 years, 182 girls, 31% White) reported on children's aggression and affect-relevant personality traits, personality pathology, and callous-unemotional traits.

Results: Both reactive and instrumental aggressions were characterized by higher levels of trait irritability, fear, withdrawal, sadness, and callous-unemotional traits in zero-order analyses. Instrumental aggression was characterized by low trait positive emotions. Reactive aggression was uniquely associated with irritability, fear, withdrawal, and sadness, whereas instrumental aggression was uniquely associated with callous-unemotional traits and (low) positive emotions. Groups identified by latent profile analyses were differentiated only by aggression severity.

Conclusions: The findings support both the similarity and distinction of reactive and instrumental aggression vis-à-vis their affective phenomenology. Consistent with existing theories, reactive aggression was linked to multiple forms of negative emotionality, whereas instrumental aggression was linked to higher levels of callous-unemotional traits. In a novel finding, instrumental aggression was uniquely characterized by lower positive emotions. The findings highlight the utility of pre-registered approaches employing comprehensive personality-based affective frameworks to organize and understand similarities and differences between aggression functions.

Objective: Researchers employed two recruitment strategies in a school-based comparative effectiveness trial for students with a diagnosis of attention-deficit/hyperactivity disorder (ADHD) or autism. This study assessed the: 1) effectiveness of school-based referrals for identifying students meeting diagnostic criteria and 2) impact of eliminating requirements for existing diagnoses on recruitment, sample characteristics, and intervention response.

Method: Autistic students and students with ADHD in schools serving underresourced communities were recruited for an executive functioning (EF) intervention trial over 2 years. In Year 1, school staff nominated students with previous diagnoses. In Year 2, school staff nominated students demonstrating EF challenges associated with ADHD or autism; previous diagnosis was not required. Study staff then confirmed diagnoses.

Results: More students were included in Year 2 (N = 106) than Year 1 (N = 37). In Year 2, 96% of students referred by school staff met diagnostic criteria for ADHD or autism, 53% of whom were not previously diagnosed. Newly identified students were less likely than previously diagnosed students to be receiving services and, for those with ADHD, were more likely to speak primarily Spanish at home. Previously diagnosed and newly identified students did not differ on other demographic variables or intervention response. Caregivers of previously diagnosed students reported more symptoms than caregivers of newly identified students for both diagnostic groups. Previously diagnosed students with ADHD had more researcher-rated symptoms than newly identified students.

Conclusions: Recruitment for an intervention study using behavior-based referrals from school staff enhanced enrollment without compromising the sample's diagnostic integrity and engaged children who otherwise would have been excluded.

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: Cognitive disengagement syndrome (CDS) includes excessive daydreaming, mental confusion, and hypoactive behaviors that are distinct from attention-deficit/hyperactivity disorder inattentive (ADHD-IN) symptoms. A growing number of studies indicate that CDS symptoms may be associated with ratings of social withdrawal. However, it is important to examine this association in children specifically recruited for the presence or absence of CDS, and to incorporate multiple methods including direct observations of peer interactions. The current study builds on previous research by recruiting children with and without clinically elevated CDS symptoms and using a multi-method, multi-informant design including recess observations and parent, teacher, and child rating scales.

Method: Participants were 207 children in grades 2-5 (63.3% male), including 103 with CDS and 104 without CDS, closely matched on grade and sex.

Results: Controlling for family income, medication status, internalizing symptoms, and ADHD-IN severity, children with CDS were observed during recess to spend more time alone or engaging in parallel play, as well as less time involved in direct social interactions, than children without CDS. Children with CDS were also rated by teachers as being more asocial, shy, and socially disinterested than children without CDS. Although children with and without CDS did not differ on parent- or self-report ratings of shyness or social disinterest, children with CDS rated themselves as lonelier than children without CDS.

Conclusions: Findings indicate that children with CDS have a distinct profile of peer functioning and point to the potential importance of targeting withdrawal in interventions for youth with elevated CDS symptoms.

Latinx children, youth, and families in the United States have been disproportionally affected by the COVID-19 pandemic compared to non-Latinxs, experiencing a higher burden of deaths, economic adversity, parental stress, and mental health problems. At the same time, Latinx children, youth, and families in the United States have rich cultural and community resources that serve as a source of protection and promotion. To our knowledge, no special issue has been devoted to the impact of the pandemic on Latinx children, youth, and families, which limits opportunities to examine its implications for clinical theory, research, assessment, policy, and practice. To address this gap, we present this special issue entitled "Understanding the impact of the COVID-19 pandemic on the mental health of Latinx children, youth, and families: Clinical challenges and opportunities," a collection of nine articles written by Latinx scholars. In this introduction, we explain why it is important to center Latinx children, youth, and families and why we need to use a structural-intersectional approach. We summarize the articles in this collection by grouping them by themes: immigration and family separation; the impact of family economic adversity; school and family contexts of mental health; the pandemic experience of Latinx LGBTQ and AfroLatinx youth; and a model to imagine the future of Latinx children, youth, and families. We conclude with a brief summary and suggestions for future research.

Objective: Latinx youth exhibit disproportionately higher internalizing symptoms than their peers from other racial/ethnic groups. This study compares depression and anxiety symptoms between referred students of Latinx and non-Latinx backgrounds before and during the COVID-19 pandemic and examines key determinants within the Latinx sample.

Method: Data are analyzed from four academic years - two before and two during the pandemic - from 1220 5^th through 8^th grade students (M_age = 12.1; 59.6% female; 59.9% Latinx or mixed-Latinx) referred for services across 59 Chicago Public School District (CPS) elementary schools. Using the Children's Depression Inventory (CDI) and the Revised Child Anxiety and Depression Scale (RCADS), mean scores and risk levels for depression, social anxiety, and generalized anxiety are examined.

Results: Higher internalizing risk and comorbidity rates were found in the second year of the pandemic, compared to pre-pandemic levels. Latinx students reported higher depression, social anxiety, and generalized anxiety symptoms than non-Latinx students. During the pandemic, more Latinx students were classified as having comorbid depression and anxiety, and scored in the clinical range for depression, generalized anxiety, and social anxiety than non-Latinx students. Within the Latinx sample, girls and gender non-conforming students reported the highest maladjustment.

Conclusions: Results highlight the pressing need to examine the long-term impact of COVID-19 on the mental health of Latinx children and adolescents, and to address their internalizing problems.

The number of unaccompanied immigrant minors (UIMs) and families from Central America seeking asylum in the U.S. continues to rise. This growth, combined with restrictive government policies, led to crowded and suboptimal conditions in Customs and Border Patrol and non-governmental organization facilities. COVID-19 further taxed facilities and exacerbated uncertainty surrounding length of detention, basic human rights, and family reunification. The current project features testimonies from the authors who work as clinical experts and providers in Texas - a top destination for Central American immigrants. In collaboration with a deputy director of a not-for-profit human rights organization, volunteer psychologists, and the director of a humanitarian respite center, we describe challenges faced by administrators and clinical staff in addressing the mental health needs of immigrant children and families during the COVID-19 pandemic. The primary themes identified were anti-immigrant policies that occurred concurrently with COVID-19; difficulty implementing COVID-19 protocols alongside scarcity of supplies and volunteers; increased mental health needs among UIMs and immigrant families; and challenges in UIM placement upon release from custody. Strategies for addressing clinical challenges in the near- and long-term and opportunities for improvement in care systems to immigrant youth, including correcting anti-immigrant policies, addressing ongoing COVID-19 protocols and challenges, meeting mental and physical health needs, facilitating release and reunification for unaccompanied immigrant minors, and maximizing youth resilience through trauma-informed interventions, are presented.