Child and Adolescent Clinical Psychology

Evidence supports the distinctions between forms (relational vs. physical) and functions (proactive vs. reactive) of aggression; however, little research has investigated these two subtype frameworks simultaneously or by teacher-report in early childhood. We examined the factor structures, interrelations, and longitudinal associations of teacher-reported forms and functions of aggression in young children. Preschool and kindergarten students (N = 133; ages 3-6 years; 58.6% male) were rated by their teachers during the spring semester and on two subsequent occasions over the following school year (a three-wave cross-sequential design). Bayesian confirmatory factor analyses and path models were estimated, controlling for covariates and cross-classification of students within classrooms. Correlated two-factor models showed acceptable measurement characteristics for both aggression frameworks. Within and between frameworks, aggression subtypes were highly correlated with one another. Ph...

La atención a la salud mental en la infancia y la adolescencia es un problema prioritario de salud pública. La Psicología Clínica es una disciplina fundamental en la atención a la salud mental infanto-juvenil. Este estudio tiene como finalidad describir algunas de las características de la atención psicológica a la Salud Mental de niños y adolescentes en el Sistema Nacional de Salud de España. Para ello se ha realizado una encuesta a 141 Psicólogos Clínicos que trabajan en el ámbito infanto-juvenil de todo el territorio español. Los resultados indican el papel fundamental que desempeña la Psicología Clínica en la atención de trastornos mentales, incluidos trastornos mentales graves en niños y adolescentes. Entre los resultados se observa que el 97% de las personas encuestadas consideraba que es muy importante la creación de la Especialidad en Psicología Clínica Infanto-Juvenil.

Treatment effects may not be observed if an empirically supported intervention is not administered with treatment adherence. This retrospective study investigated how therapists' adherence to Multisystemic therapy (MST) varied during a 6-year period in Sweden. Adherence was measured using the Therapist Adherence Measure, which was provided by caregivers. The associations between treatment adherence and therapist-reported posttreatment youth outcomes were also assessed. Retrospective adherence data were obtained for 973 families with youths between 12 and 17 years old who received MST from 68 therapists divided into 10 teams. Implementation of MST occurred in 2 waves between March 2003 and August 2009. Multilevel structural equation modelling was used to evaluate family- and cohort-level predictors and outcomes of treatment adherence. The results confirm previous research: Treatment adherence predicts MST treatment outcomes. With respect to the relationship between MST treatment experience and MST treatment adherence, the analysis showed mixed results. An increase in years that a team had been active predicted an increase in therapist adherence to MST. Therapists from the 2nd implementation wave had higher therapist adherence rates than therapists from the 1st implementation wave. Nevertheless, a therapists' experience with MST did not predict MST treatment adherence. The results suggest that the found links among treatment experience, treatment adherence, and treatment outcomes provide support for the hypothesis that the collective experience of the team members promotes treatment adherence. However, results are mixed and further research is needed.

Examined roles for attitudes about violence as a possible influence on the frequency of commonplace aggression toward peers among 1,033 adolescents in the 7th through 9th grades. The peer victimization measure adapted from prior studies yielded 2 reliable subscales: Victimization of Self and Victimization of Others. The attitudes and beliefs measure modified for this study yielded 3 reliable subscales (Aggression Is Legitimate and Warranted, Aggression Enhances Power and Esteem, One Should Not Intervene in Fights). These attitudes were meaningfully related to self-reported aggression toward peers but less clearly related to self-victimization. The attitudes were plausible mediators of the relation between gender and aggression toward others and appeared influential for both boys' and girls' aggression toward peers. Little support was found for these attitudes moderating the relation between self-victimization and aggression toward others, yet a clear link between victimization of self and aggression toward others was evident. Results support an emphasis on attitudes and values regarding aggression in violence-prevention efforts, as well as direct efforts to reduce self-victimization.

Anxiety disorders are common among young children, with earlier onset typically associated with greater severity and persistence. A stable behaviorally inhibited (BI) temperament and subsequent shyness and social withdrawal (SW) place children at increased risk of developing anxiety disorders, particularly social anxiety. In this Future Directions article, we briefly review developmental and clinical research and theory that point to parenting and peer interactions as key moderators of both the stability of BI/SW and risk for later anxiety, and we describe existing interventions that address early BI/SW and/or anxiety disorders in young children. We recommend that future research on early intervention to disrupt the trajectory of anxiety in children at risk (a) be informed by both developmental science and clinical research, (b) incorporate multiple levels of analysis (including both individual and contextual factors),

... Login to save citations to My List. Citation. Database: PsycINFO. [Journal Article]. Treating nocturnal enuresis in one session of family therapy: A case study.-700 A. Selig, Andrew L. Journal of Clinical Child Psychology, Vol 11(3), Win 1982, 234-237. Abstract. ...

A questionnaire was presented to staff and students at a suburban high school. Participants were required to endorse or reject each of the 14 forced‐choice propositions concerning nonverbal behaviors typically included in social skills training (SST) programs. In addition, they were asked to indicate their estimate of peer group endorsement of each proposition. Results showed that both staff and students

The goal of the study was to examine baseline characteristics-child gender, IQ, age, internalizing problems, symptoms of hyperactivity/impulsivity (HI), oppositional defiant disorder, and sluggish cognitive tempo, and parent income, education, attention deficit/hyperactivity disorder (ADHD) severity, and anxiety/depression (A/D)-associated with response to behavioral treatments for ADHD, predominantly inattentive type. We employed data from 148 children (M = 8.7 years), 58% male, and 57% Caucasian in a randomized clinical trial. Positive treatment response was defined as (a) 5 or fewer inattentive symptoms and (b) a decrease of at least 3 inattentive symptoms from baseline to posttreatment. Child HI, parental A/D, and child IQ were associated with positive response, as follows: Child HI had a main effect in which it was negatively associated with treatment response (36% with 2 or more HI symptoms were positive responders vs. 59% of those with 1 or no symptoms) that was qualified by ...

Attention-deficit/hyperactivity disorder (ADHD) is associated with poor sleep quality, but there is more to learn about the longitudinal association and aetiology of this association. We investigated the following: (a) Is there an association between childhood ADHD and poor sleep quality in young adulthood? (b) Is this driven by the long-term effects of childhood ADHD or concurrent associations with ADHD in young adulthood? (c) To what extent do genetic and environmental influences explain the overlap between symptoms of ADHD and poor sleep quality? Participants were from the Environmental Risk Longitudinal Twin Study of 2,232 twin children born in the United Kingdom in 1994-1995. We ascertained ADHD diagnoses at ages 5, 7, 10, 12, and 18. We assessed sleep quality using the Pittsburgh Sleep Quality Index at age 18. We used regression models to examine longitudinal associations and bivariate twin modelling to test genetic and environmental influences. Children with ADHD had poorer s...

A major form of data analysis in clinical child and adolescent psychology is multiple regression. This article reviews issues in the application of such methods in light of the research designs typical of this field. Issues addressed include controlling covariates, evaluation of predictor relevance, comparing predictors, analysis of moderation, analysis of mediation, assumption violations, outliers, limited dependent variables, and directed regression and its relation to structural equation modeling. Analytic guidelines are provided within each domain.

Growing evidence supports the effectiveness of Trauma and Grief Component Therapy for Adolescents (TGCT-A) in reducing posttraumatic stress disorder (PTSD) symptoms and maladaptive grief (MG) reactions. This pilot study explored whether the specific focus of students' narratives (i.e., focus on trauma vs. focus on loss) as shared by TGCT-A group members would predict initial pretreatment levels, as well as pre- to posttreatment change trajectories, of PTSD symptoms and MG reactions. Thirty-three adolescents from three middle schools completed a 17-week course of group-based TGCT-A. PTSD and MG symptoms were assessed at pretreatment, twice during treatment, and at posttreatment. The focus (trauma vs. loss) of each student's narrative was coded using transcripts of members' narratives as shared within the groups. The reliable change index showed that 61% of students reported reliable pre-post improvement in either PTSD symptoms or MG reactions. Students whose narratives fo...

Early intervention for psychotic disorders, a growing international priority, typically targets help-seeking populations with emerging psychotic ("positive") symptoms. We assessed the nature of and degree to which treatment of individuals at high risk for psychosis preceded or followed the onset of positive symptoms. The North American Prodrome Longitudinal Study-2 collected psychosocial treatment histories for 745 (98%) of 764 high-risk participants (M age = 18.9, 57% male, 57.5% Caucasian, 19.1% Hispanic) recruited from 8 North American communities. Similar to prior findings, 82% of participants reported psychosocial treatment prior to baseline assessment, albeit with significant variability across sites (71%-96%). Participants first received treatment a median of 1.7 years prior to the onset of a recognizable psychosis-risk syndrome. Only one fourth sought initial treatment in the year following syndrome onset. Although mean sample age differed significantly by site, ag...

Few culturally congruent interventions are available to reduce abusive practices in families living in abject poverty in francophone West Africa. This study tests the effects of economic intervention—alone and in combination with a family-focused component—on parenting outcomes and children’s reports of violence in rural Burkina Faso. Female caregivers and their 10- to 15-year-old children from 360 ultrapoor families were recruited to participate in a parallel cluster randomized control trial with 3 study arms: the waitlist (control) group, the economic intervention group (Trickle Up [TU]), and the economic intervention plus family coaching group (TU+). Effects were tested using repeated-measures mixed-effects regressions. At 12 months from baseline, caregivers from the TU+ group reported a reduced use of harsh discipline compared to the control group (Cohen’s d = –0.57, p = .001) and the TU group (d = –0.48, p = .001). Changes were maintained at 24 months. TU+ caregivers also expressed more supportive parenting attitudes at 12 months compared to the control group (d = 0.39, p = .022) and the TU group (d = 0.55, p = .001). Compared to TU caregivers, caregivers in the TU+ group also reported a better quality of child–parent relationship (d = 0.40, p = .041). At 24 months, children in the TU+ group had lower odds of experiencing physical (odds ratio = 0.35, p = .050), 95% confidence interval [0.12, 1.00], and emotional (odds ratio = 0.52, p = .033), 95% confidence interval [0.28, 0.95], violence at home, compared to the control group children. The evidence suggests that involving all family members in sessions on child protection in addition to economic strengthening strategies can foster supportive parenting environments and reduce family violence among children living in ultralevel poverty in West Africa.

Investigated the family drawings of 180 children ages 5 to 7 years in various family settings, including stepfather, single-parent, complex stepfamilies, and 2-parent control families. The relations of family type and biological relatedness to omission of family members and grouping of parents were examined. Children from step- and single-parent families were more likely to exclude family members than children from "control" non-step families, and exclusion was predicted from biological relatedness. Children who were biologically related to both resident parents were also more likely to group their parents together. Omission of family members was found to be associated with children's adjustment (specifically more externalizing and internalizing behavior) as reported by teachers and parents. The results indicate that biological relatedness is a salient aspect of very young children's representations of their families. The association between adjustment and exclusion of family members and grouping of parents indicates that family drawings may be useful research and clinical tools, when used in combination with other methods of assessment.

This study compared individual cognitive behavioral therapy (CBT) and a supportive child-centered therapy (CCT) for child anxiety disorders on rates of treatment response and recovery at posttreatment and 1-year follow-up, as well as on real-world measures of emotional functioning. Youth (N = 133; ages 9-14) with anxiety disorders (generalized, separation, and/or social anxiety) were randomized using a 2:1 ratio to CBT (n = 90) or CCT (n = 43), which served as an active comparison. Treatment response and recovery at posttreatment and 1-year follow-up were assessed by Independent Evaluators, and youth completed ecological momentary assessment of daily emotions throughout treatment. The majority of youth in both CBT and CCT were classified as treatment responders (71.1% for CBT, 55.8% for CCT), but youth treated with CBT were significantly more likely to fully recover, no longer meeting diagnostic criteria for any of the targeted anxiety disorders and no longer showing residual sympto...

We used population sample data from 25 societies to answer the following questions: (a) How consistently across societies do adolescents report more problems than their parents report about them? (b) Do levels of parent-adolescent agreement vary among societies for different kinds of problems? (c) How well do parents and adolescents in different societies agree on problem item ratings? (d) How much do parent-adolescent dyads within each society vary in agreement on item ratings? (e) How well do parent-adolescent dyads within each society agree on the adolescent's deviance status? We used five methods to test cross-informant agreement for ratings obtained from 27,861 adolescents ages 11 to 18 and their parents. Youth Self-Report (YSR) mean scores were significantly higher than Child Behavior Checklist (CBCL) mean scores for all problem scales in almost all societies, but the magnitude of the YSR-CBCL discrepancy varied across societies. Cross-informant correlations for problem sc...

We assessed the predictive validity of attention-deficit=hyperactivity disorder (ADHD) in 20 girls and 98 boys who met the Diagnostic and Statistical Manual for Mental Disorders (4th ed., American Psychiatric ssociation, 1994) criteria for ADHD at 4 to 6 years of age compared to 24 female and 102 male comparison children. Over the next 8 years, both girls and boys who met criteria for ADHD in Year 1 exhibited more ADHD symptoms and impairment than same-sex comparison children. Effect sizes were consistently large, ndicating that the diagnosis of ADHD at 4 to 6 years of age has predictive validity for both sexes. Both girls and boys with ADHD in Year 1 also exhibited higher levels of symptoms of conduct disorder, major epression, and anxiety disorders in early adolescence than same-sex comparison children, controlling levels of the same symptoms in Year 1. This indicates both substantial homotypic and heterotypic continuity for ADHD in both sexes, but significant interactions with ti...

The metacognitive model has increased our understanding of the development and maintenance of generalized anxiety disorders in adults. It states that the combination of positive and negative beliefs about worry creates and sustains anxiety. A recent review argues that the model can be applied to children, but empirical support is lacking. The aim of the 2 presented studies was to explore the applicability of the model in a childhood sample. The first study employed a Danish community sample of youth (n = 587) ages 7 to 17 and investigated the relationship between metacognitions, worry and anxiety. Two multiple regression analyses were performed using worry and metacognitive processes as outcome variables. The second study sampled Danish children ages 7 to 12, and compared the metacognitions of children with a GAD diagnosis (n = 22) to children with a non-GAD anxiety diagnosis (n = 19) and nonanxious children (n = 14). In Study 1, metacognitive processes accounted for an additional 14% of the variance in worry, beyond age, gender, and anxiety, and an extra 11% of the variance in anxiety beyond age, gender, and worry. The Negative Beliefs about Worry scale emerged as the strongest predictor of worry and a stronger predictor of anxiety than the other metacognitive processes and age. In Study 2, children with GAD have significantly higher levels of deleterious metacognitions than anxious children without GAD and nonanxious children. The results offer partial support for the downward extension of the metacognitive model of generalized anxiety disorders to children.