Peer Victimization and Suicidal Thoughts and Behaviors in Depressed Adolescents

Suicide is a leading cause of death among youth worldwide, and depressed adolescents are at a significantly elevated risk to report suicidal ideation, planning, and attempts. Peer victimization is a robust predictor of adolescent suicidal thoughts and behaviors (STBs), but little research has focused on why bullying leads to suicidal thoughts and behaviors. To address this empirical gap, we recruited 340 (246 female) depressed adolescents ages 13–19 (M = 15.59, SD = 1.41) within 48 h of admission for acute psychiatric treatment. At the initial assessment, participants were administered clinical interviews characterizing psychopathology, nonsuicidal self-injury, and STBs (ideation, plans, and attempts). Further, they completed questionnaires assessing 3 forms of victimization (overt, relational, and reputational), recent risky behavior engagement, and psychiatric symptom severity. Controlling for internalizing symptoms and age, overt and reputational bullying were associated with more frequent past month suicide attempts, but not suicide ideation. Past month risky behavior engagement, but not NSSI, mediated the relation between victimization and attempts. However, sex differences revealed that this effect only held for males whereas bullying was directly associated with suicide attempts among females. In contrast, overt and relational bullying were non-linearly associated with suicide plans, and these relations were not mediated by risky behaviors or NSSI. Results highlight the complex network of factors that lead victimized adolescents to engage in STBs and may inform targeted suicide prevention and intervention programs.     

Parasympathetic Regulation and Inhibitory Control Predict the Development of Externalizing Problems in Early Childhood

The current report examined the longitudinal relations between cognitive self-regulation, physiological self-regulation, and externalizing problems. At age 4 (n = 98; 49 girls) and 6 (n = 87; 42 girls), children completed the Day-Night task, which taps the inhibitory control dimension of executive function. During the task, cardiac activity was measured and respiratory sinus arrhythmia (RSA) was derived as an index of parasympathetic activity. Mothers reported on externalizing problems. A cross-lagged path model was used to estimate longitudinal predictions while controlling for stability in all constructs over time. Earlier inhibitory control negatively predicted later externalizing problems, but not vice versa. However, RSA reactivity moderated this link; better inhibitory control predicted fewer externalizing problems only when reactivity to the Day-Night task ranged from mild RSA suppression to RSA augmentation. Externalizing problems at 6 years were highest among preschoolers who augmented RSA but showed poor inhibitory control performance, suggesting that risk for psychopathology may be better delineated by viewing self-regulation from an integrated, multi-system perspective.     

Disentangling Child-Specific and Family-Wide Processes Underlying Negative Mother-Child Transactions

The current study examines the transactional processes between maternal negativity and child disruptive behavior during early childhood, using a sibling comparison design. This design allows for a more sophisticated test of the behavioral training hypothesis than is possible when only one child per family is included in the analysis as it excludes two confounders (passive gene-environment correlation and family-wide environmental influence). Three hundred and ninety-seven families were visited on three occasions when the target child was 1.5, 3 and 4.5 years old (920 children, 51.5% female). The target child and up to three older siblings per family were included in data collection and analysis. Mothers and fathers reported on children’s disruptive behavior and mothers reported on their negativity to children. Within-family cross-lag pathways, as well as a significant indirect effect through which children increased their own disruptive behavior via maternal negativity confirmed a behavioral training effect. Family level maternal negativity and sibling disruptive behavior showed high levels of stability over three to four years and no context effect for maternal negativity or sibling disruptive behavior was seen. The theoretical and clinical implications of these findings are discussed.     

Bending the Curve: A Community-Based Behavioral Parent Training Model to Address ADHD-Related Concerns in the Voluntary Sector in Denmark

Limited access to evidence-based behavioral parent training (BPT) for addressing attention deficit/hyperactivity disorder (ADHD) has been a growing concern internationally. Models to improve access to BPT are needed, particularly those that can be readily implemented in community settings and that leverage the potential workforce to increase capacity to deliver BPT. The purpose of this study was to evaluate a BPT model which included oft-used content, methods, processes of BPT (common-elements), non-professionally delivered (task-shifted/shared) BPT intervention, and an efficient ancillary support system (training, fidelity, and supervision methods) for families of youth with parental concerns about ADHD. In a randomized controlled trial of 161 families of children (79% male; mean age 7.04 [1.55]), the Caring in Chaos (CiC) BPT model, delivered by community volunteers across 12 community-based sites in Denmark, was compared to a wait-list control condition on key child and parent outcomes at immediate post-treatment and 4-month follow-up assessment points. Results suggested that the CiC model led to significantly greater improvement in parenting behavior, parenting sense of competence, child functional impairment, parental stress and parental depressive symptoms compared to the wait list condition at immediate post-treatment, with maintenance of gains in most of these areas at follow-up assessment. No effect of intervention was found on ADHD symptoms. The results of this study suggest that developing efficient BPT intervention models, such as the CiC model, can result in readily implemented interventions by a variety of individuals in community settings. Such models are necessary to bend the curve on addressing unmet needs of families of youth with concerns about ADHD.     

Will Victims Become Aggressors or Vice Versa? A Cross-Lagged Analysis of School Aggression

Peer aggression and victimization are ubiquitous phenomena in schools which warrant the attention of educators and researchers. The high connection between aggression and victimization behooves researchers to look into how the comorbidity of them develops over time. The present study investigated the associations between aggression and victimization over 3 years in early adolescence and whether these associations are moderated by gender and teacher support. Participants were 567 Grade 7, 8 and 9 students (49.38% girls) from 3 schools in Hong Kong. Over the course of study, they were asked to fill in a set of questionnaires that consisted of items related to peer aggression, victimization, and teacher support at 5 time points. Four models of cross-lagged relations between peer aggression and victimization were tested. The results supported a reciprocal model of peer aggression and victimization for both boys and girls although girls engaged in less peer aggression and victimization than boys. Further analyses also revealed that teacher support acted as a suppressor of the reciprocal relations. The present study sheds lights on intervention strategies that may remediate peer aggression and victimization in schools.     

Peer Victimization and Adjustment in Young Adulthood: Introduction to the Special Section

A substantive number of children and adolescents are bullied by their peers, with serious risks for the victims’ emotional, behavioral, physical, and academic adjustment. However, while the immediate and short-term consequences of peer victimization in childhood and adolescence are very well documented, knowledge about the potential long-term consequences for victims’ functioning once they reach adulthood is only slowly emerging. Based on prospective, longitudinal data from different countries, the 4 papers in this special section investigate the association between peer victimization suffered in childhood and adolescence and victims’ developmental outcomes in late adolescence/early adulthood. This introduction highlights the major findings of each paper and discusses the implications for future research.     

Distilling Heterogeneity among Children with Disruptive Behavior: Associations between Symptom Patterns and Social Functioning

Children with disruptive behavior (DB) are a heterogeneous group who exhibit several characteristics that may contribute to poor social functioning. The present study identified profiles of reactive aggression, proactive aggression, callous-unemotional (CU) traits, and prosocial behavior in a sample of children with DB. Associations with social functioning (social interaction, social status) were then examined, along with sex differences in profile membership. Parent ratings of 304 clinic-referred children ages 6–12 years with DB were analyzed using latent profile analysis. Five profiles were identified: 1) Moderate prosocial behavior, reactive aggression, and CU, and low proactive aggression (labelled Moderate); 2) Relatively high prosocial behavior and low reactive and proactive aggression and CU traits (Prosocial); 3) High prosocial behavior and reactive aggression, moderate proactive aggression, and low-moderate CU (Reactive-Prosocial); 4) Low prosocial behavior, high CU, high-moderate reactive aggression, and low-moderate proactive aggression (Reactive-CU); and 5) Low prosocial behavior and high reactive and proactive aggression and CU (Aggressive-CU). Profiles characterized by CU traits, reactive aggression, and low prosocial behavior were associated with the most problematic parent-rated social interaction and social status. The results highlight the need to differentiate profiles of psychopathology in children with DB to better address factors most associated with social functioning.     

Preventing Conduct Disorder and Callous Unemotional Traits: Preliminary Results of a School Based Pilot Training Program

This study investigated whether a school-based pilot prevention program is effective in reducing Conduct Disorder (CD) symptoms and callous unemotional (CU) traits (i.e., lack of empathy and guilt) in a community sample of children. A total of 304 children from three schools in Cyprus were randomly assigned at school level to either a prevention group that received a skill building training program (N = 94; M _age  = 7.91, SD = .74; 52.1% female) or a control group that received no training (N = 210; M _age  = 7.82, SD = .81; 50.5% female). To evaluate the effectiveness of the program, CD symptoms and CU traits were assessed before the implementation of the training program and at 3 and 9 months after training. Additionally, the child’s impulsivity, parental involvement and friend support were assessed pre- and post-prevention. Significant post-training reductions in CU traits were identified for the prevention, but not the control, group at both 3-month and 9-month follow-ups and in CD symptoms at the 9 month follow-up. Furthermore, children in the prevention group scored lower on impulsivity and higher on paternal involvement and friend support compared to the control group after participating in the training program. This study provides preliminary evidence that child focused training delivered in the school setting can provide lasting benefits by preventing the development of CU traits, impulsivity, and CD. The program was also successful in improving the child’s social relationships with peers and parents. These findings emphasize the importance of school based prevention efforts.     

Young Children’s Physiological Reactivity during Memory Recall: Associations with Posttraumatic Stress and Parent Physiological Synchrony

Autonomic reactivity is implicated in stress response and social engagement – both key components of posttraumatic stress disorder (PTSD) – but few studies have examined autonomic reactivity in pediatric samples, and no known studies have examined physiological synchrony among children with PTSD and caregivers. In a sample of 247 young children (94 girls, 153 boys), most (85%) of whom had exposure to trauma and 40% who met criteria for PTSD, we examined children’s patterns of respiratory sinus arrhythmia (RSA) at baseline and in response to a memory recall task, as well as correspondence between parents’ and children’s RSA. Children with PTSD demonstrated significantly higher reactivity than other groups during their recollection of a traumatic memory, but not during other memory tasks. Regarding synchrony, caregivers’ and children’s RSA were more significantly and positively correlated during the trauma recall task among children who had had exposure to a potentially traumatic event but did not meet PTSD criteria, suggesting physiological synchrony may be protective in contexts of trauma. Overall, findings demonstrate physiological reactivity differences among young children with PTSD. While more work is needed to understand the meaning of parent-child physiological synchrony, these data suggest that children’s psychopathology is associated with physiological synchrony processes among young children with exposure to trauma.