The Development of Co-Occurrent Anxiety and Externalizing Problems from Early Childhood: a Latent Transition Analysis Approach

Research on Child and Adolescent Psychopathology - Research into co-occurrent internalizing and externalizing problems during childhood is flourishing. In particular, investigation on the...     

An Ecological Risk Model for Early Childhood Anxiety: The Importance of Early Child Symptoms and Temperament

Childhood anxiety is impairing and associated with later emotional disorders. Studying risk factors for child anxiety may allow earlier identification of at-risk children for prevention efforts. This study applied an ecological risk model to address how early childhood anxiety symptoms, child temperament, maternal anxiety and depression symptoms, violence exposure, and sociodemographic risk factors predict school-aged anxiety symptoms. This longitudinal, prospective study was conducted in a representative birth cohort (n = 1109). Structural equation modeling was used to examine hypothesized associations between risk factors measured in toddlerhood/preschool (age = 3.0 years) and anxiety symptoms measured in kindergarten (age = 6.0 years) and second grade (age = 8.0 years). Early child risk factors (anxiety symptoms and temperament) emerged as the most robust predictor for both parent-and child-reported anxiety outcomes and mediated the effects of maternal and family risk factors. Implications for early intervention and prevention studies are discussed.     

A Brief,Early Cognitive-Behavioral Program for Cancer-Related PTSD,Anxiety, and Comorbid Depression

Depression and anxiety disorders, including PTSD, are highly prevalent and frequently co-occur in newly diagnosed head and neck cancer (HNC) patients, as well as in longer-term survivors. There is, however, scant empirical evidence to inform clinicians how to best treat distressed HNC patients, particularly in the initial months following their diagnosis. The present article describes the development of a brief, early cognitive-behavioral intervention (the HNC-CBT program) in treating cancer-related PTSD and/or comorbid anxiety and depressive disorders in recently diagnosed HNC patients. The program was developed to be implemented concurrently with patients’ medical treatment(s) to help individuals manage their acute anxiety and PTSD reactions, as well as prevent chronic psychopathology in the postmedical treatment recovery phase. A case study is also presented to illustrate how to apply this intervention with clinically distressed HNC patients. Feasibility issues are also discussed in the implementation of this program during the course of medical treatment.     

Therapist-Led,Internet-Delivered Treatment for Early Child Social Anxiety: A Waitlist-Controlled Evaluation of the iCALM Telehealth Program

Despite recent advances in the treatment of early child social anxiety, the broad accessibility of brick-and-mortar services has been limited by traditional barriers to care, and more recently by new obstacles related to efforts to slow the spread of COVID-19. The present waitlist-controlled trial examined the preliminary efficacy of a family-based behavioral parenting intervention (i.e., the iCALM Telehealth Program) that draws on Parent-Child Interaction Therapy and videoconferencing to remotely deliver clinician-led care for anxiety in early childhood. Young children (3–8 years) with a diagnosis of social anxiety disorder (N = 40; 65% from ethnic/racial minority backgrounds) were randomly assigned to iCALM or waitlist. Intent-to-treat analyses found that at post, independent evaluators classified roughly half of the iCALM-treated children, but only 6% of waitlist children, as “Responders” (Wald test = 4.51; p = .03). By Post, iCALM led to significantly greater reductions than waitlist in child anxiety symptoms, fear, discomfort, and anxiety-related social impairment, and also led to greater improvements in child soothability. By 6-month follow-up, the percentage of iCALM-treated children classified as “Responders” rose to roughly 60%. Exploratory moderation tests found iCALM was particularly effective in reducing life impairments and parental distress among families presenting with higher, relative to lower, levels of baseline parental accommodation. The present findings add to a growing body of research supporting the promise of technology-based strategies for broadening the portfolio of options for delivering clinician-led mental health services.     

Impact of a Kentucky Maternal, Infant, and Early Childhood Home-Visitation Program on Parental Risk Factors

As public health organizations continue to implement maternal and child health home-visitation programs, more evaluation of these efforts is needed, particularly as it relates to improving parental behaviors. The purpose of our study was to assess the impact of families’ participation in a home-visitation program offered by a central Kentucky health department on parental risk factors. A family social worker or nurse interviewed parents pre-intervention, completing a Parent Survey which assessed multiple parental risk factors associated with negative health and well-being and to calculate a total risk score. Upon exiting the program, parents are re-interviewed to document improvements, review progress and accomplished goals, plan for transitional services, and calculate a new risk score. As of December 2010, 64 families had completed the home-visitation program and had pre- and post-risk scores available for analysis. Based on paired-sample t tests, there was a statistically significant difference in total mean risk scores among both mothers and fathers from pre to post. The McNemar–Bowker test also revealed statistically different scores for four of the six risk factors for mothers and fathers pre- and post-home-visitation: lifestyle behaviors and mental health, coping skills and support systems, stresses, and anger management skills. Findings suggest that families who were deemed at-risk for adverse pregnancy and child health outcomes benefit from participation in the home-visitation program. Programs designed to promote positive pregnancy outcomes and child development may benefit from providing social support, fostering parental knowledge, skill development and problem solving, insuring proper medical care, and connecting parents with community resources.     

Social Validity of a Training and Coaching Program for Parents of Children With Autism Spectrum Disorder on a Waiting List for Early Behavioral Intervention

Due to limited public resources, many children with autism spectrum disorder and their families must wait several months, if not years, to access early behavioral intervention (EBI) services. Service providers must thus develop alternative support models to assist families placed on waiting lists. The present study assessed the social validity of one such initiative, a training and coaching program for parents whose children had been put on a waiting list for EBI services. This program consisted of group training sessions on strategies to cope with their child’s disorder based on applied behavioral analysis and on one-hour, weekly follow-up meetings to support parents’ interventions with their child over the course of 12 months. Social validity was assessed through parental satisfaction with this program and their perception of its effects on themselves, the family, the child, and parental stress. The 94 participants were generally satisfied with the program overall, although they wished for more frequent and intensive interventions. They reported that the program had positive effects on their psychological well-being, their family’s quality of life, and their child’s behavior. However, parenting stress levels were found to have increased over the 12-month period. These results demonstrate that training and individually supporting parents can be beneficial for families of children with ASD who cannot have access to early behavioral intervention immediately upon receiving a diagnosis. Importantly, however, these lower-cost, parent-focused programs cannot be considered a substitute for more intensive and children-driven services.     

Gender-Typed Play Behavior in Early Childhood: Adopted Children with Lesbian, Gay, and Heterosexual Parents

This study examined whether the gender-typed play of young children varies as a function of family structure. Using a sample of 126 couples (44 lesbian couples, 34 gay male couples, and 48 heterosexual couples) located throughout the United States, with an adopted child between the age of 2 and 4?years old (mean?=?2.5?years), we examined parent reports of children’s gender-typed play behavior utilizing the Pre-School Activities Inventory (PSAI; Golombok and Rust 1993). Findings revealed that the perceived play behaviors of boys and girls in same-gender parent families were more similar (i.e., less gender-stereotyped) than the perceived play behavior of boys and girls in heterosexual-parent families (which were more divergent; that is, gender-stereotyped). Sons of lesbian mothers were less masculine in their play behavior than sons of gay fathers and sons of heterosexual parents. Our findings have implications for researchers who study gender development in children and adolescents.     

A Multivariate Genetic Analysis of Specific Phobia, Separation Anxiety and Social Phobia in Early Childhood

BACKGROUND: Comorbidity amongst anxiety disorders is very common in children as in adults and leads to considerable distress and impairment, yet is poorly understood. Multivariate genetic analyses can shed light on the origins of this comorbidity by revealing whether genetic or environmental risks for one disorder also influence another. We examined the genetic and environmental influences on the comorbidity between three common childhood anxiety disorders: Specific Phobia, Separation Anxiety and Social Phobia. METHODS: Using a two-phase design 4,662 twin-pairs were screened in the first phase and 854 pairs were assessed in the second phase by maternal-informant diagnostic interview using DSM-IV criteria. RESULTS: Multivariate genetic analysis revealed significant shared environmental over-lap between Specific Phobia and Separation Anxiety and significant familial and non-shared environmental over-lap between Specific Phobia and Social Phobia. CONCLUSIONS: Familial influences, especially shared environment, are central to the comorbidity between Specific Phobia and both Separation Anxiety and Social Phobia.     

Using Acceptance and Commitment Therapy During Methadone Dose Reduction: Rationale,Treatment Description,and a Case Report

Many clients who undergo methadone maintenance (MM) treatment for heroin and other opiate dependence prefer abstinence from methadone. Attempts at methadone detoxification are often unsuccessful, however, due to distressing physical as well as psychological symptoms. Outcomes from an MM client who voluntarily participated in an Acceptance and Commitment Therapy (ACT)–based methadone detoxification program are presented. The program consisted of a 1-month stabilization and 5-month gradual methadone dose reduction period, combined with weekly individual ACT sessions. Urine samples were collected twice weekly to assess for use of illicit drugs. The participant successfully completed the program and had favorable drug use outcomes during the course of treatment, and at the 1-month and 1-year follow-ups. Innovative behavior therapies, such as ACT, that focus on acceptance of the inevitable distress associated with opiate withdrawal may improve methadone detoxification outcomes.     

幼儿外倾性与攻击行为的关系:自我控制和母亲温暖教养的调节作用

本研究以上海市某幼儿园的237名3~6岁幼儿为被试,请母亲填写幼儿气质及教养方式问卷,幼儿园教师评定幼儿的攻击行为,探讨幼儿外倾性与攻击行为的关系,以及自我控制和母亲温暖教养方式在其中的保护作用。结果表明,自我控制和母亲温暖可以调节幼儿外倾性与攻击行为的关系。与较低的自我控制和母亲温暖的幼儿相比,幼儿较高的自我控制和母亲温暖,可以弱化外倾性与攻击行为的正向关联。结果揭示了自我控制和母亲温暖对幼儿外倾性具有保护作用,有助于减弱这些个体的攻击行为。     

幼儿外倾性与攻击行为的关系:自我控制和母亲温暖教养的调节作用

本研究以上海市某幼儿园的237名3~6岁幼儿为被试,请母亲填写幼儿气质及教养方式问卷,幼儿园教师评定幼儿的攻击行为,探讨幼儿外倾性与攻击行为的关系,以及自我控制和母亲温暖教养方式在其中的保护作用。结果表明,自我控制和母亲温暖可以调节幼儿外倾性与攻击行为的关系。与较低的自我控制和母亲温暖的幼儿相比,幼儿较高的自我控制和母亲温暖,可以弱化外倾性与攻击行为的正向关联。结果揭示了自我控制和母亲温暖对幼儿外倾性具有保护作用,有助于减弱这些个体的攻击行为。     

Sociometry: Rationale and Technique for Effecting Behavior Change in the Elementary School

Though sociometry has been used for some years in both educational, psychological, and military settings, it is the argument of this article that it should be used more by elementary counselors and school psychologists as a technique both to assess social desirability in students and as an interim criterion of behavior modification. The theoretical foundations of sociometry are found in both studies relating to the nature of perception and in more modern social learning theory. The suggestion is advanced that social desirability is related to motivation to achieve. Consequently, the assessment of the social climate of the classroom is a first step in introducing procedures designed to enhance the level of effective learning.     

An Imbalance of Approach and Effortful Control Predicts Externalizing Problems: Support for Extending the Dual-Systems Model into Early Childhood

Although the association between deficits in effortful control and later externalizing behavior is well established, many researchers (Nigg Journal of Child Psychology and Psychiatry, 47(3-4), 395–422, 2006; Steinberg Developmental Review, 28(1), 78–106, 2008) have hypothesized this association is actually the product of the imbalance of dual systems, or two underlying traits: approach and self-regulation. Very little research, however, has deployed a statistically robust strategy to examine that compelling model; further, no research has done so using behavioral measures, particularly in longitudinal studies. We examined the imbalance of approach and self-regulation (effortful control, EC) as predicting externalizing problems. Latent trait models of approach and EC were derived from behavioral measures collected from 102 children in a community sample at 25, 38, 52, and 67 months (2 to 5 ½ years), and used to predict externalizing behaviors, modeled as a latent trait derived from parent-reported measures at 80, 100, 123, and 147 months (6 ½ to 12 years). The imbalance hypothesis was supported: Children with an imbalance of approach and EC had more externalizing behavior problems in middle childhood and early preadolescence, relative to children with equal levels of the two traits.     

Development of an Intervention for Foster Parents of Young Foster Children with Externalizing Behavior: Theoretical Basis and Program Description

Foster parents are often faced with serious externalizing behaviors of their foster child. These behavioral problems may induce family stress and are related to less effective parenting and often increase. Foster children with behavioral problems are also more at risk of placement breakdown. An intervention to support foster parents of young foster children with externalizing behaviors is necessary to improve the effectiveness of foster placements. Based on research on effective parenting interventions and special needs of foster children, a treatment protocol was developed. This paper describes theoretical foundations for the content and form of the intervention and gives an overview of the modular treatment protocol. Preliminary outcomes of this intervention as well as challenges and future developments and research activities are discussed.