Cognitive-behavioral therapies for hyperactive children: Premises,problems, and prospects

The impetus for the widespread use of CBT for children with attention deficit disorder (hyperactivity) is examined, followed by an evaluation of various facets of treatment efficacy. The many unknowns concerning treatment ingredients, targets of change, domain specificity, individual differences, palatability, and treatment-emergent side effects are then reviewed. The final section focuses on future directions, specifying some reasons for optimism despite the disappointing outcomes to date. Nontraditional uses of CBT are also proposed, including the implementation of cognitive strategies to counteract undesirable emanative effects of extant treatments and to facilitate drug discontinuance in children taking psychoactive medication.     

Social skills, social outcomes, and cognitive features of childhood social phobia.

Social skills, social outcomes, self-talk, outcome expectancies, and self-evaluation of performance during social-evaluative tasks were examined with 27 clinically diagnosed social phobic children ages 7-14 and a matched nonclinical group. Results showed that, compared with their nonanxious peers, social phobic children demonstrated lower expected performance and a higher level of negative self-talk on social-evaluative tasks. In addition, social phobic children showed social skills deficits as assessed by self- and parent report, an assertiveness questionnaire, and direct behavioral observation. Furthermore, compared with the control group, social phobic children were rated by themselves and others as significantly less socially competent with peers and were found to be less likely to receive positive outcomes from peers during behavioral observation. Implications for the assessment and treatment of childhood social phobia are discussed.     

Suicidal ideation among adolescent school children, involvement in bully-victim problems, and perceived social support.

Relationships among suicidal ideation, involvement in bully-victim problems at school, and perceived social support were investigated with samples of adolescent students (N = 1103 and N = 845) attending secondary school in South Australia. Results obtained from self-reports and peer nomination procedures to identify bullies and victims indicated that involvement in bully-victim problems at school, especially for students with relatively little social support, was significantly related to degree of suicidal ideation.     

A behavior genetic investigation of adolescent motherhood and offspring mental health problems

The present study examines the relations between adolescent motherhood and children's behavior, substance use, and internalizing problems in a sample of 1,368 children of 712 female twins from Australia. Adolescent motherhood remained significantly associated with all mental health problems, even when using a quasiexperimental design capable of controlling for genetic and environmental confounds. However, the relation between adolescent motherhood and offspring behavior problems and substance use was partially confounded by family background variables that influence both generations. The results are consistent with a causal relation between adolescent motherhood and offspring mental health problems, and they highlight the usefulness of behavior genetic designs when examining putative environmental risks for the development of psychopathology. The generalizability of these results to the United States, which has a higher adolescent birth rate, is discussed.     

Adolescent over-general memory,life events and mental health outcomes: Findings from a UK cohort study

Previous research suggesting that over-general memory (OGM) may moderate the effect of life events on depressive symptoms and suicidality has sampled older adolescents or adults, or younger adolescents in high-risk populations, and has been conducted over relatively short follow-up periods. The authors examined the relationship between OGM at age 13 and life events and mental health outcomes (depression, self-harm, suicidal ideation and planning) at age 16 years within a sample of 5792 adolescents participating in the Avon Longitudinal Study of Parents and Children (ALSPAC), approximately 3800 of whom had also provided data on depression and self-harm. There was no clear evidence of either direct or interactive effects of OGM at age 13 on levels of depression at age 16. Similarly there was no clear evidence of either direct or interactive effects of OGM on suicidal ideation and self-harm. Although there was some evidence that over-general autobiographical memory was associated with reduced risk of suicidal planning and increased risk of self-harm, these associations were absent when confounding variables were taken into account. The findings imply that although OGM is a marker of vulnerability to depression and related psychopathology in high-risk groups, this cannot be assumed to generalise to whole populations.     

Young adult follow-up of hyperactive children: self-reported psychiatric disorders,comorbidity, and the role of childhood conduct problems and teen CD

We report on the psychiatric disorders present at young adult follow-up (Mean age 20–21 years; 13 + year follow-up) and the comorbidity among them for a large sample of hyperactive (H; N = 147) and community control (CC; N = 71) children. The H group had a significantly higher risk for any nondrug psychiatric disorders than the CC group (59% vs. 36%). More of the H group met criteria for ADHD (5%); major depressive disorder (26%); and histrionic (12%), antisocial (21%), passive–aggressive (18%), and borderline personality disorders (14%) at follow-up than the CC group. Severity of childhood conduct problems contributed to the risk for passive–aggressive, borderline, and antisocial personality disorders. But it only affected risk for antisocial personality after controlling for severity of teen conduct disorder (CD), which also contributed to the risk for these same 3 disorders. Examination for comorbidity among these disorders indicated that presence of either borderline or antisocial personality disorder significantly increased the risk for major depression and the other significant personality disorders. More of the hyperactive group had received various forms of mental health treatment during and since leaving high school than the control group. Results suggest that hyperactive children are at significant risk for at least 1 nondrug disorder in young adulthood, principally major depression and several personality disorders, and that this risk is largely mediated by severity of CD at adolescence.     

Co-occurring mental health and substance use problems in offenders: implications for risk assessment

We undertook a secondary data analysis to study issues relevant to co-occurring mental health and substance disorder in a combined sample of offenders (N = 3,197). Using the Personality Assessment Inventory, we compared the frequency of depressive, traumatic stress, and personality disorder symptom elevations across offenders with and without substance problems, identified the extent to which co-occurring problems were accompanied by risk factors for suicide and aggression, and tested for gender differences. Offenders with substance problems were more likely than others to have increased mental health problems and risk factors for suicide or aggression. Women with substance problems, compared with men, had higher depression, traumatic stress, and borderline features, in addition to lower antisocial features. The frequency with which suicide and aggression risk factors were associated with mental health problems was generally similar across men and women. Measurement issues relevant to co-occurring disorder and risk assessment are discussed.     

Methylphenidate in hyperactive children: Differential effects of dose on academic,learning, and social behavior

Methylphenidate (Ritalin) has been shown to have differential effects on hyperactive children's behavior as a function of dose level. In the present investigation, a triple-blind, placebo-control, within-subject (crossover) experimental design was employed in which 12 hyperactive boys between 6 and 10 years received three different dosages of methylphenidate (5, 10, and 15 mg) in a randomly assigned sequence. Dosage effects were assessed on clinic(PAL-Paired Associates Learning test) and school-(percent on task, teacher ratings, work completion rates, and accuracy) related behaviors. For 10 of the children, classified as responders to medication by the PAL using the criteria of Swanson, Kinsbourne, and colleagues, a series of ANCOVAs with repeated measures showed significant dosage effects on teacher ratings (p 01), percent on task (p 01), academic accuracy (p 05), and assignment completion rates (p 05). PAL performance was also significantly enhanced (p 01) after optimal dose levels were considered. Subsequent trend analysis showed a significant positive linear relationship between dose and each of the dependent variables. A comparison of fixed-dose and miligram-per-kilogram plots showed that children's performance across the different dosages were clearly individualistic and task-specific, even when similar body weights were compared. The implications of using clinic-based testing to determine optimal medication responsivity were discussed.We would like to express our sincere appreciation to the following pediatricians for their valuable assistance: W. H. McDermott, D. J. Chronley, R. B. Trivett, F. J. Jehle, P. M. Small, and F. T. Leong. Grateful acknowledgement is also extended to the two anonymous reviewers whose comments contributed to the content of this paper, and to the undergraduate and graduate student members of the Children's Learning Clinic.     

The effects of widowhood on physical and mental health, health behaviors, and health outcomes: The Women's Health Initiative.

This study examined whether widowhood was associated with physical and mental health, health behaviors, and health outcomes using a cross-sectional (N=72,247) and prospective (N=55,724) design in women aged 50-79 years participating in the Women's Health Initiative observational study (85.4% White). At baseline, married women reported better physical and mental health and generally better health behaviors than widowed women. Whereas women who remained married over the 3-year period showed stability in mental health, recent widows experienced marked impairments and longer term widows showed stability or slight improvements. Both groups of widows reported more unintentional weight loss over the 3-year period. Changes in physical health and health behaviors were inconsistent, with generally small effect sizes. Findings underscore the resilience of older women and their capacity to reestablish connections, but point to the need for services that strengthen social support among women who have difficulty during this transition.     

A daily diary study of mental health and community involvement outcomes for three Chinese American social identities

Approximately 100 American youths of Chinese descent participated in a 14-day diary study, completing daily reports on ethnic feelings, American feelings, ethnic community involvement, and psychological well-being. Participants were divided into 4 identity orientations (Chinese, American, bicultural, or other) and then assessed for differential patterns of mental health and community involvement. Chinese-centered identities were characterized by positive well-being and positive self-esteem. However, the American-centered and bicultural groups had well-being and self-esteem levels equal to that of the Chinese-centered group. Although the measures of menial health failed to differentiate the identity categories, both the Chinese- and bicultural-centered groups showed high involvement in Chinese culture, whereas American-centered participants were, significantly less involved.     

Interaction of social skill and general mental ability on job performance and salary.

Job and organizational changes have promoted the importance of social skill at work, yet research in this area has been limited. The authors investigated the interaction between social skill and general mental ability (GMA) in the explanation of job performance and salary, controlling for personality and demographic characteristics. The results indicated that the relationships between social skill and job performance were stronger among workers high than low in GMA. In a similar manner. the relationships between GMA and job performance were stronger among workers high than low in social skill. The interaction on salary indicated that increases in social skill (or GMA) for high-GMA (or social skill) individuals were associated with higher salary levels. It is interesting, however, that increases in social skill (or GMA) for those low in GMA (or social skill) contributed to lower salaries. Implications of these results and directions for future research are discussed.     

Social desirability,adequacy of social support and mental health

The extent to which the association between satisfaction with social support and mental health was due to social desirability was determined. Whether this association differed between those high and low on social desirability was also examined. Measures consisted of the Crowne – Marlowe Scale, the Adequacy of Social Integration and Attachment Indices, the General Health Questionnaire, the Zung Self‐Rating Depression Scale and four scales from the Delusions‐Symptoms‐States Inventory. The sample comprised 132 women and 93 men randomly drawn from a larger sample of 756 selected at random from the Canberra electoral roll. Although social desirability was positively associated with satisfaction with social support and mental health, the association between mental health and satisfaction with social support was little reduced when social desirability was controlled, indicating that social desirability did not account for the association between social support and mental health. The association between satisfaction with social support and mental health did not differ between those high and low in social desirability, suggesting that this association was not moderated by social desirability. Copyright © 2000 John Wiley & Sons, Ltd.     

Middle childhood and adolescent contextual and personal predictors of adult educational and occupational outcomes: a mediational model in two countries

The authors examined the prediction of occupational attainment by age 40 from contextual and personal variables assessed during childhood and adolescence in 2 participant samples: (a) the Columbia County Longitudinal Study, a study of 856 third graders in a semirural county in New York State that began in 1960, and (b) the Jyv?skyl? Longitudinal Study of Personality and Social Development, a study of 369 eight-year-olds in Jyv?skyl?, Finland, that began in 1968. Both samples were followed up during adolescence and early and middle adulthood. Structural modeling analyses revealed that in both countries, for both genders, children's age 8 cognitive-academic functioning and their parents' occupational status had independent positive long-term effects on the children's adult occupational attainment, even after other childhood and adolescent personal variables were controlled for. Further, childhood and adolescent aggressive behavior negatively affected educational status in early adulthood, which in turn predicted lower occupational status in middle adulthood.     

Perspectives of people with mental health problems at hot spots: Attitudes and perceptions of safety,crime, and the police

People who live in places with high levels of crime and disorder are more likely to experience mental illness compared with those who do not live in these types of place (Weisburd et al., 2018; Weisburd & White, 2019). The increased police presence on high crime streets may also increase the likelihood that these individuals will encounter law enforcement. There is a strong body of literature focused on the relationship between neighborhoods and the physical and mental health of residents (e.g. Arcaya et al., 2016; Duncan & Kawachi, 2018; Leventhal & Brooks‐Gunn, 2003), but there are very few studies that look at the perceptions of people with mental illness directly, particularly as they relate to the environment of the street on which they live and attitudes toward the police. In turn, existing studies generally look at the most serious mental health problems (e.g. schizophrenia), ignoring more common mental health concerns such as post‐traumatic stress disorder (PTSD) and depression. This paper uses self‐report data from a large in‐person survey of people who live on crime hot spot and non‐hot spot streets in order to assess attitudes among a broader group of persons with mental health problems. Furthermore, we examine the interaction between living in crime hot spots and non‐hot spots and perceptions of these residents. Our findings in this broader sample confirm earlier studies that identify greater fear and less trust of the police among persons with mental illnesses. At the same time, our findings suggest that fear of crime and perceptions of police are moderated by living in a crime hot spot.     

The effect of acculturation and discrimination on mental health symptoms and risk behaviors among adolescent migrants in Israel

This study examines the role of acculturation, perceived discrimination, and self-esteem in predicting the mental health symptoms and risk behaviors among 1.5 and second generation non-Jewish adolescents born to migrant families compared with native-born Jewish Israeli adolescents in Israel. Participants included n = 65 1.5 migrant adolescents, n = 60 second generation migrant adolescents, and n = 146 age, gender, and socioeconomic matched sample of native-born Jewish Israelis. Participants completed measures of acculturation pattern, perceived discrimination, and self-esteem as well as measures of mental health symptoms and risk behaviors. Results show that migrant adolescents across generations reported worse mental health symptoms compared with native-born Jewish Israelis. However, only the 1.5 generation migrants reported higher engagement in risk behaviors compared with second generation migrants and native-born Jewish Israelis. Our findings further showed that acculturation plays an important role in predicting the mental health status of migrant youth, with those characterized with integrated acculturative pattern reporting lower mental health symptoms compared with assimilated acculturation pattern. Importantly, contextual factors, such as higher perception of discrimination in the receiving culture as well as individual factors such as lower self-esteem and female gender were strongly associated with worse mental health symptoms. The findings manifest the complex relationship between contextual factors and individual level variables in the acculturative process of migrants as well as the importance of examining the effect of migration generation on mental health outcomes.     

Help-seeking for mental health problems of children: preferences and attitudes in the United Arab Emirates

Parental attitudes, religious beliefs, and other sociocultural factors have all been recognized to influence help-seeking patterns in relation to child psychiatric morbidity. But few systematic studies have addressed this issue in the Arab region. In this study, we investigated the help-seeking preferences for mental health problems in a community sample. 325 parents contacted as part of a community-based study of child psychiatric disorders were surveyed using a semistructured interview schedule. Only 38% of those surveyed indicated they would seek help from mental health specialists in the event of psychiatric problems developing in a family member, including their children. Main reasons given for nonconsultation were reluctance to acknowledge that a member of their family has a mental illness, stigma attached to attending mental health services, and the skepticism about the usefulness of mental health services. Willingness to utilize psychiatric services was associated with better parental education, occupation, and socioeconomic status. Our results suggest that sociocultural factors and parental perceptions may have a major effect on whether children with psychiatric disturbance receive professional help.     

Celtic culture,Calvinism, social and mental health on the Island of Lewis

The five points of federal Calvinism, as outlined by the Synod of Dort, have had a strong influence on the Protestant church. Their negative effects on the culture and society of the Western Isles of Scotland are often overlooked, or simply accepted as an expresion of that culture. In this paper, an attempt is made to show how Celtic culture on the Isle of Lewis has been held back by this theology, and the effect of this repression on society and the individual. Particular areas of concern are the neglect of the Gaelic language, and the incidence of violence, alcoholism, and depression. Iain Macritchie, S.T.M., comes from the village of Ballantrushal on the Island of Lewis. He is a Church of Scotland minister with a particular interest in training ministers for work in the Highlands and Islands of Scotland, to which he has returned after a year on the Scottish Fellowship at Union Theological Seminary.