Changes in adolescent and parent hopefulness in psychotherapy: effects on adolescent outcomes as evaluated by adolescents,parents, and therapists

We examined the role of hope in the behavioral and socioemotional outcomes of adolescents referred to psychotherapy. Adolescents (n = 3517), aged 12–17 years, and their parents rated adolescents’ behavior problems, adolescents’ adaptive behavior, and their own subjective experience of hopefulness at intake and at 3-month follow-up. Therapists also rated adolescents’ behavior problems and adaptive behavior at intake and follow-up. Adolescents who reported increased hopefulness during treatment showed significantly fewer problems and significantly greater adaptive behavior at follow-up than adolescents who reported stable or decreased hopefulness. Similarly, adolescents’ outcomes were significantly associated with parents’ change in hopefulness during treatment. Results were consistent for adolescent, parent, and therapist ratings of outcomes. Our findings provide some of the first empirical evidence for the importance of hopefulness in the psychosocial treatment of adolescents and highlight the need to attend to hopefulness in both youths and their parents.     

The test of time: predictors and effects of duration in youth mentoring relationships

The effects and predictors of duration in youth mentor relationships were examined. The study included 1,138 young, urban adolescents (Mean age = 12.25, all of whom applied to Big Brothers Big Sisters programs. The adolescents were randomly assigned to either the treatment or control group, and administered questions at baseline and 18 months later. Adolescents in relationships that lasted a year or longer reported the largest number of improvements, with progressively fewer effects emerging among youth who were in relationships that terminated earlier. Adolescents who were in relationships that terminated within a very short period of time reported decrements in several indicators of functioning. Older adolescents, as well as those who had been referred for services or had sustained emotional, sexual or physical abuse, were most likely to be in early terminating relationships, as were married volunteers aged 26–30 and those with lower incomes. Several dyadic factors were also found to be related to earlier terminations, including race, gender, and relationship quality.     

Parental Marital Discord and Treatment Response in Depressed Adolescents

Evidence suggests that parental marital discord contributes to the development of internalizing and externalizing symptoms in children and adolescents. Few studies, however, have examined the association between parental marital discord and youth’s response to treatment. The present study examined the impact of interparental discord on treatment response in a randomized control trial of adolescents with major depression enrolled in the Treatment for Adolescents with Depression Study (TADS). Participants were 260 adolescents from two-parent households randomly assigned to one of four treatment groups: fluoxetine (FLX), cognitive behavior therapy (CBT), their combination (COMB), or placebo (PBO). Logistic regressions revealed that parental marital discord interacted with youth gender and co-morbid oppositionality symptoms to predict group differences in treatment response.     

Helping behaviour and moral judgement among adolescents

This study examined the development of helping behaviour and moral judgement during adolescence. Adolescents of three age groups, 12–13, 14–15 and 16–17 years, were asked to fill out a moral judgement questionnaire and were later asked to volunteer to help old people under three helping conditions: when tangible reward was promised in return for their help; when social reward was promised; and when no reward was promised. The volunteers who arrived at the appointed hour on the set date were asked by the experimenter to explain in writing why they had decided to help. The results showed that the older the adolescents, the less they expressed their willingness to help. Helping conditions had a differential effect on behaviour and influenced the three age groups differently. Finally, the results showed that the older the adolescents, the more altruistic the motives expressed and the more relativistically oriented they were. These results are explained within the framework of adolescents' social-developmental psychology.     

Use of Multisystemic Therapy to Improve Regimen Adherence Among Adolescents with Type 1 Diabetes in Poor Metabolic Control: A Pilot Investigation

The purpose of the current study was to conduct a pilot investigation to determine the effectiveness of Multisystemic Therapy (MST) for improving regimen adherence and metabolic control among adolescents with poorly controlled Type 1 diabetes. Thirty-one adolescents were randomly assigned to either MST or a control condition. MST treatment lasted approximately six months. Data were collected at study entry and at a six-month posttest. Twenty-five adolescents completed the study. Adolescents who received MST had significantly improved adherence to blood glucose testing and metabolic control from study entry to the six-month posttest, whereas controls did not. Adolescents receiving MST also had a decreased number of inpatient admissions at the six-month posttest. Improvements in metabolic control were related to improvements in parent report of adolescent adherence. Results suggest that MST holds promise as an intervention for improving adherence behavior and health outcomes among adolescents in poor metabolic control.     

Attachment-related differences in perceptions of an initial peer interaction emerge over time: Evidence of reconstructive memory processes in adolescents

This study examined whether attachment, assessed using the Adult Attachment Interview (AAI; George, Kaplan, & Main, 1996) was linked to how adolescents reconstructed their memory for an initial interaction with an unfamiliar peer. Adolescents (N = 189, 62% female) completed a 10-min laboratory task with a student whom they did not know. Immediately following this task, adolescents rated their perceptions of the interaction. Adolescents completed the same perception measure 2 weeks later. Although adolescents classified as secure and insecure on the AAI did not differ in how they perceived unfamiliar peers initially, attachment-related differences emerged over time. Insecure adolescents remembered the interactions as less positive and more negative and also reported being treated with greater hostility than they had initially reported 2 weeks earlier. In contrast, secure adolescents' memories for the negative aspects of the interaction and for hostile treatment remained stable, although, like insecure adolescents, they remembered the conflicts as being less positive than initially reported. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Behavioral Treatment of Non-Ulcer Dyspepsia

Abstract

A behavioral treatment program, largely based on applied relaxation was tested in a group of patients (n=32) suffering from non-ulcer dyspepsia. They were compared to a randomized Control group (n=33) and a non-randomized Extra control group (n=29), consisting of patients who had declined the offer of behavioral treatment. Self-recorded pain intensity had decreased significantly more in the Treatment group than in the Control group at post-treatment. Also, the Treatment group experienced fewer pain occasions than the Extra controls at post-treatment. There were no differences between groups at the one-year follow-up.     

An investigation of psychopathology in nonreferred suicidal and nonsuicidal adolescents

This investigation examined self-reported psychopathology in a school-based sample of 456 suicidal and nonsuicidal adolescents. The sample consisted of four groups: three at-risk for suicidal behavior based on current suicidal ideation as assessed by the Suicidal Ideation Questionnaire (SIQ; Reynolds, 1988), past suicide attempts, or both; and one nonsuicidal comparison group. Psychopathology was examined using ten scales from the Adolescent Psychopathology Scale (APS; Reynolds, 1998a) including: Major Depression, Conduct Disorder, Substance Abuse, Schizophrenia, Adjustment Disorder, Anorexia Nervosa, Borderline Personality Disorder, Obsessive-Compulsive Personality Disorder, Schizotypal Personality Disorder, and Avoidant Personality Disorder. Analyses were conducted separately for males and females using a MANOVA design that examined psychopathology severity among the four groups. Adolescents who engaged in past or current suicidal behavior had higher psychopathology severity scores compared to their nonsuicidal peers. Males with current suicidal thoughts who had attempted suicide had the highest levels of psychopathology severity compared to males in the other three groups. Females with a past suicide attempt or current suicidal ideation had higher psychopathology severity scores compared to nonsuicidal females. Results show greater psychopathology in school-based adolescents who have engaged in past and/or current suicidal behavior. The need for clinicians and mental health professionals working with at-risk youth to focus on concurrent psychopathology along with suicidal behavior is discussed.     

Differences in risk factors and adjustment for male and female delinquents in treatment foster care

Differences by gender in the presence of risk factors, patterns of previous delinquency, and response to treatment were examined for a sample of 88 adolescents who were placed in Treatment Foster Care. Females were found to have fewer foster parent-reported problem behaviors than their male counterparts during the first month of treatment. By month 6, problem behavior levels for males had dropped, while scores for female subjects had increased to the level of males at month 1. No differences in pre-post arrest data or program completion rates for males and females were found. Implications for research on and treatment of female adolescents with conduct problems are discussed.     

Multi-Informant Assessments of Adolescent Social Anxiety: Adding Clarity by Leveraging Reports from Unfamiliar Peer Confederates

Adolescent social anxiety (SA) assessments often include adolescent and parent reports, and low reporting correspondence results in uncertainties in clinical decision-making. Adolescents display SA within non-home contexts such as peer interactions. Yet, current methods for collecting peer reports raise confidentiality concerns, though adolescent SA assessments nonetheless would benefit from context-specific reports relevant to adolescent SA (i.e., interactions with unfamiliar peers). In a sample of 89 adolescents (30 Evaluation-Seeking; 59 Community Control), we collected SA reports from adolescents and their parents, and SA reports from unfamiliar peer confederates who interacted with adolescents during 20-minute mock social interactions. Adolescents and parents completed reports on trait measures of adolescent SA and related concerns (e.g., depressive symptoms), and adolescents completed self-reports of state arousal within mock social interactions. Adolescents’ SA reports correlated with reports on parallel measures from parents in the .30s and with peer confederates in the .40s to .50s, whereas reports from parent-confederate dyads correlated in the .07 to .22 range. Adolescent, parent, and peer confederate SA reports related to reports on trait measures of adolescent SA and depressive symptoms, and distinguished Evaluation-Seeking from Community Control Adolescents. Confederates’ SA reports incrementally predicted adolescents’ self-reported SA over and above parent reports, and vice versa, with combined Rs ranging from .51 to .60. These combined Rs approximate typical correspondence levels between informants who observe adolescents in the same context (e.g., mother-father). Adolescent and peer confederate (but not parent) SA reports predicted adolescents’ state arousal in social interactions. These findings have implications for clarifying patterns of reporting correspondence in clinical assessments of adolescent SA.     

Psychosocial implications of poor motor coordination in children and adolescents

Utilising Harter's theory of competence motivation (Harter, S. The determinants and mediational role of global self-worth in children. In: N. Eisenberg, Contemporary topics in developmental psychology, Wiley, New York, 1987, pp. 219-242.), the current study examined perceived competence and social support, and their influence on self-worth and anxiety in children and adolescents with and without developmental coordination disorder (DCD). A group of children aged 8-10 years, and a group of adolescents aged 12-14 years, with significant movement problems were compared with matched control groups on measures of perceived competence, perceived social support, self-worth and anxiety. Those with DCD were found to perceive themselves as less competent in several domains, and having less social support than control participants. Overall, DCD groups had lower self-worth and higher levels of anxiety than the control groups. Adolescents also perceived themselves as less competent with poorer social support and lower self-worth than younger children. In addition, anxiety was significantly higher for the adolescent group compared to their younger counterparts.     

Trajectories of sleep problems among adolescents after the Wenchuan earthquake: the role of posttraumatic stress disorder symptoms

Objective: We examined the trajectories of sleep problems in adolescents after the Wenchuan earthquake, and assessed predictors such as posttraumatic stress disorder symptoms. Methods: We surveyed adolescents at 1, 1.5, 2, and 2.5 years after the Wenchuan earthquake. In total, 391 adolescents completed self-report questionnaires. Results: We identified five latent sleep problem trajectories, specifically, U-shaped (3.8%), low-stable (68.0%), high-stable (10.8%), increasing (8.7%), and decreasing (8.7%) trajectories. Additionally, we found that posttraumatic stress disorder hyper-arousal symptoms were more frequent in individuals who had non-low-stable trajectories. Adolescents in the U-shaped group were less likely to have intrusive symptoms. Conclusion: After natural disasters, consequent sleep problems in adolescents do not remain stable over time, and sleep problem trajectories had considerable heterogeneity.     

An Intensive Summer Treatment Program for ADHD Reduces Parent–Adolescent Conflict

There are currently almost no treatment efforts to reduce parent–adolescent conflict in adolescents with ADHD. As such, this study investigated the effect of an intensive Summer Treatment Program for Adolescents with ADHD (STP-A) on parent–adolescent conflict. Twenty adolescents and their parents completed the 8 week behavioral treatment program, which included 320 hours of adolescent-directed treatment, 15 hours of parent behavior management training, and daily feedback from staff on parent implementation of a home-based behavioral contract. Results indicated that 70–85 % of adolescents who attended the STP-A demonstrated reliable improvement in parent–adolescent conflict from baseline to post-treatment. Treatment response was associated with higher levels of conflict at baseline, but not adolescent ODD severity or parent ADHD severity. Several patterns of treatment non-response were detected through visual examination of weekly conflict scores during the STP-A. Discussion suggests that intensive, parent-involved treatment programs may be necessary to improve home-conflict in adolescents with ADHD.     

Characteristics of Suicidality Among Adolescents

The identification of high-risk adolescent suicide attempters in a population of depressed and suicidal adolescents is of crucial importance. This retrospective study examined characteristics of suicidality (recent and lifetime, active and passive) and psychopathology (depression, aggression, impulsivity, stressful life events, SCL-90 dimensions) among four groups of depressed adolescent outpatients: (1) suicide attempters who required medical treatment (n = 84), (2) suicide attempters who did not require medical treatment (n = 57), (3) suicidal ideators who had never made a suicide attempt (n = 40), and (4) nonsuicidal patients (n = 44). Results indicate that the nonsuicidal group could be differentiated from the three suicidal groups on the basis of suicidality and psychopathology, and that the three suicidal groups could be differentiated from one another on the basis of suicidality but not psychopathology. These findings are discussed in terms of the usefulness of certain self-report measures of suicidality for identifying suicidal adolescents and for differentiating among them. Furthermore, the findings suggest that psychopathological factors do not determine which suicidal adolescents make a medically dangerous suicide attempt and which do not.     

青少年家庭义务感的研究

本研究采用家庭义务感问卷对711名高一和高三的城乡青少年进行了调查,考察当前青少年家庭义务感的基本特征.结果表明,(1)青少年总体上具有较强的家庭义务感;(2)农村青少年比城市青少年更为重视“未来对家庭的支持”;女青少年比男青少年更重视当前与未来对家庭的支持,以及对家人的尊敬;独生与非独生青少年的家庭义务感无显著差异;(3)在“当前对家庭的支持”与“未来对家庭的支持”方面,青少年的义务感高于他所感知到的父母的期望,但在“对家人的尊敬”上,青少年的态度与父母的期望间无显著差异.     

A controlled evaluation of assertion training with adolescents

A controlled evaluation of an assertion training package for adolescent students is described. Adolescents who received the treatment were compared to adolescents who received a placebo-counseling program. Although there were no significant differences between the groups prior to the program, the students who received the assertion training treatment significantly improved their ratings on the Piers-Harris Children's Self-Concept Scale both at termination and at a one-month follow-up. No effects were found on a locus of control scale or an anxiety scale for either program.     

Psychopathy as Predictor and Moderator of Multisystemic Therapy Outcomes among Adolescents Treated for Antisocial Behavior

Objective

The aim of the present study was to determine whether psychopathic traits act as a predictor and/or moderator of the effectiveness of Multisystemic Therapy (MST).

Method

The sample included N?=?256 adolescents (188 boys and 68 girls) referred for conduct problems, randomized to MST or Treatment As Usual (TAU). The mean age was 16 years (SD?=?1.31). Assessments were carried out before and immediately after treatment (6 months later). Three psychopathic traits (callous/unemotional traits, narcissism, and impulsiveness) were assessed with parent reports. Adolescents and parents were informants on externalizing problems.

Results

MST was more effective than TAU in decreasing externalizing problems for the “lower callous/unemotional” and “lower narcissism” group, but not for the “high callous/unemotional” and “high narcissism” group (moderators). Impulsiveness was found to predict more post-treatment externalizing problems rated by adolescents (predictor), but not more post-treatment externalizing problems rated by parents.

Conclusions

These findings point out the clinical relevance of adequately assessing psychopathic traits in adolescents referred for treatment of antisocial behaviour, and identifying those adolescents who show high levels of these traits. It is important to tailor MST specifically to meet the needs of juveniles with high levels of callous/unemotional traits and high levels of narcissism to obtain the same level of effectiveness as with juveniles scoring lower on these traits.     

Peer isolation and drug use among white non-Hispanic and Mexican American adolescents.

The social-emotional characteristics and drug-use patterns of adolescents who reported having no friends (i.e., isolates) were compared to those of adolescents in drug-using and non-drug-using peer groups. Adolescents who did not have drug-using peers reported the lowest drug use and those with drug-using peers had the highest drug use, with adolescents who were isolated falling in between. Isolated youth reported more shyness, greater feelings of alienation, and lower social acceptance than did those in the other groups. Isolated youth also reported more anger and depression than did youth with non-drug-using peers, but less anger and equivalent depression when compared to adolescents with drug-using peers. Results are discussed in terms of social-emotional characteristics of isolated youth and risk/protective factors.     

Treatment adherence among Latina female adolescent suicide attempters

Clinicians must identify factors among suicide-attempting adolescents and their families that increase treatment adherence. Researchers assessed a consecutive series of 140 disenfranchised Latina adolescents (ages 12-18 years) and their mothers presenting at a large urban emergency room after a suicide attempt by the adolescent. Adherence was examined as it related to service delivery, individual background characteristics, and psychosocial factors (current symptomatology, treatment attitudes). Each factor was found to predict adolescent treatment adherence. Adolescents receiving a specialized emergency room program, those with a diagnosis of disruptive behavior disorder, and those from single-parent households attended significantly more therapy sessions compared to their suicide-attempting peers receiving standard emergency room care. Adolescents with a diagnosis of anxiety disorders and those whose mothers reported more psychopathology and perceived more cohesive family relationships tended to attend significantly fewer treatment sessions. The implications for the delivery of emergency room interventions are discussed.     

Health-Related Hindrance of Personal Goals of Adolescents with Cancer: The Role of the Interaction of Race/Ethnicity and Income

This study examined the interaction of race/ethnicity and income to health-related hindrance (HRH) of personal goals of adolescents with cancer. Adolescents (N = 94) receiving treatment for cancer completed a measure of HRH, (including identification of personal goals, rating the impact of health on goal pursuit, and ratings of goal appraisals). The interaction of race/ethnicity and income on HRH was examined. Goal content and appraisal were compared by race/ethnic groups. The interaction between race/ethnicity and income was significant in predicting HRH, with HRH increasing for minority adolescents as income increases and HRH decreasing for white adolescents as income increases. Higher income minority adolescents reported the most goals. Low income minorities reported the least difficult goals. Goal content did not differ between groups. Sociodemographic factors contribute to HRH in adolescents with cancer. Structural and psychosocial support during treatment to maintain goal pursuit may improve psychosocial outcomes.