Effects of differential reinforcement on the behavior and self-esteem of children with emotional and behavioral disorders

Students in a residential special school for children with emotional and behavioral disorders participated in a study designed to reduce their levels of inappropriate behavior. The residential care staff rated the students' behavioral problems and their class teachers rated their overt self-esteem pre and post intervention. In addition, the students completed self-ratings of their self-esteem. The students were divided into two groups, experimental and control. A multiple baseline across behaviors design was used to assess behavioral changes in the experimental group. Both groups received tangible rewards to the same level but only the experimental group received them contingent upon behaving appropriately. Results showed that the experimental group students made substantial reductions in their levels of inappropriate behavior, which were maintained at a three-month followup. Also, ratings of their behavioral problems by residential child care staff suggested that this improvement in behavior had generalized beyond the classroom to the residential setting. However, no significant differences were found between the pre- and post-intervention ratings of their self-esteem or teacher ratings of their overt self-esteem.     

Family involvement and empowerment in mental health service provision for children with emotional and behavioral disorders

Involvement of families is a critical component in effective systems of care for children with disabilities and their families. We investigated the sociodemographic correlates of family involvement in mental health services for children who have emotional and behavioral disorders. Further, we investigated the relationship between family involvement and family empowerment. The Family Involvement Scale-Family Version was used to measure involvement of families in the provision of mental services for their children and the Family Empowerment Scale was used to measure pempowerment in families with children who have emotional and behavioral disorders. In additions, demographic data concerming family composition, race, education, incone, membership in a parent support group, and the mental health status of the children were also collected. The results showed that mothers, as well as respondents with less formal education, reported greater involvement in services for their children than fathers and those who were more educated. Further, the knowledge subscale of empowerment was significantly correlated with all, subscales of family involvement and personal empowerment was significantly correlated with the treatment subscale of family involvement.     

The effects of fixed-time reinforcement schedules on problem behavior of children with emotional and behavioral disorders in a day-treatment classroom setting

The current study assessed the effects of fixed-time reinforcement schedules on problem behavior of students with emotional-behavioral disorders in a clinical day-treatment classroom setting. Three elementary-aged students with a variety of emotional and behavioral problems participated in the study. Initial functional assessments indicated that social attention was the maintaining reinforcer for their verbally disruptive behavior. Baseline phases were alternated with phases in which attention was provided on fixed-time schedules in the context of an ABAB design. The results indicated that the provision of attention on fixed-time schedules substantially reduced the participants' rate of verbal disruptions. These decreases were maintained during initial thinning of the schedules. The results provide one of the first examples that such an intervention can be successfully implemented in a classroom setting.     

Personality traits as moderators of the associations between deployment experiences and PTSD symptoms in OEF/OIF service members

Abstract

This investigation examined traits from the five-factor model of personality as moderators of the associations of combat and aftermath of battle experiences with symptoms of posttraumatic stress disorder (PTSD) in 214 National Guard/Reserve service members deployed to operations enduring and Iraqi freedom. Extraversion significantly moderated the associations of both combat experiences and aftermath of battle experiences with PTSD severity, with associations weakening as levels of extraversion increased. The relation between aftermath of battle experiences and PTSD was also moderated by the other four personality factors, with the relation being weaker at higher levels of agreeableness, conscientiousness, and openness, and lower levels of neuroticism. These results suggest that personality traits may impact individual responses to war trauma, particularly war-related experiences that are not directly threatening to one's safety (i.e., aftermath of battle events vs. actual combat events). Although this investigation was cross-sectional, these findings indicate that personality traits are an important risk/resiliency factor to consider in people's responses to traumatic events.     

A cognitive‐behavioral model of anxiety disorders in children and adolescents

This study investigated a cognitive‐behavioral model of anxiety disorders in Japanese children and adolescents. Participants comprised 532 children from elementary schools and 751 adolescents from junior high schools as a community group, and 41 children and adolescents who fulfilled the criteria for childhood anxiety disorders as a clinical group. All participants completed three questionnaires about anxiety symptoms, self‐statements, and cognitive errors. While the clinical group showed more anxiety symptoms, negative self‐statements, and cognitive errors than the community group, there was no significant difference in positive self‐statements. Multigroup structural equation modeling found the presence of cognitive links for the community and clinical groups. Specifically, cognitive errors generated negative self‐statements, exacerbating a higher‐order factor (childhood anxiety) affecting six anxiety symptoms corresponding to the diagnostic criteria of psychological disorders. Mediated relationships were supported in only the community sample. Clinical implications for prevention and treatment of anxiety disorders in children and adolescents are discussed.     

School competence and emotional/behavioral problems among Norwegian school children as rated by teachers on the Teacher Report Form

Of 1,409 eligible children aged 6-13 years in grades 1 to 7 who were randomly selected from a national sample of Norwegian schools, 858 participated in the present study (60.9%). The sample was stratified by school centrality, region and size of grade cohort. The teachers assessed their children's academic performance, adaptive school functioning, and levels of emotional/behavioral problems using the 2001 version of the Teacher Report Form (TRF). Only one child was randomly selected from each grade cohort. Girls had significantly higher scores than boys in the Working Hard, Appropriate Behavior, Learning, and Total Adaptive Functioning domains. For girls, only the Working Hard domain was of medium effect size. While boys had significantly higher scores than girls on Attention, Thought Problems, Rule-Breaking, Aggression, Externalizing Problems and Total problems, only Attention Problems showed a medium effect size. Significant sex by age interaction effects were also found for Rule-Breaking, Externalizing, Internalizing, Anxious-Depressed and Total Problems. In all these comparisons, 10-13-year-old boys had significantly higher scores than 6-9-year olds, while girls had similar problem levels across age groups. Our mean Total Problems score (17.2) was lower than the grand mean (21.6) reported in a multi-country comparison but higher than in another Norwegian large-scale survey. Overall, our findings indicate that teachers in Scandinavia report, just as do parents, relatively low levels of emotional/behavioral problems among school-aged children.     

Effects of self-control training for elementary students with emotional and behavioral disorders

Progressive delay training (PDT) has been used to promote self-controlled choices (i.e., selecting a larger, later reward over a smaller, immediate reward) for people with a variety of developmental characteristics. However, the efficacy of PDT has not been evaluated in children with emotional and behavioral disorders (EBD), who often have co-occurring symptoms of impulsivity. The purpose of this study was to evaluate the effects of PDT with a rule-following requirement on the impulsive choices of 6 elementary students with EBD using a modified changing criterion design. Results indicated that PDT alone did not improve self-control, but a modified version of PDT with a rationale and rule for selecting the delayed reward promoted self-control for 3 participants. The remaining 3 participants continued to make impulsive choices despite further modifications to the PDT protocol. We discuss implications of our results and directions for future research on treating impulsivity in children with EBD.     

Attentional bias and emotional reactivity as predictors and moderators of behavioral treatment for social phobia

Cognitive behavioral therapy (CBT) is a well-established treatment for anxiety disorders, and evidence is accruing for the effectiveness of acceptance and commitment therapy (ACT). Little is known about factors that relate to treatment outcome overall (predictors), or who will thrive in each treatment (moderators). The goal of the current project was to test attentional bias and negative emotional reactivity as moderators and predictors of treatment outcome in a randomized controlled trial comparing CBT and ACT for social phobia. Forty-six patients received 12 sessions of CBT or ACT and were assessed for self-reported and clinician-rated symptoms at baseline, post treatment, 6, and 12 months. Attentional bias significantly moderated the relationship between treatment group and outcome with patients slow to disengage from threatening stimuli showing greater clinician-rated symptom reduction in CBT than in ACT. Negative emotional reactivity, but not positive emotional reactivity, was a significant overall predictor with patients high in negative emotional reactivity showing the greatest self-reported symptom reduction.     

Parenting stress and external stressors as predictors of maternal ratings of child adjustment

This study sought to disentangle the effects of different kinds of stress on maternal ratings of child externalizing and internalizing problems, social inhibition, and social competence, with a primary focus on parenting stress. The relations were explored in a sample consisting of mothers of 436 children (M_age = 7 years) in Sweden. Half the sample had had early clinical contacts during infancy due to child regulation problems, and the rest were mothers without known such early contacts. Demographic factors, family stressors, and parenting stress were examined in stress – adjustment models. Family stressors were clinical contact during infancy, current child and parent health problems, recent negative life events, and insufficient social support. Parenting stress as a mediator of the effect of other stressors on rated child adjustment was tested as was social support as a moderator of the effect of parenting stress on adjustment. The results showed that a higher parenting stress level was associated with maternal ratings of more externalizing and internalizing behaviors, more social inhibition, and lower social competence. Other family stressors and background variables were also found to be of importance, mainly for externalizing and internalizing problems and to some extent for social competence. Social inhibition had a unique relation to parenting stress only. Parenting stress mediated effects of other stressors in twelve models, whereas social support had no moderating effect on the link between parenting stress and child adjustment. Thus, parenting stress seems to be an important overarching construct. Clinical implications are proposed.     

The utility of screen for child anxiety related emotional disorders (scared) as a tool for identifying children at high risk for prevalent anxiety disorders

Abstract

The current study examined the utility of the Screen for Child Anxiety Related Emotional Disorders (SCARED) as a screening tool for the identification of children at high risk for prevalent childhood anxiety disorders. The child version of the Structured Clinical Interview for DSM (KSCID) was used as the diagnostic standard. It was investigated whether SCARED scores are indicative for the presence of generalized anxiety disorder, separation anxiety disorder, and social phobia. Five-hundred-and-thirty-seven children aged 7–14 years completed the SCARED. From this sample, 82 children were selected on the basis of their SCARED scores. A subgroup of these children scored relatively high on the generalized anxiety disorder, separation anxiety disorder, and/or social phobia scale(s) of the SCARED. A comparison group of children scored relatively low on these SCARED scales. Both groups of children then received the semi-structured interview to assess to what extent they fulfilled the DSM-IV criteria for the relevant anxiety disorders. Results provided some support for the predictive validity of the SCARED generalized anxiety disorder and separation anxiety disorder subscales. The implications of these findings for the detection of anxiety disorders in normal children are briefly discussed.     

Towards a cognitive-behavioral model of PTSD in children and adolescents

Posttraumatic stress disorder in children and adolescents has been studied only for the past 15–20 years and is the subject of a burgeoning corpus of research. Much research has focused on examining whether children and adolescents have the same responses to trauma as those experienced by adults. Many of the research tools used to investigate children's responses are taken from measures designed for use with adults, and these measures have proven to be useful. However, it has not been established that children's responses to traumatic events are related to the same underlying processes as are adults' responses. The possible application of 2 recent cognitive models of PTSD in adults to understanding PTSD in children and adolescents is discussed in this paper, within the context of what is already known about children's reaction to trauma and existing theoretical accounts of childhood PTSD. Particular attention is paid toward the nature of children's memories of traumatic events and how these memories relate to the reexperiencing symptoms of PTSD, and cognitive processes that may play a role in the maintenance of PTSD. It is proposed that the adoption of a more specific cognitive–behavioral framework in the study of this disorder may be beneficial and lead to better treatment outcomes.     

Wraparound care in vermont: Program development,implementation, and evaluation of a statewide system of individualized services

Over the past decade, there has been a dramatic shift in the provision of mental health services to children, adolescents, and their families. This shift has been marked by a movement away from restrictive treatment options toward the development of comprehensive community-based systems of care designed to keep the most challenging children in their homes, schools, and communities. Based on a model of intensive case management referred to as Wraparound Care, Vermont's statewide approach emphasizes aggressive outreach, use of the least restrictive treatment options, and care that is flexible, unconditional, and child- and family-centered. We chart the development of Vermont's Wraparound Care Initiative and present residential, educational, and behavioral outcome data for a cohort of 40 youth receiving Wraparound Care over a 12-month period. The results showed that after 12-months, youth who had been previously removed from their homes or were at imminent risk of such removal, were residing in significantly less restrictive community-based living arrangements and exhibiting significantly fewer problem behaviors than at intake. These results are discussed in light of recent national studies and previous studies on similar cohorts of Vermont youth receiving Wraparound Care.     

Professional and Provider Perspectives on Family Involvement in Therapeutic Foster Care

Therapeutic foster care (TFC) offers a promising community-based treatment option for children with serious emotional and behavioral disorders in the child welfare system. Family involvement is believed to contribute to achieving the goal of family reunification in TFC, but there has been little attention to family involvement in TFC. I present findings of a qualitative study of child welfare professionals' and TFC providers' perspectives on family involvement. Respondents' views of parent-child contact, parent-professional communication and information sharing, and family involvement in decision making were examined. Values and attitudes toward family involvement, practices related to family involvement, barriers to involvement, and strategies to promote involvement emerged as themes. Professionals in this study believed in the value of family involvement, but there were challenges at the organizational level and related to some TFC providers' lack of training to work with families.     

Relationship between types of humour and stress response and well‐being among children in Japan

This study examined the relationship between three types of children's humour (aggressive, self‐defeating, and playful) and the children's stress response and well‐being in the Japanese context, where a collectivistic culture is prevalent. To do so, 500 study participants (250 elementary and 250 junior high school students) were recruited. The participants reported the types of humour, stress responses, and level of well‐being that they experienced. After correlation analysis, aggressive humour and playful humour showed a positive correlation with stress responses; in addition, aggressive humour showed a negative correlation with well‐being. Self‐defeating humour showed a negative correlation with stress responses and a positive correlation with well‐being. We also conducted a cluster analysis using the scores for the three types of humour, analysing four groups: “aggressive humourists” (respondents who demonstrated above‐average aggressive humour and scored average for all other humours), “nonhumourists” (below‐average humour in all areas), “self‐deprecating humourists” (above‐average self‐defeating humour, below‐average aggressive humour, and average playful humour), and “multiple humourists” (above‐average humour in all areas). Upon comparing the results of stress responses and well‐being scores among the four groups, we found that self‐deprecating humourists reported the highest level of well‐being. These results show that in collectivistic cultures, self‐defeating humour may be adaptive.     

Factor structure of the Children's Revised Impact of Event Scale among children and adolescents who survived the 2008 Sichuan earthquake in China

To evaluate the psychometric properties of the Chinese version of Children's Revised Impact of Event Scale (CRIES) and its applicability among Chinese children and adolescents, a study was conducted on two samples, the first, 1 month after the 2008 Sichuan earthquake, the second, 7 months after the earthquake. High levels of posttraumatic stress symptoms were found among both groups of children. The results also showed a decline of intrusion and arousal symptoms in accordance with the different periods of time elapsed since the earthquake; however, no difference was found in the avoidance symptoms between the two samples. Both the subscales and the CRIES total showed moderate to good reliability. Confirmatory factor analysis (CFA) of CRIES supported the presumed three inter-correlated factors model. However, the results of the second sample (with more than 6 months elapsed subsequent to the earthquake) are more likely to support this model than those of the first sample. This study generally justifies the use of CRIES as a screening instrument for probable PTSD victims among children and adolescents exposed to horrible natural disasters in China. Limitations of the present study and directions for future research are also discussed.