General and Domain-Specific Effectiveness of Cognitive Remediation after Stroke: Systematic Literature Review and Meta-Analysis

Cognitive remediation (CR) has been shown to improve cognitive abilities following a stroke. However, an updated quantitative literature review is needed to synthesize recent research and build understanding of factors that may optimize training parameters and treatment effects. Randomized controlled trials of CR were retrieved from seven electronic databases. Studies specific to adult stroke populations were included. Treatment effects were estimated using a random effects model, with immediate and longer-term follow-up outcomes, and moderator effects, examined for both overall and domain-specific functioning. Twenty-two studies were identified yielding 1098 patients (583 in CR groups). CR produced a small overall effect (g?=?0.48, 95% CI 0.35–0.60, p?<?0.01) compared with control conditions. This effect was moderated by recovery stage (p?<?0.01), study quality (p?=?0.04), and dose (p?=?0.04), but not CR approach (p?=?0.63). Significant small to medium (g?=?0.25–0.75) post-intervention gains were evident within each individual outcome domain examined. A small overall effect (g?=?0.27, 95% CI 0.04–0.51, p?=?0.02) of CR persisted at follow-up (range 2–52 weeks). CR is effective and efficient at improving cognitive performance after stroke. The degree of efficacy varies across cognitive domains, and further high-quality research is required to enhance and sustain the immediate effects. Increased emphasis on early intervention approaches, brain-behavior relationships, and evaluation of activity and participation outcomes is also recommended.     

Maternal Depression in Families of Children with ADHD: A Meta-Analysis

Although research has demonstrated a relationship between maternal depression and child attention deficit/hyperactivity disorder (ADHD); the strength of the relationship is currently unclear. The results of some studies have found a strong association between maternal depression and child ADHD, while other studies have found little or no association. A meta-analysis was conducted to clarify the strength of the association between maternal depression and child ADHD. The current study included 51 published and unpublished studies that included a quantitative comparison between maternal depression and child ADHD. Mothers of children with ADHD had significantly higher levels of depressive symptoms than mothers of children without ADHD (d?=?0.58; 95% CI [0.43, 0.74]; p?<?.001; k?=?18). The relationship between maternal depressive symptoms and child ADHD symptoms was moderate (r?=?.22; 95% CI [.17, .28]; p?<?.001; k?=?21). 17.11% of mothers of children with ADHD currently met criteria for a depressive disorder (95% CI [11.95, 23.89], p?<?.001, k?=?19). The DSM version used to evaluate child ADHD status was the only moderator that was statistically significant (p?=?.021, k?=?15). Specifically, studies that used the DSM-III or DSM-III-R were associated with larger effect sizes than studies that used the DSM-IV or DSM-IV-TR. The results suggest that clinicians should screen for the possible co-occurrence of maternal depression when working with families of children with ADHD.     

<Emphasis Type="Italic">DRD4</Emphasis> Variants Moderate the Impact of Parental Characteristics on Child Attention-Deficit Hyperactivity Disorder: Exploratory Evidence from a Multiplex Family Design

Parental ADHD symptomatology and related impairments have been robustly associated with youth ADHD across decades of work. Notably, these factors may impede typical development of child self-regulation capabilities through both neurobiological and interpersonal processes. High heritability of estimates for the disorder further suggest that these effects are likely genetically-mediated, at least in part. Variation within the dopamine D4 receptor gene (DRD4) has been shown to moderate parental influences on youth ADHD. Use of a multiplex family design (i.e., samples of families that included multiple affected members) may facilitate identification of additional gene variants of interest and advance understanding of gene-environment interplay in regard to parenting. Thirty multiplex families consisting of 114 individuals (66 youth, 48 parents) completed a multi-stage, multi-informant diagnostic and neurocognitive assessment, measures of parenting, and provided saliva samples for DNA analyses. Sanger sequencing of the DRD4 gene yielded 16 rare variants; a polygenic risk score was computed for both parents and youth. Generalized estimating equations (GEE) examined the predictive effects of parental ADHD symptoms, parental neurocognitive functioning, and poor parenting dimensions on youth ADHD as well as moderation of these effects by parental and youth DRD4 variants. Findings indicated that parental DRD4 variants moderated the impact of parental ADHD and neurocognitive functioning on youth ADHD symptoms. Youth DRD4 variants moderated the impact of parental inconsistent discipline on child ADHD. In all cases, stronger associations were observed for those individuals with more risk variants. These exploratory findings highlight the potential utility of a multiplex family design for examining the interplay between parent and child characteristics in predicting youth outcomes.     

Psychometric Properties of the Parenting Sense of Competence Scale in Treatment-Seeking Post-9/11 Veterans

Although evidence suggests deployment-related stress impacts parenting, few measures of parenting competency have been validated in returning post-9/11 veterans. As part of clinical care in a multidisciplinary clinic serving veterans and military families, 178 treatment-seeking OEF/OIF/OND veterans completed measures including the 16-item Parenting Sense of Competence Scale (PSOC), a widely-used measure of parental efficacy and satisfaction; the Family Assessment Device—general functioning subscale; and the depression, anxiety, and stress scale. Utilizing data from an IRB-approved de-identified data repository, we examined the psychometrics and factor structure of the PSOC. According to a proposed clinical cut-off, 10?% of our clinical sample of veterans exhibited low self-confidence in parenting. A confirmatory factor analysis of the 2-factor structure introducing correlated error terms between items 3 and 9, and between items 10 and 11, revealed to be a satisfactory fit to the data (Χ ² /df?=?1.57, RMSEA?=?0.056 [90?% CI 0.039–0.073]; CFI?=?0.928; TLI?=?0.914; SRMR?=?0.055). In addition, the PSOC exhibited good convergent validity with measures of parental distress (r?=??.22, p?<?0.01 with anxiety symptoms, and r?=??.33, p?<?.001 with depressive symptoms) and family functioning (r?=??.53, p?<?.0001), very good temporal stability (r?=?.81, p?<?.0.0001), and excellent internal consistency (α?=?.85). The PSOC exhibited satisfactory psychometric properties in treatment-seeking veterans and may be used by clinicians and researchers to assess parenting sense of competence, including satisfaction and sense of efficacy, in this population.     

The Effectiveness of Psychosocial Interventions Delivered by Teachers in Schools: A Systematic Review and Meta-Analysis

The growing mental health needs of students within schools have resulted in teachers increasing their involvement in the delivery of school-based, psychosocial interventions. Current research reports mixed findings concerning the effectiveness of psychosocial interventions delivered by teachers for mental health outcomes. This article presents a systematic review and meta-analysis that examined the effectiveness of school-based psychosocial interventions delivered by teachers on internalizing and externalizing outcomes and the moderating factors that influence treatment effects on these outcomes. Nine electronic databases, major journals, and gray literature (e.g., websites, conference abstract) were searched and field experts were contacted to locate additional studies. Twenty-four studies that met the study inclusion criteria were coded into internalizing or externalizing outcomes and further analyzed using robust variance estimation in meta-regression. Both publication and risk of bias of studies were further assessed. The results showed statistically significant reductions in students’ internalizing outcomes (d = .133, 95% CI [.002, .263]) and no statistical significant effect for externalizing outcomes (d = .15, 95% CI [?.037, .066]). Moderator analysis with meta-regression revealed that gender (%male, b = ?.017, p < .05), race (% Caucasian, b = .002, p < .05), and the tier of intervention (b = .299, p = .06) affected intervention effectiveness. This study builds on existing literature that shows that teacher-delivered Tier 1 interventions are effective interventions but also adds to this literature by showing that interventions are more effective with internalizing outcomes than on the externalizing outcomes. Moderator analysis also revealed treatments were more effective with female students for internalizing outcomes and more effective with Caucasian students for externalizing outcomes.     

Childhood Adversity and Children’s Academic Functioning: Roles of Parenting Stress and Neighborhood Support

Existing research has shown that adverse childhood experiences from family instability and lack of safety increase children’s risk for poor academic functioning. A recent conceptual framework, however, has emphasized the need to investigate how parenting might mediate while community context might moderate the association between childhood adversity and children’s cognitive development. In the current study, we tested the roles of parenting stress and neighborhood support in the association between cumulative childhood adversity and children’s current academic functioning. We conducted a secondary data analysis on the subsample of school-aged children (i.e., 6–17 years old; N?=?65,680) from the 2011–2012 United States National Survey of Children’s Health (NSCH). The parent provided telephone survey data on six types of adversity (e.g., parent’s divorce) that the target child experienced, parenting stress, neighborhood support, as well as the child’s academic functioning. Controlling for the child’s age, gender, ethnicity, and the parent’s education level, structural equation modeling (SEM) revealed a significant moderated mediating effect: parenting stress partially mediated the association between history of childhood adversity and children’s current academic functioning (β?=??1.760, p?<?0.001), while neighborhood support moderated the association between parenting stress (β?=?0.492, p?<?0.001) and academic functioning.     

Long-Term Neuropsychological Outcomes of Childhood Onset Acute Disseminated Encephalomyelitis (ADEM): a Meta-Analysis

The long-term neurocognitive prognosis of childhood onset acute disseminated encephalomyelitis (ADEM) is unclear. This review and quantitative synthesis of the available literature examined whether there are long-term impacts of childhood ADEM on neurocognitive functioning. A search of online databases (MEDLINE, EMBASE, EBSCO CINAHL, PsycINFO and the Cochrane Database of Systematic Reviews) from their inception to October 2015 and reference lists identified 13 papers eligible for inclusion in the systematic review; seven of these were eligible for inclusion in meta-analyses. The systematic review indicated that, at a group level there is a positive long-term neuropsychological outcome from childhood onset ADEM. However, despite the apparent absence of long-term negative impacts of ADEM at a group level, at an individual level impairments in the areas of IQ, attention, executive functioning, processing speed, learning and memory, visuospatial skills and internalising symptoms were found in up to 43% of patients when aggregated across the studies. No significant negative effect of ADEM for any of the neuropsychological domains examined was found in meta-analyses. However, the effects for Processing Speed (r _mean = ?0.296 (CI 95% = ?0.605-0.013)) and Internalising symptoms (r _mean = 0.242 (CI 95% = ?0.014-0.564)) approached significance (p = 0.06), suggesting a trend towards ADEM leading to long-term reduced processing speed and elevated internalising symptoms. Together, our findings suggest that despite a generally positive neurocognitive outcome post childhood ADEM there are a subset of individuals who can suffer from ongoing specific cognitive impairments. Clinical implications and research priorities are discussed.     

Impact of Well-being Interventions for Siblings of Children and Young People with a Chronic Physical or Mental Health Condition: A Systematic Review and Meta-Analysis

Siblings of children and young people with a chronic illness are at increased risk of poor psychological functioning. A number of studies have attempted to implement and evaluate interventions targeting the psychological well-being of this at-risk group. This systematic review summarises the evidence regarding psychological functioning of siblings following an intervention targeting their well-being. The meta-analysis considered behaviour and knowledge, two of the most frequently studied outcomes. The following databases were used: PsycINFO, EMBASE, CINAHL, PubMed, Scopus and Web of Science. Seventeen studies were eligible to be included in the systematic review and eight in the meta-analysis. Results from the systematic review reflected the inconsistency of intervention evaluations in this area with a high level of heterogeneity and a total of 23 outcomes considered across the 17 included studies. The meta-analysis estimated effect sizes using a standardised mean difference (SMD) approach. Pre-post analysis suggested significant improvement in behavioural outcomes and knowledge of their sibling’s health conditions with a SMD of ? 0.44 [95% CI (? 0.6, ? 0.29); p = 0.000] and 0.69 [(95% CI = 0.42, 0.96); p = 0.000], respectively. The SMD was not significant for behavioural outcomes when considering treatment–control studies. In conclusion, the findings suggest interventions for well-being have a positive effect on the psychological functioning of siblings of children and young people with a chronic illness, but their specificity needs to be established. There is a need for further, more methodologically robust research in this area.     

The Effectiveness of Coping Power Program for ADHD: An Observational Outcome Study

The present study evaluates the implementation of the Coping Power Program (CPP)-Child Component in a group of patients with attention deficit/hyperactivity disorder (ADHD), and explores the effects of this treatment on changes in the primary and associated symptoms of ADHD. A clinical sample of 50 children and preadolescents (8–13 years) with ADHD was involved. The clinical sample was split into a treatment group (TG; N?=?26), which was included in the child training program (CPP), and a control group (CG; N?=?24), which was placed on a waiting list. The Clinical Global Impression-Severity (CGI-S) and the Child Behavior Checklist 6–18 (CBCL 6–18) were assessed at baseline and at the end of treatment. The outcomes were assessed as a CBCL-subscale response rate and a CGI-S shift. Our results showed a significant improvement in children’s global functioning and in emotional and behavioral symptoms. The children in the TG were more likely to shift from a more severe functional impairment class to a less severe one (69.2% of TG vs. 20.8% of CG). Further, the CGI-S scores diminished significantly in the TG (p?<?0.01). There were significant differences in the changes in Social Problems (p?<?0.05), Attention Problems (p?<?0.05) and Rule-Breaking Behavior Scales (p?<?0.05). CPP seemed to be effective in children and adolescents with ADHD without comorbidity for ODD or CD. Our study revealed an improved outcome, not only in the core symptoms of ADHD, but also in global functioning and social adjustment. Possible improvements to the present formulation of CPP-C are discussed.     

Attachment Representations and Maternal Confidence: The Mediating Role of Postnatal Depressive Symptoms and Negative Thoughts

Attachment security can act as an inner resource to promote women’s adjustment to motherhood. However, the mechanisms explaining the relationship between attachment representations and maternal adaptation outcomes are not well understood. This study aimed to examine the direct and indirect effects of attachment representations on maternal confidence, through postpartum negative automatic thoughts and depressive symptoms. The sample consisted of 387 postpartum women who completed a cross-sectional online survey including measures of attachment representations, depressive symptoms, postpartum negative automatic thoughts and maternal confidence. Our results showed a significant relationship between more insecure attachment representations and higher depressive symptoms (p?<?.001), but also with more frequent postpartum negative automatic thoughts (p?<?.001); depressive symptoms and postpartum negative automatic thoughts were also inversely associated with women’s maternal confidence (p?<?.001). Moreover, indirect effects of attachment representations on maternal confidence were found, but only through postpartum negative thoughts [attachment-related anxiety: 95% CI?=??0.03/?0.01; attachment-related avoidance: 95% CI?=??0.05/?0.01]. The results of the present study emphasize the important role of the cognitive component of depressive symptomatology (postpartum negative automatic thoughts) in the relationship between attachment representations and maternal confidence, allowing to draw specific implications. We highlight the implications for clinical practice during the perinatal period to address both negative thoughts and women’s maternal confidence.     

Early Feeding,Child Behaviour and Parenting as Correlates of Problem Eating

Mealtimes are a common source of stress for families. Examining factors related to problem eating may provide markers by which to identify families requiring assistance and salient targets for treatment. The current study investigated parenting practices and cognitions, generalisation of child behavioural issues, and early feeding history as they relate to problem eating in typically developing young children. We compared a community sample of 105 parents of 1.5–6-year-old children via survey and observation with 96 parents seeking treatment for their child’s problem eating. History of problems with breastfeeding, χ²(1)?=?3.88, p?=?.049, and the transition to solids, χ²(1)?=?7.27, p?=?.007, were more common among problem eaters than comparisons. Problem eaters had a greater number of problem behaviours outside of mealtimes, F(1181)?=?10.88, p?=?.001, though not more frequently than comparisons and not to clinical levels, F(1181)?=?1.81, p?=?.181. Parents of problem eaters reported more unhelpful mealtime parenting strategies, F(1155)?=?22.59, p?<?.001, yet general parenting style was similar by group, F(1187)?=?0.42, p?=?.527. Parents’ cognitions about mealtimes, F(1155)?=?119.81, p?<?.001, including mealtime-specific self-efficacy, F(1155)?=?171.30, p?<?.001, were poorer amongst problem eaters, and were the only factors to predict problem eating in the total sample. General parenting self-efficacy was poorer in parents of problem eaters (Behaviour: F(1187)?=?42.36, p?<?.001; Setting: F(1187)?=?10.64, p?=?.001). Evidence of feeding issues in infancy may support early detection of and intervention for later problem eating. The significance of broader child behaviour is less clear. Parent factors, particularly those specific to mealtimes, and cognitive in nature (including mealtime parenting self-efficacy) clearly differentiated the groups, and represent important targets for intervention.     

A Psychometric Evaluation of the Behavioral Inhibition Questionnaire in a Non-Clinical Sample of Israeli Children and Adolescents

This study examined the psychometric properties of a Hebrew version of the Behavioral Inhibition Questionnaire (BIQ) in a non-clinical sample of Israeli children and adolescents. We produced a Hebrew translation of the BIQ and collected 227 responses to it from parents of children aged 4–15. Some respondents in the larger sample also completed the Screen for Child Anxiety Related Emotional Disorders (SCARED) questionnaire (n?=?91) and the Conners’ Abbreviated Parent-Teacher (CONNERS) questionnaire (n?=?39), in addition to the BIQ. Lastly, 21 children of BIQ respondents (aged 8–14) completed a self-report version of the questionnaire. Confirmatory factor analysis (CFA) was performed to assess how well the established six correlated factor model of the BIQ applied to the sample data. The Hebrew BIQ demonstrated good internal consistency (Chronbach’s α?=?.94, n?=?227) and 3 month test–retest reliability, (r?=?.95, p?<?.001, n?=?21). It also showed both convergent validity, as scores on the BIQ were correlated with the SCARED (r?=?.66, p?<?.01. n?=?91), and discriminant validity, as BIQ scores were not correlated with the CONNERS (r?=?.24, n?=?39). Finally, mother reports of BI were significantly correlated to child reports of BI via the BIQ (r?=?.60, p?<?.01, n?=?21). Thus, through this preliminary study we demonstrated that the Hebrew version of the BIQ is an effective tool for screening for BI among Israeli children, making it a useful instrument for future research.     

Distress Tolerance and Social Support in Adolescence: Predicting Risk for Internalizing and Externalizing Symptoms Following a Natural Disaster

The purpose of the multi-measure, multi-wave, longitudinal study was to examine the interactive relation between behavioral distress tolerance (DT) and perceived social support (PSS) in 352 tornado-exposed adolescents aged 12–17 years (M = 14.44; SD = 1.74). At baseline, adolescents completed a computer-based task for DT, and self-report measures of PSS, depressed mood, posttraumatic stress disorder (PTSD), substance use, and interpersonal conflict. Symptoms also were assessed 4 and 12 months after baseline. Findings showed that lower levels of DT together with lower levels of PSS conferred risk for elevated symptoms of prospective depression (t(262) = ?2.04, p = .04; r_{effect size} = 0.13) and PTSD (t(195) = ?2.08, p = .04; r_{effect size} = 0.15) following a tornado. However, only PSS was significant in substance use t(139) = 2.20, p = .03; r_{effect size=}0.18) and conflict (t(138) = ?4.05, p < .0001; r_{effect size=}0.33) in our sample. Implications regarding adolescent DT, the transdiagnostic nature of PSS, and the clinical applications of our findings in the aftermath of a natural disaster are discussed.     

Development and Validation of the Knowledge of Parenting Strategies Scale: Measuring Effective Parenting Strategies

The current study aimed to develop and evaluate a measure of parenting knowledge, the Knowledge of Parenting Strategies Scale (KOPSS); specifically, to establish the scales internal reliability, ensure a clinically appropriate length, provide a community sample for future comparison, demonstrate adequate test–retest reliability and convergent validity, and to compare the scale to dysfunctional discipline styles. A total of n?=?865 parents were involved in the development and evaluation of the scale. In Study 1, data was collected from n?=?229 parents and Rasch analyses revealed seven items did not fit the measurement model. Study 2 involved a further sample of community families (n?=?346) and revealed the scale could be further shortened to 16 items. Study 3 revealed the scale has good test–retest reliability over a one-week period (r?=?.88, p?<?.001). Study 4 demonstrated convergent validity through a comparison to the Knowledge of Effective Parenting Scale (r?=?.583, p?=?.009). Study 5 utilised a sample of community families (n?=?190), revealing the scale was negatively correlated with hostile and lax discipline (r?=??.29, p?<?.001; r?=??.15, p?<?.05). Lastly, Study 6 showed scores on the KOPSS significantly improved following clinic-based and Internet-based Behavioural Parent Training. The KOPSS was found to be a valid and reliable measure of parenting knowledge of effective parenting strategies, which can be used to evaluate knowledge acquisition in parenting programs, and test the role of knowledge in behaviour change.     

Family Exploration: The Contribution of Stability and Change Processes

Building upon the redefinition of exploration as a family process, this study analyses how the processes of family stability and change may favour exploration by members of multiple family relational contexts. Sixty non-clinical family triads (mother, father, child) participated in an experimental observational study and were video-recorded while playing in different interactive configurations. The children (37 females and 23 males) were 4–5 years old (M?=?55 months). The mothers’ ages ranged from 29 to 45 (M?=?38) and the fathers’ ages ranged from 29 to 46 (M?=?39). All the parents were employed and were living together. All participants were Caucasians of Italian nationality. Using the Triadic Interactions Analytical Procedure (TIAP), the family morphostatic processes and the family morphogenetic processes were analysed in relation to the family members’ exploration. Data analyses showed that family stability continual construction (morphostasis) and family change (morphogenesis) involve different interactive and relational dynamics (χ²(8)?=?13.84, p?>?.05; CFI?=?.97, TLI?=?.94, SRMR?=?.06), even if they are intertwined processes (p?<?.001). Both morphostatic and morphogenetic processes were correlated to the level of exploration showed by family members (respectively r?=?.32, p?<?.05, and r?=?.59, p?<?.001), even if the morphogenetic processes had a stronger relation with family exploration (z?=?1.85, p _one-tailed ?<?.05).     

Subtypes of Adaptive and Maladaptive Perfectionism in Anorexia Nervosa: Associations with Eating Disorder and Affective Symptoms

Perfectionism is hypothesized to contribute to the etiology of anorexia nervosa (AN). However, there is little research regarding whether individuals with AN can be classified according to maladaptive (e.g., evaluative concerns) and adaptive (e.g., high personal standards) facets of perfectionism that predict distinct outcomes and might warrant different intervention approaches. In this study, a latent profile analysis was conducted using data from adults with AN (n?=?118). Frost Multidimensional Perfectionism Scale (Frost et al. Cognitive Therapy and Research, 14(5), 449–46, 1990) subscales were used to identify subgroups differing according to endorsed perfectionism features (e.g., adaptive and maladaptive perfectionism). Generalized linear models were used to compare subgroups on eating disorder and affective symptoms measured through questionnaire and ecological momentary assessment. Four subgroups were identified: (a) Low Perfectionism; (b) High Adaptive and Maladaptive Perfectionism; (c) Moderate Maladaptive Perfectionism; and (d) High Maladaptive Perfectionism. Subgroups differed on overall eating disorder symptoms (p?<?.001), purging (p?=?.005), restrictive eating (p?<?.001), and body checking (p?<?.001) frequency, depressive (p?<?.001) and anxiety (p?<?.001) symptoms, and negative (p?=?.001) and positive (p?<?.001) affect. The Low Perfectionism group displayed the most adaptive scores and the Moderate and High Maladaptive Perfectionism groups demonstrated the most elevated clinical symptoms. The High Adaptive and Maladaptive Perfectionism group demonstrated low affective disturbances, but elevated eating disorder symptoms. Results support the clinical significance of subtyping according to perfectionism dimensions in AN. Research is needed to determine if perfectionism subtyping can enhance individualized treatment targeting in AN.     

Antisocial Process Screening Device Subscales Predict Recidivism in an Australian Juvenile Offender Sample

The present study is the first to examine the psychometric properties of the self-report Antisocial Process Screening Device (APSD-SR), and the predictive utility of its subscales for reoffending, among Australian juvenile offenders (N?= 308, M age = 17.00, SD?=?1.49). Exploratory factor analysis supported a modified three-factor structure in which four items loaded differently to prior studies. Total APSD-SR and modified subscale scores were positively associated with criminal history and mental health problems (e.g., internalizing and externalizing problems, alcohol and substance abuse/dependence). Survival analyses indicated that youth scoring high on the APSD-SR total score were faster to reoffend nonviolently (Hazard Ratio [HR]?= 1.31, p?=?.0003) and violently (HR?=?1.42, p?=?.0003) than those scoring low. Whereas the modified grandiose-manipulative subscale predicted faster time to nonviolent recidivism (HR?=?1.18, p?=?.026) as a single predictor, when all subscales were simultaneously entered into the model only callous-unemotional (CU) traits and impulsivity predicted nonviolent recidivism (HR?=?1.19, p?=?.026 and 1.22, p?=?.015, respectively), and only impulsivity predicted violent recidivism (HR?=?1.26, p?=?.014). Findings inform current understanding of the relative contribution of adolescent psychopathy dimensions to designating a particularly high-risk group of Australian youth in custody.     

Emotion Regulation and Loss of Control Eating in Community-Based Adolescents

The current study investigated concurrent and prospective associations between emotion-related constructs and loss of control (LOC) eating in adolescents. Community-based females (N?=?588) completed annual self-report assessments of LOC eating, emotional awareness, emotion regulation strategies, and neuroticism from ages 16 to 18 years. Linear regressions and a regression-based multiple mediation model using bootstrapping were computed to examine the relationships among emotion-related constructs and LOC eating frequency. In the concurrent model, age 18 emotional awareness and emotion regulation strategies were associated with age 18 LOC eating, F(6, 416)?=?12.11, p?<?0.001, accounting for 4.5 % of the variance after controlling for demographics, body mass index, and neuroticism, F change?=?10.81, p?<?0.001. In the prospective model, age 17 emotional awareness predicted age 18 LOC eating, F(7, 425)?=?11.67, p?<?0.001, accounting for 1.7 % of unique variance beyond the effects of age 16 LOC eating and age 17 demographics, body mass index, and neuroticism, F change?=?4.26, p?=?0.015. In the multiple mediation model, age 18 emotion regulation strategies mediated the association between age 17 neuroticism and age 18 LOC eating, indirect effect estimate?=?0.003, 95 % confidence interval?=?0.001–0.005, after controlling for age 16 LOC eating and age 17 demographics, body mass index, and emotion regulation variables. Results suggest that deficient emotion regulation may contribute to the onset and maintenance of LOC eating in adolescence (although effects were small), and may partially explain the well-established prospective relationship between negative emotionality and later LOC eating. Prevention and early intervention programs should seek to improve adaptive coping in at-risk populations.     

Attitudes Toward Genetic Testing for Celiac Disease

HLA molecular typing for celiac disease (CD) is a genetic test with a high negative predictive value. The aim of this study is to explore knowledge of and attitudes towards genetic testing (GT). A 25-item questionnaire was developed by a multidisciplinary team and distributed to members of CD support groups across the United States. Respondents (n?=?1835) were mainly female (88 %), married (76 %), and college-educated (55 %), with a median age range of 31–50 years. Those who were married (82 vs 75 %, p?=?0.002), had children (82 vs 74 %, p?<?0.001), and had pursued education beyond high school (81 vs 68 %, p?=?0.004) were more likely to be aware of the availability of GT. On multivariable analysis, adjusting for age, sex, education, marital status, region of residence, and having children, college-education (OR 2.05, 95 % CI: 1.33–3.16) and having children (OR 1.56, 95 % CI: 1.15–2.11) remained significant predictors of GT awareness. A majority of patients with a personal or family history of CD planned GT for their children, and the most common concerns regarding GT were cost and impact on health care and/or insurance. In conclusion, awareness of GT is high among CD support group members. Efforts should be made to increase knowledge of GT in those with a lower educational level, and healthcare professionals should attempt to address concerns regarding GT cost and the impact of results on health care and insurance status.