Everyday Impact of Cognitive Interventions in Mild Cognitive Impairment: a Systematic Review and Meta-Analysis

Cognitive interventions in Mild Cognitive Impairment (MCI) seek to ameliorate cognitive symptoms in the condition. Cognitive interventions may or may not generalize beyond cognitive outcomes to everyday life. This systematic review and meta-analysis sought to assess the effect of cognitive interventions compared to a control group in MCI on generalizability outcome measures [activities of daily living (ADLs), mood, quality of life (QOL), and metacognition] rather than cognitive outcomes alone. PRISMA guidelines were followed. MEDLINE and PsychInfo were utilized as data sources to locate references related to cognitive interventions in individuals with MCI. The cognitive intervention study was required to have a control or alternative treatment comparison group to be included. Thirty articles met criteria, including six computerized cognitive interventions, 14 therapist-based interventions, and 10 multimodal (i.e., cognitive intervention plus an additional intervention) studies. Small, but significant overall median effects were seen for ADLs (d = 0.23), mood (d = 0.16), and metacognitive outcomes (d = 0.30), but not for QOL (d = 0.10). Computerized studies appeared to benefit mood (depression, anxiety, and apathy) compared to controls, while therapist-based interventions and multimodal interventions had more impact on ADLs and metacognitive outcomes than control conditions. The results are encouraging that cognitive interventions in MCI may impact everyday life, but considerably more research is needed. The current review and meta-analysis is limited by our use of only PsychInfo and MEDLINE databases, our inability to read full text non-English articles, and our reliance on only published data to complete effect sizes.     

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.     

Functional Disability in Mild Cognitive Impairment: A Systematic Review and Meta-Analysis

Accumulating evidence suggests that the pre-dementia syndrome mild cognitive impairment (MCI) is characterized by decrements in instrumental activities of daily living (IADL). The current review was a quantitative synthesis of the available literature to objectively characterize IADL disability in MCI while clarifying inconsistencies in findings across studies. It was hypothesized that individuals with MCI would display significantly greater functional impairment relative to cognitively intact controls. Candidate moderators specified a priori included functional assessment approach, MCI subtype, depressive symptoms, and language conducted. Online databases (PubMed/MEDLINE and PsycINFO) and reference lists were searched to identify peer-reviewed publications assessing IADL in MCI compared to normal aging. A total of 151 effect sizes derived from 106 studies met inclusionary criteria (N?=?62,260). Random effects models yielded a large overall summary effect size (Hedges’ g?=?0.76, 95 % confidence interval: 0.68???0.83, p?<?.001) confirmed in multi-level analyses adjusted for nesting of effect sizes within studies (g?=?0.78, 95 % confidence interval: 0.69???0.87). Functional assessment strategy and MCI subtype were significant moderators of effect size, whereas depressive symptoms and language were not. Results convincingly demonstrate that MCI is associated with significant difficulties in the performance of complex everyday tasks. It appears that functional decline, like cognitive decline, exists on a continuum from healthy aging to dementia onset. Implications for clinical practice and research priorities are discussed.     

Cognitive Interventions for Cognitively Healthy,Mildly Impaired,and Mixed Samples of Older Adults: A Systematic Review and Meta-Analysis of Randomized-Controlled Trials

Cognitive interventions may improve cognition, delay age-related cognitive declines, and improve quality of life for older adults. The current meta-analysis was conducted to update and expand previous work on the efficacy of cognitive interventions for older adults and to examine the impact of key demographic and methodological variables. EBSCOhost and Embase online databases and reference lists were searched to identify relevant randomized-controlled trials (RCTs) of cognitive interventions for cognitively healthy or mildly impaired (MCI) older adults (60+ years). Interventions trained a single cognitive domain (e.g., memory) or were multi-domain training, and outcomes were assessed immediately post-intervention using standard neuropsychological tests. In total, 279 effects from 97 studies were pooled based on a random-effects model and expressed as Hedges’ g (unbiased). Overall, results indicated that cognitive interventions produce a small, but significant, improvement in the cognitive functioning of older adults, relative to active and passive control groups (g = 0.298, p < .001, 95% CI = 0.248–0.347). These results were confirmed using multi-level analyses adjusting for nesting of effect sizes within studies (g = 0.362, p < .001, 95% CI = 0.275, 0.449). Age, education, and cognitive status (healthy vs. MCI) were not significant moderators. Working memory interventions proved most effective (g = 0.479), though memory, processing speed, and multi-domain interventions also significantly improved cognition. Effects were larger for directly trained outcomes but were also significant for non-trained outcomes (i.e., “transfer effects”). Implications for future research and clinical practice are discussed. This project was pre-registered with PROSPERO (#42016038386).     

Meta-Analysis of the Effects of Computerized Cognitive Training on Executive Functions: a Cross-Disciplinary Taxonomy for Classifying Outcome Cognitive Factors

The growing prevalence of neurodegenerative disorders associated with aging and cognitive decline has generated increasing cross-disciplinary interest in non-pharmacological interventions, such as computerized cognitive training (CCT), which may prevent or slow cognitive decline. However, inconsistent findings across meta-analytic reviews in the field suggest a lack of cross-disciplinary consensus and on-going debate regarding the benefits of CCT. We posit that a contributing factor is the lack of a theoretically-based taxonomy of constructs and representative tasks typically used. An integration of the Cattell-Horn-Carroll (CHC) taxonomy of broad and narrow cognitive factors and the Miyake unity-diversity theory of executive functions (EF) is proposed (CHC-M) as an attempt to clarify this issue through representing and integrating the disciplines contributing to CCT research. The present study assessed the utility of this taxonomy by reanalyzing the Lampit et al. (2014) meta-analysis of CCT in healthy older adults using the CHC-M framework. Results suggest that: 1) substantively different statistical effects are observed when CHC-M is applied to the Lampit et al. meta-analytic review, leading to importantly different interpretations of the data; 2) typically-used classification practices conflate Executive Function (EF) tasks with fluid reasoning (Gf) and retrieval fluency (Gr), and Attention with sensory perception; and 3) there is theoretical and practical advantage in differentiating attention and working-memory tasks into the narrow shifting, inhibition, and updating EF domains. Implications for clinical practice, particularly for our understanding of EF are discussed.     

Effectiveness of Two Cognitive Interventions Promoting Happiness with Video-Based Online Instructions

A 3-month experimental online study examined the short-term and 1 month follow-up effects of regularly practicing one of two cognitive interventions on subjective well-being. Participants were 435 self-selected adults (366 female, 69 male, aged 18–63) randomly assigned to one of three conditions: writing about best possible selves in the future (n = 135), making gratitude lists (n = 150) or writing to-do-lists as a control condition (n = 150). The study was fully self-administered and exercise instructions were given in online videos. Repeated-measures MANOVA revealed that both interventions significantly increased subjective well-being in comparison to the control condition. Effect sizes for the different components of subjective well-being ranged from r = .09–.13 (η² = .01–.02) for the 2 months intervention period. These effects were maintained until the 1-month follow-up. Enjoyment and interest regarding the exercise as indicators of perceived person-intervention-fit moderated the effect; participants of the happiness interventions who perceived a better fit showed greater increases in subjective well-being. These findings confirm previous research on these interventions and encourage further studies on online interventions, especially regarding possibilities to increase participants’ motivation and reduce dropout attrition.     

Mindfulness Among Genetic Counselors Is Associated with Increased Empathy and Work Engagement and Decreased Burnout and Compassion Fatigue

Genetic counselors experience high rates of compassion fatigue and an elevated risk for burnout, both of which can negatively impact patient care and retention in the profession. In other healthcare professions, mindfulness training has been successfully used to address similar negative psychological sequelae and to bolster empathy, which is the foundation of our counseling work. We aimed to assess associations between mindfulness and key professional variables, including burnout, compassion fatigue, work engagement, and empathy. Data were collected via an anonymous, online survey that included validated measures of mindfulness and these key professional variables. The survey was completed by 441 genetic counselors involved in direct patient care. Half of the respondents (50.1%) reported engaging in yoga, meditation, and/or breathing exercises. Mindfulness was positively correlated with work engagement (r?=?0.24, p?<?0.001) and empathy (as measured through four subscales: perspective taking (r?=?0.15, p?=?0.002), empathic concern (r?=?0.11, p?=?0.03), fantasy (r?=???0.11, p?=?0.03) and personal distress (r?=???0.15, p?=?0.001)). Mindfulness was negatively correlated with compassion fatigue (r?=???0.48, p?<?0.001) and burnout (r?=???0.50, p?<?0.001). Given these findings, mindfulness training may be a valuable addition to graduate and continuing education for genetic counselors. The integration of mindfulness into the genetic counseling field will likely improve professional morale and well-being, while promoting workforce retention and bolstering the relational and counseling aspects of our clinical work.     

Emotion Regulation in Families of Children with Behavior Problems and Nonclinical Comparisons

The current study compared parents’ emotion regulation (ER) in clinical (those with a child with externalizing behavioral problems) and low-risk comparison families. Additionally, mediation models were explored with parent ER predicting child behavior problems through child ER. Participants were 60 families with children (71.7% boys; 73% Caucasian) ages 2 through 8 years (M?=?4.62; SD?=?1.69) from a rural population in the United States: 34 clinical families referred for parent training and 26 nonclinical families. A blocking design was used to balance the two groups on key demographic characteristics. Parents’ and children’s ER was assessed using parent-report surveys and structured behavioral observations. Analyses indicated higher rates of parental emotion dysregulation (specifically, more difficulty when upset with achieving goal-directed behaviors, p?=?.01, d?=?0.67; controlling impulses, p?=?.01, d?=?0.64; limited use of ER strategies, p?=?.02, d?=?0.62; and more negative verbalizations to their child during the observed task, p?<?.01, d?=?0.73) and child emotion dysregulation (specifically, more difficulty as reported by parents, p?<?.01, d?=??2.42) in the clinical group. Mediational analyses indicated there were indirect paths from parental ER to children’s behavioral problems through child ER. Findings from this research suggest a need to measure and target ER in both parents and their children when working with families who are referred for treatment of child behavior problems.     

Associations of Quality of Life,Physical Activity and Mood States in Women with Breast Cancer Treated with Curative Intent

This study aims to investigate the associations between quality of life, physical activity and mood states in women with breast cancer. A total of 354 women (mean age, 51.74?±?8.63 years; body mass index (BMI), 28?±?5.67 kg/m²) completed the Baecke Physical Activity Questionnaire, Profile of Mood States (POMS), European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) and European Organisation for Research and Treatment of Cancer Breast Cancer-Specific Quality of Life Questionnaire (EORTC QLQ-BR23). Pearson’s correlation and multiple linear regressions were used to verify the relations between outcomes and independent variables. Correlations between scores on POMS, Baecke Physical Activity Questionnaire and global health status/quality of life subscale of EORTC QLQ-C30 found associations (p?<?0.01) between physical activity (r?=?0.191), vigour (r?=?0.333) and fatigue (r?=??0.433). Multiple linear regression analysis of the global health status/quality of life subscale of the EORTC QLQ-C30 showed significant differences for vigour (p?<?0.001), social function (p?=?0.003), side effects of systemic therapy (p?=?0.019), arm and breast symptoms (p?<?0.001) and Baecke physical activity score (p?=?0.006). Physical activity is an independent factor related to the quality of life in women with breast cancer. Understanding these variables may influence clinical decisions during treatment and allow positive interventions regarding symptoms, functions and lifestyle.     

Factors Influencing Adolescents’ Self-control According to Family Structure

We compared factors influencing adolescents’ self-control according to their family structure. Participants were 944 adolescents in five cities in South Korea (115 from single-parent families, 65 from grandparent-led families, and 764 from two-parent families). Data were collected using self-report questionnaires containing items on self-control, stress, parenting attitude, parent–adolescent communication, and family cohesion. Data were analyzed using stepwise multiple regressions with SPSS program. The factors influencing adolescents’ self-control differed across the three family structure groups. For single-parent families, stress and parental attitudes were significantly related to adolescents’ self-control (adjusted R²?=?0.37, p?<?0.001). In contrast, for grandparent-led families, family cohesion and parental attitude were significantly related to adolescents’ self-control (adjusted R²?=?0.31, p?<?0.01), while for two-parent families, stress, parental attitude, and parent–adolescent communication were related to the outcome (adjusted R²?=?0.24, p?<?0.001). Parental attitude was thus a common factor relating to self-control, regardless of family structure. On the other hand, the main factors influencing adolescents with low self-control were gender and stress. Our results confirm that adolescents’ self-control is not only affected by personal factors but also by parental and family factors. It is important to improve individual program to improve adolescents’ self-control according to family structure. The results of study may act as a base for improving individual intervention programs aimed at promoting adolescents’ self-control by factoring in family structure.     

Exploration of Male Attitudes on Partnerships and Sexuality with Female <Emphasis Type="Italic">BRCA1/2</Emphasis> Mutation Carriers

Women with BRCA mutations are inundated with decisions about managing cancer risks and childbearing considerations. Decisions become more complicated when women face disclosing their mutation and risk-reduction options to a romantic partner. This study identifies the concerns and perspectives of male romantic partners regarding these unique decisions. Twenty-five male participants completed an online survey posted to cancer support group message boards. Participants reported relationship changes regarding intimacy levels (n?=?9), attraction (n?=?2), and communication (n?=?22) after mutation disclosure. Participants whose partners had not undergone prophylactic mastectomy (n?=?14) reported concerns regarding sexual relations (n?=?5), post-surgical appearance (n?=?2), post-surgical attraction (n?=?5), and health/lifespan (n?=?9). Participants did not express attitude changes toward childbearing. While mutation disclosure conversations and surgical options are concerns for many BRCA mutation carriers in relationships, male partners share these concerns. Aspects of the relationship may change, but male study participants continued to support their partners. This information can benefit female BRCA mutation carriers, their current or future partners, and genetic counselors working with this particular population.     

The Factor Structure of the Forms of Self-Criticising/Attacking &amp; Self-Reassuring Scale in Thirteen Distinct Populations

There is considerable evidence that self-criticism plays a major role in the vulnerability to and recovery from psychopathology. Methods to measure this process, and its change over time, are therefore important for research in psychopathology and well-being. This study examined the factor structure of a widely used measure, the Forms of Self-Criticising/Attacking & Self-Reassuring Scale in thirteen nonclinical samples (N?=?7510) from twelve different countries: Australia (N?= 319), Canada (N?= 383), Switzerland (N?= 230), Israel (N?=?476), Italy (N?=?389), Japan (N?=?264), the Netherlands (N?=?360), Portugal (N?=?764), Slovakia (N?=?1326), Taiwan (N?=?417), the United Kingdom 1 (N?=?1570), the United Kingdom 2 (N?=?883), and USA (N?=?331). This study used more advanced analyses than prior reports: a bifactor item-response theory model, a two-tier item-response theory model, and a non-parametric item-response theory (Mokken) scale analysis. Although the original three-factor solution for the FSCRS (distinguishing between Inadequate-Self, Hated-Self, and Reassured-Self) had an acceptable fit, two-tier models, with two general factors (Self-criticism and Self-reassurance) demonstrated the best fit across all samples. This study provides preliminary evidence suggesting that this two-factor structure can be used in a range of nonclinical contexts across countries and cultures. Inadequate-Self and Hated-Self might not by distinct factors in nonclinical samples. Future work may benefit from distinguishing between self-correction versus shame-based self-criticism.     

Pilot Mindfulness Intervention for Children Born with Esophageal Atresia and Their Parents

A pilot mindfulness home intervention was conducted for 6 weeks among 8–12-year-old children born with esophageal atresia and their parents. Participants were randomly assigned to a waiting list control (WLC) group (n?=?8) and an experimental group (n?=?12). When all participants had completed the mindfulness-based program, data were pooled and treated for the entire sample (n?=?19). Self-assessment measures included the Mindful Attention Awareness Scale for Adolescents (MAAS-A), the Child and Adolescent Mindfulness Measure (CAMM), the modified Spielberger State-Trait Anxiety Inventory—Child (STAI-C), the Children’s Depression Inventory (CDI), and the Cognitive Emotion Regulation Questionnaire Kids version (CERQ-k). Parental assessment measures included the modified STAI-C. The results underlined the program’s feasibility and acceptability. Clinical effects of the mindfulness-based program were observed. Self-assessed data for children who had practiced mindfulness compared to the WLC group showed increased mindfulness and decreased depression. Reduced anxiety was found in all groups. Positive affect tended to improve from pre-test to post-test in children who had practiced mindfulness compared to the WLC group. Parental assessments showed significant improvement in positive affect and decreases in anxiety and negative affect in the intervention group compared to the WLC group. Cognitive emotion regulation strategies were also affected by the mindfulness-based program. Rumination scores significantly decreased from pre-test to post-test in the intervention group. This preliminary study suggests that regular mindfulness practice presents a promising approach to reducing the burden of this neonatal malformation.     

EFL Teachers’ Verbal and Nonverbal Immediacy: A Study of its Impact on Students’ Emotional States,Cognitive Learning,and Burnout

Effective teacher–student interaction is an essential element of an ideal classroom which promotes the opportunity for expanded learning and stimulates the connections between students and teacher. The focus of the present study is on an instructional communication element that is teacher immediacy. It is defined as the mutual sensory and psychological stimulation between teacher and students. It can be verbal or nonverbal. Verbal immediacy is characterized as stylistic differences in expression from which like–dislike is inferred and includes using humor or personal examples, getting feedback, or even calling students by name. Nonverbal immediacy encompasses behaviors such as appropriate eye contact, the use of gestures, movement about the classroom, smiling, and vocal variety. In particular, the present study sought to explore the impact of English as a foreign language (EFL) teachers’ perceived verbal/nonverbal immediacy on students’ self-actualization, stress-control, and self-esteem. Moreover, it examined the role of EFL teachers’ immediacy behaviors in students’ cognitive learning and emotional exhaustion, which is a burnout subscale. To this end, 206 EFL students participated from selected universities of Mashhad, a city in northeast of Iran. The respondents were asked to complete five inventories about themselves and the previous EFL teacher they had had classes with. The results of structural equation modeling demonstrated that teacher immediacy behavior had a positive significant impact on all student-related variables: stress tolerance (β?=?.65, t?=?7.59), self-actualization (β?=?.69, t?=?8.02), self-esteem (β?=?.63, t?=?7.71), burnout (β?=?.31, t?=?4.05), and cognitive learning (β?=?.45, t?=?6.08). The highest impact was exerted on self-actualization and self-esteem.     

Photographic Assessment of Change in Trichotillomania: Psychometric Properties and Variables Influencing Interpretation

Although photographic assessment has been found to be reliable in assessing hair loss in Trichotillomania, the validity of this method is unclear, particularly for gauging progress in treatment. The current study evaluated the psychometric properties of photographic assessment of change in Trichotillomania. Photographs showing hair loss of adults with Trichotillomania were taken before and after participating in a clinical trial for the condition. Undergraduate college students (N?=?211) rated treatment response according to the photos, and additional archival data on hair pulling severity and psychosocial health were retrieved from the clinical trial. Photographic assessment of change was found to possess fair reliability (ICC?=?0.53), acceptable criterion validity (r?=?0.51), good concurrent validity (r?=?0.30–0.36), and excellent incremental validity (ΔR ²?=?8.67, p?<?0.01). In addition, photographic measures were significantly correlated with change in quality of life (r?=?0.42), and thus could be considered an index of the social validity of Trichotillomania treatment. Gender of the photo rater and pulling topography affected the criterion validity of photographic assessment (partial η ²?=?0.05–0.11). Recommendations for improving photographic assessment and future directions for hair pulling research are discussed.     

Executive Functioning Correlates of <Emphasis Type="Italic">DSM-5</Emphasis> Maladaptive Personality Traits: Initial Evidence from an Italian Sample of Consecutively Admitted Adult Outpatients

In order to evaluate the associations between computer-administered tasks of executive functioning (EF), and maladaptive personality domains and traits listed in DSM-5 Alternative Model of Personality Disorders, 53 consecutively admitted psychotherapy outpatients (female participants: n?=?27, 50.9%; male participants: n?=?26, 49.1%; participants’ mean age?=?37.28 years, SD?=?11.50 years) were administered the Psychology Experiment Building Language (PEBL) EF tasks and the Personality Inventory for DSM-5 (PID-5). According to rank-order correlation analyses, a number of non-negligible and specific associations were observed between selected PID-5 scales and indices of participants’ performance on EF tasks. MM robust regression models showed that participants’ performance on computer-administered EF tasks explained a non-negligible amount of variance in selected PID-5 scale scores (median R² value?=?.17). As a whole, our trait-level analyses of PID-5 dimensions suggest the clinical usefulness of integrating self-reports and EF laboratory tasks in routine clinical assessment.     

Religious versus Conventional Internet-based Cognitive Behavioral Therapy for Depression

The accessibility and efficacy of two Internet-supported interventions for depression: conventional cognitive behavioral therapy (C-CBT) and religious CBT (R-CBT) were investigated. Depressed participants (N = 79) were randomly assigned to either active treatment or wait-listed control group. Self-report measures of depression, anxiety, and life quality were collected before, immediately after, and 6 months after the intervention. Significant differences among the three conditions emerged at post-intervention with medium to large effect sizes (Cohen’s d between 0.45 and 1.89), but no differences between the R-CBT and C-CBT were found. However, the addition of religious components to CBT contributed to the initial treatment appeal for religious participants, thus increasing the treatment accessibility.     

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.     

The Treatment of Childhood Disruptive Behavior Disorders in Ambulatory Mental Health Centers

Over the years, evidence-based treatments for children with disruptive behavior disorders (DBDs; e.g., conduct disorder, oppositional defiant disorder) have been developed, however, there is not much information about the treatment children receive in usual mental healthcare settings. This study examined the common treatment provided in US ambulatory mental health clinics to children aged 3 to 9 years who are diagnosed with DBDs. An online survey was filled by appropriate respondents from 145 ambulatory mental health centers across 33 states within the US. The most common treatment provided for childhood DBDs was a combination of child therapy (CT) and parent training (PT) (n?=?81, 56%), followed by family therapy (n?=?42, 29%), CT (n?=?17, 12%), and PT (n?=?5, 3%). Behavioral and cognitive principles were reported as the most common treatment orientations across all types of treatment (n?=?116/145, 80%). The mean number of sessions administered was 31.38?±?22.72, and PT as a standalone treatment required approximately a third of sessions (10.6?±?1.34). In treatments combining CT and PT, the utilization of specific parenting programs was associated with fewer administered sessions. Results suggest that the importance of parental involvement in treating DBDs is acknowledged in routine practice. However, more studies are needed to determine why certain types and orientations of treatments are favored over others.