Inaccuracy of Perceived Competence Ratings Is Associated With Problem Behaviors in 5-Year-Old Children

The authors examined problem behaviors in preschool children as a function of perceived competence. Prior research has demonstrated a link between inaccuracy of self-perceptions and teacher-reported externalizing behaviors in preschool aged boys. This study extended past research by adding data collected from observed behaviors in a laboratory setting, as well as parent reports of internalizing and externalizing behaviors. Five-year-old children completed the Pictorial Scale of Perceived Competence and Social Acceptance for Young Children (PSPCSA) in the lab, participated in a 10-min puzzle interaction task with their cotwin and mother, and completed a short task assessing cognitive abilities. Children were grouped into 3 self-esteem categories (unrealistically low, realistic, and unrealistically high) based on comparisons of self-reported (PSPCSA) versus actual competencies for maternal acceptance, peer acceptance, and cognitive competence. Results showed that children who overreported their maternal acceptance and peer acceptance had significantly more parent-reported externalizing problems as well as internalizing problems. There were no significant differences in accuracy for cognitive competence. The findings from this study underscore the negative impact of unrealistically high self-appraisal on problem behaviors in young children.     

问题彩民的购彩心理与行为特征

问题彩民是指因购买彩票而对个人、家庭、组织及社会层面产生不良影响的一类彩民。问题彩民购彩心理与行为特征的研究主要包括人口学变量、购彩心理特征、购彩行为特征以及干预措施等方面。未来的研究应注意建构问题彩民购彩意向影响因素模型、采用跟踪调查和个案研究、探究问题彩民神经生理机制以及加强对问题彩民的干预研究。     

Behavioral assessment of avoidance in agoraphobia

Behavioral avoidance testing is a substantial addition to self-report questionnaires in the assessment of agoraphobia. However, the tests currently in use have drawbacks and limitations. A multitask behavioral avoidance test (M-BAT) is presented, designed to meet some of these problems. The test was administered to a group of 58 patients and proved to be reliable in terms of internal consistency. Concordance with self-report measures of agoraphobia indicated a high concurrent validity. In comparison with self-report questionnaires, the tests produced a slightly more conservative picture of gains achieved in treatment. Finally, the data revealed that the multitask test was more concordant with other measures of agoraphobia than a single-task test would have been.     

Teaching Young Children Responses to Inappropriate Approaches by Strangers in Public Places

The application of behavioral principles to a wide array of social problems is not noly appropriate; in many areas, it is critical. The popular press has recently focused a great deal of attention on the sexual abuse, molestation, kidnapping, and abduction of children. The goals of the present study were as follows: (1) to train children to respond to approaches by stangers in public places, (2) to assess short-term maintenance of the responses, and (3) to socially validate the procedures and situations. Social validation efforts included the contracting teachers, parents, local law enforcement officers, welfare workers, a special council for child protective services, the local Campfire offic and faculty persons in related disciplines. Popular literature was examined to obtain general lists of potential situations and recommended behaviors on the part of the child. The professionals consulted assisted the experimenter in narrowing the situations and responses to those most applicable locally. A multiple baseline across subjects design was used, with six subjects assessed and trained in pairs. Each subject showed little or no ability to actually respond appropriately to strangers during baseline assessment. Only with the introduction of the intervention phase did the subjects behaviors change to learn correct responses for the two selected situations. A three-week follow-up revealed correct responses maintained at acceptable levels.     

Behavioral versus Behavioral and Pharmacological Treatment in ADHD Children Attending a Summer Treatment Program

As part of the behavioral treatment in the Multimodal Treatment Study of Children with ADHD (MTA), children participated in an intensive summer treatment program (STP). This study examined the differences between 57 children in the combined treatment (Comb) group, who were medicated, and 60 children in the behavioral treatment (Beh) group, who were unmedicated throughout the STP. Comb children were significantly better than Beh on 5 measures: rule following, good sportsmanship, peer negative nominations, and STP teacher posttreatment ratings of inattention/overactivity. Groups did not differ on any of the other 30 measures, and responded similarly to the STP over time. Comparisons to normative data revealed that Comb children were more likely to fall within the normative range on 6 measures. The differences between these results and the main MTA results, in which Comb was always superior to Beh, are discussed in terms of the relative intensity of combined treatments. The implications for future studies of pharmacological and behavioral treatment for ADHD are discussed.     

儿童2-4岁的行为抑制性对其陌生同伴交往的预测

该研究用纵向追踪的实验室观察研究了儿童2岁、4岁时的行为抑制性,及其4岁时与陌生同伴交往特征的关系。结果发现：儿童2岁时的抑制性能预测其在4岁时的社交发起行为缺乏,但不能预测各种游戏活动类型。儿童4岁时的行为抑制性与其单独一被动活动、平行活动及社会互动活动呈显著负相关;与交往中的抑制行为呈显著正相关;儿童4岁时的抑制性分数能预测儿童交往的主动性的缺乏。稳定极端抑制儿童和稳定极端非抑制儿童在抑制行为、平行游戏、社会互动游戏、社交发起和玩新奇玩具方面存在显著差异。     

Behavioral Treatment of Self-Choking in a Developmentally Normal Child

ABSTRACT

In the past, self-choking behavior has been associated with individuals who were either developmentally disabled or experienced psychosis symptoms, and has usually been treated with aversive procedures. A time-series design using several different non-aversive behavioral procedures was used to analyze these treatment effects on an 11-year-old girl whose habit of self-choking interfered with normal functioning. Habit reversal procedures, which implement an incompatible response in place of the target behavior, did not, as first hypothesized, have a positive effect on self-choking behavior. However, attention from a male therapist as a positive reinforcer initially decreased the frequency of self-chokes and percent of time spent self-choking. Attention contingent on performance was not as effective on the child's behavior as attention administered noncontingently. Overall, the behavioral treatment approach applied here does not appear to reduce the target behavior in a clinically significant manner. Implications for future treatment approaches for this behavior are discussed.     

Attachment,Behavioral Inhibition,and Anxiety in Preschool Children

This study examined the association between insecure attachment, behavioral inhibition, and anxiety in an at risk sample of preschool children. The relationship between maternal anxiety and child anxiety was also assessed. Participants were 104 children aged 3–4 years who were assessed for behavioral inhibition and mother–child attachment (using the Strange Situation procedure). DSM-IV criteria were used to assess childhood anxiety disorders. Insecure attachment and behavioral inhibition were both independently associated with child anxiety, even after controlling for the effect of maternal anxiety. Maternal anxiety was also associated with child anxiety. This study identified both constitutional and environmental factors associated with the expression of anxiety in young children. Furthermore, the highest levels of anxiety were shown by children who were behaviorally inhibited and insecurely attached and whose mothers were also anxious.     

Use of preexposure prophylaxis and condom purchasing decisions

Preexposure prophylaxis (PrEP) prevents human immunodeficiency virus (HIV) but not other sexually transmitted infections (STIs). Men who have sex with men (MSM) who take PrEP tend to report reduced condom use, but little is known about the underlying mechanisms. For this study, MSM who take PrEP (i.e., PrEP experienced; n = 88) and MSM who do not (i.e., PrEP naïve; n = 113) completed an online study, including the condom purchase task (CoPT). The CoPT assesses decisions to purchase condoms across escalating prices (range: free–$55) for sex with different types of hypothetical partners: those least likely to have an STD (least STD) and those that participants most want to have sex with (most want sex with). When condoms were free, PrEP-experienced MSM had a lower rate of condom purchasing than did PrEP-naïve MSM. For both partner types, PrEP-experienced MSM reached a price break point (i.e., would not buy condoms) at a lower price than did PrEP-naïve pariticipants. For the most-want-sex-with partner at the price at which participants elected not to buy condoms, only 23% of PrEP-experienced MSM chose to abstain from sex when not purchasing condoms versus 53% among PrEP-naïve MSM. Similar patterns were observed for the least-STD partner. The results support the potential utility of the CoPT in identifying behavioral mechanisms related to condom use and PrEP.     

Randomized Effectiveness Trial of an Internet,Pure Self-Help,Cognitive Behavioral Intervention for Depressive Symptoms in Young Adults

This study evaluated an Internet-delivered, cognitive behavioral skills training program versus a treatment-as-usual (TAU) control condition targeting depression symptoms in young adults aged 18 to 24 years. Potential participants were mailed a recruitment brochure; if interested, they accessed the study website to complete an online consent and baseline assessment. Intervention participants could access the website at their own pace and at any time. Reminder postcards were mailed periodically to encourage return use of the intervention. The pure self-help intervention was delivered without contact with a live therapist. The primary depression outcome measure was the Patient Health Questionnaire, administered at 0, 5, 10, 16, and 32 weeks after enrollment. A small but significant between-group effect was found from Week 0 to Week 32 for the entire sample (N = 160, d = .20, 95% confidence interval [CI] 0.00–0.50), with a moderate effect among women (n = 128, d .42, 95%C1 = 0.09–0.77). Greater depression reduction was associated with two measures of lower website usage, total minutes, and total number of page hits. Although intervention effects were modest, they were observed against a background of substantial TAU depression pharmacotherapy and psychosocial services. Highly disseminable, low-cost, and self-help interventions such as this have the potential to deliver a significant public health benefit.     

Experiences of mandated reporting among family therapists: a qualitative analysis

Mandated reporting of child abuse by Family Therapists (FTs) has been examined by the authors in two previous studies. The first study found that mandated reporting issues negatively affected FTs abilities to maintain a systemic focus. The second study surveyed types and frequencies of negative experiences of FTs with mandated reporting. A 46-item questionnaire was administered to 101 FTs. Results were significant for four of the items. The respondents also provided 116 comments related to mandated reporting experiences. This study provides a qualitative analysis of the written comments of the respondents regarding their xexperiences with mandated reporting of child abuse.     

Development of an Everyday Spatial Behavioral Questionnaire

The authors developed a 12-category, 116-item critical incident questionnaire of spatial behavior. The authors administered the Everyday Spatial Behavioral Questionnaire (ESBQ) to volunteer undergraduates (114 women, and 31 men) and tests of spatial ability to establish both the reliability and construct validity of the instrument. The authors found that Cronbach's alpha across the subscale scores was .92, and that 8 of the 12 subscales had alphas of .70 or greater. The authors found validity of the ESBQ through canonical correlation analysis. Specifically, spatial tests, gender, and age variables, jointly with the ESBQ subscales, identified 2 apparent continua of spatial skills. The authors labeled the first continuum movement through space (from moving a vehicle at one end of the continuum, to moving one's own body through space at the other end of the continuum). The authors labeled the second identified continuum drawing/perceiving perspective/path finding, and it appeared to represent a continuum of 3-dimensional visualization or redirection. Another suggested label was dimensional discernment. Thus, the ESBQ is a first step toward identifying new ways to think about and quantify people's spatial experience.     

Attachment, Behavioral Inhibition, and Anxiety Disorders Symptoms in Normal Adolescents

The current study examined relationships between attachment style, behavioral inhibition, and anxiety disorders symptoms not only relying on youths' self-report but also including the parents' point of view. A large group of young adolescents aged 11–15 years and their parents (N = 280) completed measures of attachment style and behavioral inhibition and the Revised Children's Anxiety and Depression Scale, a questionnaire designed to measure symptoms of anxiety disorders in terms of the Diagnostic and Statistical Manual of Mental Disorders. Highly similar results were found for child and parent report. That is, attachment style and behavioral inhibition were found to be interrelated with insecure attachment being associated with higher levels of behavioral inhibition. Furthermore, adolescents who were classified as insecurely attached and/or high on behavioral inhibition displayed higher levels of anxiety disorders symptoms. Finally, attachment status and behavioral inhibition both accounted for a unique proportion of the variance of anxiety disorders symptomatology.     

Using a Behavioral Treatment Package for Sleep Problems in Children With Autism Spectrum Disorders

This study investigated the effectiveness of a behavioral treatment package for sleep problems in children diagnosed with Autism Spectrum Disorders. Treatment consisted of four behaviorally based components: circadian rhythm management, positive bedtime routines, white noise, and graduated extinction. A multiple-baseline design across three participants was used. Families completed a baseline of various lengths followed by 1 month of intervention. Results indicated the treatment package was effective in decreasing sleep onset latency and the frequency of night awakenings. A week of follow-up data showed continued improvement. Parents reported their children slept better and satisfaction with the four intervention components.     

Applying Utilization Management Principles to a Comprehensive Service System for Children with Emotional and Behavioral Disorders and Their Families: A Feasibility Study

The Comprehensive Services Act for At Risk Youth and Families of Virginia (CSA), is a service, funding, and organizational reform initiative designed to improve the provision of child centered and family focused services within a community setting. We conducted this study in order to assess the feasibility of applying utilization management principles to the CSA in order to improve the appropriateness, quality, and cost effectiveness of this service delivery system. Data were gathered through focus groups, surveys, clinical profiling, and analysis of costs, and service utilization. While overall program costs increased since inception of the program, the costs per child served rose less than the rate of inflation. CSA appeared to be serving children with a high degree of emotional and behavioral difficulties. There was considerable variation among localities in placement patterns. A majority of survey and focus group respondents were willing to consider the application of utilization management principles to the CSA as long as decision making remained within localities. We concluded that there is a constructive role for utilization management approaches to improve the appropriateness and quality of services as well as enhancing efficiency in child mental health.     

Predictors and Outcomes of Sudden Gains and Sudden Regressions in Cognitive Behavioral Therapy for Youth Anxiety

Sudden gains (SGs), referring to large, stable symptom improvement occurring between consecutive treatment sessions, have been associated with improved outcomes among adults with various psychological disorders. Little research exists on SGs or sudden symptom worsening (i.e., sudden regressions [SRs]) during treatment for youth disorders. The current study examined predictors and outcomes of SGs/SRs via multiple informants in youth anxiety treatment. Participants were 118 youth (age M = 11.6, SD = 2.5; 53.8% female) and their caregivers receiving a cognitive-behavioral therapy protocol for a principal anxiety disorder. Anxiety symptom severity was assessed weekly via the State-Trait Anxiety Inventory for Children–Trait–Child/Parent versions. SGs and SRs occurred in 45.8 and 31.3% of youth, respectively. SRs were more common among youth with comorbid mood or externalizing disorders, while SGs occurred more often among youth with greater pretreatment anxiety symptom severity. SGs were not associated with posttreatment outcomes, but SRs predicted significantly higher posttreatment internalizing symptoms based on child report (β = .23, p = .03) and externalizing symptoms based on child (β = .15, p = .04) and parent report (β = .16, p = .03), controlling for overall magnitude of symptom change. SRs among youth receiving cognitive-behavioral therapy for anxiety are associated with pretreatment clinical complexity and poorer posttreatment outcomes and may serve as a warning sign to clinicians of possible treatment failure.     

Adaptations of an Integrated Behavioral Health Program During COVID-19

The coronavirus disease 2019 (COVID-19) pandemic has consistently been described as an “unprecedented” global health crisis. While the focus has been primarily on the medical and economic impact of the pandemic, psychological sequelae are anticipated. Primary care is the main point of access for mental health care in the United States, making it the ideal locale to provide psychological services for a larger proportion of the population than traditional mental health care settings. The aim of this paper is to describe how our multi-state, multi-site integrated primary care program adapted and applied cognitive behavioral therapy in the context of COVID-19. Access to mental health care was disrupted despite burgeoning mental health concerns, necessitating novel approaches to providing care. A stepped-care approach was implemented within our primary care practice, which consisted of a combination of low-intensity, high-yield stress management and resiliency building resources and cognitive behavioral therapy that were delivered flexibly based on patient preference, technological capabilities, state ordinances, insurance coverage, and institutional policies. The lessons learned from this experience can inform other integrated primary care clinics in responding to the current and future pandemics.     

Profile Characteristics and Behavioral Change Trajectories of Young Residential Children

We aimed to identify profile characteristics for a recent sample of young residential children, examine the differential impact that profile characteristics have on behavior change, and describe the relationship between behavioral symptomatology and length of stay in residential treatment. A sample of 142 consecutively admitted residential treatment children were studied over a five-year period. Hierarchical Linear Modeling was the primary statistical method used to analyze behavioral rating data for a subset of 57 children assessed by teachers and treatment staff using the Devereux Scales of Mental Disorders. Younger age, female gender, and lower IQ were associated with increased levels of psychopathology. Residential length of stay was strongly linked to levels of behavioral symptomatology. HLM is a valuable analytic strategy that employs client profile characteristics to model behavioral change trajectories and help predict treatment responsiveness. System reform philosophies that promote expectations for rapid symptom improvement and removal of residential treatment from the continuum of care may exceed current treatment capacities.