Child and adolescent disorders: Issues for psychosocial treatment research

The recent efforts of the National Institute of Mental Health (NIMH) to encourage child and adolescent research are described, including the creation of the Child and Adolescent Psychosocial Interventions Research Consortium as a forum to identify, delineate, and examine research needs in psychosocial treatments. This is followed by a summary review of the contents of this special issue: history of psychotherapy research with children, developmental issues, diagnosis and assessment, ecological and cultural validity, laboratory versus clinic research outcomes, cognitive behavioral treatments for childhood disorders, nontraditional treatments, and overview and future directions. Finally, methodological issues that need to be addressed in future research are discussed, such as the developmental level of children in treatment research, issues of comorbidity, family involvement, and duration of treatment.     

Problems and prospects in group psychotherapy research

The scientific basis of psychotherapeutic findings involves a number of difficulties which are above all connected with the insufficient state of basic research in this field. In this situation, significant advances can only be expected on the basis of a systematic long-term investigation and research programme. This applies in particular to the problems of personality and efficiency diagnostics and to group process research. On the basis of some intermediate results, it is shown that by the combined and systematic use of procedures a number of possibilities for the differentiated recording of the complex processes in therapeutic groups can be obtained.     

Child psychopathology risk factors for drug abuse: overview.

Introduces the special section on Child Psychopathology Risk Factors for Substance Use Disorders. This article summarizes important principles, the current literature, contributions to this section, and issues for future research. Psychopathological conditions are strongly associated with substance use disorders, and some childhood psychopathological conditions may constitute precursors to this comorbidity. Conduct disorder constitutes a strong risk factor for substance use disorders, and bipolar disorder, although more rare, may also constitute a significant risk. Data for other child psychiatric conditions are mixed or lacking; however, important subgroups may be at risk and merit further attention. Underlying characteristics, such as temperament and self-regulation, merit further study as possible explanatory variables. Such studies hold the key for targeting and improving preventive and therapeutic interventions.     

Child psychopathology and deviant family hierarchies

The association between child psychopathology and reversals in family hierarchies (where the child is seen as equal or higher in the hierarchy than the parental figures) were examined with the Madanes Family Hierarchy Test on a sample of 177 clinic-referred boys. Madanes' original findings of the association of substance use and deviant family hierarchy were replicated in this younger sample, (age 7 to 12). Boys diagnosed with Conduct Disorder reported significantly more deviant hierarchies while boys diagnosed with Overanxious Disorder reported significantly fewer deviant hierarchies. Follow-up results revealed some instability and lack of informant agreement, but the hierarchy measure was not confounded by age, race, SES, IQ, or parents' marital status.     

Emotion dysregulation and adolescent psychopathology: a prospective study

Background

Emotion regulation deficits have been consistently linked to psychopathology in cross-sectional studies. However, the direction of the relationship between emotion regulation and psychopathology is unclear. This study examined the longitudinal and reciprocal relationships between emotion regulation deficits and psychopathology in adolescents.

Methods

Emotion dysregulation and symptomatology (depression, anxiety, aggressive behavior, and eating pathology) were assessed in a large, diverse sample of adolescents (N = 1065) at two time points separated by seven months. Structural equation modeling was used to examine the longitudinal and reciprocal relationships between emotion dysregulation and symptoms of psychopathology.

Results

The three distinct emotion processes examined here (emotional understanding, dysregulated expression of sadness and anger, and ruminative responses to distress) formed a unitary latent emotion dysregulation factor. Emotion dysregulation predicted increases in anxiety symptoms, aggressive behavior, and eating pathology after controlling for baseline symptoms but did not predict depressive symptoms. In contrast, none of the four types of psychopathology predicted increases in emotion dysregulation after controlling for baseline emotion dysregulation.

Conclusions

Emotion dysregulation appears to be an important transdiagnostic factor that increases risk for a wide range of psychopathology outcomes in adolescence. These results suggest targets for preventive interventions during this developmental period of risk.     

Social science research in the 1990s: The contribution of constructivism

Social science research in this decade has not made the progress we expected of it. Our findings still diverge, generalization from these findings remains restricted, and the many questions vital to achieving a better society continue to be unanswered. In the next decade, social science research may be able to benefit from constructivism. In this article I explore some of the constructivist assumptions about people. These include their subjectivity and purpose, the central role of meaning for them, and how that meaning can be both unique and shared. I also examine some constructivist assumptions about social science. These assumptions enable us as social scientists to understand better the constructivist nature of ourselves as researchers, our research participants, and our research interactions. These assumptions also have implications for the types of data collection methods we choose to use, as well as for data analysis. An example of each is provided. The application of these assumptions seems likely to result in social science research which continues to be diverse and permits only restricted generalization, but is more relevant to the needs of our society.     

Family interaction and the course of adolescent psychopathology: An analysis of adolescent and parent effects

This study focused on evaluating the utility of three family measures for predicting outcome in a sample of disturbed but nonpsychotic adolescents: (a) the affective quality of the adolescents' voice tone when communicating with his/her parents; (b) the predominant affective quality of the parents' voice tones when communicating with the adolescent, and (c) the affective quality of the content of the parents' verbalizations to the adolescent. These measures were derived from 5-minute face to face discussions between parents and their disturbed adolescent. Results indicated that adolescents using positive or neutral voice tones during emotionally laden discussions with their parents tended to show relatively adequate levels of psychosocial adjustment as young adults, while adolescents using exclusively negative voice tones tended to show sufficient adjustment difficulties in early adulthood to warrant diagnoses within the extended schizophrenia spectrum. Although adolescent voice tone was associated with outcome, considering both adolescent and parent affective response led to improved prediction, with consideration of adolescent and parent variables leading to accurate prediction of outcome for 30 of the 33 sample cases.     

Sex and leadership styles: a meta-analysis of research published in the 1990s

Empirical research on sex differences in leadership styles, published between 1987 and 2000 in peer-reviewed journals, is reviewed by means of a meta-analysis. The leadership styles examined are interpersonal, task-oriented, democratic versus autocratic, and transformational and transactional leadership. Analysis showed that evidence for sex differences in leadership behavior is mixed, demonstrating that women tend to use more democratic and transformational leadership styles than men do, whereas no sex differences are found on the other leadership styles. Sex differences in leadership styles are contingent upon the context in which male and female leaders work, as both the type of organization in which the leader works and the setting of the study turn out to be moderators of sex differences in leadership styles.     

Philosophy of mathematics: Prospects for the 1990s

For some time now, academic philosophers of mathematics have concentrated on intramural debates, the most conspicuous of which has centered on Benacerraf's epistemological challenge. By the late 1980s, something of a consensus had developed on how best to respond to this challenge. But answering Benacerraf leaves untouched the more advanced epistemological question of how the axioms are justified, a question that bears on actual practice in the foundations of set theory. I suggest that the time is ripe for philosophers of mathematics to turn outward, to take on a problem of real importance for mathematics itself.     

The structure of child and adolescent psychopathology: generating new hypotheses

To begin to resolve conflicts among current competing taxonomies of child and adolescent psychopathology, the authors developed an interview covering the symptoms of anxiety, depression, inattention, and disruptive behavior used in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994), the International Statistical Classification of Diseases and Related Health Problems (ICD-10; World Health Organization, 1992), and several implicit taxonomies. This interview will be used in the future to compare the internal and external validity of alternative taxonomies. To provide an informative framework for future hypothesis-testing studies, the authors used principal factor analysis to induce new testable hypotheses regarding the structure of this item pool in a representative sample of 1,358 children and adolescents ranging in age from 4 to 17 years. The resulting hypotheses differed from the DSM-IV, particularly in suggesting that some anxiety symptoms are part of the same syndrome as depression, whereas separation anxiety, fears, and compulsions constitute a separate anxiety dimension.     

Measures of child and adolescent psychopathology in Asia

This article reviews measures of child and adolescent psychopathology used in Asian cultures. Sixteen imported measures from the West are identified and their psychometric equivalence across cultures is reviewed; 2 new measures are briefly introduced. Although initial evidence is generally promising, more studies are needed to support their use in Asia. One recently developed Singapore measure cannot be considered genuinely indigenous. Culture-specific items proposed for imported measures could be grouped into existing diagnostic constructs. There is, as yet, no strong theoretical support for culture-bound diagnostic constructs in Asian cultures.     

Psychoeducation and managed care: Clinical issues for the 1990s

Managed care has challenged mental health professionals to develop more efficient ways of addressing patient care needs. Psychoeducational programs, for patients and their families, have emerged as a medium by which relevant education and mutual support can be provided to participants. A review of the literature, a comprehensive model of psychoeducation, and the advantages of such models within the managed care program are offered. Also addressed are issues and import, treatment and research considerations.     

Overcoming Learned Helplessness: Managerial Strategies for the 1990s

Problems of work force quality in the United States in the 1990s, strategies for managerial response to these problems, and sources of employee resistance to change are discussed.     

Psychological Aspects of Disaster: Issues for the 1990s

In 1987 a series of disasters shocked the UK. For many it was the start oftheir involvement with the traumatic effects of disaster management. In response, the British Psychological Society established a working party to consider issues which might need to be addressed. Six areas were identified for consideration: prevention, planning, training, assessment and provision of services, inter-agency and professional co-operation, and the role of government. In spite of a large and growing literature on trauma and disaster management, satisfactory responses to the needs of those involved are still lacking. Lessons learned from the fire at Bradford were not effectively applied to subsequent disasters, in spite of the valiant efforts of those involved to pass on the results of their experience. This paper addresses some of those critical lessons, and suggests areas that require considered action for disaster planning in the 1990s.     

The role of fathers in child and adolescent psychopathology: make room for daddy.

This review summarizes research concerning the relation between paternal factors and child and adolescent psychopathology. When compared with mothers, fathers continue to be dramatically underrepresented in developmental research on psychopathology. However, findings from studies of children of clinically referred fathers and nonreferred samples of children and their fathers indicate that there is substantial association between paternal characteristics and child and adolescent psychopathology. Findings from studies of fathers of clinically referred children are stronger for fathers' effects on children's externalizing than internalizing problems. In most cases the degree of risk associated with paternal psychopathology is comparable to that associated with maternal psychopathology. Evidence indicates that the presence of paternal psychopathology is a sufficient but not necessary condition for child or adolescent psychopathology.     

Child and adolescent services research at the national institute of mental health: Research opportunities in an emerging field

This article describes an important new area of research on services for children and adolescents with mental disorders at the National Institute of Mental Health, the parameters of mental health services research for youth, and the opportunities that are available for grant-funded investigations in this area.     

Implications of MMPI/MMPI--a findings for understanding adolescent development and psychopathology

The MMPI (Hathaway & McKinley, 1943) and the MMPI-Adolescent (MMPI-A; Butcher et al., 1992) have been used in the evaluation of adolescents for over 60 years, resulting in over 200 studies involving tens of thousands of adolescents. This literature not only informs us concerning characteristics of this test instrument but also holds important implications for our understanding of adolescent development and psychopathology. In this article, based on an invited master lecture at the 2005 Annual Meeting of the Society for Personality Assessment, I present several points illustrating the relevance of MMPI and MMPI--A research in enriching our understanding of adolescence.