Development and Implementation of a Transdiagnostic,Stepped-Care Approach to Treating Emotional Disorders in Children via Telehealth

Stepped-care interventions may increase the accessibility of evidence-based treatments but remain relatively underexplored in the child mental health literature. Further, while the feasibility and efficacy of stepped-care interventions have been examined for specific diagnoses or classes or disorders, transdiagnostic stepped-care interventions have not yet been developed. We discuss the development and initial implementation of a transdiagnostic approach to emotional disorders using the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C; Ehrenreich-May et al., 2018). A case series is presented to illustrate the delivery of UP-C stepped care (UPC-SC) via telehealth, using a collaborative decision-making process to inform step-up/step-down decisions. Lessons learned are discussed to guide refinements of UPC-SC and inform a larger trial.     

A Test of the Three-Component Model of Gender-Based Prejudices: Homophobia and Transphobia Are Affected by Raters’ and Targets’ Assigned Sex at Birth

Sex Roles - The present study tested a three-component model of homophobia and transphobia that differentiates between general and specifically gender-based social threats that motivate these...     

Synchronous change and perception of object unity: evidence from adults and infants.

Adults and infants display a robust ability to perceive the unity of a center-occluded object when the visible ends of the object undergo common motion (e.g. Kellman, P.J., Spelke, E.S., 1983. Perception of partly occluded objects in infancy. Cognitive Psychology 15, 483-524). Ecologically oriented accounts of this ability focus on the primary of motion in the perception of segregated objects, but Gestalt theory suggests a broader possibility: observers may perceive object unity by detecting patterns of synchronous change, of which common motion is a special case. We investigated this possibility with observations of adults and 4-month-old infants. Participants viewed a center-occluded object whose visible surfaces were either misaligned or aligned, stationary or moving, and unchanging or synchronously changing in color or brightness in various temporal patterns (e.g. flashing). Both alignment and common motion contributed to adults' perception of object unity, but synchronous color changes did not. For infants, motion was an important determinant of object unity, but other synchronous changes and edge alignment were not. When a stationary object with aligned edges underwent synchronous changes in color or brightness, infants showed high levels of attention to the object, but their perception of its unity appeared to be indeterminate. An inherent preference for fast over slow flash rates, and a novelty preference elicited by a change in rate, both indicated that infants detected the synchronous changes, although they failed to use them as information for object unity. These findings favor ecologically oriented accounts of object perception in which surface motion plays a privileged role.     

Peer-group association and adolescent tobacco use

Mosbach & Leventhal (1988) examined the relation of cigarette smoking to peer-group identification in rural Wisconsin adolescents. They found that among dirts (problem-prone youth), regulars (average youth), hot-shots (good social or academic performers), and jocks (athletes), youth most likely to smoke were dirts and hot-shots. We performed a replication with a Southern California cohort and also for use of smokeless tobacco. We hypothesized that jocks would be the main users of smokeless tobacco. We identified the same groups and an additional one, skaters (skateboarders or surfers). As Mosbach & Leventhal found, cigarettes were used most by dirts. Contrary to their results, but consistent with other research, we found that hot-shots were least likely to smoke. Contrary to our prediction, we found that skaters and dirts were more likely to use smokeless tobacco than were jocks. Our data show that both tobacco forms are used by problem-prone youth.     

Assessment of Emotional Avoidance in Adolescents: Psychometric Properties of a New Multidimensional Measure

Emotional avoidance—which includes cognitive and attentional processes that function as means of avoiding or dampening emotional experiences—may be a transdiagnostic risk and maintenance factor for emotional disorders. However, existing measures generally assess separate aspects of emotional avoidance, and few multidimensional measures exist for adolescents. The aim of the current study was to establish the psychometric properties of a new multidimensional measure of emotional avoidance for adolescents--the Emotional Avoidance Strategy Inventory for Adolescents (EASI-A; Fairholme et al. 2008)--employing an exploratory structural equation modeling framework. Analyses yielded a three-factor structure for the EASI-A, including subscales measuring Avoidance of Emotion Expression, Avoidance of Thoughts and Feelings, and Distraction. Moderate correlations were observed between the EASI-A and a measure of thought suppression, and the EASI-A was significantly associated with anxiety and depression symptoms. The EASI-A is a new, psychometrically sound measure that will aid in the assessment of avoidance as a vulnerability factor for psychopathology and as an outcome and mechanism for treatments of emotional disorders in adolescents.