Family Functioning in Pediatric Trichotillomania

Little is known about how pediatric trichotillomania (TTM), a clinically significant and functionally impairing disorder, is impacted by, and impacts, family functioning. We explored dimensions of family functioning and parental attitudes in a sample of children and adolescents who participated in an Internet-based survey and satisfied conservative diagnostic criteria for TTM (ages 10–17, n = 133). Analyses reveal trends toward higher levels of dysfunction in families of TTM youth relative to normative samples, although no differences achieved statistical significance. However, scores on the Family Assessment Measure and the Attitudes Toward My Child scales were similar to those in clinical samples of youth with cystic fibrosis, an eating disorder, or an anxiety disorder. While these results indicate that family functioning and parental attitudes in TTM were not generally or extremely problematic, family issues may nevertheless warrant particular clinical evaluation and attention in more severe TTM cases.     

Parent-Collected Behavioral Observations: An Empirical Comparison of Methods

Treatments for disruptive behaviors are often guided by parent reports on questionnaires, rather than by multiple methods of assessment. Professional observations and clinic analogs exist to complement questionnaires, but parents can also collect useful behavioral observations to inform and guide treatment. Two parent observation methods of child aggression and noncompliance were compared: the Parent Daily Report (PDR) and Behavior Record Cards (BRC). Parents tracked misbehavior for 2 weeks using the PDR or BRC. BRC data proved to be more accurate, though both systems yielded strong reliability and moderate validity. The BRC is recommended to clinicians on empirical and conceptual grounds.     

Parental Emotion Coaching: Associations With Self-Regulation in Aggressive/Rejected and Low Aggressive/Popular Children

This study investigated associations between maternal and paternal emotion coaching and the self-regulation skills of kindergarten and first-grade children. Participants were 54 children categorized as either aggressive/rejected or low aggressive/popular by peer reports. Findings indicated a statistical trend for fathers of low aggressive/popular children to engage in more emotion coaching than fathers of aggressive/rejected children. Paternal emotion coaching accounted for significant variance in children's regulation of attention. Maternal emotion coaching moderated the relation between children's status and regulation of emotion. Findings suggest that interventions focused on parental emotion coaching may prove beneficial for increasing the self-regulation and attention skills of children with social and conduct problems.     

Effects of Mothers' Locus of Control for Child Improvement in a Developmentally Delayed Sample

A potentially important variable that has received little attention in the literature is the locus of control (LOC) a caregiver holds for child improvement, including its influence on the caregiver's treatment compliance and on actual child improvement. In this study, 131 mother-child dyads were assessed across 1 year, to evaluate the utility of the LOC construct in a practice setting. Children were approximately 4 years old at the first assessment, and all of them had been diagnosed with a developmental disability. Mothers' compliance with treatment (mothers' attendance at sessions; teachers' ratings of mothers' support and knowledge) was tracked, and measures of child development status and mothers' locus of control were administered. Statistical results indicated that mothers' locus of control was not significantly correlated with children's gains in development over the year. The mothers' beliefs about whether the child or chance would be responsible for improvement were associated with lower compliance with treatment, whereas the mothers' beliefs that child improvement was attributable to professional intervention were associated with enhanced involvement in treatment.     

The Attention and Executive Function Rating Inventory (ATTEX): Psychometric properties and clinical utility in diagnosing ADHD subtypes

Klenberg, L., Jämsä, S., Häyrinen, T., Lahti‐Nuuttila, P. & Korkman, M. (2010). The Attention and Executive Function Rating Inventory (ATTEX): Psychometric properties and clinical utility in diagnosing ADHD subtypes. Scandinavian Journal of Psychology, 51, 439–448. This study presents a new inventory, the Attention and Executive Function Rating Inventory (ATTEX), and examines the psychometric properties and the clinical utility of ATTEX in indentifying the attention deficit hyperactivity disorder combined type (ADHD‐C) and the ADHD predominantly inattentive type (ADHD‐I) in school environments. A normative sample of Finnish 7‐ to 15‐year‐old children and adolescents (N = 701) and a clinical sample consisting of children with ADHD‐C (N = 190) and ADHD‐I (N = 25) were examined with the ATTEX and the ADHD Rating Scale‐IV. The ATTEX and its scales had good internal consistency reliability (0.67–0.98) and criterion validity (0.68–0.95). Normative data was provided for the total normative sample and for boys and girls separately. Gender differences were noted in the ATTEX scores, boys having consistently higher scores on all ATTEX scales. The effect of age was significant only for one of the ten scales, the Motor hyperactivity scale, 7‐year‐olds having more problems of hyperactivity than 14‐year‐olds. Lower parent education level and the child’s learning difficulties were related to higher ratings of EF problems in ATTEX. When different cutoff scores for boys and girls were applied, ATTEX was sensitive in identifying children with attention deficit disorders. In addition, ATTEX was accurate in differentiating children with ADHD‐I from children with ADHD‐C. In this Finnish sample, ATTEX showed solid psychometric properties and could be used as a reliable tool in the diagnostic evaluation of ADHD‐C and ADHD‐I.     

Concerns of Older Veteran Callers to the Veterans Crisis Line

When the Veterans Crisis Line (VCL) was implemented, it was uncertain if veterans, and particularly older male veterans, would utilize the service. We examined VCL use by a growing group of veterans at increased risk for suicide: those aged 60 and older. Real‐time clinical data were gathered from a weekly random sampling of calls. Approximately 25% of calls were from veterans aged 60 or older; over 80% reported benefit from the call. Several significant differences in presenting concerns between older and younger callers were found. Targeted outreach to encourage older veterans to use the VCL is suggested.     

Using Structured Telephone Follow‐up Assessments to Improve Suicide‐Related Adverse Event Detection

Adverse event (AE) detection and reporting practices were compared during the first phase of the Emergency Department Safety Assessment and Follow‐up Evaluation (ED‐SAFE), a suicide intervention study. Data were collected using a combination of chart reviews and structured telephone follow‐up assessments postenrollment. Beyond chart reviews, structured telephone follow‐up assessments identified 45% of the total AEs in our study. Notably, detection of suicide attempts significantly varied by approach with 53 (18%) detected by chart review, 173 (59%) by structured telephone follow‐up assessments, and 69 (23%) marked as duplicates. Findings provide support for utilizing multiple methods for more robust AE detection in suicide research.     

Perceived Racism and Suicide Ideation: Mediating Role of Depression but Moderating Role of Religiosity among African American Adults

Suicide is a public health problem for African Americans who are young and of working age. The purpose of this study was to examine mediated and moderated effects of perceived racism on suicide ideation in a community sample of 236 African American men and women. Measures of suicide ideation, depression symptoms, intrinsic/extrinsic religiosity, and perceived racism were administered. Perceived racial discrimination was directly and indirectly associated with suicide ideation. For participants who reported low levels of extrinsic religiosity, the mediated effect of perceived racism (via depression symptoms) was significant. These findings provide some insight into suicide vulnerability for specific subgroups of African Americans.