Improving the Transportability of CBT for Internalizing Disorders in Children

Research provides strong support for the efficacy and effectiveness of cognitive behavioral therapy (CBT) for the treatment of childhood internalizing disorders. Given evidence for limited dissemination and implementation of CBT outside of academic settings, efforts are underway to improve its transportability so that more children with mental health needs may benefit from treatment. Creative modifications to existing treatments aim to deliver CBT for anxiety disorders and depression in a more transportable format. Notable progress has been made within the areas of computerized CBT, camp-based CBT, school-based CBT, and CBT delivered through primary care settings. These approaches are discussed within the context of key elements of transportability that are particularly germane to the dissemination and implementation of child treatments.     

Against the odds: academic underdogs benefit from incremental theories

An implicit theory of ability approach to motivation argues that students who believe traits to be malleable (incremental theorists), relative to those who believe traits to be fixed (entity theorists), cope more effectively when academic challenges arise. In the current work, we integrated the implicit theory literature with research on top dog and underdog status to predict self-efficacy in an academic context. To examine our predictions, we assessed college students’ (N  =  165) implicit theories of mathematical ability and manipulated their underdog versus top dog status in a math competition. We hypothesized that holding an incremental (vs. entity) theory would interact with competition status (underdog vs. top dog) to predict mathematical self-efficacy. When in an underdog position, incremental (vs. entity) theories boosted students’ mathematical self-efficacy. Moreover, a mediated moderation model revealed that the experience of less helplessness accounted for greater self-efficacy in mathematical ability among academic underdogs with incremental (vs. entity) theories. Implications for teaching practices are discussed.     

Parental goals and talk with toddlers

Myriad studies support a relation between parental beliefs and behaviours. This study adds to the literature by focusing on the specific relationship between parental goals and their communication with toddlers. Do parents with different goals talk about different topics with their children? Parents' goals for their 30‐month olds were gathered using semi‐structured interviews with 47 primary caregivers, whereas the topics of conversations that took place during interactions were investigated via coding videotapes of observations in the home. Parents' short‐ and long‐term goals spanned several areas, including educational, social–emotional, developmental and pragmatic goals. Parental utterances most frequently focused on pragmatic issues, followed by play and academic topics. Parents who mentioned long‐term educational goals devoted more of their talk to academic topics and less to pragmatic topics, controlling for socio‐economic status. Thus, parental goals differ and these differences relate to the conversations parents engage in with their children. Copyright © 2010 John Wiley & Sons, Ltd.     

Processing emotional category congruency between emotional facial expressions and emotional words

Facial expressions are critical for effective social communication, and as such may be processed by the visual system even when it might be advantageous to ignore them. Previous research has shown that categorising emotional words was impaired when faces of a conflicting valence were simultaneously presented. In the present study, we examined whether emotional word categorisation would also be impaired when faces of the same (negative) valence but different emotional category (either angry, sad or fearful) were simultaneously presented. Behavioural results provided evidence for involuntary processing of basic emotional facial expression category, with slower word categorisation when the face and word categories were incongruent (e.g., angry word and sad face) than congruent (e.g., angry word and angry face). Event-related potentials (ERPs) time-locked to the presentation of the word-face pairs also revealed that emotional category congruency effects were evident from approximately 170 ms after stimulus onset.     

Depressive symptoms predict decline in perceptual speed in older adulthood

Depressive symptoms and cognitive decline are associated in older age, but research is inconsistent about whether one condition influences the development of the other. We examined the directionality of relations between depressive symptoms and perceptual speed using bivariate dual change score models. Assessments of depressive symptoms and perceptual speed were completed by 1,206 nondemented older adults at baseline, and after 2, 8, 11, and 15 years. After controlling for age, education, baseline general cognitive ability, and self-reported health, allowing depressive symptoms to predict subsequent change in perceptual speed provided the best fit. More depressive symptoms predicted subsequently stronger declines in perceptual speed over time lags of 1 year.     

Psychometric properties of an insomnia-specific measure of worry: the Anxiety and Preoccupation about Sleep Questionnaire

The aim of this study was to examine the psychometric properties of the Anxiety and Preoccupation about Sleep Questionnaire (APSQ), with a focus on factorial validity and internal consistency as well as discriminative, convergent, and association with sleep parameters and daytime impairment. Among a randomly selected sample from the general population (N = 5,000), 2,333 participants completed a survey on nighttime symptoms, daytime symptoms, health outcomes, and psychological processes. The study sample consisted of 1800 participants who did not fulfill criteria for another sleep disorder than insomnia. A two-factor solution, accounting for 70.7% of the variance, was extracted from the 10 APSQ items. One six-item factor determined worries about the consequences of poor sleep (α = .91); the second factor, with four items, assessed worries about the uncontrollability of sleep (α = .86). The two factors were significantly intercorrelated (ρ = .65) and significantly associated with the total APSQ (ρs = .97 and .76, respectively). The APSQ and the two subscales showed discriminant validity between three sleep status groups (normal sleep, poor sleep, and insomnia disorder; R(2) = .33-.41). The APSQ and the subscales demonstrated convergent validity with measures on cognitive arousal, sleep-related beliefs, anxiety, and depression. They also were significantly correlated with sleep parameters and daytime impairment. The findings suggest that the APSQ is a psychometrically sound instrument for assessing worry in insomnia.     

Perseverative thought: a robust predictor of response to emotional challenge in generalized anxiety disorder and major depressive disorder

Generalized anxiety disorder (GAD) and major depressive disorder (MDD) frequently co-occur, yet the reasons for their comorbidity remain poorly understood. In the present experiment, we tested whether a tendency to engage in negative, repetitive thinking constitutes a common risk process for the two disorders. A mixed sample of adults with comorbid GAD–MDD (n = 50), GAD only (n = 35), MDD only (n = 34), or no lifetime psychopathology (n = 35) was administered noncontingent failure and success feedback on consecutive performance tasks. Perseverative thought (PT), measured by negative thought intrusions during a baseline period of focused breathing, emerged as a powerful prospective predictor of responses to this experimental challenge. Participants reporting more frequent negative thought intrusions at baseline, irrespective of thought content or diagnostic status, exhibited a stronger negative response to failure that persisted even after subsequent success. Higher PT over the course of the experiment was associated with later behavioral avoidance, with negative affect and other traits closely linked to anxiety and depression, and with the presence and severity of GAD and MDD. These findings provide evidence for a broadly-defined PT trait that is shared by GAD and MDD and contributes to adverse outcomes in these disorders.     

Cognitive and behavioral functioning in Coffin-Siris syndrome and epilepsy: a case presentation

The authors characterized the cognitive, adaptive, and behavioral sequelae of Coffin-Siris (CS) syndrome and epilepsy in a 7.5-year-old child. Little is known about the early neurobehavioral presentation of CS. Clinical features consistent with this genetic anomaly include underdeveloped tips and nails of the fifth fingers, extended infranasal depression, and craniofacial abnormalities. MRI findings often reveal callosal agenesis. The authors conducted a neuropsychological evaluation and obtained parental ratings of behavioral and adaptive functioning. Attentional abilities were limited. As assessed by the Mullen Scales of Early Learning, receptive language abilities (age equivalent [AE]: 3-3) were relatively stronger than expressive skills (AE: 1-4). Adaptive functioning was low across all domains (Vineland Adaptive Behavior Composite AE: 1-9). On the Behavior Assessment for Children (BASC-2), social skills dysfunction, stereotyped and self-stimulatory behaviors, restricted interests, ritualistic play, and inappropriate object usage were noted. No significant mood disturbances were endorsed. Study findings indicate a diffuse pattern of neurobehavioral deficits in a child with CS and epilepsy. Further clinical assessment and research should include multidimensional assessment techniques, including evaluation of adaptive behavior, in an effort to capture the full range developmental sequelae in children with CS.     

Influence of school-level variables on aggression and associated attitudes of middle school students

This study sought to understand school-level influences on aggressive behavior and related social cognitive variables. Participants were 5106 middle school students participating in a violence prevention project. Predictors were school-level norms opposing aggression and favoring nonviolence, interpersonal climate (positive student–teacher relationships and positive student–student relationships), and school responsiveness to violence (awareness and reporting of violence and school safety problems). Outcomes were individual-level physical aggression, beliefs supporting aggression, and self-efficacy for nonviolent responses. School norms and both interpersonal climate variables had effects on all three outcomes in theorized directions. Only one of the responsiveness measures, awareness and reporting of violence, had theoretically consistent effects on all outcomes. The other, school safety problems, affected self-efficacy later in middle school. Evidence of gender moderation was generally consistent with greater influence of school-level factors on female adolescents. Discussion focuses on implications in light of previous research and intervention possibilities.     

Serotonin Transporter Genotype Moderates the Link Between Children’s Reports of Overprotective Parenting and Their Behavioral Inhibition

The goal of the current study was to examine environmental and genetic correlates of children’s levels of behavioral inhibition (BI). Participants were 100 mother child pairs drawn from the community who were part of a larger study of the intergenerational transmission of depression. Results indicated that higher levels of maternal overprotection, as reported by the child, were associated with elevations in BI among children carrying two copies of the lower expressing 5-HTTLPR alleles (S or L_G), but not among those carrying only one copy or those homozygous for the L_A allele. In addition, this interaction was specific for the social component of BI, not the nonsocial component. This relation was maintained even after statistically controlling for children’s and mother’s psychopathology. Together, these findings add to emerging research demonstrating that G × E interactions predict variation in BI during childhood.