Clinical Effectiveness of the LE<Superscript>3</Superscript>AN Program: A Military Healthy Lifestyle Program

For several decades, obesity has been a major health concern within the general population of the United States as well as within the unique military population. Unlike the civilian sector, military service requires individuals to meet weight and body fat standards. In order to assist overweight military personnel return to standards, Tripler Army Medical Center initiated the LE³AN Program. LE³AN is a one-week, day-treatment, cognitive-behavioral weight management program coupled with 12 months of weekly follow-up. Baseline data was collected on 387 consecutive participants. Despite physical fitness training and required standards in each military service, the average BMIs for men and women were in the obese range, with male participants’ BMIs significantly higher than women’s (34.3 vs 31.9, p<.005). One year outcome data was collected from 167 participants, i.e. 43.2% of treatment initiators. Among participants who completed treatment, men maintained a 6.56% loss of their initial weight while women maintained a 7.35% loss. Over a quarter, 26.6%, of those who started the program (but did not complete it) maintained at least a 5% weight loss at one year, while 61.6% of treatment completers maintained 5% weight losses. The opinions expressed in this article reflect the views of the authors and not those of the Department of Defense or the U.S. Army.     

Parent Beliefs about Treatment Credibility and Effectiveness: Assessment and Relation to Subsequent Treatment Participation

We assessed parents’ beliefs about treatment credibility and effectiveness and examined the influence of these beliefs on subsequent treatment participation. Seventy-six parents completed the Credibility/Expectancies Questionnaire—Parent Version (CEQ-P), and subsequently participated in treatment for their child's clinically referred conduct problems. The key findings were that: (a) the CEQ-P is composed of two components that measure parents’ treatment credibility and expectancies; (b) the total scale and each component are internally consistent and have strong test-retest reliability; (c) scores on the CEQ-P are significantly associated with scores on a measure of parent motivation for treatment, supporting the construct validity of this measure; and (d) scores on the CEQ-P at the first clinic visit significantly predict subsequent adherence to treatment procedures above and beyond demographic variables and parent motivation for treatment. This study provides an efficient and psychometrically sound measure of parent beliefs about treatment and demonstrates the importance of such beliefs for subsequent treatment adherence.     

Community Influences on Adjustment in First Grade: An Examination of an Integrated Process Model

We examined the impact of neighborhood characteristics both directly and indirectly as mediated by parent coaching and the parent/child affective relationship on behavioral and school adjustment in a sample of urban dwelling first graders. We used structural equations modeling to assess model fit and estimate direct, indirect, and total effects of neighborhood structural and social characteristics on parenting behavior and child outcomes. Observed physical incivilities in the neighborhood were associated with lower levels of parent eliciting behavior and higher levels of child behavior problems. The effects of neighborhood structural characteristics were mediated partially through neighborhood community involvement with children, which had a direct significant impact on parent eliciting behavior and an indirect effect on child behavior problems. Neighborhood community involvement with children was associated with higher levels of parent eliciting behavior and lower levels of child behavior problems. Observed physical incivilities had a significant indirect association with poor school adjustment and a marginally significant association with positive school adjustment to first grade. Neighborhood community involvement with children was more strongly associated with positive school adjustment than poor school adjustment.     

Phenomenology of Early Childhood Onset Obsessive Compulsive Disorder

This paper describes the phenomenological features of early childhood onset obsessive compulsive disorder (OCD; defined as children meeting DSM-IV criteria for OCD with age of onset <8 years). Fifty-eight children (ages 4–8) were included in the sample. OCD and comorbid diagnoses were determined by structured interview, and OCD severity was measured using the Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS). Mean age of OCD onset was almost five, and mean age of presentation was between 6 and 7. Mean symptom severity was in the moderately severe range. Comorbidity and family history of OCD were common. Contamination and aggressive/catastrophic obsessions and washing and checking compulsions were endorsed most frequently. Results indicate that early childhood onset OCD may have a lower boy to girl ratio and lower rates of depressive disorders, but may be similar to later childhood onset OCD in terms of OCD symptom presentation and severity.     

Same-Sex and Other-Sex Peer Reports: Unique Contributors to Understanding Children’s School Adjustment

The present study proposed to understand how same-sex and other-sex peer nominations relate differently to teacher reports of children’s behaviors and measures of children’s friendships. Students provided peer nominations, mutual friend data, and social network data. Teachers rated students’ antisocial behavior and social competence. As expected, other-sex peer social preference scores predicted teacher ratings of antisocial behavior, while same-sex peer social preference scores predicted data on friendships and social groups. Unexpectedly, both same and other sex peer nominations predicted children’s teacher-rated social competence. Findings suggest that other-sex peers offer a unique perspective on children’s social behavior that is neither superfluous nor unimportant to understanding children’s psychosocial adjustment.     

A Psychometric Analysis of the Child Behavior Checklist DSM-Oriented Scales

The Child Behavior Checklist for Ages 6–18 (CBCL/6-18) possesses newly developed DSM-Oriented Scales, constructed through expert clinical judgment to match selected categories for behavioral/emotional problems as described in the DSM-IV. The present investigation examined the basic psychometric properties for all six DSM-Oriented Scales (i.e., Affective, Anxiety, Somatic, Attention-Deficit/Hyperactivity, Oppositional, and Conduct Scales) in a large clinical sample of children and adolescents (N = 673). Findings from the present study provide strong evidence for the reliability, as well as convergent and discriminative validity, of these scales. It appears that the DSM-Oriented Scales may provide accurate supplementary information that may be considered when formulating clinical diagnoses.

The development of intergroup bias in childhood: how social norms can shape children's racial behaviours

The present research examined the developmental course of racial behaviours in childhood. It tested the hypothesis that White children's expressions of racial prejudice do not necessarily decline in middle childhood due to the development of particular cognitive skills but that instead, as argued by the socio-normative approach, children older than seven will go on expressing prejudiced attitudes under appropriate conditions. This would be explained by the presence of an anti-racism norm, along with the existence of values promoting equal rights, which impede blatant expressions of racism. In the first study 283 White children aged 6-7 and 9-10 years performed a task of resource allocation to White and Black target children in conditions of high (White interviewer was present) or low (White interviewer was absent) salience of the anti-racist norm. The 6- to 7-year-old children discriminated against the Black target in both conditions whereas older children discriminated against the Black child only when the anti-racist norm was not salient. In Study 2, 187 White children aged 6-7 and 9-10 years performed the same resource allocation task in conditions of explicit activation of similarity vs dissimilarity or egalitarian vs merit-based norms regarding race relations. Supporting the hypothesis of the role of racist or anti-racist norms on the expression of intergroup discrimination, results have again shown that 6- to 7-year-old children discriminated against the Black target in both conditions while older children presented significantly different prejudiced/nonprejudiced behaviours consistent with the activated norms. These results were discussed in terms of the need for a reanalysis of the assumptions and research results of the cognitive-developmental theory and of further developments in the socio-normative approach regarding the development of prejudice in childhood.     

East Asian child-rearing attitudes: an exploration of cultural, demographic and self-disclosure factors among US immigrants

Child-rearing attitudes among East Asian groups have been emphasized in the developmental psychology literature in the context of their association with academic achievement. Although child-rearing attitudes play an important role in the transmission of cultural values, much of the research on East Asian child-rearing attitudes has ignored cultural variables and has instead focused on authoritarian parenting style. The current study examined the association between three classes of variables-culture (i.e., ethnic identity, self-construal, acculturation), demographics (sex, years in the US, English fluency), and self-disclosure-and traditional child-rearing attitudes (TCRA) among East Asian immigrants in the United States. It was hypothesized that higher levels of TCRA would be associated with higher levels of ethnic identity, interdependent self-construal, separation, and guarded self-disclosure, and fewer years spent in the United States. The participants included 170 East Asian (Chinese, Japanese, and Korean) immigrants (88 men, 82 women) who were administered a battery of psychometrically established measures. Our hypotheses were largely supported. We found that, while there was no significant sex by ethnicity effect for TCRA, men were significantly more likely than women to endorse TCRA and the Korean group had significantly higher TCRA than the Japanese group. Ethnic identity, interdependent self-construal, separation, years in the US, and guarded self-disclosure were significant independent predictors of TCRA. The findings suggest the need for broadening the content of assessment tools of child-rearing attitudes and measuring associated cultural and noncultural variables among East Asian ethnic groups. Future research on child-rearing attitudes among Asian ethnic groups may benefit from (1) measuring multiple dimensions of TCRA, (2) assessing associated cultural variables directly rather than inferring them in an ad hoc fashion based on observed ethnicity differences, (3) measurement of demography (including sex and years spent in the host country) and (4) examining the potential influence of guarded self-disclosure.     

Community vs. Clinic-Based Modular Treatment of Children with Early-Onset ODD or CD: A Clinical Trial with 3-Year Follow-Up

This study examines the treatment outcomes of 139, 6–11 year-old, clinically referred boys and girls diagnosed with Oppositional Defiant Disorder (ODD) or Conduct Disorder (CD) who were randomly assigned to a modular-based treatment protocol that was applied by research study clinicians either in the community (COMM) or a clinic office (CLINIC). To examine normative comparisons, a matched sample of 69 healthy control children was included. Multiple informants completed diagnostic interviews and self-reports at six assessment timepoints (pretreatment to 3-year follow-up) to evaluate changes in the child’s behavioral and emotional problems, psychopathic features, functional impairment, diagnostic status, and service involvement. Using HLM and logistic regression models, COMM and CLINIC showed significant and comparable improvements on all outcomes. By 3-year follow-up, 36% of COMM and 47% of CLINIC patients no longer met criteria for either ODD or CD, and 48% and 57% of the children in these two respective conditions had levels of parent-rated externalizing behavior problems in the normal range. We discuss the nature and implications of these novel findings regarding the role of treatment context or setting for the treatment and long-term outcome of behavior disorders. This study was supported by grants to the first author from the National Institute of Mental Health (MH 57727) and to the second author by the National Institute of Nursing Research (NR 07615). The fourth author was supported by grant K01 MH078039 from the National Institute of Mental Health. The authors acknowledge the research and clinical staff of the Resources to Enhance the Adjustment of Children (REACH) program, and Drs. David Brent, Tammy Chung, William Gardner, John Lochman, and Wayne Osgood. Reprints may be obtained from Dr. Kolko, WPIC, 3811 O’Hara St., Pittsburgh, PA 15213.     

Deficits in executed and imagined aiming performance in brain-injured children

Motor disorders are a frequent consequence of acquired brain injury (ABI) in children and much effort is currently invested in alleviating these deficits. The aim of the present study was to test motor imagery (MI) capabilities in children with ABI (n=25) and an age- and gender-matched control group (n=25). A computerized Virtual Radial Fitts Task (VRFT) was used to investigate the speed-accuracy trade-offs (or Fitts' law) that occur as target size is varied for both executed and imagined performance. In the control group, the speed for accuracy trade-off for both executed and imagined performance conformed to Fitts' law. In the ABI group, only executed movements conformed to Fitts' law. These findings suggest that children with ABI show an inferior ability to imagine the time needed to complete goal-directed movements with differential difficulty levels.