Examining Influences on Problem Recognition and Help-Seeking for Child Externalizing Behaviors Among African American Mothers

Childhood behavior problems are one of the most common clinical referrals. If left untreated, these behaviors can result in detrimental consequences to the child’s development (Wehmeier et al., 2010; Scholtens et al., 2012). Behavior parent training has been identified as first-line treatment for oppositional behavior; however, many racial minority families fail to enroll in behavior parent training. The current study examines maternal help-seeking for children displaying oppositional behavior in hopes to delineate variables that might influence parent training enrollment among African American families. Participants were 112 African American mothers who were provided child behavior vignettes and completed measures assessing factors related to problem recognition, parental attributions, child rearing values, mental health stigmatization, racial identity, and treatment utilization. Results found that when presented with a child displaying clinically significant externalizing child behaviors, slightly more than half of African American mothers recognized clinically significant child behavior problems. Mothers were more likely to engage in behavioral parent training if problematic behavior was recognized. Additionally, mothers’ attributions of child behavior, cultural values, and mental health stigmatization were influential to help seeking. This study supports the importance of considering cultural variables that impact problem recognition and subsequent treatment utilization among African American families.     

Making Lemonade out of Lemons: Dialectical Behavior Therapy via Telehealth During a Pandemic

The COVID-19 pandemic has created a burden on healthcare systems and increased demand for mental healthcare at a time when in-person services are limited. Many programs offering dialectical behavior therapy (DBT) for complex clients have pivoted to telehealth in order to increase access to critical mental healthcare. There is, however, limited research on the provision of telehealth treatment for clients with complex psychopathology more broadly, or the telehealth implementation of DBT more specifically. The aim of this study was to examine the use of telehealth services and related clinician attitudes and experiences in the context of DBT. We examined the degree of telehealth platform adoption among DBT clinicians, as well as changes in stress and self-care strategies. A supplemental aim was to gather clinicians’ recommendations for providing DBT via telehealth. Participants included N = 99 DBT practitioners (79.8% female; 20.2% male). Qualitative and quantitative methods were used for data analysis. Findings show that telehealth DBT has been widely adopted among DBT clinicians, and that clinicians’ attitudes to telehealth DBT are cautiously optimistic. Participants described three main areas of stress associated with DBT via telehealth provision, as well as lost and novel self-care strategies.     

When the poor give more than the rich: The role of resource evaluability on relative giving

Five experiments examined the role of resource evaluability on giving. We systematically varied participants' resources they and another potential donor received and whether they could donate to a recipient either by themselves or with the other donor. Participants in the relative advantage condition received more resources than the other donor, and those in the relative disadvantage condition received fewer resources than the other donor. The presence of the other donor made participants' resources evaluable and shaped giving: Relatively disadvantaged participants were proportionally more generous than advantaged participants but only when they could evaluate their resources. Neither the mere presence of others nor reputational concerns could explain the results. Exploratory mediation and moderation analyses further showed that relatively disadvantaged participants give proportionally more the higher and the more equal they perceive their status to the advantaged donor. This shows that the generosity of those who have less does depend on how they evaluate their status compared to other donors. Our results provide insights into the question of why and when resource asymmetries between donors result in prosocial giving and can influence fundraising strategies of charitable organizations.     

Predictors of COVID-19 precautionary behaviors to protect people with disabilities

Disability is conceptualized using one of two major frameworks: the medical and the social model of disability. The medical model of disability describes disability as an individual issue in which the appropriate intervention is to remove the disability. The social model of disability describes disability as a social construction in which the appropriate intervention is societal change to increase accessibility. This study drew on models of disability to understand predictors of engagement in COVID-precautionary behavior prior to the vaccine to protect people with disabilities (PWD) from contracting COVID-19. Participants (n = 720) with and without disabilities (n = 77 and n = 633, respectively) completed an online questionnaire measuring disability beliefs, attitudes toward PWD, concerns about PWD contracting COVID-19, and engagement in behavior protecting PWD from contracting COVID-19. Medical model beliefs were negatively associated with behavior. In addition, negative attitudes toward PWD and low concern about PWD contracting COVID-19 fully accounted for the relationship. Social model beliefs were positively associated with behavior. In addition, positive attitudes toward PWD and greater concern about PWD contracting COVID-19 partially explained the relationship. These findings suggest that framing disability as a social construction rather than a medical issue could promote greater public health behavior to protect PWD from contracting COVID.     

Coping with COVID: Use,factor structure,and health behavior implications of specific emotion regulation strategies during the coronavirus pandemic

This series of studies examined U.S. individuals' use of specific emotion regulation/coping strategies during the early months of the COVID-19 pandemic, investigated the factor structure among strategies during this universally experienced stressor, and the extent to which these factors predicted engagement in COVID-related health-promoting behaviors. In Study 1, participants (N = 520) rated their use of 17 strategies for coping with pandemic-related stress during the past 24 h. Differences emerged in strategy use across demographic groups (age, race, income). Results of exploratory factor analysis suggest a factor structure grouping strategies in terms of goals beyond emotion regulation per se, rather than phases of the emotion process or a binary adaptive versus maladaptive distinction. In Study 2 (N = 264), participants reported daily on their coping strategy use and weekly on their engagement in COVID-specific health behaviors for 22 days. Results of confirmatory factor analysis replicate the factor structure found in Study 1. Some significant associations of coping strategy use with health-promoting behaviors were observed, but these were sporadic and largely involved baseline measures rather than predicting change over time. Theoretical and practical implications are discussed.     

Neuropsychiatric and experiential correlates of violent juvenile delinquency

This article reviews evidence regarding contributions of neuropsychiatric and psychological vulnerabilities to violent delinquency, and the interaction between intrinsic vulnerabilities and experiential factors in the genesis of antisocial juvenile behavior. Consideration is given to biochemical and physiological factors, genetics, medical status, and neurological, psychiatric, and neuropsychological factors. Implications for treatment are discussed.     

Behavioral case formulation: An experimental assessment study of transient tic disorder

A nine-year-old male, who met DSM III-R criteria for transient tic disorder, participated in an experimental assessment strategy to generate support for a case formulation. In addition to presenting motor disturbance, assessment procedures revealed six problem areas. All problems were formulated as manifestations of a hypersensitivity to evaluation, etiologically related to the boy's relationship with an insecure and critical father. It was hypothesized that the patient's tic disorder was a consequence of his hypersensitivity to father's excessive criticism, which then generalized to other evaluative situations. Using a controlled single-subject design, predictions derived from the formulation were tested by exposing the child to a planned combination of evaluative observers (e.g., father, mother, therapist, etc.) who watched him as he worked on a series of puzzles. The dependent measures included (1) behavioral recordings of tic frequency and (2) frontalis EMG responses. The results indicated significant differences in tic rate and EMG as a function of the type of observer. Consistent with the formulation, the patient displayed the highest levels of tic behavior and EMG response when his father was the observer and lowest in the presence of the mother. Predictions regarding other stimulus conditions were also confirmed. These results provided support for the case formulation that was used to design an effective treatment intervention. Findings suggest that the case formulation model offers a method whereby novel case hypotheses can be generated for poorly understood psychopathology and tested later in the experimental situation.     

Nonsuicidal physically self-damaging acts in adolescents

To determine the frequency and correlates of nonsuicidal physically self-damaging acts in 12–14 year olds, a two stage epidemiologic survey with a self-administered questionnaire (N=3283) followed by a psychiatric interview of a subsample of the adolescents and their parents (N=444) was used. Prevalence estimates of interview validated nonsuicidal physically self-damaging acts were 2.46% in males and 2.79% in females. Significant relationships were found between nonsuicidal physically self-damaging acts and suicidal ideation, major depression and undesirable life events. Data suggest that physically self-damaging acts occur at substantial rates during early adolescence. The strong correlation between nonsuicidal self-destructive acts and both suicidal ideation and major depression clarifies prior conflicting reports in the literature and suggests that a history of self-damaging acts should be taken into consideration when evaluating for possible depression and suicide risk.     

EXPERIMENTAL ANALYSIS AND TREATMENT OF MULTIPLY CONTROLLED SELF-INJURY

A functional analysis of the self-injurious behavior (SIB) of 3 adults with profound developmental disabilities showed that each engaged in SIB in more than one assessment condition. Such outcomes may result from a failure to isolate the variable maintaining SIB, or they may reflect multiple sources of control over SIB. In order to identify more clearly the determinants of SIB, each subject was exposed to a series of treatments appropriate to one or both of the apparent functions of SIB. These treatments, applied sequentially on baselines appropriate to each behavioral function, identified the maintaining variables for SIB through differential outcomes across baselines. Results indicated that the SIB of 2 subjects was multiply controlled, confirming the outcomes of the functional analysis. However, the SIB of the 3rd subject was eliminated using a treatment designed for a single function, suggesting spurious results of the original assessment. Alternative interpretations of undifferentiated assessment data are discussed, as are analysis and treatment issues related to multiply determined behavior disorders.     

STIMULUS (INSTRUCTIONAL) FADING DURING EXTINCTION OF SELF-INJURIOUS ESCAPE BEHAVIOR

Three individuals with developmental disabilities were exposed to a series of assessment conditions to identify the source of reinforcement for their self-injurious behavior. In each case, self-injury occurred most often in instructional (demand) situations containing a brief time-out from the task contingent on self-injury, indicating that the behavior was an escape response (i.e., maintained by negative reinforcement). Treatment was implemented in a multiple baseline across subjects design and consisted of extinction (prevention of escape) plus instructional fading (initial elimination of instructions followed by their gradual reintroduction). Results showed that the combined treatment produced immediate and large reductions in self-injury that were maintained as the frequency of instructions was increased across sessions to match the original baseline rate of presentation. Results of a component analysis conducted with 1 subject suggested that stimulus fading accelerated the behavior-reducing effects of extinction.