Modified Comprehensive Behavioral Intervention for Tics: Treating Children With Tic Disorders,Co-Occurring ADHD,and Psychosocial Impairment

Our objective was to evaluate the feasibility and acceptability, and preliminary efficacy of a modified comprehensive behavioral intervention for tics (MCBIT) therapy for youth with chronic tic disorders (CTDs), co-occurring attention-deficit hyperactivity disorder (ADHD), and associated psychosocial impairment. Seventeen youth ages 10–17 with CTD and co-occurring ADHD were randomly assigned to the MCBIT group (n = 9) or to a control group where they received traditional comprehensive behavioral intervention for tics (CBIT) therapy (n = 8). Both groups received ten 55-minute weekly treatment sessions, and two 55-minute biweekly relapse prevention sessions. Sixteen of the 17 participants completed the study, and acceptability ratings in both treatment groups were high with no significant differences in expectation of improvement. The MCBIT and CBIT groups in combination showed significant improvement in tic severity, ADHD symptom severity, and tic-related impairment. Group differences were not significant. The results indicate that MCBIT treatment is feasible and acceptable for youth with CTD and ADHD, and is similarly well tolerated relative to traditional CBIT. Results were not sufficiently superior to recommend MCBIT over CBIT for this population. However, given the demonstrated benefit of behavioral treatments that target co-occurring conditions concurrently, continuing to examine novel behavioral approaches that can target tics and related conditions simultaneously and successfully is recommended.     

Efficacy of a Therapist-Assisted Self-Help Internet-Based Intervention Targeting PTSD,Depression, and Insomnia Symptoms After a Disaster: A Randomized Controlled Trial

This study aimed at evaluating the efficacy of an online CBT intervention with limited therapist contact targeting a range of posttraumatic symptoms among evacuees from the 2016 Fort McMurray wildfires.One hundred and thirty-six residents of Fort McMurray who reported either moderate PTSD symptoms (PCL-5 ≥ 23) or mild PTSD symptoms (PCL-5 ≥ 10) with moderate depression (PHQ-9 ≥ 10) or subthreshold insomnia symptoms (ISI ≥ 8) were randomized either to a treatment (n = 69) or a waitlist condition (n = 67). Participants were on average 45 years old, and mostly identified as White (82%) and as women (76%). Primary outcomes were PTSD, depression, and insomnia symptoms. Secondary outcomes were anxiety symptoms and disability. Significant Assessment Time × Treatment Condition interactions were observed on all outcomes, indicating that access to the treatment led to a decrease in posttraumatic stress (F[1,117.04] = 12.128, p = .001; d = .519, 95% CI = .142–.895), depression (F[1,118.29] = 9.978, p = .002; d = .519, 95% CI = .141–.898) insomnia (F[1,117.60] = 4.574, p = .035; d = .512, 95% CI = .132–.892), and anxiety (F[1,119.64] = 5.465, p = .021; d = .421, 95% CI = .044–.797) symptom severity and disability (F[1,111.55] = 7.015, p = .009; d = .582, 95% CI = .200–.963). Larger effect sizes (d = 0.823–1.075) were observed in participants who completed at least half of the treatment. The RESILIENT online treatment platform was successful to provide access to specialized evidence-based mental health care after a disaster.     

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.     

Penalized optimal scaling for ordinal variables with an application to international classification of functioning core sets

Ordinal data occur frequently in the social sciences. When applying principal component analysis (PCA), however, those data are often treated as numeric, implying linear relationships between the variables at hand; alternatively, non-linear PCA is applied where the obtained quantifications are sometimes hard to interpret. Non-linear PCA for categorical data, also called optimal scoring/scaling, constructs new variables by assigning numerical values to categories such that the proportion of variance in those new variables that is explained by a predefined number of principal components (PCs) is maximized. We propose a penalized version of non-linear PCA for ordinal variables that is a smoothed intermediate between standard PCA on category labels and non-linear PCA as used so far. The new approach is by no means limited to monotonic effects and offers both better interpretability of the non-linear transformation of the category labels and better performance on validation data than unpenalized non-linear PCA and/or standard linear PCA. In particular, an application of penalized optimal scaling to ordinal data as given with the International Classification of Functioning, Disability and Health (ICF) is provided.     

Implementation and evaluation of a juvenile mental health training for law enforcement in a medium-sized jurisdiction

The need for specialized training programs that are focused on youth mental health needs, awareness of community-based services, and de-escalation skills is growing across law enforcement agencies due to calls for service that involve youth in mental health crisis. The current study evaluates a juvenile mental health training for law enforcement that was developed based on agency needs. The training was completed by 159 officers and a pre-/post-test design was used. Findings suggest that officers were satisfied with the training and improvements were seen across several training constructs (confidence, preparedness, stigma, resource awareness, and de-escalation skills). Satisfaction with the training predicted change in confidence and preparedness. Recommendations for future research and the implementation of juvenile mental health trainings are discussed.     

Rice-farming areas report more anxiety across two years of the COVID-19 pandemic in China

Cultures responded to the COVID-19 pandemic differently. We investigated cultural differences in mental health during the pandemic. We found regional differences in people's reports of anxiety in China over two years from 2020 to 2021 (N = 1186). People in areas with a history of rice farming reported more anxiety than people in wheat-farming areas. Next, we explored more proximal mechanisms that could help link the distal, historical factor of rice farming to people's modern experience of anxiety. Rice areas scored higher on collectivism and tight social norms than wheat areas, and collectivism, rather than norm tightness, mediated the rice-anxiety relationship. These findings advance our understanding of the distal sources of cultural differences, the proximal mechanisms, and mental health problems during the pandemics.     

Family mental health during the COVID-19 pandemic: Changes in parent-adolescent internalizing symptoms in the United States

The current paper examined the temporal linkage of internalizing symptoms among parent-adolescent dyads during the beginning of the COVID-19 pandemic, and whether COVID-19-related concerns were associated with parent-adolescent linkage of symptoms. Using a 5-week survey-based study, parent-adolescent dyads filled out weekly surveys measuring COVID-19 concerns and internalizing symptoms. Parent and adolescent depressive symptoms did not change over time; however, adolescents experienced decreases in anxiety. Parent-adolescent dyads exhibited linkage in depressive symptoms but not anxiety symptoms. However, linkage in anxiety symptoms varied by parent's COVID-related stress. Study findings provide insight into how COVID-19 disruptions impacted family well-being during adolescence.     

Do health beliefs about COVID-19 predict morbidity? A longitudinal study

In a highly powered (N ≈ 5000), six-months longitudinal study (December 2020-May 2021), we tested the assumption that beliefs concerning COVID-19 and the precautions against it predicted morbidity. Six months after having filled out a survey measuring beliefs about the disease and the precautions against it, participants reported if they were or had been ill with COVID-19. A lower likelihood of being or having been ill with COVID-19 was predicted by personal optimism concerning infection, perceived personal control over infection, perceived effectiveness of precautions, and self-reported personal or better-than-average adherence to the precautions. A higher likelihood of being or having been ill with COVID-19 was predicted by perceived personal control over a good outcome of an infection, egocentric impact perception concerning the impact of the disease, perceived difficulty of adherence to the precautions, and both personal and egocentric impact perception concerning the impact of the precautions. Comparative optimism did not predict morbidity, nor did personal optimism concerning severe disease or a good outcome, perceived personal control over severe disease, and moralization of the precautions. We discuss implications for public health communication.     

Implicit and explicit COVID-19-vaccine harmfulness/helpfulness associations predict vaccine beliefs,intentions, and behaviors

We investigated the role of implicit and explicit associations between harm and COVID-19 vaccines using a large sample (N = 4668) of online volunteers. The participants completed a brief implicit association test and explicit measures to evaluate the extent to which they associated COVID-19 vaccines with concepts of harmfulness or helpfulness. We examined the relationship between these harmfulness/helpfulness COVID-19 vaccine associations and vaccination status, intentions, beliefs, and behavior. We found that stronger implicit and explicit associations that COVID-19 vaccines are helpful relate to vaccination status and beliefs about the COVID-19 vaccine. That is, stronger pro-helpful COVID-19 vaccine associations, both implicitly and explicitly, related to greater intentions to be vaccinated, more positive beliefs about the vaccine, and greater vaccine uptake.     

Safety behaviors were associated with greater anxious symptoms during the first year of the COVID-19 pandemic

Research shows that people who use safety behaviors are at greater risk factor for anxiety than people who do not use safety behaviors. However, the perception of some safety behaviors changed during the COVID-19 pandemic; behaviors that were once considered unnecessary or excessive were now commonplace (e.g., monitoring bodily symptoms, avoiding crowds). The purpose of this study was to determine the degree to which the pandemic changed the status of health-related safety behaviors as a risk factor for symptoms of anxiety. To this end, we tested the effect of safety behavior use on anxious symptoms during the first year of the pandemic using a longitudinal design with 8 time points and participants (n = 233) from over 20 countries. Despite possible changes in their perception, those engaging in high levels of safety behaviors reported the greatest levels of anxious symptoms throughout the pandemic year. However, the outcomes for safety behavior users were not all negative. Safety behavior use at baseline was the only predictor of participants' willingness to receive the COVID-19 vaccine (measured one year later).