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.     

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.     

Behavioral Parent Training Engagement Among Young Children With Autism Spectrum Disorder

The purpose of the current study was to examine engagement with Behavioral Parent Training (BPT) for families of children with Autism Spectrum Disorder (ASD) and assess openness to novel delivery formats for BPT (e.g., telehealth, group). Participants were caregivers of 501 children with ASD (ages 2–6) enrolled in the SPARK (Simons Foundation Powering Autism Research for Knowledge) online national registry. The study assessed: (1) rates of child disruptive behavior diagnoses, (2) engagement and satisfaction with BPT, (3) parent and child factors (e.g., diagnostic history), and (4) openness to novel delivery formats. Almost 25% of young children with ASD in this sample had disruptive behavior problems rising to the level of a diagnosis of ADHD or ODD and thus would benefit from BPT. However, only one third of these families had actually been referred to BPT. Families indicated high level of interest in participating in BPT, with a particular interest in Parent Child Interaction Therapy (PCIT) as well as novel delivery formats such as telehealth and group. Specific components of the therapy and delivery formats were indicative of parent satisfaction (e.g. groups, longer treatment sessions, longer treatment length). Specific parent and child characteristics were predictive of openness to novel formats (e.g. parental depression, more severe behavioral challenges, lower verbal skills). Results underscore the need for increased referrals and access to BPT programs the ASD population. Both parent and child characteristics are important for determining appropriate delivery formats.     

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.     

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.     

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.     

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.