Antidepressant Medication: Is It a Viable and Valuable Adjunct to Cognitive-Behavioral Therapy for School Refusal?

Cognitive-behavioral therapy (CBT) is an evidence-based treatment for school refusal. However, some youth do not respond to CBT. The serious risks associated with school nonattendance call for novel approaches to help those who do not respond to CBT. Because school refusal is commonly associated with anxiety disorders, and the combination of CBT and antidepressant medication enhances outcomes in the treatment of anxiety disorders, combined treatment may be effective for school refusal. This narrative review evaluates the current evidence base for adding antidepressant treatment to CBT for school refusal. Six randomized controlled trials (RCTs), two open trials, six case studies/series, and one observational study were identified and reviewed. There is support for combined CBT and imipramine, but this medication is not typically used due to the risk of concerning side effects. Two recent RCTs failed to provide evidence for the superiority of combined CBT and fluoxetine. Further research in this area is required because the extant studies have a number of methodological limitations. Recommendations are provided for clinicians who consider prescribing antidepressant medication or referring for adjunctive antidepressant treatment for school refusal.     

Differentiation Between School Attendance Problems: Why and How?

School attendance problems (SAPs) are heterogeneous with respect to etiology and presentation. The long history of conceptualizing SAPs has led to a vast array of terms and definitions as well as different perspectives on the most helpful approach to classification. For educators, practitioners, researchers, and policymakers, this presents a challenge in understanding, assessing, and intervening with SAPs. This paper outlines evolution in the conceptualization of SAPs, focusing on two contemporary approaches to differentiating between them. One approach draws on the longstanding differentiation between SAP types labeled school refusal, truancy, and school withdrawal. A fourth type of SAP, labeled school exclusion, is also considered. The other approach focuses on the function of absenteeism, measured via the School Refusal Assessment Scale (SRAS). Anecdotal and scientific support for the SAP typology is presented, along with the benefits and shortcomings of the SRAS approach to differentiation. The paper offers suggestions for how to differentiate between SAPs and introduces the SNACK, a brief screening measure that permits differentiation by SAP type.     

Chaos,danger, and maternal parenting in families: Links with adolescent adjustment in low‐ and middle‐income countries

The current longitudinal study is the first comparative investigation across low‐ and middle‐income countries (LMICs) to test the hypothesis that harsher and less affectionate maternal parenting (child age 14 years, on average) statistically mediates the prediction from prior household chaos and neighborhood danger (at 13 years) to subsequent adolescent maladjustment (externalizing, internalizing, and school performance problems at 15 years). The sample included 511 urban families in six LMICs: China, Colombia, Jordan, Kenya, the Philippines, and Thailand. Multigroup structural equation modeling showed consistent associations between chaos, danger, affectionate and harsh parenting, and adolescent adjustment problems. There was some support for the hypothesis, with nearly all countries showing a modest indirect effect of maternal hostility (but not affection) for adolescent externalizing, internalizing, and scholastic problems. Results provide further evidence that chaotic home and dangerous neighborhood environments increase risk for adolescent maladjustment in LMIC contexts, via harsher maternal parenting.     

Early executive functioning in a global context: Developmental continuity and family protective factors

This study extends the methodological and theoretical understanding of executive functions (EFs) in preschoolers from low‐ and middle‐income countries (LMIC). First, the authors describe a rigorous process of adapting and evaluating six EF tasks to produce a culturally and developmentally appropriate measure of emerging EFs in a large sample of at‐risk children in rural Pakistan. Next, the authors identify critical developmental and family factors that relate to preschoolers’ EFs over the first 4 years of life. Direct assessment of children's general cognitive skills at age two showed developmental continuity with EFs at age four, and these early cognitive skills mediated the effect of an antecedent parenting intervention on EFs as well as associations of targeted individual and family factors with EFs. Furthermore, directly assessed maternal cognitive capacities and observed maternal scaffolding uniquely predicted EFs in preschoolers. This study is also the first to demonstrate a significant overlap between direct assessments of IQ and EFs in young children from LMIC. Children's general intelligence mediated the associations of EFs with antecedent physical growth and cognitive skills as well as concurrent family factors (maternal verbal intelligence, maternal scaffolding, and home stimulation). After controlling for shared variance between preschoolers’ general intelligence and EFs, three factors emerged as unique predictors of EFs: exposure to an early parenting intervention, physical growth status at age two, and number of older siblings. The findings have important implications for the design of interventions that aim to improve EFs in young children in LMIC. A video abstract of this article can be viewed at https://vimeo.com/316329544/5abde94cd7     

Towards an evidence‐base for student wellbeing and mental health: Definitions,developmental transitions and data sets

Against a background of huge changes in the world of university and college students since the turn of the millennium, together with a multitude of reports on student mental health/wellbeing, this article argues that the field of student mental health is hampered by the imprecise use of terms, a rush to action by universities in the absence of a robust evidence‐base, and a lack of overall coordination and collaboration in the collection and use of data. In response, we argue for clearer and more consistent use of definitions of, as well as differentiations between, student wellbeing and mental health, for a longitudinal approach to the student body that captures their developmental transitions to and through university, and a strategic and systematic approach to the use of bona fide measures in the collection of data on wellbeing and on the process of outcomes in embedded university counselling services. Such a coordinated approach will provide the necessary evidence‐base upon which to develop and deliver appropriate support and interventions to underpin and enhance the quality of students’ lives and learning while at university or college.     

Learning to teach through video playback: student teachers confronting their own practice

The aim of this study was to examine the use of video playback with student teachers to promote teacher learning and to analyse patterns of reflection. A total of 14 student teachers video recorded their lessons in the practice setting and later confronted their performance, facing their videotaped lesson during the course of an interview with their university supervisor. The interviews were then transcribed and coded. Our results indicate that video playback facilitates student teacher learning and that the quality of reflection ranges from routine to dialogic. This suggests that further research into how to elicit higher levels of reflection is needed. The role of the supervisor in promoting deeper thinking should be further examined.     

大学生社会排斥对社交焦虑的影响：负面评价恐惧与人际信任的作用

为探讨大学生社会排斥对社交焦虑的影响以及负面评价恐惧和人际信任在二者之间的作用机制,研究采用大学生社会排斥问卷（SEQU）、社交焦虑量表（SASSCS）、负面评价恐惧量表（BFNES）及人际信任量表（ITS）对450名大学生进行测试。结果表明：（1）大学生社会排斥不仅对个体的社交焦虑水平产生影响,还会通过负面评价恐惧的中介作用对社交焦虑产生影响;（2）人际信任能够调节大学生社会排斥对社交焦虑的直接作用,具体而言,与高人际信任的大学生相比较,较低人际信任的大学生的社会排斥对社交焦虑的预测作用更加显著。     

Comparing cognitive fusion and cognitive reappraisal as predictors of college student mental health

Transdiagnostic cognitive behavioral interventions target different cognitive processes to promote mental health, including cognitive fusion and cognitive reappraisal. Determining the relative impact of cognitive fusion and reappraisal on a range of student mental health concerns could help interventions target psychopathological cognitive processes more effectively. Therefore, this study examined the longitudinal impact of cognitive fusion and reappraisal on mental health and functioning outcomes. A series of hierarchical regression models tested the effects of cognitive fusion and reappraisal in a sample of college students (n = 339). When controlling for reappraisal and baseline symptoms, fusion predicted distress, depression, generalized anxiety, social anxiety, hostility, academic distress, and student role problems 1 month later. Reappraisal predicted only student role problems longitudinally when controlling for fusion. These results suggest that cognitive fusion is a stronger predictor than reappraisal for a range of student mental health concerns and may be a particularly important target for improving student mental health.     

Conversation: The challenges of teaching in a “nano department”

A panel at the 2016 American Academy of Religion conference staged, taped, transcribed, and edited this conversation about the challenges and opportunities of teaching in a “nano department” – an undergraduate religion or religious studies department (or combined religion and philosophy department) with only one, two, or three faculty members. Two things quickly become evident: one is the impossibility of coverage of the full religious studies curriculum, and the other is the necessity for collaboration with other departments. Neither of these is unique to nano departments, but there exists an intimacy between students and faculty in small departments, a necessary freedom to rethink the place of the study of religion in the liberal arts curriculum, and a disruptive value in what can be critiqued and contributed from a marginalized position. Arguably, nano departments are the canaries in the academic coal mine, charting the future of the humanities that cannot be discerned from the vantage point of Research‐1 contexts.