Treating Speech Anxiety in Youth: A Randomized Controlled Microtrial Testing the Efficacy of Exposure Only Versus Exposure Combined With Anxiety Management Strategies

CBT for anxious youth usually combines anxiety management strategies (AMS) with exposure, with exposure assumed to be critical for treatment success. To limit therapy time while retaining effectiveness, one might optimize CBT by restricting treatment to necessary components. This study tested whether devoting all sessions to exposure is more effective in reducing speech anxiety in youth than devoting half to AMS including cognitive or relaxation strategies and half to exposure. After a 6-week waitlist period, adolescents with speech anxiety (N = 65; age 12–15; 42 girls) were randomized to a 5-session in-school group-based CBT training consisting of either (1) exposure-only (EXP+EXP) or (2) cognitive strategies followed by exposure (COG+EXP) or (3) relaxation strategies followed by exposure (REL+EXP). Clinical interviews, speech tests, and self-report measures were assessed at pretest, posttest, and follow-up. For all conditions (a) the intervention period resulted in a stronger decline of speech anxiety than waitlist period; (b) there was a large sized reduction of speech anxiety that was maintained at six-week follow-up; (c) there was no meaningful difference in the efficacy of EXP+EXP versus COG+EXP or REL+EXP. These findings suggest that devoting all sessions to exposure is not more effective than combining exposure with AMS. AMS appeared neither necessary for CBT to be effective, nor necessary for youth to tolerate exposure. This indicates that CBT can be optimized by restricting treatment to exposure.     

Becoming who they want to be: A cross-national examination of value-behavior concordance and mindfulness in adolescence*

Aristotle, Shakespeare, and Gandhi suggested the good life involves living according to one’s values, yet little research has examined the role of value-behavior concordance (VBC) in adolescence. Mindfulness may develop during adolescence and foster VBC via heightened awareness of one’s values and behaviors. We employed data from 5877 adolescents (M _age = 17.53, SD = 3.67; 53% female) from seven countries (Australia, Canada, India, Thailand, Ukraine, United Kingdom, and United States), and examined invariance of links involving age, mindfulness, VBC, and meaning. In all countries, older adolescents were more mindful than younger adolescents, and higher levels of mindfulness were positively linked to VBC. Further, in six countries mindfulness was linked to meaning, in part, through VBC, suggesting a generalizable process where mindful youth experience greater meaning because they live according to their values. As evidence suggests mindfulness can be cultivated through meditation, mindfulness may be a trainable skill that helps young people become who they want to be.     

Socioeconomic deprivation and the development of neuropsychological functions: A study with “street children” in Ecuador

Socioeconomic status (SES) is known to have a considerable influence on the development of neuropsychological functions. In particular there is strong evidence for less efficient development of prefrontal-cortex-related functions in children raised in low-SES households. “Street children” are a common feature of low SES in many low- and middle-income countries, and some researchers have suggested that the unique life experiences of street children may drive their neurocognitive development. This study compares a group of 36 former street children in Quito, Ecuador with a control group of 26 never street-connected schoolchildren. All children were assessed with a range of neuropsychological tests. Although the street children group performed significantly below the level of the control group on all measures, they did not demonstrate a generalized lower ability. By controlling the effects of fluid intelligence it was found that there are relatively independent effects on visuospatial ability and executive planning ability. Furthermore, the executive function test scores in general are significantly less affected than the other cognitive functions and may be temporary effects caused by recent substance abuse within the street child sample. The findings generally support results from other countries suggesting that low SES is associated with negative effects on neuropsychological development. However, they also suggest that the local social and economic context, such as in the case of street children, might mitigate the harmful effects of low SES on the development of some executive functions.     

An Emotion Regulation Treatment for Young People With Complex Substance Use and Mental Health Issues: A Case-Series Analysis

Individuals accessing treatment within the youth alcohol and other drug (AoD) sector represent a highly vulnerable population who present with complex patterns of substance use and mental health comorbidity. Current treatments often fail to address this complexity. Emotion regulation (ER) has been identified as a promising transdiagnostic treatment target for this population of young people. The current study aimed to investigate the acceptability and feasibility of an adjunct ER intervention, ERIC (Emotion Regulation and Impulse Control) in young people receiving AoD treatment at a residential rehabilitation service. A mixed methods case series design was utilized. Ten participants aged between 16–20 years old completed 4–6 sessions of ERIC as an adjunct to their existing residential treatment. Participants undertook a post intervention feedback session and completed a number of self-report measures of ER, depression and anxiety at baseline and 2 weeks after receiving ERIC. Qualitative feedback from young people following the delivery of ERIC was positive, and suggested that ERIC was a viable and useful intervention. Participants reported that the components of ERIC, which involved metaphors and experiential exercises, were particularly beneficial and memorable. Pre-post measures indicated that 60% of the young people had both reliable and clinically significant reductions in overall emotion dysregulation, while reliable and clinically significant reductions in depression and anxiety were observed in 50% and 60% of participants respectively. Results support the acceptability of ERIC for this cohort of young people with complex substance use and mental health needs. Furthermore, these findings support the viability of delivering flexible and adjunctive ER treatments to young people seeking AoD treatment.     

Nonfirmands: Danish youth who choose not to have a Lutheran confirmation

Most Danish youth participate in the traditional Lutheran ritual of confirmation. However, a growing minority does not. Based on survey data collected in 2011 from over 600 Danish pupils, this study examines the ways in which Danish ‘nonfirmands’ are different from their peers who participate in confirmation in relation to religious background, personal religious beliefs, intellectual engagement, and demographic factors. We further explore key motivations for ‘nonfirmation’ expressed by the nonfirmands in the sample. Broadly speaking, our findings highlight secular socialization and individual beliefs about God as key elements in understanding the nonfirmand and his or her reasons for opting out of confirmation. We expect confirmations to continue to decline in popularity as nonfirmation gains social acceptance, as nonfirmands raise their own children, and as Denmark becomes increasingly secular.     

Neoliberalism,Black Masculinity,and Black Male Youth: The Value Of Transdisciplinary Studies To Urban Educators

Drawing on Critical Race Theory and a transdisciplinary framework, this article considers how hegemonic neoliberal discourses contribute to and reinforce negative constructions of Black masculinity and the implications for educating Black male youth (BMY). Neoliberal secondary educational reforms of the last three decades in Ontario, which have resulted in heightened standardization in schools and promote norms of individual attainment, competition, and social control, have served to intensify the stigmatization and alienation BMY. In response to the interlocking racial, gendered, and class oppression they experience within the prevailing neoliberal context, many BMY have increasingly embraced a defensively situated resistant Black masculinity. We argue that, rather than viewing the communities and counternarratives of BMY as sites of deficiency, educators need to conceptualize the experiential knowledge of such young people as that which can nourish transdisciplinary knowledge production and be integrated into classroom curricula and pedagogy. Inviting the cultural wealth of BMY into school can help bridge the divide between schools and the communities of such youth, thereby making mainstream schooling more inclusive by diversifying curricula, democratizing the classroom, and challenging the neoliberalization of education. The authors highlight Hip-Hop as an example of cultural wealth that illuminates the knowledge and lived realities of BMY and can be utilized by urban educators to promote academic engagement and intercultural exchange in classrooms.     

Exploring Associations Among African American Youths' Perceptions of Racial Fairness and School Engagement: Does Gender Matter?

In addition to experiencing race as a unique social milieu within school, gender may also provide an important context for African American students. The authors explored gender differences in associations between African American youths' perceptions of racial fairness and school engagement (behavioral, emotional, and cognitive). One hundred thirty-nine (72 girls, 67 boys) African American high schoolers were recruited from the southeastern region of the United States. Gender differences were found for neither perceptions of racial fairness nor emotional and cognitive engagement. Girls reported higher behavior engagement relative to boys. Also, racial fairness was positively associated with emotional engagement among girls. For boys, racial fairness related positively to the three engagement dimensions. Implications and resources relevant for school psychology practice are discussed.     

Interaction Effects of Neighborhood Disadvantage and Individual Social Support on Frequency of Alcohol Use in Youth Living with HIV

Youth living with HIV (YLH) experience multiple disease‐related stresses along with the same structural and developmental challenges faced by their uninfected peers; alcohol use among YLH represents a risk behavior by virtue of potential effects on youth health and increased likelihood of engaging in unprotected sex while drinking alcohol. Research aimed at better understanding the interplay of individual‐ and neighborhood‐level influences on alcohol use for YLH is needed to inform interventions. This study examined whether socioeconomic disadvantage (SED) and social support influence, independently and through interaction, alcohol use in YLH. Data from the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) consisted of YLH across 538 neighborhoods in the United States who acquired HIV behaviorally. Neighborhood‐specific data were compiled from the 2010 U.S. Census Bureau and matched with individual‐level data from the ATN (N = 1,357) to examine effects that contribute to variation in frequency of alcohol use. Other drug use, being male, being non‐Black, and older age were associated with greater alcohol use. Higher social support was negatively associated with alcohol use frequency. A cross‐level interaction indicated that the association found between decreasing social support and increasing alcohol use frequency was weakened in areas with lower SED. Implications are discussed.     

Childhood self-regulatory skills predict adolescent smoking behavior

Cigarette smoking is the primary preventable cause of premature death. Better self-regulatory capacity is a key psychosocial factor that has been linked with reduced likelihood of tobacco use. Studies point to the importance of multiple forms of self-regulation, in the domains of emotion, attention, behavior, and social regulation, although no work has evaluated all of these domains in a single prospective study. Considering those four self-regulation domains separately and in combination, this study prospectively investigated whether greater self-regulation in childhood is associated with reduced likelihood of either trying cigarettes or becoming a regular smoker. Hypotheses were tested using longitudinal data from a cohort of 1709 US children participating in the Panel Study of Income Dynamics – Child Development Supplement. Self-regulation was assessed at study baseline when children ranged in age from 6 to 14 years, using parent-reported measures derived from the Behavior Problems Index and Positive Behavior Scale. Children ages 12–19 self-reported their cigarette smoking, defined in two ways: (1) trying and (2) regular use. Separate multiple logistic regression models were used to evaluate odds of trying or regularly using cigarettes, taking account of various potential confounders. Over an average of five years of follow-up, 34.5% of children ever tried cigarettes and 10.6% smoked regularly. Higher behavioral self-regulation was the only domain associated with reduced odds of trying cigarettes (odds ratio (OR) = .85, 95% confidence interval (CI) = .73–.99). Effective regulation in each of the domains was associated with reduced likelihood of regular smoking, although the association with social regulation was not statistically significant (ORs range .70–.85). For each additional domain in which a child was able to regulate successfully, the odds of becoming a regular smoker dropped by 18% (95% CI = .70–.97). These findings suggest that effective childhood self-regulatory skills across multiple domains may reduce future health risk behaviors.     

Companion Animals and Vulnerable Youth: Promoting Engagement between Youth and Professional Service Providers

Vulnerable youth have fewer social ties as a result of inadequate housing and a lack of social support. It is well established that many of these youth tend to underutilize mental health, medical, and social services. Among marginalized and stigmatized populations, the affirming and nonjudgmental presence of companion animals appears to be important for developing collaborative relationships between youth and professional service providers. This paper reviews literature on the benefits of companion animals for assisting providers in their attempts to help youth find a stable living environment. Recommendations are made for providers considering incorporating therapy animals into their existing services.