Common problems and coping strategies II: Findings with adolescent suicide attempters

This study investigated the most common precipitants of adolescent suicide attempts and the strategies used to cope with such problems. Adolescent suicide attempters were compared with both distressed and nondistressed nonsuicidal adolescents on problems reported and coping strategies utilized. All three groups reported four problems as occurring most frequently: school, parents, friends, or boyfriend/girlfriend. The suicide attempters and distressed controls reported problems with parents more frequently than did nondistressed controls, while this latter group reported problems at school more frequently than did suicide attempters or distressed controls. Suicide attempters used social withdrawal, problem solving, and emotional regulation more than did nondistressed controls, but not more frequently than distressed controls. Distressed controls used wishful thinking and resignation more than did suicide atempters. Results are discussed in terms of the similarities between suicide attempters and nonsuicidal distressed adolescents and the need to more closely investigate specific subgroups of suicide attempters.     

Common problems and coping strategies I: Findings with normal adolescents

This study investigated problems commonly experienced by adolescents and the strategies they use to cope with these events. Coping strategies were examined across the subjects' omotional state and their evaluation of the problem. In general, adolescents reported four common Stressors that were similar across age groups and gender. However, males differed from females in the frequency of these problems. Further, while the Stressors were similar, the frequency with which the coping strategies were employed and the efficacy ascribed to them differed across sex and across problem type. These findings are discussed in terms of the stress and coping literature with adults and the implications for clinical assessment and treatment of adolescents.     

DISTRACTION: ITS UTILIZATION AND EFFICACY WITH CHILDREN UNDERGOING DENTAL TREATMENT

We investigated the utilization and efficacy of distraction in reducing the anxious and disruptive behavior of 4 children undergoing dental treatment. During the distraction procedure, the children were shown a poster and told a story about it during dental treatment. They earned a prize if they attended to the poster and story and could correctly answer questions about them following each intervention visit. The children's disruptive behavior was assessed via direct observation, and results were analyzed within a multiple baseline design. The children exhibited high levels of anxious and disruptive behavior across baseline visits, regardless of the length of time in treatment or number of visits. Anxious and disruptive behavior decreased upon introduction of the intervention for all children. This was accompanied by the children meeting the criterion for correct answers on the distraction quiz. However, 2 of the children demonstrated an increase in their anxious and disruptive behavior across intervention visits. Results are discussed in terms of the need to evaluate treatment strategies that promote maintenance as well as initial changes.     

A comparison of the relative efficacy of self-control therapy and a behavioral problem-solving therapy for depression in children

Twenty-nine children 9 to 12 years old who were identified as moderately to severely depressed using the Children's Depression Inventory were randomly assigned to either a self-control, behavioral problem-solving, or waiting list condition. The self-control treatment focused on teaching children self-management skills. The behavioral problem-solving therapy consisted of education, self-monitoring of pleasant events, and group problem solving directed toward improving social behavior. Subjects were assessed pre-and posttreatment and at 8-week follow-up with multiple assessment procedures and from multiple perspectives. At posttreatment, subjects in both active treatments reported significant improvement on self-report and interview measures of depression while subjects in the waiting list condition reported minimal change. Results were maintained at follow-up. The general success of the experimental treatments was discussed and recommendations for further treatment components were provided.Second authorship on this article is shared by Drs. Reynolds and Kaslow. The authors would like to thank Mr. Ed Guzwieski, Principal, and the teachers of Oregon Middle School for their cooperation with this study. The authors also would like to thank Mary Wysopal for conducting the posttreatment and follow-up interviews, and Carol Fairbanks for rating the audiotapes.     

USING REINFORCEMENT AND CUEING TO INCREASE HEALTHY SNACK FOOD CHOICES IN PRESCHOOLERS

We examined the effects of behavioral procedures to modify the food choices of preschoolers during a snack period at school (training setting) and at home (generalization setting). In the first experiment, we evaluated the usefulness of nutrition training and a generalization programming strategy of cueing to improve healthy snacking; in the second experiment we investigated the effect of nutrition training alone. In addition, three cases are presented that illustrate individualized procedures to facilitate generalization of healthy snacking to home. Results indicated that children's healthy snack choices increased in the preschool training setting, that generalization to home was achieved only when procedures to program it were implemented, and that the best results were found when the generalization procedures were tailored to the individual child.     

INCREASING CALORIE CONSUMPTION IN CHILDREN WITH CYSTIC FIBROSIS: REPLICATION WITH 2-YEAR FOLLOW-UP

Three mildly malnourished children with cystic fibrosis and their parents participated in a behavioral group-treatment program that focused on promoting and maintaining increased calorie consumption. Treatment included nutritional education, gradually increasing calorie goals, contingency management, and relaxation training, and was evaluated in a multiple baseline design across four meals. Children's calorie intake increased across meals, and total calorie intake was 32% to 60% above baseline at posttreatment. Increased calorie consumption was maintained at the 96-week follow-up (2 years posttreatment). The children's growth rates in weight and height were greater during the 2 years following treatment than the year prior to treatment. Increases in pace of eating and calories consumed per minute were also observed 1 year posttreatment. These findings replicated and extended earlier research supporting the efficacy of behavioral intervention in the treatment of malnutrition in children with cystic fibrosis.