Family managment and deviant peer association as mediators of the impact of treatment condition on youth antisocial behavior.

The influence of family management skills (i.e., supervision, discipline, and positive adult–youth relationship) and deviant peer association on youth antisocial behavior was examined within the context of a randomized clinical trial contrasting multidimensional treatment foster care and services-as-usual group care. Participants were male adolescents with histories of chronic and serious juvenile delinquency who were mandated into residential care by the juvenile court. As hypothesized, family management skills and deviant peer association mediated the effect of treatment condition and accounted for 32% of the variance in subsequent antisocial behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical supervision in treatment transport: Effects on adherence and outcomes.

This nonexperimental study used mixed-effects regression models to examine relations among supervisor adherence to a clinical supervision protocol, therapist adherence, and changes in the behavior and functioning of youths with serious antisocial behavior treated with an empirically supported treatment (i.e., multisystemic therapy [MST]) 1 year posttreatment. Participants were 1,979 youths and families treated by 429 clinicians across 45 provider organizations in North America. Four dimensions of clinical supervision were examined. Mixed-effects regression model results showed that one dimension, supervisor focus on adherence to treatment principles, predicted greater therapist adherence. Two supervision dimensions, Adherence to the Structure and Process of Supervision and focus on Clinician Development, predicted changes in youth behavior. Conditions required to test hypothesized mediation by therapist adherence of supervisor adherence effects on youth outcomes were not met. However, direct effects of supervisor and therapist adherence were observed in models including both of these variables. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Foster placement disruptions associated with problem behavior: Mitigating a threshold effect.

Objective: Placement disruptions have adverse effects on foster children. Identifying reliable predictors of placement disruptions might assist in the allocation of services to prevent disruptions. There were two objectives in this study: (a) to replicate a prior finding that the number of daily child problem behaviors at entry into a new foster home predicts subsequent placement disruptions in foster preschoolers and (b) to determine whether this association is mitigated by a treatment foster care intervention. Method: Problem behavior and placement disruptions were examined in 60 children in regular foster care (age range = 3.10–5.91 years [M = 4.34, SD = 0.83], 58.3% male, 93.4% Caucasian) and 57 children in a treatment foster care program (age range = 3.01–6.78 years [M = 4.54, SD = 0.86], 49.1% male, 82.5% Caucasian). Using the Parent Daily Report Checklist (Chamberlain & Reid, 1987), a brief telephone interview, foster caregivers reported problem behavior 6 times over 3 months. Placement disruptions were tracked over 12 months. Results: The regular foster care children with 5 or fewer problem behaviors were at low risk for disruption, but their risk increased 10% for each additional behavior (p = .013). The intervention appeared to mitigate this “threshold effect”; number of problem behaviors did not predict risk of placement disruption in the treatment foster care group (p = .63). Conclusions: These findings replicate previous evidence linking child problem behavior to placement disruptions and further highlight the need for early preventative interventions. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Multidimensional treatment foster care for girls in the juvenile justice system: 2-year follow-up of a randomized clinical trial.

This study is a 2-year follow-up of girls with serious and chronic delinquency who were enrolled in a randomized clinical trial conducted from 1997 to 2002 comparing multidimensional treatment foster care (MTFC) and group care (N = 81). Girls were referred by juvenile court judges and had an average of over 11 criminal referrals when they entered the study. A latent variable analysis of covariance model controlling for initial status demonstrated maintenance of effects for MTFC in preventing delinquency at the 2-year assessment, as measured by days in locked settings, number of criminal referrals, and self-reported delinquency. A latent variable growth model focusing on variance in individual trajectories across the course of the study also demonstrated the efficacy of MTFC. Older girls exhibited less delinquency over time relative to younger girls in both conditions. Implications for gender-sensitive programming for youths referred from juvenile justice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Our method of arthrodesis of the wrist

An interdisciplinary review of 16 ventilator-assisted, cervical-cord injured youth, aged 3-19 years, was completed to explore long-term outcomes and develop recommendations for care. Ten youths were younger than 12 years; 6 were adolescents. The mean initial hospital length of stay was 192 days. Discharged youths were followed for 1-73 months after hospitalization. Nursing implications were developed using a systems approach with North American Nursing Diagnosis Association (NANDA) approved diagnoses. Nursing case management was used to coordinate discharge planning and continuity of care. At the time of data collection 13 youths had been successfully reintegrated to home, school and community, the least restrictive environments for all.     

Maternal and adolescent ratings of psychopathology in young offender and non-clinical males.

Compared maternal and youth ratings of the youths' adjustment using the Child Behavior Checklist and Youth Self-Report with 50 young offenders and 51 non-clinical males (aged 12–16 yrs). While delinquent youths were in the clinical range only on the delinquent behavior subscale, maternal ratings were in the clinical range on most subscales. By contrast, maternal and youth reports in controls showed comparable ratings on Internalizing scales, with normal adolescents endorsing significantly more Externalizing behavior problems than their mothers. Maternal and youth ratings in the controls were in the normal range on all scales. Possible causes of these differences between young offenders' and their mothers' reporting of symptoms are discussed, and implications of these findings for forensic assessment of adolescents are presented. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Do treatment manuals undermine youth–therapist alliance in community clinical practice?

Objective: Some critics of treatment manuals have argued that their use may undermine the quality of the client–therapist alliance. This notion was tested in the context of youth psychotherapy delivered by therapists in community clinics. Method: Seventy-six clinically referred youths (57% female, age 8–15 years, 34% Caucasian) were randomly assigned to receive nonmanualized usual care or manual-guided treatment to address anxiety or depressive disorders. Treatment was provided in community clinics by clinic therapists randomly assigned to treatment condition. Youth–therapist alliance was measured with the Therapy Process Observational Coding System—Alliance (TPOCS–A) scale at 4 points throughout treatment and with the youth report Therapeutic Alliance Scale for Children (TASC) at the end of treatment. Results: Youths who received manual-guided treatment had significantly higher observer-rated alliance than usual care youths early in treatment; the 2 groups converged over time, and mean observer-rated alliance did not differ by condition. Similarly, the manual-guided and usual care groups did not differ on youth report of alliance. Conclusions: Our findings did not support the contention that using manuals to guide treatment harms the youth–therapist alliance. In fact, use of manuals was related to a stronger alliance in the early phase of treatment. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The Psychopathy Checklist: Youth Version and adolescent and adult recidivism: Considerations with respect to gender, ethnicity, and age.

The present study investigated the predictive accuracy of the Psychopathy Checklist: Youth Version (PCL: YV; A. E. Forth, D. S. Kosson, & R. D. Hare, 2003) for youth and adult recidivism, with respect to gender, ethnicity, and age, in a sample of 161 Canadian young offenders who received psychological services from an outpatient mental health facility. The PCL: YV significantly predicted any general, nonviolent, and violent recidivism in the aggregate sample over a 7-year follow-up; however, when results were disaggregated by youth and adult outcomes, the PCL: YV consistently appeared to be a stronger predictor of youth recidivism. The PCL: YV predicted youth recidivism for subsamples of female and Aboriginal youths, and very few differences in the predictive accuracy of the tool were observed for younger vs. older adolescent groups. Both the 13-item (i.e., D. J. Cooke & C. Michie, 2001, 3-factor) and the 20-item (i.e., R. D. Hare, 2003, 4-factor) models appeared to predict various recidivism criteria comparably across the aggregate sample and within specific demographic subgroups (e.g., female and Aboriginal youth). The Antisocial facet contributed the most variance in the prediction of adult outcomes, whereas the 3-factor model contributed significant incremental variance in the prediction of youth recidivism outcomes. Potential implications concerning the use of the PCL: YV in clinical and forensic assessment contexts are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of the Postponing Sexual Involvement curriculum among youths in California

Postponing Sexual Involvement (PSI) is a widely implemented middle school curriculum designed to delay the onset of sexual intercourse. In an evaluation of its effectiveness among seventh and eighth graders in California, 10,600 youths from schools and community-based organizations statewide were recruited and participated in randomly assigned intervention or control groups; the curriculum was implemented by either adult or youth leaders. Survey data were collected before the program was implemented, and at three months and 17 months afterward. At three months, small but statistically significant changes were found in fewer than half of the measured attitudes, behaviors and intentions related to sexual activity; at 17 months, none of these significant positive effects of the PSI program had been sustained. At neither follow-up were there significant positive changes in sexual behavior; Youths in treatment and control groups were equally likely to have become sexually active, and youths in treatment groups were not less likely than youths in control groups to report a pregnancy or a sexually transmitted infection. The evaluation suggests that PSI may be too modest in length and scope to have an impact on youths' sexual behavior.     

More than child's play: Variable- and pattern-centered approaches for examining effects of sports participation on youth development.

The authors used data from Grades 5 through 7 of the longitudinal 4-H Study of Positive Youth Development to assess relations among sports participation, other out-of-school-time (OST) activities, and indicators of youth development. They used a mixture of variable- and pattern-centered analyses aimed at disentangling different features of participation (i.e., intensity, breadth). The benefits of sports participation were found to depend, in part, on specific combinations of multiple activities in which youths participated along with sports. In particular, participation in a combination of sports and youth development programs was related to positive youth development and youth contribution, even after controlling for the total time youths spent in OST activities and their sports participation duration. Adolescents' total time spent participating in OST activities, duration of participation in sports, and activity participation pattern each explained a unique part of the variance in some of the indicators of youth functioning. These findings suggest the need for future research to simultaneously assess multiple indices of OST activity participation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting frequency of treatment visits in community-based youth psychotherapy.

The current study examines factors associated with the number of treatment visits attended by a youth and/or family, including sociodemographic variables, youth clinical characteristics and parent/family characteristics at intake, therapist characteristics, and treatment entry characteristics. A total of 57 therapists in two publicly funded youth mental health clinics and 169 youths and parents from the therapists' combined caseloads were included in the study. Negative binomial regression was used to examine whether factors within these domains predict the number of treatment visits in this community-based sample. Both therapist and treatment entry characteristics significantly predicted the frequency of treatment visits. Specifically, youth self report of higher symptom severity and stronger parent-youth treatment goal agreement were associated with a higher number of treatment visits. Implications for research and practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The generalizability of the Youth Self-Report syndrome structure in 23 societies.

As a basis for theories of psychopathology, clinical psychology and related disciplines need sound taxonomies that are generalizable across diverse populations. To test the generalizability of a statistically derived 8-syndrome taxonomic model for youth psychopathology, confirmatory factor analyses (CFAs) were performed on the Youth Self-Report (T. M. Achenbach & L. A. Rescorla, 2001) completed by 30,243 youths 11-18 years old from 23 societies. The 8-syndrome taxonomic model met criteria for good fit to the data from each society. This was consistent with findings for the parent-completed Child Behavior Checklist (Achenbach & Rescorla, 2001) and the teacher-completed Teacher's Report Form (Achenbach & Rescorla, 2001) from many societies. Separate CFAs by gender and age group supported the 8-syndrome model for boys and girls and for younger and older youths within individual societies. The findings provide initial support for the taxonomic generalizability of the 8-syndrome model across very diverse societies, both genders, and 2 age groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family Intervention for Suicide Prevention: A specialized emergency department intervention for suicidal youths.

Suicide attempts and suicidal ideation are common problems among youths seen in clinical practice. Despite the high risk of repeated suicidal behavior in these patients, clinicians are faced with a lack of empirically supported treatments for these youths. This article describes the Family Intervention for Suicide Prevention (FISP), a second-generation adaptation of the Specialized Emergency Room Intervention, an evidence-based practice. Although designed for use in emergency settings, the FISP can be used by practitioners working in a wide range of settings where youths present with suicidal emergencies. Rooted in cognitive–behavioral and family systems theory, the FISP is designed to mobilize family support and problem solving, reframe the suicide attempt as a critical event that requires treatment, reinforce more adaptive coping, motivate patients and families to initiate and adhere to follow-up treatment, and promote linkage to follow-up care. This approach can be used with a wide range of patients and offers an evidence-informed tool for practicing clinicians. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Experimental evaluation of a modular approach to mobilizing antitobacco influences of peers and parents

The experimental evaluation of two components of a community intervention to prevent adolescent tobacco use are described. Youth antitobacco activities (e.g., peer quizzes, sidewalk art, poster and T-shirt giveaways, etc.) and family communications activities (pamphlets to parents and student quizzes of parents) were evaluated in two time-series experiments, each of which was conducted in two experimental and one control community. Students in Grades 6 and 8 and their parents were assessed in a series of four phone surveys in the first experiment and six phone surveys in the second. Implementation of the youth antitobacco and family communications activities led to significantly greater exposure of young people to antitobacco information. They led to increases in parent and youth knowledge about tobacco use and more negative attitudes toward tobacco. In Experiment 2, youths in intervention communities had significantly lower rated intentions to smoke. The findings suggest the value of a modular approach to community interventions for influencing the social context relevant to the onset of adolescent tobacco use.     

Beyond neighborhood poverty: Family management, neighborhood disorder, and adolescents’ early sexual onset.

The authors examined how neighborhood disorder modifies associations between family management practices and youth transitions to sex among low-income African American and Latino urban families. The sample included 846 young adolescents and their mothers who participated in Welfare, Children and Families: A Three-City Study. Results from multilevel logistic regression models indicated no main effects of family management practices or neighborhood-level conditions on transitions to sex once accounting for demographics. However, higher levels of family routines and parental knowledge (i.e., awareness of youths’ friends, whereabouts, and activities) were more strongly associated with a lower probability of youth sexual onset as neighborhood disorder increased. Results provide further evidence for the contextually specific nature of parenting impacts on adolescent adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial factors and high-risk sexual behavior: race differences among urban adolescents

Adolescence is a period of sexual experimentation. We examined psychosocial predictors of high-risk sexual behavior and condom use. The sample included 824 ninth-graders, most of whom are African American. We conducted separate analyses for whites and African Americans. Predictors included alcohol and substance use, delinquency, prosocial behaviors, and family and peer influences. We found that problem behaviors predicted high-risk sexual behavior, but the effects were stronger for white youth. We also found that friends' behaviors were more predictive than family influences, except for family conflict. In general, the models explained more variance for white youths than for African-American youths. The results suggest that problem behavior theory and social interactions theory may be most relevant for white youth and that other models may be necessary to explain high-risk sexual behavior among African-American youths.     

Extended time on academic assignments: Does increased time lead to improved performance for children with attention-deficit/hyperactivity disorder?

Researchers examined the impact of an extended time accommodation on appropriate classroom behavior and rate of work completion for 33 children with attention-deficit/hyperactivity disorder (ADHD). Participants received standard (30 min) or extended (45 min) time to complete seatwork in a within-subject, crossover design study. Appropriate behavior (i.e., rule-following behavior) and rate of problems completed accurately per minute were compared across conditions. Children completed significantly more problems correctly per minute when given standard time compared with extended time; however, no difference in appropriate behavior was found between the two conditions. Appropriate behavior over time was examined by segmenting each condition into time intervals. Analyses indicated that children's appropriate behavior significantly decreased over time in both conditions. The implications of these findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Disasters and youth: A meta-analytic examination of posttraumatic stress.

Objective: Meta-analyze the literature on posttraumatic stress (PTS) symptoms in youths post-disaster. Method: Meta-analytic synthesis of the literature (k = 96 studies; Ntotal = 74,154) summarizing the magnitude of associations between disasters and youth PTS, and key factors associated with variations in the magnitude of these associations. We included peer-reviewed studies published prior to 1/1/2009 that quantitatively examined youth PTS (≤18 years at event) after a distinct and identifiable disaster. Results: Despite variability across studies, disasters had a significant effect on youth PTS (small-to-medium magnitude; rpooled = .19, SEr = .03; d = 0.4). Female gender (rpooled = .14), higher death toll (disasters of death toll ≤25: rpooled = .09; vs. disasters with ≥1,000 deaths: rpooled = .22), child proximity (rpooled = .33), personal loss (rpooled = .16), perceived threat (rpooled = .34), and distress (rpooled = .38) at time of event were each associated with increased PTS. Studies conducted within 1 year post-disaster, studies that used established measures, and studies that relied on child-report data identified a significant effect. Conclusion: Youths are vulnerable to appreciable PTS after disaster, with pre-existing child characteristics, aspects of the disaster experience, and study methodology each associated with variations in the effect magnitude. Findings underscore the importance of measurement considerations in post-disaster research. Areas in need of research include the long-term impact of disasters, disaster-related media exposure, prior trauma and psychopathology, social support, ethnicity/race, prejudice, parental psychopathology, and the effects of disasters in developing regions of the world. Policy and clinical implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)