Journal of Clinical Child & Adolescent Psychology

Pina, Armando A.; Polo, Antonio J.; Huey, Stanley J.

doi: 10.1080/15374416.2019.1567350pmid: 30746965

This is the official update on the status of evidence-based psychosocial interventions for ethnic minority youth. Compared to a decade ago, there has been expansion of well-designed intervention studies, growth in the number (not type) of interventions meeting evidence-based criteria, and greater focus on testing ethnicity/race moderator effects. In terms of standard of evidence, 4 psychosocial interventions are now well-established and 10 are probably efficacious or possibly efficacious, with most protocols drawing on cognitive and behavioral change procedures and/or family systems models. Yet the research literature remains mostly focused on testing interventions with European Americans (White Caucasians), and little to no progress has been made in testing the effects of interventions with Asian American or Native American youth. Knowledge of the effects of cultural tailoring on program engagement, outcomes, and mechanisms of change remains scant.

Boersma-van Dam, Elise; Hale, Bill; Koot, Hans; Meeus, Wim; Branje, Susan

doi: 10.1080/15374416.2016.1253017pmid: 27936944

This 6-year longitudinal study examined the relation between 3 conflict management styles (i.e., problem solving, conflict engagement, and compliance) and depressive symptoms in adolescent–best friend relationships. Participants were 479 Dutch adolescents and their best friend who reported annually on depressive symptoms and conflict management styles toward each other. Bidirectional effects between conflict management styles and depressive symptoms were studied both within adolescents (intraindividual) and between adolescent best friends (interpersonal). A positive interpersonal effect of depressive symptoms of one dyad member on depressive symptoms of the other member was found. Similarly, higher positive problem solving and conflict engagement of one dyad member predicted respectively higher problem solving and conflict engagement of the other dyad member. Adolescents who reported more depressive symptoms reported more conflict engagement and compliance over time. In addition, for boys, higher levels of depressive symptoms of one dyad member were related to more problem solving by the other member over time. The current study contributed to the literature by showing that depressive symptoms and conflict management are related constructs in adolescents and that both intrapersonal and interpersonal processes contribute to this relation.

Sheppard, Christopher S.; Giletta, Matteo; Prinstein, Mitchell J.

doi: 10.1080/15374416.2016.1261713pmid: 28010134

The current study demonstrated that chronic peer victimization, as compared to time-limited victimization, is particularly associated with peer status and peer-reported adjustment at the adolescent transition. Using a cohort sequential design, a sample of 653 adolescents (48% female, 87% Caucasian) in Grades 6–8 were assessed at 3 annual time points; data captured indices of peer victimization, likeability, popularity, and several peer-reported indices of internalizing (e.g., sadness, worry) and externalizing (e.g., anger, fighting) symptoms across Grades 6–10. Four trajectories of victimization experiences were identified—chronic, high decreasing, low increasing, and low stable—suggesting instability in victimization experiences over time. Adolescents who experienced chronic victimization, as compared to those with low-stable, decreasing, or increasing levels of victimization, were rated by peers more often on indices of maladjustment and less often on measures of popularity and likeability. Findings highlight negative associations with chronic victimization and underscore the need for targeted interventions to prevent chronic victimization. Overall, findings further emphasize the role of chronicity in victimization and highlight the importance of identifying chronic victims for intervention and prevention efforts.

Becker, Stephen P.; Garner, Annie A.; Tamm, Leanne; Antonini, Tanya N.; Epstein, Jeffery N.

doi: 10.1080/15374416.2017.1286595pmid: 28287826

Sluggish cognitive tempo (SCT) symptoms are associated with social difficulties in children, though findings are mixed and many studies have used global measures of social impairment. The present study tested the hypothesis that SCT would be uniquely associated with aspects of social functioning characterized by withdrawal and isolation, whereas attention deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms would be uniquely associated with aspects of social functioning characterized by inappropriate responding in social situations and active peer exclusion. Participants were 158 children (70% boys) between 7–12 years of age being evaluated for possible ADHD. Both parents and teachers completed measures of SCT, ADHD, ODD, and internalizing (anxiety/depression) symptoms. Parents also completed ratings of social engagement and self-control. Teachers also completed measures assessing asociality and exclusion, as well as peer ignoring and dislike. In regression analyses controlling for demographic characteristics and other psychopathology symptoms, parent-reported SCT symptoms were significantly associated with lower social engagement (e.g., starting conversations, joining activities). Teacher-reported SCT symptoms were significantly associated with greater asociality/withdrawal and ratings of more frequent ignoring by peers, as well as greater exclusion. ODD symptoms and ADHD hyperactive-impulsive symptoms were more consistently associated with other aspects of social behavior, including peer exclusion, being disliked by peers, and poorer self-control during social situations. Findings provide the clearest evidence to date that the social difficulties associated with SCT are primarily due to withdrawal, isolation, and low initiative in social situations. Social skills training interventions may be effective for children displaying elevated SCT symptomatology.

Price, Julia; Drabick, Deborah A.G.; Ridenour, Ty A.

doi: 10.1080/15374416.2017.1405351pmid: 29351384

Indices of deviant peer group involvement are inconsistent and confound type, frequency, and severity of deviant peer behaviors. These measurement approaches thus obfuscate potential meaningful differences in deviant peer involvement in terms of subtypes, developmental patterns, and long-term outcomes. The current study employed latent class analysis to derive subtypes of deviant peer involvement and examined relations to substance use disorder in adulthood, a common outcome of deviant peer involvement. Youth (76% Caucasian) completed assessments across four time points: ages 10–12 years (Time 1; N = 775, 71% male), 12–14 years (Time 2; n = 649, 72% male), 16 years (Time 3; n = 613, 73% male), and 22 years (Time 4; n = 425, 71% male). At Times 1 to 3, participants completed an interview assessing deviant peer involvement. At Time 4, participants completed a structured interview assessing substance use disorder. Classes of youth with different profiles of deviant peer associations were derived at Times 1, 2, and 3. Classes varied by type (conduct problems vs. substance use) and severity of deviant peer behavior. Youth reported higher levels of involvement with deviant peers across adolescence, suggesting that some of these deviant peer behaviors may be normative. Earlier involvement with deviant peers and involvement with groups defined by severe conduct problems and substance use were related to the greatest risk for substance use disorder at Time 4. Type and severity of peer deviant behavior differentially relate to long-term risk for substance use disorder and should be included in screening and assessment for risk across adolescence.

Czyz, E. K.; King, C. A.; Biermann, B. J.

doi: 10.1080/15374416.2018.1496442pmid: 30142300

This pilot randomized controlled trial examined the feasibility and acceptability of a motivational interview (MI)–enhanced safety planning intervention (MI-SafeCope) for teens hospitalized due to suicide risk and explored proximal outcomes (possible mechanisms of change). Participants were 36 hospitalized adolescents (ages 13–17; 78.8% female) with last-week suicidal ideation and/or past-month suicide attempts. Adolescents were randomized to MI-SafeCope, a three-component intervention (individual and family sessions, postdischarge call), or to treatment as usual. Primary outcomes were feasibility and acceptability. We also explored differences in proximal outcomes assessed at 2 weeks, 1 month, and 3 months (family connectedness, motivation for safety plan use, parental motivation to encourage safety plan use), as well as daily for 4 weeks (self-efficacy, coping behavior, safety plan use). Participation and retention rates and intervention satisfaction ratings indicate feasibility and acceptability. Mixed-effects models of daily assessments indicated, for the MI-SafeCope group, significantly higher self-efficacy to refrain from suicidal action (B = 1.15, p = .030), greater reliance on self to cope with suicidal ideation (B = 1.56, p = .042), and higher likelihood of safety plan use to manage suicidal thoughts (B = 0.25, p = .004). Parents in the MI-SafeCope group reported higher motivation to encourage safety plan use (B = 1.04, p = .031). Safety planning incorporating MI is feasible and acceptable with hospitalized teens. Preliminary findings suggest that MI strategies may be promising in maintaining adherence to safety plans, increasing self-efficacy and coping, and in fostering parents’ motivation to encourage safety plan use. Our study also highlights the benefit of daily-level assessment of individuals’ response to suicide-specific interventions.

Glenn, Catherine R.; Millner, Alexander J.; Esposito, Erika C.; Porter, Andrew C.; Nock, Matthew K.

doi: 10.1080/15374416.2018.1528548pmid: 30632815

Prior research indicates that adults’ implicit identification with death can be used to predict suicidal thoughts and behaviors (STBs) in the community. However, no studies have examined whether this effect is found among adolescents—a group for whom suicide is the 2nd leading cause of death. The current study tested the utility of implicit identification with death, using a Death Implicit Association Test (IAT), for detecting and predicting STBs in adolescents. Participants were 141 adolescents 12–19 years of age (81.6% female, 74.5% White) with a current psychiatric disorder and/or currently receiving outpatient psychiatric treatment. All participants completed the Death IAT and self-report measures of STBs at baseline, as well as self-report measures of STBs at 6-month and 1-year follow-ups. At baseline, stronger implicit identification with death (higher Death IAT score) was related to greater suicide ideation (SI) frequency, severity, and duration, but did not differ based on suicide attempt history. Prospectively, higher Death IAT scores predicted any occurrence (but not frequency) of SI over the subsequent year, but not when controlling for prior SI. Death IAT scores were higher among adolescents with prior attempts who reattempted suicide over the follow-up. Examination of stimuli-level results suggested that Death IAT differences may be driven by responses on trials with specific words, including suicide and die. Implicit identification with death may be a useful behavioral indicator of suicide risk in adolescents. Preliminary findings suggest that the Death IAT may aid in predicting STBs among youth receiving outpatient treatment.

Van Meter, Anna R.; Paksarian, Diana; Merikangas, Kathleen Ries

doi: 10.1080/15374416.2018.1528549pmid: 30648897

Suicide is the second leading cause of death among young people. Both mental illness and social factors are associated with suicide in adolescents, and youth with mental disorders often experience social deficits, which may compound risk. The cumulative effects of mental disorders and social factors on suicidal ideation and behaviors (SIB) in adolescents have not previously been explored. Adolescents 13–18 years of age (N = 6,447; 49% female, 65% non-Hispanic White) participated in the National Comorbidity Survey Replication Adolescent Supplement. Adolescents were interviewed to assess mental health diagnoses, history of SIB, and relationship quality. Parents completed self-reports about adolescent mental health and family characteristics. Logistic regression estimated associations of friend, sibling, and family relationships with 12-month SIB and lifetime suicide attempt (SA); associations between relationships, SIB, and SA were compared across classes of mental disorders. Friendship negativity (odds ratio [OR] = 1.20, 95% confidence interval (CI) [1.04, 1.40]), and family conflict (OR = 1.26, 95% CI [1.13, 1.41]), were positively associated with SIB, beyond the risk conferred by mental disorders, particularly mood disorders (OR = 4.75, 95% CI [3.20, 7.05]). Friendship positivity (OR = 0.89, 95% CI [0.80, 0.99]); sibling relationship positivity (OR = 0.79, 95% CI [0.68, 0.91]); family cohesion (OR = 0.77, 95% CI [0.69, 0.87]); maternal care (OR = 0.76, 95% CI [0.69, 0.84]); and paternal care (OR = 0.68, 95% CI [0.59, 0.78]), were inversely associated with SIB. Sibling relationship positivity, family conflict, and paternal care were similarly associated with SA. Self-reported adolescent friend and family relationship characteristics are associated with SIB and SA beyond the risk conferred by mental disorders. This suggests that perceptions of friend and family relationships may be an appropriate target to reduce suicide risk among adolescents.

Massing-Schaffer, Maya; Helms, Sarah W.; Rudolph, Karen D.; Slavich, George M.; Hastings, Paul D.; Giletta, Matteo; Nock, Matthew K.; Prinstein, Mitchell J.

doi: 10.1080/15374416.2018.1469093pmid: 29889554

This study examined associations between multiple types of interpersonal and noninterpersonal stressors and the subsequent occurrence of suicide ideation and attempts among female adolescents. Adolescents ages 12 to 18 years old (n = 160) at elevated risk for suicidal thoughts and behaviors were followed for 18 months, divided into two 9-month epochs for data analysis (Periods 1 and 2). Exposure to acute relational victimization, targeted rejection, nonspecified interpersonal, and noninterpersonal life stressors over the first 9-month epoch (Period 1) was assessed using semistructured interviews and an independent life stress rating team. Participants also completed phone-based semistructured interviews of suicidal thoughts and behaviors. Preliminary analyses showed significant prospective associations between acute targeted rejection and nonspecified interpersonal stress during Period 1 and suicide ideation during Period 2, as well as relational victimization and noninterpersonal stress during Period 1 and suicide attempts during Period 2. However, in logistic regression analyses that adjusted for prior suicidality and depressive symptoms, relational victimization during Period 1 (but not targeted rejection, nonspecified interpersonal or noninterpersonal events) was associated with increased odds of suicide attempt during Period 2. Therefore, acute relational victimization exposure is associated with heightened risk for suicidal behaviors in female adolescents. Future studies should examine potential mediators and moderators of this association, and these stressors should be considered for inclusion in clinical screening tools.

Cummings, E. Mark; Taylor, Laura K.; Du, Han; Merrilees, Christine E.; Goeke-Morey, Marcie; Shirlow, Peter

doi: 10.1080/15374416.2016.1266646pmid: 28107045

Research on social ecologies of political violence has been largely confined to cross-sectional tests of the impact of political violence on child adjustment, limiting perspectives on more nuanced causal pathways, including tests of reciprocal relations between exposure to political violence and child adjustment. Based on a four-wave longitudinal study, this research breaks new ground in assessing bidirectional relations between exposure to political violence in the form of experience with sectarian antisocial behavior and adolescents’ adjustment problems. The study included 999 mother–adolescent dyads selected from working-class neighborhoods in Belfast ranked in the bottom quartile in terms of social deprivation in Northern Ireland, with approximately 35–40 families recruited to participate from each neighborhood. Across the four annual waves of data, adolescents (52% female) were 12.18 (SD = 1.82), 13.24 (SD = 1.83), 13.62 (SD = 1.99), and 14.66 (SD = 1.96) years old. Cross-lagged path models were tested through R package lavaan with full information maximum likelihood. Reflecting a reciprocal pathway, adjustment problems related to higher reports of experience with sectarian antisocial behavior 1 year later. Boys’ experience with sectarian antisocial behavior related to greater adjustment problems 1 year later, but this reciprocal path did hold for the girls. These findings offer promising directions toward better modeling of dynamic relations between exposure to political violence and adolescent adjustment over time.