Journal of Child and Family Studies

Given that the development of treatment fidelity assessment protocol is an integral but too frequently ignored aspect of clinical trials for psychological treatments, the Intensive Mental Health Program (IMHP) sought to build fidelity activities into training, program evaluation, and clinical recordkeeping from the outset of a 3 year study period. We describe (a) operational definitions and measurement of the IMHP treatment model, (b) planned fidelity-promoting activities, (c) evaluation methods, and (d) fair to appreciable accomplishment of IMHP fidelity targets. Discussion of the circumstances and processes possibly hindering better fidelity for several IMHP treatment features accompanies presentation of fidelity data. We summarize pitfalls and compensatory strategies identified during IMHP program evaluation and offer practical suggestions to enhance accountability and evaluative activity in future clinical research.

Adolescent involvement in bullying as a victim or perpetrator has been associated with negative health outcomes, including emotional distress and substance use. Whether negative affect and substance use are acute responses to bullying involvement or whether they develop over time is unknown. Such knowledge is needed to understand the conditions under which bullying contributes to adverse outcomes, as well as to inform the development of appropriate interventions. This study examined the daily-level associations among bullying, negative affect, and substance use (i.e., alcohol, cigarettes, electronic-cigarettes, marijuana) among a community sample of adolescents (N = 204) ages 13–16 years (55% female, 81% European American, 13% African–American) who had reported bully victimization or perpetration in the past 6 months. Participants completed a brief on-line survey every day for 56 consecutive days, reporting on their experiences with bully victimization, bully perpetration, mood, and substance use for that day. Consistent with hypotheses, being bullied on a given day was associated with reporting greater than average levels of sadness (b= 0.279, 95% CI= [0.172, 0.387]), anger (b= 0.354, 95% CI= [0.242, 0.466]), and cigarette use (OR= 1.453, 95% CI= [1.006, 2.099]) on that day; however, it was not associated with alcohol, electronic-cigarette, or marijuana use. Perpetration was not associated with same day negative affect or substance use. Results of the current study suggest that negative affect and cigarette use may be acute responses to bully victimization. Bully perpetration does not appear to be proximally linked to mood or substance use after accounting for victimization.

Psychopathic traits have been shown to designate youth who are at-risk for varied forms of aggression. The present study examined the indirect effects of social-cognitive factors (i.e., hostility and general approval of aggression) in the association between psychopathic traits (i.e., callous-unemotional traits, narcissism) and two functions of adolescent aggression (i.e., reactive, proactive). Participants were 209 (178 males, 31 females) adolescents aged 16 to 19 attending a residential program for youth who have dropped out of high school. Using a cross-sectional design, participants completed self-report measures of callous-unemotional traits (i.e., callousness, uncaring, unemotional), narcissism, aggression, hostility, and approval of aggression. Results indicated significant indirect effects of callousness on both functions of aggression through hostility. Similarly, there were significant indirect effects of narcissism on both functions of aggression through hostility. Significant indirect effects were also evident for general approval of aggression in the relations between callous-unemotional traits (both callous and uncaring dimensions) and both functions of aggression, and between narcissism and both functions of aggression. These results suggest the importance of examining social-cognitive processes insofar as they may contribute to the relation between psychopathic traits and aggression in youth and serve as possible targets of intervention.

Abstract Objective The objective was to determine if Spanish foster care children and Spanish non-foster children differ on sluggish cognitive tempo (SCT), ADHD-inattention (IN), ADHD-hyperactivity/impulsivity (HI), oppositional defiant disorder (ODD), limited prosocial emotions (LPE), anxiety, depression, social and academic impairment measures and if the duration of foster care predicts a reduction in symptom and impairment differences between foster and non-foster care children. Method Foster care parents of 49 children (8 to 13 years, 57% girls) and non-foster care mothers and fathers of 1776 children (8 to 13 years, 49% girls) completed the Child and Adolescent Behavior Inventory (CABI). Results Foster care children had significantly higher scores on all symptom and impairment measures than non-foster care mother and father groups (d values from 0.37 to 1.53). A longer duration in foster care (range 8 to 86 months) was also associated with significant lower scores on SCT, ADHD-IN, anxiety, depression, and academic impairment. In addition, while foster care children with a shorter duration in foster care (less than medium months) had significantly higher scores than the non-foster care groups on all measures (d values from 0.66 to 2.25), children with a longer duration in foster care did not differ from the non-foster care groups on anxiety, depression, ADHD-IN, ADHD-HI, LPE, social and academic impairment. Conclusions Although foster care children had elevated psychopathology and impairment scores relative to non-foster care children, a longer stay in foster care was associated with the elimination of the difference on most symptom and impairment measures.

Many typically-developing (TD) siblings provide care for their siblings with autism spectrum disorder (ASD), both as children and as adults. Research on parentification (i.e., when children assume responsibilities typically reserved for adults) has been mixed, with some studies supporting positive outcomes for TD siblings and others indicating negative outcomes. Some of these discrepancies may be due to inconsistencies in differentiating types of parentification. The current study examined how different types of parentification during childhood (retrospectively-reported) related to distress outcomes and attitudes about sibling relationships among 41 TD adult siblings of individuals with ASD. Results indicated that parent-focused parentification was positively related with anxiety and stress among TD siblings. Sibling-focused parentification was positively related to stress but was also related to more positive sibling relationship attitudes. Accounting for demographic variables and the other form of parentification, parent-focused parentification was a unique predictor of distress, whereas sibling-focused parentification was a unique predictor of positive sibling relationship attitudes. Although parentification is often viewed negatively, sibling-focused parentification and perceived benefits of parentification may predict positive outcomes. Results suggest that parentification may prove important in understanding the complex nature of sibling relationships. Specifically, strengthening the sibling bond and reducing parent-focused parentification during childhood may curtail sibling relationship problems and general distress in TD siblings later in life.

This study evaluated two Internet-based versions of Parent Management Training (PMT) and the effects of greatly reducing the contact required of a mental health professional on treatment of children referred for conduct problems. We were interested whether reduced contact with a therapist influenced treatment outcome, therapeutic alliance, parent adherence to treatment prescriptions, and parent reactions to and evaluations of the treatment procedures. Sixty children and their caregivers were assigned to receive either Full Contact PMT (with the amount of weekly contact similar to traditional PMT; approximately 50 min of direct therapist contact each week) or Reduced Contact PMT (with most information provided through recordings; approximately 10 min of direct therapist contact each week). Children in both groups showed significant and similar reductions in antisocial behaviors specifically, internalizing and externalizing symptoms more generally, and improvements in overall adaptive functioning. Therapeutic alliance also was similar across the two treatment groups. However, parents rated Full Contact treatment as more acceptable than the reduced version. Both treatments were similar in outcomes to in-person treatment as evaluated by a nonrandomized matched sample used as a benchmark in supplementary analyses. Overall, the findings indicate that therapist contact can be reduced while positive treatment outcomes are maintained but that interventions that reduce direct time with a therapist may be viewed less positively by clients.