J Clin Child Adolesc Psychol [JOURNAL]
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200 papers
Links Between Objectively-Measured Hourly Smartphone Use and Adolescent Wake Events Across Two Weeks.
Garrett SL, Burnell K, Armstrong-Carter EL … +3 more , Nelson BW, Prinstein MJ, Telzer EH
J Clin Child Adolesc Psychol · 2025 · PMID 38039087 · Publisher ↗
PURPOSE: Psychosocial and bioregulatory pressures threaten sleep during adolescence. Although recent work suggests that the ubiquity of smartphone use throughout adolescence may also relate to poorer sleep outcomes, most...
PURPOSE: Psychosocial and bioregulatory pressures threaten sleep during adolescence. Although recent work suggests that the ubiquity of smartphone use throughout adolescence may also relate to poorer sleep outcomes, most existing research relies upon self-report and retrospective measures. This study drew upon objective measures of smartphone use and sleep at the hourly level to understand how smartphone use was associated with the duration of wake events during sleeping hours. METHODS: Across a 14-day daily study, 59 racially and ethnically diverse adolescents ages 15 to 18 had their sleep assessed via Fitbit Inspire 2 devices and uploaded screenshots of their screen time, pickups, and notifications as logged by their iPhone's iOS. Multi-level modeling was performed to assess hourly level associations between adolescent smartphone use and wake-events during their sleep sessions ( = 4,287 hourly cases). RESULTS: In hours during adolescents' sleep session with more screen time or pickups, adolescents had longer wake event duration. More notifications in a given hour were not associated with wake event duration in the same hour. CONCLUSIONS: Using objectively measured smartphone and sleep data collected at the hourly level, we found that during sleeping hours, when adolescents are actively engaging with their smartphones, their sleep is disrupted, such that their wake events are longer in that hour.
Affective Contributions to Instrumental and Reactive Aggression in Middle Childhood: Variable- and Person-Centered Approaches.
Shields A, Reardon K, Lawler T … +1 more , Tackett J
J Clin Child Adolesc Psychol · 2024 · PMID 38039086 · Publisher ↗
OBJECTIVE: Research on the role of affect in childhood aggression motives has largely focused on domain-level affective traits. Lower-order affective facets may show more distinct relationships with instrumental and reac...
OBJECTIVE: Research on the role of affect in childhood aggression motives has largely focused on domain-level affective traits. Lower-order affective facets may show more distinct relationships with instrumental and reactive aggression - at both the variable and individual levels - and offer unique insights into whether and how several forms of affect are involved in aggression motives. METHOD: Caregivers (98% mothers) of 342 children ( = 9.81 years, 182 girls, 31% White) reported on children's aggression and affect-relevant personality traits, personality pathology, and callous-unemotional traits. RESULTS: Both reactive and instrumental aggressions were characterized by higher levels of trait irritability, fear, withdrawal, sadness, and callous-unemotional traits in zero-order analyses. Instrumental aggression was characterized by low trait positive emotions. Reactive aggression was uniquely associated with irritability, fear, withdrawal, and sadness, whereas instrumental aggression was uniquely associated with callous-unemotional traits and (low) positive emotions. Groups identified by latent profile analyses were differentiated only by aggression severity. CONCLUSIONS: The findings support both the similarity and distinction of reactive and instrumental aggression vis-à-vis their affective phenomenology. Consistent with existing theories, reactive aggression was linked to multiple forms of negative emotionality, whereas instrumental aggression was linked to higher levels of callous-unemotional traits. In a novel finding, instrumental aggression was uniquely characterized by lower positive emotions. The findings highlight the utility of pre-registered approaches employing comprehensive personality-based affective frameworks to organize and understand similarities and differences between aggression functions.
A Prospective Study of Co-Rumination in Parent-Adolescent Conversations Several Years After a Devastating Tornado.
Abel MR, Vernberg EM, Lochman JE … +3 more , McDonald KL, Jarrett MA, Powell N
J Clin Child Adolesc Psychol · 2025 · PMID 38032343 · Full text
OBJECTIVE: This study examined the association between youth post-disaster stress responses and co-rumination in conversations with a parent several years after a devastating tornado. METHOD: Adolescents ( = 200) drawn f...
OBJECTIVE: This study examined the association between youth post-disaster stress responses and co-rumination in conversations with a parent several years after a devastating tornado. METHOD: Adolescents ( = 200) drawn from an ongoing study for aggressive youth (ages 13 to 17; 80% African American) and their parents experienced an EF-4 tornado in 2011 and then provided joint recollections about their tornado experiences approximately 5 years later. Recollections were coded for the four components of co-rumination: rehashing problems, dwelling on negative affect, mutual encouragement of problem talk, and speculating about problems. Parent-rated post-traumatic stress symptoms (PTSS) and youth resting respiratory sinus arrhythmia (RSA) were measured approximately 6-months and 1-year post-tornado, respectively. RESULTS: Results indicated that co-rumination could be identified, and reliably measured, in the tornado conversations. Resting RSA moderated the association between post-disaster PTSS and the co-rumination component dwelling on negative affect, such that youth PTSS was associated with higher levels of dwelling on negative affect but only at lower levels of resting RSA (an index of physiological dysregulation). There was no association between youth PTSS and dwelling on negative affect at high resting RSA (an index of better physiological regulation). Youth PTSS and resting RSA were unrelated to the other three co-rumination components. No gender differences were found. CONCLUSIONS: Results provide preliminary evidence establishing the co-rumination coding scheme in a sample of disaster-exposed parents and adolescents. Results also indicated that PTSS and resting RSA are important youth-level factors that relate to how parents and adolescents discuss their disaster experiences even years post-exposure.
Aggression and Irritability in Middle Childhood: Between- and Within-Person Associations.
Perhamus GR, Ostrov JM, Murray-Close D
J Clin Child Adolesc Psychol · 2024 · PMID 37976108 · Full text
OBJECTIVE: This study tested predicted bidirectional associations between irritability and physical and relational forms of aggression, disentangling theorized within- and between-person effects using latent curve models...
OBJECTIVE: This study tested predicted bidirectional associations between irritability and physical and relational forms of aggression, disentangling theorized within- and between-person effects using latent curve models with structured residuals (LCM-SR) over one year in middle childhood. Gender differences and robustness of results when controlling for other externalizing problems (i.e., attention problems, delinquency) were also considered. METHOD: Children in third, fourth, and fifth grade ( = 704, 49.9% female) were recruited from schools in a large midwestern city. The sample was diverse in regard to race/ethnicity (31% Black, 29% White, 13% Hmong, 14% Latinx, 4% Native American, 4% Asian, 5% other races/ethnicities). Irritability, attention problems, and delinquency were measured using teacher-report, and physical and relational aggression were measured using self-report at three time points over one calendar year. RESULTS: At the between-person level, higher mean levels of irritability predicted higher initial levels of physical and relational aggression. Irritability continued to predict higher levels of physical aggression across the course of the study, whereas the effect of irritability on relational aggression diminished. Boys showed higher starting levels of physical aggression, but no other significant gender differences emerged. No significant within-person associations were found. CONCLUSIONS: The present study suggests that irritability may represent a between-person risk factor for high levels of physical and relational aggression in middle childhood, although effects on physical aggression may be more persistent. This highlights the importance of considering affective processes to understand the development of aggression trajectories.
Psychometric Properties and Clinical Utility of CBCL and P-GBI Sleep Items in Children and Adolescents.
Langfus JA, Chen YL, Janos JA … +3 more , Youngstrom JK, Findling RL, Youngstrom EA
J Clin Child Adolesc Psychol · 2025 · PMID 37972333 · Full text
OBJECTIVE: Sleep is crucial to overall health, playing a complex role in a wide range of mental health concerns in children and adults. Nevertheless, clinicians may not routinely assess sleep problems due to lack of awar...
OBJECTIVE: Sleep is crucial to overall health, playing a complex role in a wide range of mental health concerns in children and adults. Nevertheless, clinicians may not routinely assess sleep problems due to lack of awareness or limitations such as cost or time. Scoring sleep-related items embedded on broader scales may help clinicians get more out of tools they are already using. The current study explores evidence of reliability, validity, and clinical utility of sleep-related items embedded on two caregiver-report tools: the Child Behavior Checklist (CBCL) and Parent General Behavior Inventory (P-GBI). METHOD: Youth aged 5-18 years and their parents were recruited from both an academic medical center ( = 759) and an urban community health center ( = 618). Caregivers completed the CBCL and P-GBI as part of a more comprehensive outpatient evaluation. Exploratory factor analyses, multi-group confirmatory factor analyses, and graded response models evaluated dimensionality, reliability, and invariance across samples. Correlations and receiver operating characteristic curve analyses probed associations with diagnostic and demographic variables. RESULTS: Two subscales emerged for each itemset. Across both samples, P-GBI sleep subscales were more reliable and consistent than CBCL sleep subscales, showed greater coverage of sleepiness and insomnia constructs, were better at discriminating individuals within a wider range of sleep complaints, and showed significant correlation with mood disorder diagnoses. CONCLUSIONS: The P-GBI sleep items provide a brief, reliable measure for assessing distinct dimensions of sleep complaints and detecting mood symptoms or diagnoses related to the youth's sleep functioning, making them a useful addition to clinical practice.
Longitudinal Impact of the Pandemic on Social Disruption and Loneliness in Autistic and Non-Autistic Youth.
Gerber AH, Keluskar J, Lerner MD
J Clin Child Adolesc Psychol · 2025 · PMID 37956102 · Full text
OBJECTIVE: The coronavirus pandemic drastically increased social isolation. Autistic youth already experience elevated social isolation and loneliness, making them highly vulnerable to the impact of the pandemic. We exam...
OBJECTIVE: The coronavirus pandemic drastically increased social isolation. Autistic youth already experience elevated social isolation and loneliness, making them highly vulnerable to the impact of the pandemic. We examined trajectories of social disruption and loneliness in autistic and non-autistic youth during a six-month period of the pandemic (June 2020 until November 2020). METHOD: Participants were 76 youth, ages 8 through 17, (M = 12.82, N = 51) with an IQ ≥ 70. Youth completed a biweekly measure of loneliness (Revised UCLA Loneliness Scale) and their parent completed a measure of pandemic-related family social disruption (Epidemic Pandemic Impacts Inventory). RESULTS: There were no time trends in loneliness across all youth, however, social disruption displayed linear, quadratic, and cubic trends. Non-autistic youth reported relatively greater declines in social disruption compared to autistic youth. Additionally, autistic youth reported relatively greater declines in loneliness relative to non-autistic youth. Greater social disruption was associated with higher loneliness, however, autistic youth demonstrated a relatively stronger relationship between social disruption and loneliness compared to non-autistic youth. CONCLUSIONS: The current study was one of the first to investigate social disruption and loneliness in autistic youth during the COVID-19 pandemic. Results indicated that autistic youth experienced relative decreases in loneliness during this time, perhaps due to reductions in social demands. Nonetheless, when autistic youth did experience social disruption, they reported relatively higher levels of loneliness. This work contributes to our understanding of risk factors for loneliness and highlights the need to understand the benefits, as well as the challenges, to remote schooling and social interactions.
External and Internal Validity Considerations in Youth Effectiveness Trials: Lessons Learned from the COMET Study.
Jensen-Doss A, Woodard G, Patel-Syed Z … +3 more , Ehrenreich-May J, Rosenfield D, Ginsburg GS
J Clin Child Adolesc Psychol · 2023 · PMID 37947431 · Full text
OBJECTIVE: Effectiveness trials aim to increase the generalizability and public health impact of interventions. However, challenges associated with this design present threats to external and internal validity. This pape...
OBJECTIVE: Effectiveness trials aim to increase the generalizability and public health impact of interventions. However, challenges associated with this design present threats to external and internal validity. This paper illustrates these challenges using data from a two-site randomized effectiveness trial, the Community Study of Outcome Monitoring for Emotional Disorders in Teens (COMET) and presents recommendations for future research. METHOD: COMET was a randomized effectiveness trial conducted in 19 community mental health clinics in two states comparing three interventions: treatment as usual (TAU), TAU with measurement-based care (TAU+), and the Unified Protocol forTransdiagnostic Treatment of Emotional Disorders in Adolescents with MBC (UPA). Participants included 176 clinicians (mean age = 35.5; 85.8% cisgender female; 53.0% racially and/or ethnically minorized) and 196 adolescents (mean age = 14.7; 65.3% cisgender female; 69.4% racially and/or ethnically minorized). Analyses outlined participant flow from recruitment to study completion, described participant characteristics, and examined site differences. RESULTS: Analysis of participant flow suggested that recruitment and retention of clinicians and adolescents was challenging, raising questions about whether participants were representative of participating clinics. Both the clinician and adolescent samples were racially and ethnically diverse and adolescents were low income and clinically complex. Significant site differences were observed in clinician and adolescent characteristics. CONCLUSIONS: While this study was successful in recruiting a diverse and historically under-represented sample, difficulties in recruitment and retention raise questions about external validity and site differences present challenges to internal validity of study findings. Suggestions for future effectiveness studies, drawing from implementation science approaches, are discussed.
Serving the Underserved? Uptake, Effectiveness, and Acceptability of Digital SSIs for Rural American Adolescents.
Szkody E, Chang YW, Schleider JL
J Clin Child Adolesc Psychol · 2025 · PMID 37931065 · Full text
OBJECTIVE: Rural teens are less likely to access care for depression than urban teens. Evidence-based digital single-session interventions (SSIs), offered via social media advertisements, may be well suited to narrowing...
OBJECTIVE: Rural teens are less likely to access care for depression than urban teens. Evidence-based digital single-session interventions (SSIs), offered via social media advertisements, may be well suited to narrowing this gap in treatment access and increasing access to support for adolescents living in rural areas. We evaluated the viability of using social media-based advertisements to equitably recruit adolescents living in rural areas with elevated depression symptoms to digital SSIs; we sought to characterize and assess whether SSI completion rates and acceptability differed for adolescents living in rural versus more urban areas, across three intervention conditions (two active, evidence-based SSIs; one placebo control); and we tested whether digital SSIs differentially reduced depressive symptoms. METHOD: We used pre-intervention and three-month follow up data from 13- to 16-year-old adolescents ( = 2,322; 88% female; 55% non-Hispanic White) within a web-based randomized control trial of three free, digital SSIs (ClinicalTrials.gov identifier: NCT04634903) collected eight months into the COVID-19 pandemic in the United States. RESULTS: Digital SSIs reached adolescents at population-congruent rates; however, social media ads resulted in relative underrepresentation of youths from rural areas who hold minoritized racial/ethnic identities. Adolescents living in rural areas also completed digital SSIs at similar rates to their urban peers, found SSIs equivalently as acceptable, and reported comparable depression symptom reductions as youth living in urban areas. CONCLUSION: Digital SSIs and their dissemination through social media may offer a promising means of narrowing the gap between access to evidence-based mental health support between adolescents living in rural and urban areas; however, targeted efforts are warranted to reach racially minoritized youths in rural U.S. counties.
Cognitive Disengagement Syndrome Symptoms from Early Childhood to Adolescence in a Nationally Representative Spanish Sample.
Burns GL, Montaño JJ, Becker SP … +1 more , Servera M
J Clin Child Adolesc Psychol · 2025 · PMID 37931059 · Publisher ↗
OBJECTIVE: The identification of a common set of symptoms for assessing cognitive disengagement syndrome (CDS, formerly sluggish cognitive tempo) for early childhood (ages 5-8), middle childhood (ages 9-12), and adolesce...
OBJECTIVE: The identification of a common set of symptoms for assessing cognitive disengagement syndrome (CDS, formerly sluggish cognitive tempo) for early childhood (ages 5-8), middle childhood (ages 9-12), and adolescence (ages 13-16) is needed to advance research on the developmental psychopathology of CDS (i.e. a common symptom set with comparable internal and external validity for each age group). METHOD: Parents of a nationally representative sample of 5,525 Spanish children and adolescents (ages 5 to 16, 56.1% boys) completed measures of CDS, attention-deficit/hyperactivity disorder-inattention (ADHD-IN), and other measures. RESULTS: First, the 15 CDS symptoms showed convergent and discriminant validity relative to the ADHD-IN symptoms within each age group. Second, CDS showed stronger first-order and unique associations than ADHD-IN with anxiety, depression, somatization, daytime sleep-related impairment, and nighttime sleep disturbance, whereas ADHD-IN showed stronger first-order and unique associations than CDS with ADHD-hyperactivity/impulsivity, oppositional defiant disorder, and academic impairment. Third, CDS showed stronger first-order and unique associations than ADHD-IN with a history of having an anxiety, depression, or bipolar disorder diagnosis, whereas ADHD-IN showed stronger first-order and unique associations with having an ADHD diagnosis. CONCLUSIONS: The identification of a common set of CDS symptoms spanning early childhood to adolescence allows for the advancement of research on CDS, with a particular need now for longitudinal studies and examination of CDS with other functional outcomes and across other cultural contexts.
Associations Between Structural Stigma and Psychopathology Among Early Adolescents.
Martino RM, Weissman DG, McLaughlin KA … +1 more , Hatzenbuehler ML
J Clin Child Adolesc Psychol · 2025 · PMID 37916808 · Full text
OBJECTIVE: Ample evidence demonstrates that structural stigma - defined as societal-level conditions, cultural norms, and institutional policies and practices that constrain opportunities, resources, and well-being of st...
OBJECTIVE: Ample evidence demonstrates that structural stigma - defined as societal-level conditions, cultural norms, and institutional policies and practices that constrain opportunities, resources, and well-being of stigmatized populations - is associated with psychopathology in adults from marginalized groups. Yet there is limited research on whether structural stigma is similarly associated with internalizing and externalizing symptoms among youth. METHOD: Structural stigma related to sex, sexual orientation, race, and Latinx ethnicity was measured using indicators of state-level policy and aggregated attitudes. Using data from the Adolescent Brain Cognitive Development (ABCD) Study ( = 10,414; M age = 12 years, SD = 0.66; 48% female, 6.8% lesbian, gay, and bisexual (LGB), 13.4% Black, 20% Latinx), we examined associations of structural stigma with internalizing and externalizing symptoms among female, LGB, Black, and Latinx youth. RESULTS: LGB youth living in higher (vs. lower) structural stigma states had elevated levels of internalizing and externalizing symptoms. In lower structural stigma states, there were no differences in externalizing symptoms between LGB and heterosexual youth. Similarly, Latinx youth and females living in higher (vs. lower) structural stigma states had elevated levels of externalizing symptoms. In lower structural stigma states, there were no differences in externalizing symptoms between Latinx youth and non-Latinx White youth. Structural stigma related to race was unrelated to internalizing or externalizing symptoms for Black youth. CONCLUSIONS: This study provides novel evidence that macro-level social environments, in the form of structural stigma, contribute to adverse mental health outcomes for marginalized youth and partly explain disparities in externalizing symptoms.
Future Directions in the Mental Health of Transgender Youth: Towards a Social-Affective Developmental Model of Health Disparity.
Sequeira S, Carmel T, Tervo-Clemmens B … +1 more , Edmiston EK
J Clin Child Adolesc Psychol · 2023 · PMID 37910433 · Publisher ↗
Mental health disparities in transgender and gender diverse (TGD) youth are well-documented. These disparities are often studied in the context of minority stress theory, and most of this research focuses on experiences...
Mental health disparities in transgender and gender diverse (TGD) youth are well-documented. These disparities are often studied in the context of minority stress theory, and most of this research focuses on experiences of trauma and discrimination TGD youth experience after coming out. However, TGD youth may be targets of violence and victimization due to perceived gender nonconformity before coming out. In this Future Directions, we integrate research on attachment, developmental trauma, and effects of racism and homophobia on mental health to propose a social-affective developmental framework for TGD youth. We provide a clinical vignette to highlight limitations in current approaches to mental health assessment in TGD youth and to illustrate how using a social-affective developmental framework can improve clinical assessment and treatment approaches and deepen our understanding of mental health disparities in TGD people.
Key Challenges and Potential Strategies for Engaging Youth with Lived Experience in Clinical Science.
Bettis AH, Vaughn-Coaxum RA, Lawrence HR … +4 more , Hamilton JL, Fox KR, Augsberger A, REACH Youth Advisory Board
J Clin Child Adolesc Psychol · 2024 · PMID 37889603 · Full text
Centering the perspectives of youth with lived experience (YWLE) in psychopathology is critical to engaging in impactful clinical research to improve youth mental health outcomes. Over the past decade there has been a gr...
Centering the perspectives of youth with lived experience (YWLE) in psychopathology is critical to engaging in impactful clinical research to improve youth mental health outcomes. Over the past decade there has been a greater push in clinical science to include community members, and especially community members with lived experience, in all aspects of the research process. The goal of this editorial is to highlight the need for and importance of integrating YWLE into every stage of clinical science research, from idea generation to interpretation and dissemination of research findings. We identify five key problems associated with pursuing research on adolescent mental health without involvement of YWLE and propose strategies to overcome barriers to youth engagement in clinical science research. We conclude with a call to action, providing guidance to clinical scientists, institutions, and funding agencies in conducting research on youth psychopathology with YWLE.
An Exposure-Based Cognitive-Behavioral Therapy for Youth with Severe Irritability: Feasibility and Preliminary Efficacy.
Naim R, Dombek K, German RE … +3 more , Haller SP, Kircanski K, Brotman MA
J Clin Child Adolesc Psychol · 2024 · PMID 37851393 · Full text
OBJECTIVE: Clinically impairing irritability and temper outbursts are among the most common psychiatric problems in youth and present transdiagnostically; however, few mechanistically informed treatments have been develo...
OBJECTIVE: Clinically impairing irritability and temper outbursts are among the most common psychiatric problems in youth and present transdiagnostically; however, few mechanistically informed treatments have been developed. Here, we test the acceptability, feasibility, and preliminary efficacy of a novel exposure-based treatment with integrated parent management skills for youth with severe irritability using a randomized between-subjects multiple baseline design. METHOD: = 41 patients (Age, Mean (SD) = 11.23 years (1.85), 62.5% male, 77.5% white) characterized by severe and impairing temper outbursts and irritability were randomized to different baseline observation durations (2, 4, or 6 weeks) prior to active treatment; 40 participants completed the 12 session treatment of exposure-based cognitive-behavioral therapy for irritability with integrated parent management skills. Masked clinician ratings were acquired throughout baseline and treatment phases, as well as 3- and 6-months post-treatment. To examine acceptability and feasibility, drop-out rates and adverse events were examined. Primary clinical outcome measures included clinician-administered measures of irritability severity and improvement. Secondary clinical outcome measures included multi-informant measures of irritability, depression, anxiety, and attention-deficit/hyperactivity disorder symptoms. RESULTS: No patients dropped out once treatment began, and no adverse events were reported. Irritability symptoms improved during the active phase of treatment across all measurements (all s > -0.04, < .011, Cohen's range: -0.33 to -0.98). Treatment gains were maintained at follow-up (all s< -0.001, s > .400). Sixty-five percent of patients were considered significantly improved or recovered post-treatment based on the primary clinician-rated outcome measure. CONCLUSIONS: Results support acceptability, feasibility, and preliminary efficacy of this novel treatment for youth with severe irritability. Limitations and future directions are also discussed.
Therapeutic Alliance, Attendance, and Outcomes in Youths Receiving CBT or Client-Centered Therapy for Anxiety.
Bose D, Pettit JW, Silk JS … +8 more , Ladouceur CD, Olino TM, Forbes EE, Siegle GJ, Dahl RE, Kendall PC, Ryan ND, McMakin DL
J Clin Child Adolesc Psychol · 2025 · PMID 37796228 · Full text
OBJECTIVE: Positive associations between therapeutic alliance and outcome (e.g. youth symptom severity) have been documented in the youth anxiety literature; however, little is known about the conditions under which earl...
OBJECTIVE: Positive associations between therapeutic alliance and outcome (e.g. youth symptom severity) have been documented in the youth anxiety literature; however, little is known about the conditions under which early alliance contributes to positive outcomes in youth. The present study examined the relations between therapeutic alliance, session attendance, and outcomes in youths ( = 135; 55.6% female) who participated in a randomized clinical trial testing the efficacy of cognitive-behavioral therapy or client-centered therapy for anxiety. METHOD: We evaluated a conceptual model wherein: (1) early alliance indirectly contributes to positive outcomes by improving session attendance; (2) alliance-outcome associations differ by intervention type, with stronger associations in cognitive-behavioral therapy compared to client-centered therapy; and (3) alliance-outcome associations vary across outcome measurement timepoints, with the effect of early alliance on outcomes decaying over time. RESULTS: Contrary to hypotheses, provider ratings of early alliance predicted greater youth-rated anxiety symptom severity post-treatment (i.e. worse treatment outcomes). Session attendance predicted positive youth-rated outcomes, though there was no indirect effect of early alliance on outcomes through session attendance. CONCLUSIONS: Results show that increasing session attendance is important for enhancing outcomes and do not support early alliance as a predictor of outcomes.
Why Haven't You Texted Me Back? Adolescents' Digital Entrapment, Friendship Conflict, and Perceived General Health.
Fox KA, Nick E, Nesi J … +2 more , Telzer EH, Prinstein MJ
J Clin Child Adolesc Psychol · 2025 · PMID 37796196 · Full text
OBJECTIVE: Many adolescents feel pressure to be constantly available and responsive to others via their smartphones and social media. This phenomenon has been understudied using quantitative methods, and no prior study h...
OBJECTIVE: Many adolescents feel pressure to be constantly available and responsive to others via their smartphones and social media. This phenomenon has been understudied using quantitative methods, and no prior study has examined adolescents' specific stress about meeting digital availability expectations within a best friendship, or entrapment. The present study offers an important preliminary examination of this unique digital stressor in a developmental context by examining prospective associations between digital entrapment, psychosocial adjustment, and health in adolescence. METHOD: Students in a rural, lower-income school district in the southeastern US ( = 714; 53.8% female; 45.9% White, 22.7% Black, 24.0% Hispanic/Latino) completed self-report measures of digital entrapment, perceived general health, friendship conflict, and depressive symptoms at two timepoints, one year apart. RESULTS: Digital entrapment, which 76.3% of the sample reported experiencing, was associated prospectively with higher levels of friendship conflict and worse perceived general health one year later among boys, but not girls. Findings suggest that digital entrapment is an extremely common experience for adolescents that may disproportionally affect boys. Entrapment was not prospectively associated with depressive symptoms. CONCLUSIONS: Results offer insight into how boys may have different social media experiences significant to their development and health, while much work exploring gender differences in social media use thus far has elucidated negative effects for girls. Boys may perceive and respond to novel social norms of digital environments differently such that digital entrapment has the potential to be detrimental to their friendships and health.
Provider Self-Reported Use and Usefulness of Intervention Strategies for Externalizing Behaviors in Youths with ASD.
Brown C, Lerner M, Stadheim J … +6 more , Kerns C, Moskowitz L, Cohn E, Drahota A, Soorya L, Wainer A
J Clin Child Adolesc Psychol · 2025 · PMID 37706638 · Full text
OBJECTIVE: To examine predictors of implementation and perceived usefulness of four empirically supported strategies for treating externalizing behavior in youths with ASD. METHOD: Participants were 557 providers in the...
OBJECTIVE: To examine predictors of implementation and perceived usefulness of four empirically supported strategies for treating externalizing behavior in youths with ASD. METHOD: Participants were 557 providers in the United States with experience treating externalizing behavior in youths with ASD. Generalized estimating equations were used to determine whether self-reported use and usefulness of four empirically supported intervention strategies (functional communication training, functional behavior analysis, visual tools/supports, token economy) were predicted by key provider characteristics: professional discipline, experience, and practice specialization (across three indices) in ASD. Post-hoc contrasts were performed to identify provider groups reporting the greatest use and usefulness of the four strategies. RESULTS: Strategies were most often used by providers with behavioral backgrounds, though perceived usefulness of strategies varied by providers' professional discipline. Compared to providers with more than 10 years of experience, less experienced providers endorsed the highest average use and usefulness of almost all strategies. Regarding ASD practice specialization, a lower volume of ASD cases, treating fewer youths with ASD over a 5-year period, and having a higher proportion of practice time working with youths with ASD reported were associated with greater use and usefulness of the strategies. CONCLUSIONS: Empirically supported strategies are widely used by and perceived as useful by providers who treat youths with ASD and co-occurring externalizing behaviors. Use and usefulness varies based on provider discipline, experience, and ASD practice specialization.
Frustration Response and Regulation Among Irritable Children: Contributions of Chronic Irritability, Internalizing, and Externalizing Symptoms.
Derella OJ, Butler EJ, Seymour KE … +1 more , Burke JD
J Clin Child Adolesc Psychol · 2024 · PMID 37698941 · Publisher ↗
OBJECTIVE: The need to understand and treat childhood chronic irritability (CI; i.e. frequent temper loss and angry/irritable mood) is imperative. CI predicts impairment across development and complex comorbidities with...
OBJECTIVE: The need to understand and treat childhood chronic irritability (CI; i.e. frequent temper loss and angry/irritable mood) is imperative. CI predicts impairment across development and complex comorbidities with both internalizing and externalizing disorders. Research has emphasized frustration reactivity as a key mechanism of CI. However, there are understudied components of frustrative non-reward, particularly regulation-oriented frustration recovery, frustration tolerance, and cognitive control, that may further explain impairments specific to CI beyond comorbid symptoms. METHOD: Sixty-three community children ( = 25 CI/38 non-CI) and a parent completed surveys and the computerized Frustration Go/No-Go (FGNG) and Mirror Tracing Persistence Task (MTPT). Analyses compared task performance and self-rated affect across youth with or without CI, with further comparison based on negative/positive screen for ADHD ( = 45-/18+). RESULTS: In mixed effects models assessing change across task, the CI group did not demonstrate more intense frustration on the MTPT or rigged FGNG block but exhibited persisting frustration and inhibitory control difficulties into the FGNG recovery period; the CI+ADHD subgroup drove recovery effects. In GEE and logistic regression models including dimensional symptom clusters, only internalizing symptoms predicted child frustration intolerance and reactivity across tasks. ADHD severity was also associated with higher MTPT frustration reactivity, while oppositional behavior predicted lower frustration. Better frustration recovery was associated with lower irritability, but higher internalizing symptoms. CONCLUSIONS: Co-occurring symptoms may better explain some frustration-related difficulties among youth with CI. Difficulties with postfrustration affect and inhibitory control recovery suggest the importance of characterizing CI by self-regulation impairments.
Evidence Base Update on Behavioral Treatments for Overweight and Obesity in Children and Adolescents.
Davison GM, Monocello LT, Lipsey K … +1 more , Wilfley DE
J Clin Child Adolesc Psychol · 2023 Sep · PMID 37683261 · Full text
OBJECTIVE: This review provides an update to a previous Evidence Base Update addressing behavioral treatments for overweight and obesity in children and adolescents. METHOD: Articles were identified through a systematic...
OBJECTIVE: This review provides an update to a previous Evidence Base Update addressing behavioral treatments for overweight and obesity in children and adolescents. METHOD: Articles were identified through a systematic search of the biomedical literature in PubMed/MEDLINE (1946-), Elsevier EMBASE (1947-), SCOPUS (1823-), Clarivate Web of Science Core Collection (WOS, 1900-), PsycINFO (1800-), The Cochrane Library and Clinicaltrials.gov published between June 2014 and August 2022. RESULTS: Family-based treatment (FBT) remains a treatment for overweight and obesity in children and is now in adolescents and toddlers. Parent-only behavioral treatment remains in children and is now among adolescents and children. continue to include FBT-parent only for adolescents, and behavioral weight loss (BWL) with a family component for adolescents, children, and toddlers. Several variations of FBT and BWL can now be considered including FBT+motivational interviewing, FBT+social facilitation maintenance, group-based FBT, low-dose FBT, BWL+stress management, and camp-based BWL. Cognitive behavioral treatment (CBT) for adolescents also met criteria for . Current research has also established that behavioral treatments can be effectively delivered in alternative settings (e.g. primary care) and through alternative mediums (e.g. telehealth). CONCLUSIONS: Research continues to support the use of multicomponent lifestyle interventions in accordance with recent recommendations from the American Academy of Pediatrics, the American Psychological Association, and the United State Preventative Services Task Force. However, more work is needed to ensure appropriate access for children with comorbid medical and psychiatric disorders and children from socially, politically, and economically marginalized groups.
Ecological-Systems Contributors to Internalizing Symptoms in a US Sample of Adolescents During the COVID-19 Pandemic.
Thorpe D, Mirhashem R, Shen J … +3 more , Roulston C, Fox K, Schleider J
J Clin Child Adolesc Psychol · 2025 · PMID 37616119 · Full text
OBJECTIVE: Internalizing problems are common in adolescence and increased substantially during the COVID-19 pandemic. Although rates of anxiety and depression have since improved, the general increase in the prevalence o...
OBJECTIVE: Internalizing problems are common in adolescence and increased substantially during the COVID-19 pandemic. Although rates of anxiety and depression have since improved, the general increase in the prevalence of mental health problems and disruptions to mental health services during the COVID-19 pandemic has resulted in huge gaps in care. Although research has primarily focused on proximal correlates of internalizing problems, a growing literature suggests that factors outside youths' immediate microsystems are equally crucial for their mental well-being. Thus, it is important to investigate multisystemic correlates of internalizing problems to inform individual and community-based interventions to address the current mental health burden. METHOD: Leveraging secondary data from a nationally diverse U.S. sample of 2,954 adolescents (ages 13-16), we examined the associations between factors at multiple levels of youths' ecologies - spanning indicators of threat and deprivation - and their depression and anxiety symptoms during the COVID-19 pandemic. Furthermore, in follow-up exploratory analyses, we examined if these associations differed by adolescents' racial/ethnic groups. RESULTS: Consistent with socioecological models, we found that indicators of threat and deprivation in the adolescents' immediate home and more distal neighborhood environments were associated with depression and anxiety symptoms. The patterns of associations were similar across racial/ethnic groups in multigroup structural equation models. Additionally, we found that mean levels of internalizing symptoms and socioecological predictors significantly differed across racial/ethnic groups. CONCLUSION: These findings have important implications for understanding multi-level contributors to adolescent mental health, which may inform research, practice, and policy.
Technology-Enhanced BPT for Early-Onset Behavior Disorders: Improved Outcomes for Children With Co-Occurring Internalizing Symptoms.
Parent J, Highlander A, Loiselle R … +4 more , Yang Y, McKee LG, Forehand R, Jones DJ
J Clin Child Adolesc Psychol · 2024 · PMID 37494309 · Full text
OBJECTIVE: Early-onset behavior disorders (BDs) are common and costly. The evidence-base for Behavioral Parent Training (BPT), the standard of care for early intervention for BDs in young children, is well-established; y...
OBJECTIVE: Early-onset behavior disorders (BDs) are common and costly. The evidence-base for Behavioral Parent Training (BPT), the standard of care for early intervention for BDs in young children, is well-established; yet, common comorbidities such as internalizing symptoms are common and their impact, not well understood. The goal of the current study was to examine the potential for technology to improve BPT effects on observed parenting and child behavior outcomes for families of children recruited for clinically significant problem behavior who also presented with relatively higher internalizing symptoms. METHOD: Families with low incomes ( = 101), who are overrepresented in statistics on early-onset BDs, were randomized to an evidence-based BPT program, Helping the Noncompliant Child (HNC), or Technology-Enhanced HNC (TE-HNC). Children were ages 3 to 8 years (55.4% were boys). Child race included White (64.0%), Black or African American (21.0%), more than one race (14.0%), and Hispanic/Latinx (13.9%). RESULTS: Families in both groups evidenced improvement in internalizing symptoms at posttreatment; however, TE-HNC yielded the greatest improvement in positive parenting and child compliance at posttreatment and follow-up for children with the highest internalizing symptoms at baseline. CONCLUSIONS: TE-HNC resulted in improved parenting and child behavior outcomes for children with elevated levels of co-occurring internalizing symptoms at baseline relative to standard HNC. We posit that these added benefits may be a function of TE-HNC, creating the opportunity for therapists to personalize the treatment model boosting parent skill use with more complex presentations, although a formal test of mediation will be important in future work.
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