OBJECTIVE: Peer victimization and bullying are increasingly recognized as potentially traumatic stressors. Relatively little research, however, has been conducted during middle childhood, and no known studies have examin...OBJECTIVE: Peer victimization and bullying are increasingly recognized as potentially traumatic stressors. Relatively little research, however, has been conducted during middle childhood, and no known studies have examined the impact of cyber victimization during this developmental period. Moreover, the vast majority of previous work has been cross-sectional in nature. The current short-term longitudinal study sought to address each of these gaps in the literature and to identify specific thresholds that are associated with increased risk for trauma symptoms. METHOD: Participants included a sample of 250 children (grades 3-5; 52% boys; 50% Hispanic/Latinx) and their homeroom teachers. Peer victimization was assessed using child- and teacher-reports and bullying was assessed using child-reports at Time 1. Trauma symptoms were assessed using child-reports at Times 1 and 2. RESULTS: Across both time points, 43% of children reported elevated trauma symptoms stemming from their experiences of peer victimization. Traditional and cyber victimization and bullying were associated with greater trauma symptoms, and these effects persisted 6.5 months later. Child-reports of traditional and cyber victimization and bullying at least "" were meaningful lower-bound thresholds, although children who reported experiences "" exhibited the greatest risk. CONCLUSIONS: A significant proportion of children who experience peer victimization report clinically significant trauma symptoms, and both traditional and cyber victimization as well as bullying confer lasting risk during middle childhood. Findings highlight the importance of screening to identify children negatively impacted by these experiences and the need for additional research to investigate trauma-focused interventions.
OBJECTIVE: Detecting engagement problems is crucial for delivering timely engagement intervention. Telemental health services (TMH) present challenges to how providers assess engagement. This study examined how providers...OBJECTIVE: Detecting engagement problems is crucial for delivering timely engagement intervention. Telemental health services (TMH) present challenges to how providers assess engagement. This study examined how providers detected low engagement, both broadly and at the level of specific engagement dimensions, and how they characterized low and high engagement among active cases. METHOD: Youth and/or caregivers ( = 153) receiving TMH completed a survey based on an empirically validated framework assessing five engagement dimensions, yielding scores indicating risk for low engagement. School-based providers ( = 49) completed a survey on which they identified indicators of low and/or high engagement for participating cases. Indicators were qualitatively coded across these five dimensions. RESULTS: Nearly 40% of cases met a predefined cutoff for low engagement on the self-report survey; however, 79% of these cases were not identified by providers as at risk. For the 21% of cases in which low engagement was detected, provider-reported indicators matched the self-reported engagement dimension(s) 23% of the time. Low engagement was more likely to be accurately detected for participation-oriented dimensions (i.e. attendance, homework/in-session participation) than for process-oriented dimensions (i.e. relationship, expectancy, clarity) ( = .004). Providers predominantly reported indicators of high and low engagement consistent with attendance and homework/in-session participation. CONCLUSION: Low engagement in TMH - especially when reflected in process-oriented engagement dimensions - is less consistently identified by providers. Tools such as multidimensional engagement surveys may facilitate early and ongoing detection of low engagement in service delivery, which could improve providers' ability to address engagement concerns.
OBJECTIVE: Several determinants of provider engagement in evidence-based practice (EBP) training programs have been previously identified; however, replication of these findings is sparse. The current study aimed to exte...OBJECTIVE: Several determinants of provider engagement in evidence-based practice (EBP) training programs have been previously identified; however, replication of these findings is sparse. The current study aimed to extend and replicate findings of a previous study examining predictors of provider engagement within two community-based learning collaboratives (CBLC) for youth trauma-focused cognitive-behavioral therapy (TF-CBT). METHOD: The sample consisted of 135 providers recruited across 22 agencies. The mean (SD) age of participants was 37.0 (11.1), and most participants were female ( = 104, 77%). Fifty-eight (43%) participants identified as Caucasian and 63 (46.7%) identified as Hispanic. Generalized Estimating Equations (GEEs) were run to account for nesting of clinicians within agencies. RESULTS: Overall, engagement rates were higher in the replication. Rates of completion were similar across each of the CBLC components; however, brokers were much less likely to complete the CBLC than other providers. This study reconfirmed that providers who already viewed their individual practices as trauma-informed were more likely to engage with the CBLC. The current study failed to replicate a relationship between implementation climate and overall provider training engagement, as well as between previous use of TF-CBT components and clinician training engagement. Both studies failed to find a significant relationship between positive attitudes, better organizational support, and prior TF-CBT knowledge and training engagement. CONCLUSIONS: Replicated findings underscore the importance of existing provider practices when designing and planning CBLC implementation. Future implementation efforts should identify methods to increase CBLC fit for providers at-risk of lower engagement.
OBJECTIVE: Leveraging data from a previously conducted randomized trial, we examined whether Project RISE - a digital single-session intervention focused on minority stress - was associated with equal improvements in lev...OBJECTIVE: Leveraging data from a previously conducted randomized trial, we examined whether Project RISE - a digital single-session intervention focused on minority stress - was associated with equal improvements in levels of internalized stigma, identity pride, hopelessness, depression, and anxiety among youth with a single minoritized or multiply-minoritized identities. We also tested whether higher levels of social support moderated outcomes. METHOD: Participants randomly assigned to the intervention were included ( = 261 adolescents 13-16 years old; M age = 15; 51% youth of color; 68% transgender/gender-diverse). Two-way multivariate analysis of covariances examined potential group differences across outcomes, between individuals holding multiple minoritized identities versus one. Moderation analyses were used to investigate whether social support moderated RISE outcomes. RESULTS: Identifying with multiple minoritized identities was associated with higher levels of identity pride immediately post-intervention. Identifying as a gender minority was associated with slightly greater identity pride post-intervention. Youth who endorsed gender minority identities reported higher levels of hopelessness, depression, and anxiety at 2-week follow-up, relative to cisgender youth. No other differences emerged. CONCLUSIONS: Multiply-minoritized youth, especially gender minority youth, experienced significantly higher levels of identity pride after completing Project RISE. Results highlight the importance of applying an intersectional minority stress framework to online intervention design and considering social contexts (e.g. high versus low social support) when selecting treatments for youth with intersecting identities. Clinicians should consider how interventions specifically addressed intersectional identities when providing evidence-based care.
OBJECTIVE: Anxiety often rises after the transition to high school, yet little is known about how these changes occur for lesbian, gay, bisexual, transgender, and queer (LGBTQ) adolescents who face unique minority stress...OBJECTIVE: Anxiety often rises after the transition to high school, yet little is known about how these changes occur for lesbian, gay, bisexual, transgender, and queer (LGBTQ) adolescents who face unique minority stressors. This study examined longitudinal differences in anxiety trajectories between LGBTQ and cisgender heterosexual adolescents and evaluated whether self-esteem served as a protective factor. METHOD: Participants were 367 adolescents ( = 14.05 years; 60.5% cisgender girls; 46.6% White, 18.8% Black, 17.4% Asian, 5.7% Arab/Middle Eastern/North African, 5.2% Multiracial, 3.5% Hispanic/Latinx; 22% [ = 80] LGBTQ, 78% [ = 287] cisgender heterosexual) from 38 Michigan high schools. Anxiety symptoms (Generalized Anxiety Disorder-7) and self-esteem (Rosenberg Self-esteem Scale) were assessed across five waves during ninth and tenth grade. Multiple-group latent curve modeling evaluated group differences and self-esteem's predictive role. RESULTS: LGBTQ adolescents entered high school with significantly higher anxiety symptoms than their cisgender heterosexual peers. Although their symptoms declined over time, they remained significantly higher than those of cisgender heterosexual adolescents, whose anxiety levels were stable. Higher initial self-esteem predicted lower initial anxiety for both groups; however, decreases in anxiety over time emerged only among LGBTQ adolescents with self-esteem at least 1 SD above the group mean. CONCLUSIONS: Self-esteem emerges as a critical protective factor against the development of anxiety symptoms. Given heightened anxiety symptoms for LGBTQ adolescents following the transition to high school, interventions bolstering self-esteem may be especially beneficial for reducing anxiety in this population.
OBJECTIVE: This qualitative study seeks to explore community-level risk and protective factors influencing substance use and mental health among urban youth in Paterson, New Jersey, and to identify actionable targets for...OBJECTIVE: This qualitative study seeks to explore community-level risk and protective factors influencing substance use and mental health among urban youth in Paterson, New Jersey, and to identify actionable targets for prevention and mental health interventions using a community trauma framework. METHODS: Purposive and venue-based sampling was used as a method to recruit youth ( = 90). Fifteen focus groups were conducted; a majority of the sample identified as Black (71.1%) and (16.7%) identified as Hispanic with an average age of 16 years old. The sample included 54.4% male participants and 45.6% female participants. All focus groups were audio-recorded and transcribed. RESULTS: Three major themes emerged from our focus groups with youth from Paterson, which include: 1) the socio-cultural environment and its impact on substance misuse; 2) physical and built environment, and 3) educational and economic environment, all major constructs of the Community Trauma framework, which was used as a guide to interpret findings. CONCLUSIONS: Our findings demonstrate that youth in Paterson view substance use as deeply intertwined with their socio-cultural, physical, and economic environments. These results highlight the need for multilevel interventions such as improving neighborhood safety and increasing access to culturally responsive mental health services. Policy implications include enacting zoning ordinances to limit the density of tobacco, marijuana, and alcohol retailers near schools and implementing school-based mental health programs. Taken together, these strategies can reduce youth exposure to risk environments and promote healthier developmental trajectories for urban youth of color.
OBJECTIVES: The purpose of this study was to examine longer-term outcomes of a school-based randomized controlled trial comparing a telehealth-delivered adolescent depression prevention program, Interpersonal Psychothera...OBJECTIVES: The purpose of this study was to examine longer-term outcomes of a school-based randomized controlled trial comparing a telehealth-delivered adolescent depression prevention program, Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST), to services as usual (SAU) across 17 public schools. METHOD: Adolescents ( = 242; = 14.80 years, = .70; 65% female; 21% Black; 13% Hispanic/Latinx) with elevated depression screening scores completed surveys through 15-month follow-up (approximately 1-year post-intervention). Adolescents completed a diagnostic interview to measure depression diagnoses at baseline and 15-month follow-up. Depression symptoms and diagnoses were primary outcomes and anxiety symptoms were secondary. RESULTS: Hierarchical linear modeling results indicated that adolescents in both IPT-AST and SAU demonstrated similar decreases in depression and anxiety symptoms during the follow-up and total study periods, supporting hypotheses regarding the follow-up period but not the total study. Baseline depression diagnostic status moderated intervention effects on anxiety symptoms such that, among adolescents without a depression diagnosis at baseline, those in IPT-AST showed greater reductions in anxiety symptoms than those in SAU. Exploratory analyses indicated SAU adolescents were more likely to endorse elevated depression symptoms (i.e. above a clinical cutoff) compared to IPT-AST adolescents. The hypothesis regarding depression diagnoses was partially supported; although diagnosis rates and timing to episode onset did not differ between IPT-AST and SAU, exploratory restricted mean survival time analyses demonstrated that adolescents in IPT-AST gained approximately one month free of diagnosis compared to those in SAU. CONCLUSION: Findings highlight the importance of school-based depression prevention programming for reducing longer-term risk.
J Clin Child Adolesc Psychol
· 2026 · PMID 41686140
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OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder starting in childhood, often persisting into adulthood. Diagnosis rates have risen since the first U.S. estimates in the 1990s,...OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder starting in childhood, often persisting into adulthood. Diagnosis rates have risen since the first U.S. estimates in the 1990s, with variations across sex, race/ethnicity, and other factors. This study explores ADHD diagnosis and treatment among U.S. children from 2016 to 2023, with a focus on identifying differences across sociodemographic and clinical characteristics. METHODS: Data from the National Survey of Children's Health (NSCH; 2016‒2023) on parent-reported ADHD diagnoses and treatments among non-institutionalized U.S. children aged 3‒17 years were analyzed. Trends over time and across sociodemographic and clinical subgroups were assessed using logistic regression models and joinpoint regression analysis. RESULTS: ADHD diagnosis prevalence estimates were stable from 2016 to 2019 (8.6% to 8.8%), rising after the onset of the COVID-19 pandemic in 2020 to 10.5% in 2023. Yet, from 2016 to 2023, overall ADHD treatment rates declined (76.9% to 70.8%), particularly for medication treatment (62.5% to 53.0%), while behavioral treatment stayed steady (47.3% to 48.2%). ADHD diagnosis trends differed by race, insurance status, and ADHD severity, increasing only for children in Asian, White, and multiracial groups; with private insurance, and with mild or moderate ADHD. Treatment prevalence differences by sex narrowed over time, as medication use decreased for males and behavioral treatment increased for females, specifically adolescent females. CONCLUSIONS: With a widening gap between the prevalence of ADHD diagnosis and treatment, fewer children are receiving recommended care than in the past. These results may inform interventions to improve healthcare access and address systemic barriers to treatment for all children with ADHD.
Suicide is a leading cause of death worldwide, and is one of the most devastating, complex, and perplexing of all human behaviors. Unfortunately, despite centuries of scientific and scholarly inquiry, suicidal thoughts a...Suicide is a leading cause of death worldwide, and is one of the most devastating, complex, and perplexing of all human behaviors. Unfortunately, despite centuries of scientific and scholarly inquiry, suicidal thoughts and behaviors remain exceedingly difficult to understand, predict, and prevent. Fortunately, recent advances in mathematical, computational, and digital methods are providing new opportunities to capture and model the immense complexity of suicidal thoughts and behaviors. In this paper, we first provide a brief review of existing literature and then identify four priorities for future research, including: 1) rigorous conceptual and descriptive research, 2) formal theory development and refinement, 3) measurement in context and over time, and 4) prediction of group- and individual-level suicide risk. Finally, we discuss cross-cutting considerations related to ethical dilemmas, enhancing diversity, and training the next generation of scientists. Together, these future directions offer an actionable agenda to guide the future of suicide research and make meaningful progress toward reducing its global burden.
OBJECTIVE: This evidence base update investigates the empirical support of psychosocial interventions for self-injurious thoughts and behaviors (SITBs) in youth, focusing on the period since the prior review. METHOD: Two...OBJECTIVE: This evidence base update investigates the empirical support of psychosocial interventions for self-injurious thoughts and behaviors (SITBs) in youth, focusing on the period since the prior review. METHOD: Two major scientific databases (PsycInfo and PubMed) were systematically searched to identify randomized controlled trials (RCTs) published or in press between June 1, 2018 and May 31, 2024. RESULTS: The search yielded 11 RCTs new to this update and 1 new SITB outcome to an RCT included in the prior review. Since the prior review, Dialectical Behavior Therapy for Adolescents (DBT-A) was reclassified as Level 1: Well-established intervention for reducing adolescent suicide attempts, and Family Therapy was reclassified as Level 2: Probably efficacious for reducing youth suicide ideation (SI). Cognitive behavioral therapy-individual + family was reclassified as Level 4: Experimental for reducing youth suicide attempts. Four new RCTs examining adjunctive skills or boosters for brief interventions were rated as Level 2: Probably Efficacious for reducing SI (adjunctive mindfulness skills + Psychodynamic therapy, adjunctive skills - emotion regulation) or Level 3: Possibly Efficacious for reducing SITBs (adjunctive safety planning interventions). CONCLUSIONS: DBT-A remains the sole well-established intervention for reducing SITBs, with replication by multiple independent research teams. Half the RCTs identified in this review aimed to replicate or extend prior interventions. Several newly identified trials in this review were primarily adjunctive or brief, demonstrating greater efforts to enhance the availability of interventions for SITBs in youth. Further replication of these adjunctive treatments is needed to clarify their effectiveness and potential for widespread implementation.