Seidman SB, Magee KE, Connell AM
… +5 more, Ha T, Westling E, Brown-Iannuzzi J, Stormshak E, Shaw DS
J Clin Child Adolesc Psychol
· 2026 · PMID 41628307
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OBJECTIVE: Maternal depression is strongly linked to the development of depression in youth; however, most studies have examined this association as a unidirectional pathway over time. Emerging literature suggests that y...OBJECTIVE: Maternal depression is strongly linked to the development of depression in youth; however, most studies have examined this association as a unidirectional pathway over time. Emerging literature suggests that youth psychopathology, such as externalizing behaviors, can also influence parents' mood and symptoms, yet, the impact of youth depressive symptoms on parent depressive symptoms remains poorly understood. METHOD: The current study included a sample of mother-child dyads = 2322) whose depressive symptoms were assessed across 5 time points, with measurements at 5 time points in early and middle adolescence. In terms of demographics, 47.7% of youth identified as female, 41.3% of participants identified as European American, 24.2% as African American, 12.4% as Latinx, and 12.8% as multiracial. RESULTS: Results show no significant effect of between-subjects, stable differences across time, but time-specific, within-dyad differences in depressive symptoms indicated bidirectional pathways between maternal and youth depressive symptoms across early and middle adolescence. CONCLUSION: The results highlight the critical importance of examining bidirectional pathways of risk, which may implicate family functioning and interventions for youth depression. Interventions for youth depression typically do not reliably incorporate parents; however, as the current findings suggest, both parent and youth depression are mutually reinforcing, such a bidirectional perspective could prove to be beneficial in treatment.
OBJECTIVE: We examined combined effects of chronic exposure to school, family, community, and interethnic-political violence encountered by Israeli and Palestinian youth. Our goal was to estimate the impacts of cross-con...OBJECTIVE: We examined combined effects of chronic exposure to school, family, community, and interethnic-political violence encountered by Israeli and Palestinian youth. Our goal was to estimate the impacts of cross-contextual exposure to violence during childhood/early adolescence on post-traumatic stress (PTS) symptoms and aggressive behavior in late adolescence/young adulthood. METHOD: Participants were children and one of their caregivers first recruited in 2008 for an initial three yearly waves of surveys from three age cohorts (starting ages 8, 11, 14); a randomly selected reduced sample of original participants was drawn in 2014 to yield four-wave samples of Israeli Jewish ( = 162) and Palestinian Arab ( = 400) youth; sex of child was evenly distributed across cohorts as well as ethnic groups. At all waves, youth and/or their caregivers reported on youths' exposure to violence. Youth self-reported PTS symptoms, and youth and caregivers provided ratings for a composite measure of aggression at all waves. RESULTS: Regressions controlling social demographics and baseline criterion scores showed significant prediction to both PTS and aggression from chronic, multi-contextual exposures. For aggression, exposure to persistent interethnic-political violence was a significant predictor. For PTS, exposures to persistent interethnic-political and family violence were significant predictors. CONCLUSION: Chronic exposure to violence across multiple contexts - particularly persistent interethnic-political violence - from childhood through very early adulthood amplifies aggressive behavior as well as post-traumatic stress. Researchers should incorporate indicators of chronicity and cross-contextual exposure into studies on the effects of violence in the social environment.
OBJECTIVES: As the number of ethnic/racial minority individuals in the United States continues to grow, psychology programs need to train a representative workforce that can meet the needs of an increasingly diverse popu...OBJECTIVES: As the number of ethnic/racial minority individuals in the United States continues to grow, psychology programs need to train a representative workforce that can meet the needs of an increasingly diverse population. This survey study explored (a) the approaches used by clinical child and pediatric psychology programs to train students in multicultural education and (b) the strategies and barriers to recruit and retain underrepresented students and faculty. METHOD: The survey was developed by the Diversity Committee of the Clinical Child and Pediatric Psychology Training Council (CCaPPTC) and was sent to directors from various CCaPPTC-member graduate, internship and postdoctoral training programs across the nation. Responses to open-ended questions were coded, and thematic analysis was used to group the codes into meaningful categories. Bronfenbrenner's Ecological Systems Model and the Layered Ecological Model of the Multicultural Guidelines (APA, 2017) were used to structure the analysis. RESULTS: A total of 42 directors (71% response rate) completed the survey. Thirty-seven codes categorized into 10 themes, nested within four ecological levels (micro-, meso-, exo- and macrosystems), were identified. Derived themes capture specific approaches and strategies programs used to teach diversity and recruit/retain underrepresented students and faculty. CONCLUSION: Findings highlight the importance of developing strategies at various levels of the system to enhance curriculum and recruitment/retention efforts, as well as the need to attend to the interactions between systems in order to address barriers. Specific recommendations are offered.
OBJECTIVE: Black adolescents in the United States are experiencing rising rates of internalizing concerns, such as depression, anxiety, and suicidality. While barriers to mental health help-seeking are well documented, l...OBJECTIVE: Black adolescents in the United States are experiencing rising rates of internalizing concerns, such as depression, anxiety, and suicidality. While barriers to mental health help-seeking are well documented, little is known about how digital technology shapes this process. Therefore, this study aimed to update Cauce and colleagues' cultural and contextual model of help-seeking, with interrelated stages of problem recognition, decision to seek help, and support selection, by incorporating the role of digital technology from the perspective of Black adolescents. METHOD: This mixed methods sequential explanatory research study included 372 Black adolescents (ages 14-18) with moderate to severe internalizing concerns in the United States who participated in the quantitative phase and a subset of 21 participants in the qualitative phase. RESULTS: Quantitative findings showed that Black adolescents reported greater past utilization of digital and informal sources of help, and stronger intentions to seek help from digital, informal, and formal sources in the future, while expressing lower intentions to use community-based supports. The qualitative phase revealed several themes that align with the phases of the cultural and contextual help-seeking model, as well as novel themes highlighting the role of digital technology across the help-seeking phases. CONCLUSION: These findings offer valuable insights into the growing role of digital technology in the mental health help-seeking process and present the Adolescent Cultural, Contextual, and Technological (ACCT) Mental Health Help-Seeking Model, centering the needs of Black adolescents with internalizing concerns.
OBJECTIVE: The goal of the present study was to conduct focus groups on the parameters of racial socialization in early childhood to inform the development of methods of assessment in the research context. METHODS: Black...OBJECTIVE: The goal of the present study was to conduct focus groups on the parameters of racial socialization in early childhood to inform the development of methods of assessment in the research context. METHODS: Black mothers of 4-6-year-old children were guided by four questions: if and how mothers discuss race and racism; why they decide to talk about race and racism; when and in what contexts they consider discussing race and racism; and what they say to their children. Coded transcripts were used to describe racial socialization practices. RESULTS: Mothers described balancing a desire for their children to have strong racial identities with concerns about their emotional and cognitive readiness for processing information about race and racism. Broad approaches to racial socialization, including incorporating socialization into day-to-day parenting practices, affirming their children's beauty and culture, and discussing humanistic qualities that the mothers value, characterized their racial socialization practices. Mothers described responding to their children's questions or observations of their day-to-day experiences (e.g. peers with different skin color) to introduce broad concepts about race. CONCLUSION: Black mothers want to guide their children's racial socialization in ways that are consistent with their developmental level. Developing tools that include images and prompts that place young children in familiar contexts and provide mothers with the opportunity to use the foundation of physical characteristics and interpersonal interactions to expand and scaffold discussions about race and racism with their children should yield valid and salient data for supporting the health of Black youth.
OBJECTIVE: Service integrity, or the comparison of what has occurred with what was expected to occur, is essential to managing service quality. This paper tested the reliability of an expanded set of integrity metrics th...OBJECTIVE: Service integrity, or the comparison of what has occurred with what was expected to occur, is essential to managing service quality. This paper tested the reliability of an expanded set of integrity metrics that included targets (i.e. problems targeted in intervention), practices (i.e. clinical procedures), and steps (i.e. sub-components of practices) measured at different levels of dialogue and across different types of service events. METHOD: This study was conducted in two publicly funded youth mental health systems located in geographically distinct, under-resourced communities where service inequities are common. Targets, practices, and steps were coded in 78 treatment events and 84 clinical supervision events that were digitally recorded and transcribed. Fleiss' kappa (K) and intraclass correlation coefficients () yielded estimates for the interrater reliability of codes in excerpts (i.e. small contiguous units of dialogue) as well as complete events (i.e. entire supervision or treatment sessions). RESULTS: Coders generally detected targets, practices, and steps in supervision and treatment with acceptable reliability. On average, coders detected steps more reliably than practices, targets more reliably in excerpts than in events, and supervision content more reliably than treatment content. CONCLUSIONS: These findings demonstrate the potential to reliably code a uniform set of metrics for expanding the analysis of service integrity in dynamic care settings. Assessing the extent to which delivered practices match targets, delivered treatment matches supervision discussions, and delivered steps reflect the practices intended to be delivered can yield crucial insights for improving service coordination, continuity, and overall quality of mental health care.
OBJECTIVE: Effective treatment for depression and anxiety in adolescence is a public health concern. Although psychotherapies for depression and anxiety exist, youth psychotherapies are less effective when delivered in c...OBJECTIVE: Effective treatment for depression and anxiety in adolescence is a public health concern. Although psychotherapies for depression and anxiety exist, youth psychotherapies are less effective when delivered in community settings compared to research settings. A social-ecological model, which considers individual-, interpersonal-, and community-level influences on wellbeing, posits that understanding multi-level factors can help us understand this drop in treatment effectiveness. This study employs a socioecological model to examine the influence of neighborhood factors on depression and anxiety treatment for adolescents receiving psychotherapy in community mental health clinics, after controlling for relevant individual- and interpersonal-level factors. METHOD: Demographic and clinical data from a sample of 196 adolescents undergoing mental health treatment were gathered from a two-site, randomized controlled effectiveness trial. The parent study was a 3-arm trial of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) and measurement-based care (MBC) compared to treatment as usual (TAU). All three study arms were combined for analysis. Adolescents completed a baseline assessment with an independent evaluator upon treatment initiation, and follow-up assessments at 8, 16, and 28 weeks. Individual-level variables (youth age, gender, race/ethnicity), family-level variables (household income, caregiver psychopathology, and parenting behavior), and neighborhood-level variables from the U.S. Census Bureau American Community Survey (ACS) were combined for this secondary analysis. A composite neighborhood disadvantage index consisting of seven ACS variables was used as a predictor of adolescent symptom severity and psychotherapy outcomes in multilevel models. RESULTS: Consistent with a social-ecological model, results revealed multi-level influences of adolescent symptom severity and treatment outcomes. Neighborhood disadvantage was associated with higher symptom severity (β = .03, 95% CI [.01, .04], = .004) and poorer treatment improvement from the 16-week to 28-week follow up assessment (OR = 1.13, 95% CI [1.02, 1.26]). Parent psychopathology played an important role in youth functioning, with higher caregiver depression predicting greater youth impairment at all timepoints ( < .01). CONCLUSION: Findings support the relevance of community factors as structural determinants of adolescent mental health symptoms and psychotherapy outcomes. Applying a multi-level lens that considers contextual factors is critical in the study of youth psychotherapy.
OBJECTIVE: Caregiver involvement in trauma-focused treatments for young children has shown improved outcomes. However, it remains unclear whether child outcomes are influenced by the dosage of conjoint participation and...OBJECTIVE: Caregiver involvement in trauma-focused treatments for young children has shown improved outcomes. However, it remains unclear whether child outcomes are influenced by the dosage of conjoint participation and caregiver functioning during treatment. The current study examined changes in preschool-aged children's posttraumatic stress (PTS) symptom severity during the Attachment, Regulation, and Competency (ARC) treatment and whether the change was moderated by caregiver PTS symptoms and the dosage of conjoint participation over 9 months post-intake. METHOD: One hundred ninety caregiver-child dyads (63.2% birth/adoptive mother; children M age = 5.39 years, SD = 1.02; 43.7% girls; 46.9% White/Non-Hispanic, 10.5% Black/Non-Hispanic, 6.3% Other/Non-Hispanic, 36.3% Hispanic children) received ARC treatment. This was a naturalistic observational study conducted without a comparison group. Caregiver and child PTS symptoms were measured using caregiver-reported Young Child PTSD Checklist (YCPC) and PTSD Checklist for DSM-5 (PCL-5) at baseline and quarterly during the 9-month observation period. Clinicians reported the treatment dosage on a monthly basis. RESULTS: Consistent with our hypotheses, multilevel modeling revealed that PTS symptoms generally improved for children whose caregivers reported lower PTS symptom severity, regardless of the dosage of conjoint sessions. Among dyads with higher caregiver PTS symptom severity, changes in child PTS symptoms were moderated by the dosage of conjoint sessions during ARC treatment. CONCLUSIONS: These findings suggest that while ARC treatment may be helpful in reducing PTS symptom severity among young children, conjoint caregiver-child sessions are especially important when caregivers report elevated levels of PTS symptoms.
OBJECTIVE: To compare the prevalence of attention-deficit/hyperactivity disorder (ADHD) among Asian, Black, Latino, and White children and adolescents across studies while considering method of diagnosis. METHOD: Studies...OBJECTIVE: To compare the prevalence of attention-deficit/hyperactivity disorder (ADHD) among Asian, Black, Latino, and White children and adolescents across studies while considering method of diagnosis. METHOD: Studies were included if they reported the prevalence of ADHD among at least two different racial/ethnic groups in an unselected population. Studies were grouped based on the method of diagnosis; studies involving juvenile offenders were analyzed separately. A total of 9,019 articles were retrieved and 371 articles were evaluated. After excluding studies with overlapping datasets, 28 studies were included in the population-based meta-analysis, and five studies were included in the meta-analysis involving juvenile offenders. RESULTS: For studies asking caregivers if the child had received a diagnosis of ADHD (k = 23), the pooled prevalence of ADHD was lower for Latino (6.1%) and Asian (2.6%) youth than White youth (10.5%); the prevalence in Black youth (9.4%) was not significantly different from White youth. Among juvenile offenders (k = 5), the prevalence of ADHD was significantly lower in Black (19.1%) and Latino (17.0%) youth than in White youth (31.9%). CONCLUSIONS: The present study finds some racial/ethnic differences in prevalence rates of ADHD. The study demonstrates that the type of sample and method for assessing ADHD diagnosis are important to consider.
Miranda R, Ortin-Peralta A, Rosario-Williams B
… +4 more, Rombola C, Mañaná J, Espinal J, Waseem M
J Clin Child Adolesc Psychol
· 2026 · PMID 41363778
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OBJECTIVE: A major limitation in understanding which forms of adolescent suicide ideation might predict the risk of a future suicide attempt is that current assessments of adolescents presenting to emergency departments...OBJECTIVE: A major limitation in understanding which forms of adolescent suicide ideation might predict the risk of a future suicide attempt is that current assessments of adolescents presenting to emergency departments do not consider suicide ideation subtype in assessing risk. The current study examined whether adolescent suicide ideation subtypes, assessed via interview, would differentially predict an increased risk of a future suicide attempt over time. METHOD: Adolescents (N = 131) (78% female; 84% Hispanic/Latine), ages 12-19, who presented with suicide ideation ( = 85) or a suicide attempt ( = 46) were recruited primarily from an emergency department and outpatient clinics in New York City for a longitudinal study. Adolescents were interviewed and classified into three suicide ideation subtypes (brief, intermittent, and persistent suicide ideation) and followed up to 3 times over 12 months. RESULTS: A higher proportion of adolescents with persistent suicide ideation made a suicide attempt at follow-up (47%), compared to those with brief ideation (21%), < .05. A survival analysis suggested that persistent suicide ideation was associated with a significantly greater risk of making a future suicide attempt sooner ( = 3.64; 95% = 1.61-8.24), compared to brief suicide ideation, with a similar trend for intermittent suicide ideation ( = 2.30; 95% = 1.00-5.28). CONCLUSIONS: Adolescents who present for clinical care with persistent or intermittent suicide ideation may warrant more immediate clinical attention to prevent risk of a future suicide attempt.
OBJECTIVE: While daring-impulsive (DI) traits have been deemed an important concept in subtyping youth with conduct disorder (CD) as part of a multispecifier model, no work has examined whether DI traits add to the exist...OBJECTIVE: While daring-impulsive (DI) traits have been deemed an important concept in subtyping youth with conduct disorder (CD) as part of a multispecifier model, no work has examined whether DI traits add to the existing practice of designating youth with CD beyond co-occurring attention-deficit/hyperactivity disorder (ADHD). METHOD: This study examined the utility of DI traits (versus ADHD features) in a sample of 322 justice-involved adolescent boys (ages 16-17 years). In addition to a diagnostic interview to determine severity of CD, adolescents completed measures of DI, ADHD, as well as other relevant characteristics. RESULTS: Findings revealed differential associations between DI and ADHD in relation to indices of CD, externalizing psychopathology (i.e. reactive aggression, proactive aggression, substance use), internalizing psychopathology (i.e. anxiety, depression), and domains of impulsivity (i.e. positive urgency, negative urgency, sensation seeking, premeditation, perseverance). Additionally, over and above ADHD, DI contributed incremental information in explaining CD, externalizing psychopathology, positive urgency, sensation seeking, and lack of premeditation, but not internalizing psychopathology nor negative urgency and lack of perseverance. Of the 286 adolescents with CD, 114 (39.9%) were in the DI group and only 81 (28.3%) were in the ADHD group. Finally, differential correlates emerged between adolescents exhibiting CD alone, high CD and high DI traits, and high CD and high ADHD features. CONCLUSIONS: Findings tentatively suggest DI traits and ADHD features are empirically distinct from each other in relation to CD and relevant characteristics and, therefore, improved clinical care for adolescents with CD will likely require differential consideration of DI and ADHD.
OBJECTIVE: We examined the longitudinal effects of internet-delivered PCIT (iPCIT) on caregiver and child imitation in young Hispanic/Latine children with developmental delay (DD). We also examined the moderating roles o...OBJECTIVE: We examined the longitudinal effects of internet-delivered PCIT (iPCIT) on caregiver and child imitation in young Hispanic/Latine children with developmental delay (DD). We also examined the moderating roles of acculturation and enculturation on such treatment effects. METHOD: Three-year-old, Hispanic/Latine children aging out of early intervention services for developmental delay ( = 98) and their primary caregivers were randomized to receive iPCIT or referrals as usual (RAU) in the community. Caregiver and child imitation were observationally coded during a 5-min child-directed play situation, which occurred during home-based evaluations at four timepoints - i.e. Baseline, Post, 6-month follow-up, and 12-month follow-up. RESULTS: Treatment effects were significantly moderated by caregiver acculturation. Specifically, iPCIT was associated with greater caregiver and child imitation among families reporting higher, but not lower, levels of caregiver acculturation. However, caregiver enculturation did not moderate the effects of iPCIT on either caregiver or child imitation. CONCLUSIONS: Findings suggest parenting intervention effects on levels of imitation were particularly strong for Hispanic/Latine caregivers reporting higher levels of acculturation. This highlights the promotive role acculturative identity can play in boosting parenting intervention effects, particularly those of caregiver and child imitation. Findings also underscore the importance of assessing cultural factors to better inform personalized care and skill acquisition among Hispanic/Latine samples. Future research is needed to identify mechanisms that help explain precisely how cultural identity factors, such as acculturation and enculturation, can boost treatment-related imitation gains for Hispanic/Latine children with DD and their families.
Richardson SC, Gryglewicz K, Williams JA
… +7 more, Phipps-Bennett M, Dennis S, Browne N, Trujillo A, Carlisle C, Nail M, Karver M
J Clin Child Adolesc Psychol
· 2026 · PMID 41264369
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OBJECTIVE: While suicidal behaviors among adolescents declined from 1991 to 2017, suicides among Black youth increased. There is limited research on suicidal help-seeking behaviors among Black adolescents, which is essen...OBJECTIVE: While suicidal behaviors among adolescents declined from 1991 to 2017, suicides among Black youth increased. There is limited research on suicidal help-seeking behaviors among Black adolescents, which is essential for effective suicide prevention and intervention. This study examined suicidal help-seeking behaviors and treatment preferences among Black youth and caregivers, using the Psychological Framework of Radical Hope to explore strategies for fostering hope and healing. METHODS: This qualitative study included Black youth (ages 14-19), caregivers, health and mental health providers, and community members ( = 55). Participants were predominantly Black (96%) and female (53%), with ages ranging from 14 to 68 years. Semi-structured interviews, conducted in 60-90-min virtual focus groups, explored experiences with suicidal help-seeking, service needs, and support preferences. Constant comparative methodology was employed to organize and categorize data into themes. RESULTS: Youth balanced ideas of faith and agency toward help-seeking behaviors. In contrast, caregivers, providers, and community members were less optimistic about the service needs of Black youth being met largely due to historical and current experiences with systemic barriers. Participant groups discussed how collective memory informs their experiences and inspires them to have hope for positive change. DISCUSSION: Suicide-specific interventions should integrate strategies for fostering hope, faith, and agency individually and collectively with diverse groups to support Black youth suicidal help-seeking behaviors. Clinical strategies are provided to support the design of interventions to effectively address suicidal help-seeking behaviors for Black youth and their caregivers.
Vivanti G, Lombardo MV, Zitter A
… +16 more, Boyd B, Dissanayake C, Dufek S, Flanagan HE, Iadarola S, Kaiser A, Kim SH, Levato L, Lord C, Plavnick J, Robins DL, Rogers SJ, Smith IM, Smith T, Stahmer A, Watson L
J Clin Child Adolesc Psychol
· 2025 Nov · PMID 41264359
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OBJECTIVE: To determine the proportion and profile of preschoolers on the autism spectrum who do not acquire spoken language despite receiving evidence-supported interventions that target spoken language. METHODS: We exa...OBJECTIVE: To determine the proportion and profile of preschoolers on the autism spectrum who do not acquire spoken language despite receiving evidence-supported interventions that target spoken language. METHODS: We examined an aggregate dataset comprising 707 preschoolers on the autism spectrum who had received evidence-supported interventions to determine the proportion and profile of those who experienced limited progress in spoken language. Interventions were delivered through programs affiliated with university research settings and ranged in duration from 6 to 24 months. Spoken language outcomes were determined from parent-report measures, which were validated against direct assessments and natural language samples. RESULTS: Approximately two-thirds of children who were non-speaking at baseline were using single words or more complex spoken language by intervention exit. Those who remained non-speaking had lower baseline motor imitation scores, derived mainly from parent reports. Approximately half of the children who were minimally speaking (i.e. had single words or no words) at baseline were combining words by intervention exit. Those who did not acquire word combinations had lower baseline scores in cognitive, social, adaptive and motor imitation measures, and shorter intervention duration. Age at intervention start influenced spoken language advancement differently depending on the initial spoken language level. The odds of acquiring spoken language did not differ based on the intervention received. CONCLUSIONS: Approximately one-third of children who had limited or no spoken language at baseline did not advance to spoken language stages following intervention. Development of spoken language was associated with modifiable factors at the child and intervention level.