Yan J, Xie M, Zhao Z
… +3 more, Cham H, El-Sheikh M, Yip T
J Clin Child Adolesc Psychol
· 2026 · PMID 40232148
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OBJECTIVE: This study used latent profile analyses to (1) identify heterogeneous patterns of sleep profiles; (2) examine how discrimination was related to sleep profiles; and (3) investigate how developmental outcomes va...OBJECTIVE: This study used latent profile analyses to (1) identify heterogeneous patterns of sleep profiles; (2) examine how discrimination was related to sleep profiles; and (3) investigate how developmental outcomes varied across sleep profiles among ethnically-racially minoritized adolescents. METHOD: Participants were 350 ethnically-racially minoritized adolescents (69% female; 22% Black-African American, 41% Asian American, and 37% Latinx; M = 14.27 years old, SD = 0.61) completed self-reported presurvey measures of everyday discrimination, ethnic-racial discrimination, and self-reported post-survey measures of depressive symptoms, somatic symptoms, self-esteem, and rumination. Objectively and subjectively measured sleep were assessed utilizing a short-term longitudinal (i.e., two-week) design, where adolescents wore a wrist actigraph and completed daily diaries for 14 consecutive days. RESULTS: Drawing on multiple objectively and subjectively measured sleep indicators, three profiles were identified: Nighttime Sleeper (76.57%), Disrupted Sleeper (14.29%), and Daytime Sleeper (9.14%). Adolescents experiencing higher levels of ethnic-racial discrimination were more likely to be characterized in the Disrupted Sleeper, relative to the Nighttime Sleeper profile. Compared with Asian and Latinx Americans, Black adolescents were more likely to be in the Daytime Sleeper, relative to the Nighttime Sleeper profile. Those in the Disrupted Sleeper profile exhibited the worst developmental outcomes. CONCLUSIONS: The findings inform clinical interventions focusing on sleep experiences, especially as they relate to protective processes for coping with discrimination. Clinical efforts (e.g., sleep education or therapy to develop routines for adaptive napping) may be beneficial to facilitating healthy sleep behaviors and mitigating sleep disturbances, which in turn, improve developmental well-being among ethnically-racially minoritized adolescents.
Tseng Y, Garfias Y, Daniels A
… +4 more, Kennedy D, Dorsey S, Blanks Jones J, Triplett NS
J Clin Child Adolesc Psychol
· 2026 · PMID 40232130
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OBJECTIVE: This study examined youth-serving community mental health clinicians' multicultural counseling knowledge and awareness and their perceived barriers and facilitators in discussing race and racism with clients....OBJECTIVE: This study examined youth-serving community mental health clinicians' multicultural counseling knowledge and awareness and their perceived barriers and facilitators in discussing race and racism with clients. Additionally, the study explored how clinicians' knowledge and awareness were related to their reports of barriers and facilitators in addressing race and racism. METHODS: The current study is a mixed-method study of 119 youth-serving community mental health clinicians across Washington State. We explore qualitative themes in clinicians' reports of perceived barriers and facilitators in broaching topics of race and racism. We also examine if reported barriers and facilitators correlate with the Multicultural Counseling Knowledge and Awareness Scale. RESULTS: Qualitative themes emerged at the client-, clinician-, organizational-, and societal-levels. Barriers included clinicians not engaging in racism-related discussions unless clients initiated them, clinicians' discomfort or lack of confidence, and clinicians' perceptions of harm or limitations because of their racial identification. Clinicians were more willing to broach topics of race or racism with older clients, with stronger perceptions of rapport, and when topics were broached earlier in therapy. There was no statistically significant correlation between the count of perceived barriers or facilitators' and clinicians' multicultural counseling knowledge and awareness. CONCLUSION: Qualitative and quantitative data highlight considerations for assessing and supporting clinicians' cultural humility. Enhancing multicultural competency and humility can help clinicians recognize their strengths and limitations, fostering a deeper understanding of clients' cultural backgrounds. Encouraging clinicians to facilitate open discussions about race and racism is a key step in this process.
Conduct disorder (CD) is a psychiatric diagnosis characterized by a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate social norms or rules are violated. This arti...Conduct disorder (CD) is a psychiatric diagnosis characterized by a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate social norms or rules are violated. This article presents information on CD with an emphasis on a new multispecifier personality model that could offer a valuable new perspective on CD by refining the way we specify CD. The multispecifier model may have the potential to clarify the considerable confusion that has occurred over past decades and improve our understanding of prevalence, etiology, course, and treatment of youth with conduct problems. In this paper, we present a new structure for CD designed to inspire new lines of research that may be needed to help the field more fully capitalize on this innovation. With additional research, it is hoped that the new multispecifier model will eventually buy clinicians additional information that cannot be gleaned from current diagnostic criteria and will help clinicians and researchers further uncover the factors that promote or protect against the development of CD. This paper delineates the areas of research that will be needed to fully realize the potential of a multispecifier model and ultimately to improve clinical care for children and adolescents with CD.
Hogan AL, Smith K, Mian ND
… +10 more, Black C, Hunt E, Knott C, Moser C, Smith J, Caravella KE, Hills K, Fairchild A, Carter AS, Roberts J
J Clin Child Adolesc Psychol
· 2026 · PMID 39993324
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OBJECTIVE: Co-occurring anxiety affects 40-80% of autistic individuals; however, little is understood about how anxiety manifests in young autistic children, especially those with intellectual disability (ID), partly due...OBJECTIVE: Co-occurring anxiety affects 40-80% of autistic individuals; however, little is understood about how anxiety manifests in young autistic children, especially those with intellectual disability (ID), partly due to the paucity of measures designed to assess anxiety symptoms in this population. The present study examined the utility of the Modified Anxiety Dimensional Observation Scale (M-Anx-DOS), an observational measure of anxiety-related behaviors, in preschool-aged autistic children with and without ID. METHOD: This study included 48 autistic children (Mean age = 43.96 months; 81.3% with ID) and 30 non-autistic (NA) controls (Mean age = 43.66 months). Anxiety-related behaviors were measured during the M-Anx-DOS. Parent-reported anxiety symptoms were assessed via the Preschool Anxiety Scale-Revised (PAS-R). RESULTS: Groups exhibited comparable scores on both the M-Anx-DOS and PAS-R. Within the autism group, a subset of M-Anx-DOS scores were related to age, autistic features, or IQ. The M-Anx-DOS exhibited excellent inter-rater reliability and acceptable internal consistency. Convergent validity was promising, with specific M-Anx-DOS scores correlated with parent-reported social, separation, and overall anxiety symptoms. M-Anx-DOS scores were not correlated with parent-reported ADHD or externalizing symptoms, suggesting strong discriminant validity. CONCLUSIONS: This study provides preliminary evidence of the reliability and validity of the M-Anx-DOS. These findings are promising given the importance of observational measurement of anxiety and lack of existing measures for this critical developmental period. Given the sample size and the complexity of identifying prodromal signs of anxiety in young autistic preschoolers with ID, future longitudinal work is essential to replicate and extend this work.
Meisel S, Porter N, Bobek M
… +2 more, Henderson CE, Hogue A
J Clin Child Adolesc Psychol
· 2026 · PMID 39882820
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OBJECTIVE: Changing Academic Support in the Home for Adolescents with ADHD (CASH-AA) and Medication Integration Protocol (MIP) are two family-based behavioral protocols designed to promote family solutions to academic pr...OBJECTIVE: Changing Academic Support in the Home for Adolescents with ADHD (CASH-AA) and Medication Integration Protocol (MIP) are two family-based behavioral protocols designed to promote family solutions to academic problems and medication decision-making. Building on a randomized control trial examining these protocols, the current study examined how protocol dose, an indicator of treatment adherence, was associated with treatment outcomes. METHOD: The sample consisted of 145 adolescent clients (M age = 14.8, 72% male, 42% White, 37% Hispanic, 15% Black) and 49 community and hospital-based therapists (82% female, 63% White, 29% Hispanic). Latent growth curve models examined how therapist reports of minutes adolescents and their caregivers received CASH-AA and MIP predicted levels and change in inattentive and hyperactive symptoms (MINI-International Neuropsychiatric Interview); co-occurring symptoms (Youth Self Report/Child Behavior Checklist); homework problems (Homework Problems Checklist); and medication compliance at baseline, 3, 6, and 12-month follow-ups. RESULTS: MIP minutes were prospectively associated with lower caregiver-reported inattentive and hyperactive symptoms, adolescent- and caregiver-reported externalizing symptoms and caregiver-reported homework problems at the 12-month follow-up (ẞ range = -.16 to -.39, < .05), as well as faster decline in caregiver-reported inattentive symptoms (ẞ = -.29, < .001). CASH-AA minutes were associated with greater caregiver-reported inattentive symptoms (ẞ = .11, = .049) at 12-month follow-up and slower declines in homework problems (ẞ = -.39, < .001). Neither MIP nor CASH-AA minutes were associated with internalizing symptoms or medication use. CONCLUSIONS: Findings further support MIP as an effective behavioral protocol for adolescent ADHD and indicate the need for increasing MIP implementation efforts in community settings.
OBJECTIVE: Youth disruptive behavior disorders (DBDs) have a male preponderance, but the extent to which gender biases in clinical assessment influence this imbalance remains unclear. The present study investigates wheth...OBJECTIVE: Youth disruptive behavior disorders (DBDs) have a male preponderance, but the extent to which gender biases in clinical assessment influence this imbalance remains unclear. The present study investigates whether a child patient's gender affects clinicians' diagnostic decision-making regarding Oppositional Defiant Disorder (ODD), Conduct Dissocial Disorder (CDD), and Intermittent Explosive Disorder (IED). METHOD: Clinicians ( = 403; 57.1% male; = 48.96 years, = 11.09) participated in a global ICD-11 field study. Following an experimental design, participants were asked to use ICD-10 or ICD-11 diagnostic guidelines to evaluate two clinical case vignettes, randomly manipulating the patients' gender (boy, girl) and symptom presentation (ODD-Defiant, ODD-Irritable, CDD, IED). Analyses tested whether clinicians' diagnostic accuracy and perceptions of impairment and severity were affected by the patient's gender. RESULTS: Overall, clinicians identified the correct diagnosis 64.7% of the time. Patient gender was not associated with clinicians' diagnostic accuracy (= .090-.895, |φs| = 0.01-0.18) or severity or impairment ratings (s = .079-.404, |s| = 0.04-0.19). This pattern of nonsignificant differences and negligible/small effect sizes was consistent across all clinical presentations and analyses. CONCLUSIONS: We found no evidence of an association between patient gender, diagnostic accuracy, or perceived severity or impairment when assessing youth DBDs in the present study. Results suggest that diagnostic judgments may be driven by clinical presentation rather than gender and that the male DBD preponderance may not be due to gender diagnostic biases. Further research is needed to replicate these findings among youths in clinical settings, with diverse gender identities, and with other mental health conditions.
OBJECTIVE: To examine differences in parenting factors among caregivers with children with and without externalizing behavior problems (EBP) in a community homeless shelter sample versus a stable housing sample. METHOD:...OBJECTIVE: To examine differences in parenting factors among caregivers with children with and without externalizing behavior problems (EBP) in a community homeless shelter sample versus a stable housing sample. METHOD: Nine hundred and fourteen children (ages = 2.01-7.49 years, SD = 1.45 years, 40.8% female, 54.3% Black, 46.7% Hispanic) were recruited from a service-driven research project in a shelter setting ( = 638) and a longitudinal/clinical study ( = 276). Primary caregivers (97% mothers) completed a parenting stress questionnaire and an observational measure of parent-child interactions. RESULTS: Logistic regression indicated that children who were Black and/or of Hispanic background were less likely to be identified as having elevated EBP but only in the homeless shelter sample. Multivariate analyses indicated that the homeless shelter-EBP group reported the highest levels of overall stress compared to the homeless shelter-typically developing (TD), stable housing-EBP and stable housing-TD groups. Mothers from the homeless shelter-EBP group exhibited a higher proportion of negative verbalizations relative to caregivers from all other groups while mothers from the homeless shelter-TD group exhibited a higher proportion of positive verbalizations relative to the caregivers from the homeless shelter-EBP group and the stable housing TD group. Both homeless shelter groups engaged in less total verbalizations relative to both stable housing samples, with the stable housing-EBP group exhibiting the most verbalizations. CONCLUSIONS: High levels of parenting stress and negative parent-child interactions within a homeless shelter sample are exacerbated by having a child with EBP. Embedding universal parenting programs in a homeless shelter setting to reduce parenting stress would be valuable to address health disparities in this vulnerable population.
J Clin Child Adolesc Psychol
· 2026 · PMID 39576141
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OBJECTIVE: Research to date has produced compelling evidence of the potentially traumatic consequences of racial discrimination among Black adolescents and adults. Seldom explored, however, is how the potentially traumat...OBJECTIVE: Research to date has produced compelling evidence of the potentially traumatic consequences of racial discrimination among Black adolescents and adults. Seldom explored, however, is how the potentially traumatic effects of racial discrimination may be shared across the family context. To clarify the relevance of racial trauma across the family system, the current study examined the relationship between racial discrimination and trauma symptoms among a sample of Black adolescent-caregiver dyads. METHOD: Data were drawn from a larger self-report survey study examining Black family life experiences. For this study, data from 202 Black adolescents (Mage = 14.50, 52% female) and their caregiver (Mage = 41.63, 83% female) were used to test actor-partner interdependence models examining the associations of racial discrimination and trauma symptoms. RESULTS: Significant actor effects revealed that racial discrimination was positively associated with self-reported trauma symptoms among adolescents and caregivers. Additionally, partner effects were found, such that adolescent and caregiver experiences of discrimination were positively associated with the trauma symptoms of their family member. Analyses also revealed that the association between racial discrimination and trauma symptoms among caregivers was dependent upon youth experiences of racial discrimination. CONCLUSION: The current study lends credence to theories linking racism and trauma-related symptomatology across the life course and family system. Collectively, study findings highlight the importance of understanding the effects of racism beyond the individual and underscores the value and need for family tailored interventions that can repudiate the shared impact and potential intergenerational effects of racial discrimination across Black families.
Scheve B, Xiang Z, Lam B
… +2 more, Sadeh N, Baskin-Sommers A
J Clin Child Adolesc Psychol
· 2026 · PMID 39570768
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OBJECTIVE: Impulsivity has been recognized as an important factor in suicidal thoughts and behaviors (STBs). However, previous research linking impulsivity to STBs has largely relied on cross-sectional designs, considere...OBJECTIVE: Impulsivity has been recognized as an important factor in suicidal thoughts and behaviors (STBs). However, previous research linking impulsivity to STBs has largely relied on cross-sectional designs, considered only a subset of impulsivity measures, and typically focused on middle-to-older adolescents. Here, we explored multiple measures of impulsivity and assessed their predictive relation to suicidal ideation and suicide attempts. METHOD: In a sample of 10,286 adolescents (ages 9-12; 47.4% female, 76.4% White, 19.4% Black, 6.4% Asian, 3.5% American Indian/Alaskan Native, 0.6% Native Hawaiian/Pacific Islander, 6.4% Other, 19.4% Hispanic, 12.1% Mixed/Multiple Race) from the Adolescent Brain Cognitive Development℠ Study (ABCD Study®), we assessed impulsivity when youth were 9-10 years old, and suicidal ideation and attempts when youth were 11-12 years old. We measured impulsivity in three ways: a trait-like measure (UPPS-P Impulsive Behavior Scale), a behavioral measure (delay discounting task), and a neural measure (Cortical Delay Discounting [C-DD]). Suicidal ideation and attempts were assessed using the Kiddie Schedule for Affective Disorder and Schizophrenia (KSADS) suicide module. RESULTS: Negative urgency and lack of perseverance (at ages 9-10) significantly predicted a higher likelihood of suicidal ideation (: Odds Ratio [OR] = 1.254, < .001; : OR = 1.152, = .035) and suicide attempts (: OR = 1.328, = .009; : OR = 1.270, = .009) when youth were 11-12 years old. CONCLUSIONS: Negative urgency and lack of perseverance are robust predictors of future suicidal ideation and suicide attempts in young adolescents. These findings highlight the importance of assessing for and targeting these dimensions of impulsivity in clinical settings.
OBJECTIVE: The purpose of this systematic review and meta-analysis is to provide an updated examination of the adolescent Dialectical Behavioral Therapy (DBT) literature and synthesize study findings across treatment set...OBJECTIVE: The purpose of this systematic review and meta-analysis is to provide an updated examination of the adolescent Dialectical Behavioral Therapy (DBT) literature and synthesize study findings across treatment settings (e.g. inpatient, outpatient, school), and treatment levels (e.g. clinical intervention, targeted, universal prevention). We also provide meta-analytic findings of the impact of DBT across key problem behaviors: depression, emotion dysregulation, suicidal and self-harm behaviors, externalizing problems, and eating disorders. METHOD: A reference database search was used to identify studies conducted on adolescent DBT interventions from 2000 through 2023 ( = 72). In addition to ensuring that the review process conformed to the PRISMA statement, we independently verified that each study met inclusion criteria before triple coding each article to examine variables of interest and extracted outcome data needed to conduct meta-analyses. RESULTS: DBT appears to demonstrate effectiveness in improving mental health outcomes in adolescents across a range of psychiatric problems. To meet these treatment needs, DBT interventions have been appropriately adapted based on care setting, suggesting empirical support in inpatient, residential, partial hospitalization, and intensive outpatient programs, as well as in outpatient settings, juvenile correctional facilities, and schools. CONCLUSIONS: The growing evidence base for adolescent DBT appears to reflect its promise and versatile clinical utility. Clinical implications and recommendations for future directions are discussed, including the need for more randomized controls and representation of diverse communities.
Woodard GS, Lane E, Ehrenreich-May J
… +2 more, Ginsburg GS, Jensen-Doss A
J Clin Child Adolesc Psychol
· 2025 · PMID 39531621
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OBJECTIVE: Regularly administering outcome measures, measurement-based care (MBC), informs clinical decision-making and improves youth mental health. Understanding predictors of high-fidelity MBC delivery helps ensure al...OBJECTIVE: Regularly administering outcome measures, measurement-based care (MBC), informs clinical decision-making and improves youth mental health. Understanding predictors of high-fidelity MBC delivery helps ensure all youth can benefit from this evidence-based practice. Research on client and clinician predictors of MBC fidelity has mixed findings. METHOD: Participants included 53 clinicians and 115 adolescents from a randomized controlled effectiveness trial with MBC only and MBC + Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders in Adolescents (UPA) conditions. Clients and clinicians reported demographic information. Clinicians completed broad- and narrow-band attitude measures. MBC fidelity was operationalized using the implementation index, combining rates of administering and viewing questionnaires, using objective MBC data. RESULTS AND DISCUSSION: The average MBC fidelity was 56.75% ( = 30.36) and was significantly higher in the MBC only condition ( = 67.46%, = 27.63%) than in MBC + UPA condition ( = 46.58%, = 29.52%; = .012). Clients identifying as White received significantly higher MBC fidelity than youth not identifying as White. Youth ethnicity, family income, age, severity, and number of sessions did not significantly predict MBC fidelity. Clinicians with less experience at their agency, less confidence, and who found manualized treatments less appealing, had significantly MBC fidelity than other clinicians. These results can inform future efforts to increase fidelity and in MBC delivery.
OBJECTIVE: This evidence-based update (EBU) builds on three previous reviews (1998, 2008, 2017) sponsored by the Society of Clinical Child and Adolescent Psychology with the aim of evaluating the empirical support for ps...OBJECTIVE: This evidence-based update (EBU) builds on three previous reviews (1998, 2008, 2017) sponsored by the Society of Clinical Child and Adolescent Psychology with the aim of evaluating the empirical support for psychosocial interventions for depression in youth. METHOD: In the current review period (2014-2022), 25 randomized controlled trials (RCT) were identified: four in children and 21 in adolescents. Descriptive effect sizes and number-needed-to-treat (NNT) ratios were calculated for primary outcomes. Results were integrated with prior reviews, and cumulative evidence used to classify treatments as well-established, probably efficacious, possibly efficacious, or experimental. Published secondary analyses of predictors, moderators, and mediators were examined. RESULTS: For adolescents, cognitive behavioral therapy (CBT), interpersonal psychotherapy (IPT-A), CBT in combination with antidepressant medication, and collaborative care programs were all classified as well-established. The evidence was considerably weaker for children, with no treatments achieving well-established or probably efficacious status. New developments include greater exploration of parent- and family-mediated treatment models and increasing evidence on technology-assisted interventions. Data on predictors, moderators, and mediators continued to be focused on adolescent depression samples and drawn from a limited number of RCT datasets. CONCLUSION: Since the prior EBU, there has been incremental progress in youth depression treatment research. There is an urgent need to: (a) develop innovative approaches to substantially improve on the modest effects seen in most RCTs, (b) expand the evidence base for children and other underserved groups, (c) craft evidence-based guidelines for choosing between interventions when multiple efficacious treatments do exist, and (d) address issues of treatment effectiveness and scalability to ameliorate the wide prevalence and high impact of depression in youth.
J Clin Child Adolesc Psychol
· 2025 · PMID 39422693
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OBJECTIVE: Current models of depression risk in children include both family history and cognitive models of risk; however, these models are rarely integrated. This study aimed to address this gap by examining how cognit...OBJECTIVE: Current models of depression risk in children include both family history and cognitive models of risk; however, these models are rarely integrated. This study aimed to address this gap by examining how cognitive vulnerabilities featured in the hopelessness theory of depression - negative inferential styles for the causes, consequences, and self-characteristic implications of negative events - may increase risk for the intergenerational transmission of depression. Specifically, we examined whether children of mothers with a history of major depressive disorder (MDD), compared to children of never-depressed mothers, exhibit more negative inferential styles and whether maternal history of MDD moderates prospective relations between children's inferential styles and depressive symptoms. METHOD: Participants were 251 children (ages 8-14 at baseline; 51% girls; 81% Non-Hispanic White) of mothers with ( = 129) or without ( = 122) a history of MDD. Children's inferential styles and depressive symptoms were assessed at baseline and then every 6 months for 2 years. RESULTS: Using random intercept cross-lagged panel models (RI-CLPMs), we found that children of mothers with a history of MDD, compared to children of never-depressed mothers, had more negative inferential styles for the causes and consequences of negative events, but not for self-characteristics, and higher depressive symptom levels, across the follow-up. In addition, there were reciprocal, transactional relations between children's inferential styles for causes and their depressive symptoms across the follow-up, with no evidence for moderation by maternal MDD. CONCLUSIONS: Children's inferential styles for the causes of negative events may be a useful marker of risk for the intergenerational transmission of depression, which could be targeted to reduce risk for depression.