J Clin Child Adolesc Psychol [JOURNAL]
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200 papers
Leaders in the History of Clinical Child and Adolescent Psychology Past Presidents Series: Erwin Friedman (1972-1973).
Leffler JM
J Clin Child Adolesc Psychol · 2024 · PMID 39110858 · Publisher ↗
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Shared Decision-Making with Latinx Caregivers During Community Implemented Evidence-Based Practices: Determinants and Associations with Alliance.
Wright B, Brookman-Frazee L, McLeod BD … +5 more , Flores A, Alegría M, Langer DA, Chavira D, Lau AS
J Clin Child Adolesc Psychol · 2025 · PMID 39058624 · Full text
OBJECTIVE: The current observational study examined shared decision-making (SDM) with caregivers of Latinx youth within the delivery of multiple evidence-based practices (EBPs) in community mental health services. The ai...
OBJECTIVE: The current observational study examined shared decision-making (SDM) with caregivers of Latinx youth within the delivery of multiple evidence-based practices (EBPs) in community mental health services. The aims of the study were to (1) Identify therapist and client factors associated with increased SDM within EBP sessions and (2) Examine the association between SDM and therapeutic alliance between community therapists and Latinx caregivers. METHOD: The Observing Patient Involvement in Decision-Making (OPTION) instrument measured SDM in 210 audio-recorded therapy sessions with 62 community therapists (91.94% female; 69.35% Latinx) and 109 Latinx caregivers (91.43% female) of youth who were an average age of 8.26 years (SD = 3.59). We used the Therapy Process Observational Coding System for Child Psychotherapy-Alliance scale to measure the caregiver-therapist alliance observationally. Multilevel linear regressions were conducted to examine research questions. RESULTS: Greater SDM was observed within sessions where therapists targeted conduct problems versus trauma (B = -8.79, 95% CI[-14.09, -3.49], = .001). There was a trend that SDM was higher in English-language sessions compared to Spanish. We found that the global measurement of SDM (B = .04, 95% CI[.01, .08], = .03) and the OPTION item Integrate Preferences (B = .69, 95% CI[.07, 1.32], = .03) were positively associated with alliance. CONCLUSIONS: SDM may help foster Latinx caregiver engagement within EBP delivery. Provider training in SDM may be warranted with consideration of the specific clinical contexts (e.g., by presenting problem) that are appropriate for collaborative treatment planning. More research is needed to further establish the benefits of SDM in youth psychotherapy.
A Comparison of Telehealth and In-Person Therapy for Youth Anxiety Disorders.
Rabner J, Norris LA, Olino TM … +1 more , Kendall PC
J Clin Child Adolesc Psychol · 2025 · PMID 38995683 · Full text
OBJECTIVE: At the onset of the COVID-19 pandemic, telehealth service use increased. However, little research has compared the efficacy of individual cognitive behavioral therapy (CBT) for youth with anxiety administered...
OBJECTIVE: At the onset of the COVID-19 pandemic, telehealth service use increased. However, little research has compared the efficacy of individual cognitive behavioral therapy (CBT) for youth with anxiety administered via (a) telehealth and (b) in-person. The present study used non-inferiority analyses to examine outcomes for youth with anxiety disorders (diagnosed by an Independent Evaluator; IE) treated via telehealth during the COVID-19 pandemic and youth treated via in-person therapy prior to the COVID-19 pandemic. METHOD: Participants ( = 92; M = 11.5 years; 60.1% female; 75.0% White) were 46 youth who completed telehealth treatment and 46 youth who completed services in-person, matched on age and principal anxiety diagnosis. One-sided t-tests for non-inferiority were first estimated. Next, ANOVAs and regression models were performed, examining treatment differences and candidate moderators (e.g. social anxiety disorder, comorbid attention problems). RESULTS: Results support non-inferiority across multiple indices of outcomes (i.e. self- and caregiver-reported anxiety symptoms, IE-rated functional impairment, and IE-rated treatment response). Analyses indicate that both treatments were effective in reducing anxiety symptoms and functional impairment. Caregivers reported higher post-treatment levels of anxiety for youth treated via telehealth than youth treated in person. No variables moderated the differences in outcomes between treatment modalities. CONCLUSIONS: Findings support that CBT administered via telehealth is similarly efficacious as CBT administered in-person for youth with anxiety. Implications regarding the availability and accessibility of evidence-based treatment for youth with anxiety are discussed.
Understanding Signs and Sources of Anxiety in Urban Elementary Schools Serving Predominately Ethnically/Racially Minoritized Children.
Conroy K, Urcuyo AE, Schiavone E … +4 more , Obee A, Frazier SL, Cramer E, Comer JS
J Clin Child Adolesc Psychol · 2025 · PMID 38949878 · Publisher ↗
OBJECTIVE: This mixed-methods study examined teachers' perceptions of student anxiety in urban elementary schools serving predominantly low-income and ethnically/racially minoritized youth. METHOD: Most participating tea...
OBJECTIVE: This mixed-methods study examined teachers' perceptions of student anxiety in urban elementary schools serving predominantly low-income and ethnically/racially minoritized youth. METHOD: Most participating teachers were female (87.7%) and from minoritized backgrounds themselves (89.2%), teaching in schools serving predominantly Black/African American (40%) or Hispanic (60%) students, and in which > 70% of students are eligible for free meals. Teachers were asked in surveys ( = 82) and interviews ( = 12) about the nature of student anxiety, and cultural/contextual considerations that influence anxiety. RESULTS: Overall, teachers reported prevalence and signs of student anxiety that were consistent with the literature, but they reported higher levels of impairment than in previous community samples. Regressions revealed that greater levels of student exposure to community violence and higher proportions of Black students were associated with higher teacher-perceived prevalence and concern about student anxiety, respectively. Moreover, greater emotional exhaustion in teachers was associated with higher reports of anxiety-related impairment in students. Thematic coding of interviews emphasized how teachers perceived 1) most student anxieties to be proportional responses to realistic threats and stress in students' lives (e.g. resource insecurity), 2) systems-level problems (e.g. pressure to perform on standardized tests) contribute to student anxiety, and 3) school-based anxiety sources often interact with traumas and stressors students experience outside of school (e.g. immigration experiences). CONCLUSIONS: Relative to the predominant literature that has focused on biological, cognitive, and other intraindividual factors as sources of anxiety, the present work underscores the importance of considering how broader economic and systems-level influences exacerbate anxiety in marginalized youth.
ADHD Prevalence Rose, Yet Disparities Remain: Commentary on the 2022 National Survey of Children's Health.
Chronis-Tuscano A, Bounoua N
J Clin Child Adolesc Psychol · 2024 · PMID 38905157 · Full text
This is a commentary on Danielson and colleagues' report entitled which provides updated prevalence rates related to ADHD diagnosis and treatment utilization using data from the 2022 National Survey of Children's Health...
This is a commentary on Danielson and colleagues' report entitled which provides updated prevalence rates related to ADHD diagnosis and treatment utilization using data from the 2022 National Survey of Children's Health (NSCH). This timely article is among the first to report on ADHD prevalence rates since the COVID-19 pandemic, and highlights important patterns related to ADHD diagnosis and treatment utilization. In this commentary, we contextualize these findings with consideration to the COVID-19 pandemic and within the existing literature on health disparities among youth with ADHD and their families. We end with recommendations for future work involving researchers, clinicians, and policymakers with the intention of reducing disparities in ADHD diagnosis and treatment in the U.S.
Cognitive Disengagement Syndrome in Young Autistic Children, Children with ADHD, and Autistic Children with ADHD.
Carpenter KLH, Davis NO, Spanos M … +7 more , Sabatos-DeVito M, Aiello R, Compton SN, Franz L, Schechter JC, Summers J, Dawson G
J Clin Child Adolesc Psychol · 2026 · PMID 38900723 · Full text
OBJECTIVE: Cognitive Disengagement Syndrome (CDS; previously called Sluggish Cognitive Tempo) refers to a constellation of cognitive and motor behaviors characterized by a predisposition toward mind wandering (cognitive...
OBJECTIVE: Cognitive Disengagement Syndrome (CDS; previously called Sluggish Cognitive Tempo) refers to a constellation of cognitive and motor behaviors characterized by a predisposition toward mind wandering (cognitive subdomain) and slowed motor behavior (hypoactive). While there are a number of studies linking CDS traits to greater global impairment in children with attention-deficit/hyperactivity disorder (ADHD) and autistic children, there are few studies examining the prevalence and impact of CDS traits in autistic children with co-occurring ADHD (Autistic+ADHD). The current study explored CDS traits in autistic children with and without co-occurring ADHD, children with ADHD, and neurotypical children. METHODS: Participants were 196 children between 3- and 7-years-of-age comprising four groups: Neurotypical ( = 44), ADHD ( = 51), Autistic ( = 55), and Autistic+ADHD ( = 46). CDS traits, social and communication skills, repetitive behaviors, and sensory processing were all assessed via parent report. RESULTS: Children diagnosed with ADHD, autistic children, and Autistic+ADHD children exhibited similar levels of overall CDS traits. However, when explored separately, Autistic+ADHD children had higher cognitive CDS trait scores compared to children with ADHD alone. Both overall CDS traits and the cognitive subdomain were associated with greater social difficulties, particularly social withdrawal, higher levels of repetitive behaviors, and more sensory sensitivities, regardless of diagnosis. CONCLUSIONS: Findings suggest that CDS traits may be an additional factor directly impact functional outcomes in both autistic and ADHD children. As such, clinicians should be assessing CDS traits in addition to other clinical domains associated with ADHD and autism when developing intervention plans for young neurodiverse children.
Adolescent Developmental Pathways Among Depression, Conduct Problems, and Rejection: Integrative Data Analysis Across Three Samples.
McClaine RN, Connell AM, Magee KE … +5 more , Ha T, Westling E, Brown-Iannuzzi J, Stormshak E, Shaw DS
J Clin Child Adolesc Psychol · 2025 · PMID 38869881 · Full text
OBJECTIVE: The current study investigated sex differences in longitudinal associations among youth depression, conduct problems, and peer rejection from ages 11 to 16. We hypothesized that girls would follow the irritabl...
OBJECTIVE: The current study investigated sex differences in longitudinal associations among youth depression, conduct problems, and peer rejection from ages 11 to 16. We hypothesized that girls would follow the irritable depression model, which posits that depression leads to conduct problems, and that peer rejection would mediate this relationship. We hypothesized that boys would follow the cumulative failure model, which suggests that conduct problems predict future depression, mediated by peer rejection. METHOD: We used integrative data analysis to combine three datasets, creating an aggregate sample of 2,322 adolescents, 58.4% of an ethnic minority group, and 51.3% boys. Using random-intercept cross-lagged panel modeling with data from ages 11-16, we conducted a nested model comparison. RESULTS: Results indicated that a model which allowed paths to differ by sex demonstrated better model fit than a constrained model. While depression, conduct problems, and peer rejection were relatively stable over time and had correlated random intercepts, there were few crossover paths between these domains for either sex. When the strengths of individual crossover pathways were compared based on sex, only the path from conduct problems at age 13 to depression at age 14 was significantly different, with this path being stronger for girls. CONCLUSIONS: These results suggest that stable, between-person effects largely drive relationships between depression, conduct problems, and peer rejection during adolescence, whereas there are few transactional, within-person pathways between these domains. This pattern of findings demonstrates the utility of random intercept cross-lagged panel modeling for disentangling between- and within-person effects.
Future Directions for Community-Engaged Research in Clinical Psychological Science with Youth.
Giusto A, Triplett NS, Foster JC … +1 more , Gee DG
J Clin Child Adolesc Psychol · 2024 · PMID 38830059 · Full text
Despite advances in clinical science, the burden of mental health problems among youth is not improving. To tackle this burden, clinical science with youth needs methods that include youth and family perspectives on cont...
Despite advances in clinical science, the burden of mental health problems among youth is not improving. To tackle this burden, clinical science with youth needs methods that include youth and family perspectives on context and public health. In this paper, we illustrate how community-engaged research (CEnR) methods center these perspectives. Although CEnR methods are well-established in other disciplines (e.g. social work, community psychology), they are underutilized in clinical science with youth. This is due in part to misperceptions of CEnR as resource-intensive, overly contextualized, incompatible with experimentally controlled modes of inquiry, or irrelevant to understanding youth mental health. By contrast, CEnR methods can provide real-world impact, contextualized clinical solutions, and sustainable outcomes. A key advantage of CEnR strategies is their flexibility-they fall across a continuum that centers community engagement as a core principle, and thus can be infused in a variety of research efforts, even those that center experimental control (e.g. randomized controlled trials). This paper provides a brief overview of this continuum of strategies and its application to youth-focused clinical science. We then discuss future directions of CEnR in clinical science with youth, as well as structural changes needed to advance this work. The goals of this paper are to help demystify CEnR and encourage clinical scientists to consider adopting methods that better consider context and intentionally engage the communities that our work seeks to serve.
-Factor(s) for Youth Psychopathology Across Informants and Models in 24 Societies.
Achenbach TM, Ivanova MY, Turner LV … +26 more , Ritz H, Almqvist F, Bilenberg N, Bird H, Chahed M, Döpfner M, Erol N, Hannesdottir H, Kanbayashi Y, Lambert MC, Leung PWL, Liu J, Minaei A, Novik TS, Oh KJ, Petot D, Petot JM, Pomalima R, Raine A, Sawyer M, Simsek Z, Steinhausen HC, van der Ende J, Wolanczyk T, Zukauskiene R, Verhulst FC
J Clin Child Adolesc Psychol · 2025 · PMID 38805627 · Publisher ↗
OBJECTIVE: Although the significance of the general factor of psychopathology ( is being increasingly recognized, it remains unclear how to best operationalize and measure . To test variations in the operationalizations...
OBJECTIVE: Although the significance of the general factor of psychopathology ( is being increasingly recognized, it remains unclear how to best operationalize and measure . To test variations in the operationalizations of and make practical recommendations for its assessment, we compared -factor scores derived from four models. METHODS: We compared scores derived from principal axis (Model 1), hierarchical factor (Model 2), and bifactor (Model 3) analyses, plus a Total Problem score (sum of unit-weighted ratings of all problem items; Model 4) for parent- and self-rated youth psychopathology from 24 societies. Separately for each sample, we fitted the models to parent-ratings on the Child Behavior Checklist for Ages 6-18 (CBCL/6-18) and self-ratings on the Youth Self-Report (YSR) for 25,643 11-18-year-olds. Separately for each sample, we computed correlations between scores obtained for each pair of models, cross-informant correlations between -scores for each model, and -correlations between mean item x -score correlations for each pair of models. RESULTS: Results were similar for all models, as indicated by correlations of .973-.994 between -scores for Models 1-4, plus similar cross-informant correlations between CBCL/6-18 and YSR Model 1-4 -scores. Item x correlations had similar rank orders between Models 1-4, as indicated by correlations of .957-.993. CONCLUSIONS: The similar results obtained for Models 1-4 argue for using the simplest model - the unit-weighted Total Problem score - to measure for clinical and research assessment of youth psychopathology. Practical methods for measuring may advance the field toward transdiagnostic patterns of problems.
ADHD Prevalence Among U.S. Children and Adolescents in 2022: Diagnosis, Severity, Co-Occurring Disorders, and Treatment.
Danielson ML, Claussen AH, Bitsko RH … +5 more , Katz SM, Newsome K, Blumberg SJ, Kogan MD, Ghandour R
J Clin Child Adolesc Psychol · 2024 · PMID 38778436 · Full text
OBJECTIVE: To provide updated national prevalence estimates of diagnosed attention-deficit/hyperactivity disorder (ADHD), ADHD severity, co-occurring disorders, and receipt of ADHD medication and behavioral treatment amo...
OBJECTIVE: To provide updated national prevalence estimates of diagnosed attention-deficit/hyperactivity disorder (ADHD), ADHD severity, co-occurring disorders, and receipt of ADHD medication and behavioral treatment among U.S. children and adolescents by demographic and clinical subgroups using data from the 2022 National Survey of Children's Health (NSCH). METHOD: This study used 2022 NSCH data to estimate the prevalence of ever diagnosed and current ADHD among U.S. children aged 3-17 years. Among children with current ADHD, ADHD severity, presence of current co-occurring disorders, and receipt of medication and behavioral treatment were estimated. Weighted estimates were calculated overall and for demographic and clinical subgroups ( = 45,169). RESULTS: Approximately 1 in 9 U.S. children have ever received an ADHD diagnosis (11.4%, 7.1 million children) and 10.5% (6.5 million) had current ADHD. Among children with current ADHD, 58.1% had moderate or severe ADHD, 77.9% had at least one co-occurring disorder, approximately half of children with current ADHD (53.6%) received ADHD medication, and 44.4% had received behavioral treatment for ADHD in the past year; nearly one third (30.1%) did not receive any ADHD-specific treatment. CONCLUSIONS: Pediatric ADHD remains an ongoing and expanding public health concern, as approximately 1 million more children had ever received an ADHD diagnosis in 2022 than in 2016. Estimates from the 2022 NSCH provide information on pediatric ADHD during the last full year of the COVID-19 pandemic and can be used by policymakers, government agencies, health care systems, public health practitioners, and other partners to plan for needs of children with ADHD.
A Qualitative Exploration on Risk and Protective Factors of Substance Use Among Black Adolescent Girls.
Opara I, Brooks-Stephens JR, Aneni K … +3 more , Asabor EN, Weerakoon SM, Duran-Becerra B
J Clin Child Adolesc Psychol · 2026 · PMID 38748661 · Full text
OBJECTIVE: While Black adolescent girls use drugs at much lower rates than White and Hispanic girls, Black adolescent girls often have worse health outcomes due to drug use. This study seeks to highlight the voices of Bl...
OBJECTIVE: While Black adolescent girls use drugs at much lower rates than White and Hispanic girls, Black adolescent girls often have worse health outcomes due to drug use. This study seeks to highlight the voices of Black adolescent girls in order to understand their unique risk factors for substance use and misuse. METHODS: Utilizing the intersectionality and ecological systems theoretical frameworks, the research team conducted twelve focus groups among a sample of Black adolescent girls ( = 62) between the ages of 13-18 ( = 15.6 years = 1.50). RESULTS: Thematic analysis was conducted to analyze the participant narratives. Four main themes arose: 1) stereotypes of Black adolescent girls; 2) the role of the physical and social environment (feeling unsafe in neighborhoods where they reside); 3) using drugs as a coping mechanism; 4) input on prevention programming for girls with a sub-theme involving family as a protective factor. DISCUSSION: Study findings deepen our qualitative understanding of risk and protective factors for substance use among Black adolescent girls. These findings provide insight on girls' lived experiences for researchers and intervention development to create and implement substance abuse prevention programs that are race- and gender-specific for Black adolescent girls.
Prospective Relations between Life Stress, Emotional Clarity, and Suicidal Ideation in an Adolescent Clinical Sample.
López R, Turnamian MR, Liu RT
J Clin Child Adolesc Psychol · 2024 · PMID 38690948 · Full text
OBJECTIVE: Although life stress has been linked to adolescent suicidal ideation, most past research has been cross-sectional, and potential processes characterizing this relation remain unclear. One possibility may be a...
OBJECTIVE: Although life stress has been linked to adolescent suicidal ideation, most past research has been cross-sectional, and potential processes characterizing this relation remain unclear. One possibility may be a lack of emotional clarity. Informed by stress generation, the current study examined prospective relations between episodic life stress, lack of emotional clarity, and suicidal ideation in an adolescent clinical sample. METHODS: The sample consisted of 180 youths ( = 14.89; = 1.35; 71.7% female; 78.9% White; 43.0% sexual minority) recruited from a psychiatric inpatient facility. Suicidal ideation severity was assessed at baseline and 18-month follow-up. Lack of emotional clarity and life stress were assessed at baseline, as well as 6-, and 12-month follow-ups. Two random-intercepts cross-lagged panel models were created to estimate within-person relations for variables of interest. RESULTS: At the within-person level, lack of emotional clarity at baseline predicted greater 6-month impact of interpersonal dependent stressors (b = 0.29, = .012, 95% CI [0.07, 0.52]), which subsequently predicted a greater 12-month lack of emotional clarity (b = 0.41, = .005, 95% CI [0.12, 0.70]). Next, a 12-month lack of emotional clarity but not interpersonal dependent stress, predicted greater 18-month suicidal ideation (b = 0.81, = .006, 95% CI [0.23, 1.30]; = .24, < .001). No significant relations were found for the lack of emotional clarity and independent stress. CONCLUSIONS: Results support the stress generation hypothesis and suggest that future research should be conducted evaluating whether bolstering youth's understanding of their emotional experiences may reduce subsequent suicidal ideation.
Follow-up and Mediation Outcomes of a Movement-Based Mental Health Promotion Intervention for Refugee Children in Uganda.
Jordans MJD, Koppenol-Gonzalez GV, Bleile ACE … +3 more , Orech B, Brian A, Verreault K
J Clin Child Adolesc Psychol · 2025 · PMID 38662956 · Publisher ↗
OBJECTIVE: There is limited evidence for the effectiveness of mental health promotion interventions in low- and middle-income settings, especially for longer-term benefits. This study evaluates the 5-month follow-up outc...
OBJECTIVE: There is limited evidence for the effectiveness of mental health promotion interventions in low- and middle-income settings, especially for longer-term benefits. This study evaluates the 5-month follow-up outcomes of a movement-based mental health promotion intervention for refugee children in Northern Uganda (West Nile) and further investigates what explains longer-term benefits. METHODS: This quasi-experimental study was conducted in four primary schools, randomly allocated to an experimental or a control condition. Enrolled in the study were 549 children ages 10-15 years ( = 265 = 284 control group). Primary outcomes were psychosocial well-being (Stirling Children's Wellbeing Scale), attitude toward school, and satisfaction with friendships (Multidimensional Students Life Satisfaction Scale [Friends and School subscales]). Mediators included social connectedness and sense of agency. RESULTS: At 5 months postintervention, 467 (85.1%) children were retained. Intent-to-treat analyses demonstrated sustained benefits for for well-being (estimated mean difference -1.88, 95% CI -3.14 to -0.66, = 0.25) and friendships (-1.52, 95% CI -2.55 to -0.48, = .005, = 0.25). There were no significant between-group differences for attitude toward school. Secondary benefits were shown for traumatic stress (2.18, 95% CI 0.45 to 3.91, = .014, = 0.21), quality of life (-1.29, 95% CI -2.31 to -0.30, = .014, = 0.21), bullying (0.53, 95% CI 0.08 to 0.97, = .020, = 0.20), and depression symptoms (1.31, 95% CI 0.09 to 2.52, = .035, = 0.18). Increased sense of connectedness mediates the effect of on improving well-being (indirect effect = 0.30, = 0.13, = .001), explaining 15% of variance. CONCLUSION: This study shows sustained benefits of a mental health promotion intervention 5 months postintervention. Prolonged benefits are explained by an increase in social connectedness.
The Affective Side of Disruptive Behavior: Toward Better Understanding, Assessment, and Treatment.
Evans SC, Burke JD
J Clin Child Adolesc Psychol · 2024 · PMID 38656139 · Publisher ↗
Historically, much of the progress made in youth mental health research can be classified as focusing on , characterized by disruptive behavior (e.g. aggression, defiance), or , characterized by intense negative affect (...
Historically, much of the progress made in youth mental health research can be classified as focusing on , characterized by disruptive behavior (e.g. aggression, defiance), or , characterized by intense negative affect (e.g. depression, anxiety). Until recently, however, less attention has been given to topics that lie somewhere in between these domains, topics that we collectively refer to as the . Like the far side of the moon, the affective side of disruptive behavior captures facets of the phenomenon that may be less obvious or commonly overlooked, but are nonetheless critical to understand. This affective side clarifies socially disruptive aspects of traditionally "externalizing" behavior by elucidating proximal causation via intense negative affect (traditionally "internalizing"). Such problems include irritability, frustration, anger, temper loss, emotional outbursts, and reactive aggression. Given a recent explosion of research in these areas, efforts toward integration are now needed. This special issue was developed to help address this need. Beyond the present introductory article, this collection includes 4 empirical articles on developmental psychopathology topics, 4 empirical articles on applied treatment/assessment topics, 1 evidence base update review article on measurement, and 2 future directions review articles concerning outbursts, mood, dispositions, and youth psychopathology more broadly. By deliberatively investigating the affective side of disruptive behavior, we hope these articles will help bring about better understanding, assessment, and treatment of these challenging problems, for the benefit of youth and families.
Future Directions: The Phenomenology of Irritable Mood and Outbursts: Hang Together or Hang Separately.
Carlson GA, Althoff RR, Singh MK
J Clin Child Adolesc Psychol · 2024 · PMID 38588602 · Publisher ↗
Recognition of the importance of irritable mood and outbursts has been increasing over the past several decades. This "Future Directions" aims to develop a set of recommendations for future research emphasizing that irri...
Recognition of the importance of irritable mood and outbursts has been increasing over the past several decades. This "Future Directions" aims to develop a set of recommendations for future research emphasizing that irritable mood and outbursts "hang together," but have important distinctions and thus also need to "hang separately." Outbursts that are the of irritable mood may be quite different from outbursts that are the or driving force that make youth and his/her environment miserable. What, then, is the relation between irritable mood and outbursts? As the field currently stands, we not only cannot answer this question, but we may also lack the tools to effectively do so. Here, we will propose recommendations for understanding the phenomenology of irritable mood and outbursts so that more directed and clinically useful assessment tools can be designed. We discuss the transdiagnostic and treatment implications that relate to improvements in measurement. We describe the need to do more than repurpose our current assessment tools, specifically interviews and rating scales, which were designed for different purposes. The future directions of the study and treatment of irritable mood and outbursts will require, among others, using universally accepted nomenclature, supporting the development of tools to measure the characteristics of each irritable mood and outbursts, understanding the effects of question order, informant, development and longitudinal course, and studying the ways in which outbursts and irritable mood respond to treatment.
Targeting Peer Contagion Dynamics in Children with ADHD: Effects from a Two-Site Randomized Controlled Trial.
Normand S, Lambert M, Bakeman R … +3 more , Guiet J, Brendgen M, Mikami AY
J Clin Child Adolesc Psychol · 2024 · PMID 38573210 · Publisher ↗
OBJECTIVE: Parental Friendship Coaching (PFC) teaches parents to coach their children in friendship skills. This paper examines whether PFC fosters positive peer contagion processes (i.e. dyadic mutuality) and reduces ne...
OBJECTIVE: Parental Friendship Coaching (PFC) teaches parents to coach their children in friendship skills. This paper examines whether PFC fosters positive peer contagion processes (i.e. dyadic mutuality) and reduces negative peer contagion processes (i.e. coercive joining) within the friendships of children with attention-deficit/hyperactivity disorder (ADHD). METHOD: Participants were 134 families of children with ADHD and peer problems (age 6-11 years; 69% male; 72% white) at two Canadian sites, randomized to PFC or CARE (an active comparison intervention). Children were observed in the lab at baseline, post-treatment, and at 8-month follow-up during cooperation and competition tasks with a real-life friend. Amount and reciprocity of dyadic mutuality indicators (i.e. positive affect and positive behaviors) and coercive joining indicators (i.e. aggressive, controlling, and rule-breaking behaviors) between friends were coded. RESULTS: Across treatment conditions, children showed an increase in the amount of dyadic mutuality during cooperation and a decrease in the amount of coercive joining during competition over time. Relative to CARE, PFC induced a reduced amount of coercive joining behaviors during cooperation at post-treatment and follow-up. However, PFC led to decreases in the reciprocity of positive affect during cooperation at post-treatment and to increases in the reciprocity of coercive joining during competition at follow-up relative to CARE. Moderation analyses suggest PFC was associated with better outcomes for children with externalizing comorbidity, and for those with a stable or a best friend. CONCLUSIONS: Findings highlight the importance of transactional processes, contextual differences, externalizing comorbidities, and friendship status when assessing the efficacy of PFC.
Evaluating a Movement-Based Mental Health Promotion Intervention for Refugee Children in Uganda: A Quasi-Experimental Study.
Bleile ACE, Koppenol-Gonzalez GV, Orech B … +2 more , Verreault K, Jordans MJD
J Clin Child Adolesc Psychol · 2025 · PMID 38564186 · Publisher ↗
OBJECTIVE: Mental health promotion interventions are widely implemented in humanitarian settings and low- and middle-income contexts (LMICs), yet evidence on effectiveness is scarce and mixed. This study evaluated the mo...
OBJECTIVE: Mental health promotion interventions are widely implemented in humanitarian settings and low- and middle-income contexts (LMICs), yet evidence on effectiveness is scarce and mixed. This study evaluated the movement-based mental health promotion intervention "" in Bidibidi refugee settlement, in Northern Uganda. METHOD: A quasi-experimental study including four schools (two per arm) assessed the outcomes of 10- to 15-year-old South Sudanese and Ugandan children ( = 549). Randomly allocated, they either participated in up to 11 sessions ( = 265) provided by trained facilitators; or belonged to a control group, which continued care as usual ( = 284). Primary outcomes measured psychosocial wellbeing, friendships and attitude to school; secondary outcomes included traumatic distress, depressive symptoms, quality of life, physical health, bullying, interoceptive awareness, and irritability. Data were collected at baseline and endline. RESULTS: Children joining , showed significantly more improvements on primary outcomes: emotional and psychosocial wellbeing (M = -1.49, SE = 0.6, = .01), satisfaction with and attitude toward school (-0.57, SE = 0.2, = .004); and secondary outcomes: traumatic stress (2.64, SE = 0.8, < .001), health-related quality of life (-1.56, SE = 0.4, = .001), physical health (-0.78, SE = 0.3, = .014) and the mechanisms of action scale (-3.34, SE = 0.9, < .001), specifically the subscales social connectedness (-0.74, SE = 0.3, = .007) and sense of agency (-0.91, SE = 0.3, = .005), compared to the control group. No significant differences were found on bullying, interoceptive awareness, irritability and depressive symptoms. CONCLUSION: The results are promising for as a mental health promotion intervention for children affected by armed-conflict, displacement and on-going adversity. Further research will need to assess the intervention's effectiveness.
Social Functioning in Children and Adolescents with ADHD and Autism Spectrum Disorder: A Cross-Disorder Comparison.
Crisci G, Cardillo R, Mammarella IC
J Clin Child Adolesc Psychol · 2024 · PMID 38551850 · Publisher ↗
OBJECTIVE: Social functioning can be defined according to three main components: social perception, social performance, and social knowledge. Although they are important in daily life relationships and in children's adap...
OBJECTIVE: Social functioning can be defined according to three main components: social perception, social performance, and social knowledge. Although they are important in daily life relationships and in children's adaptation, these components have never been tested together in children and adolescents with Attention Deficit/Hyperactivity Disorder (ADHD) or with Autism Spectrum Disorder (ASD) using lab-based tasks. The present study used a cross-disorder approach to compare the performance of children with ADHD and ASD and non-diagnosed (ND) peers utilizing a task that involves these three fundamental social functioning components. METHODS: Two hundred and twenty-five Italian children (86% boys) aged between 8 and 16 (66 with a clinical diagnosis of ADHD; 51 with a clinical diagnosis of ASD, level 1; 108 ND children) were enrolled. The three groups were matched for age, gender, and IQ. Social functioning was assessed using a lab-based task, including videos of problematic interactions among peers, created ad hoc for the study, and a semi-structured interview based on the Social Information Processing model. RESULTS: Data were analyzed using one-way ANOVAs and multinomial mixed effects models. Our findings suggested that both groups with ADHD and ASD presented social functioning difficulties in comparison to ND children. However, a different pattern of performance emerged. Children with ADHD showed higher difficulties in social performance than those with ASD, whereas autistic children revealed more difficulties in social perception and in some aspects of social knowledge. CONCLUSIONS: Our findings have important clinical implications for assessment, intervention, and differential diagnosis, and should encourage clinicians to investigate different aspects of social functioning and identify specific strengths and weaknesses in each social profile.
A Prospective Examination of the Interpersonal-Psychological Theory of Suicidal Behavior in Adolescents.
King CA, Brent D, Grupp-Phelan J … +6 more , Page K, Czyz E, McGuire TC, Mahabee-Gittens EM, Block L, Casper TC
J Clin Child Adolesc Psychol · 2024 · PMID 38547387 · Full text
OBJECTIVE: Given the large and complex array of suicide risk factors, theoretical frameworks are critical to furthering our understanding of risk. This study prospectively examined several key constructs of the interpers...
OBJECTIVE: Given the large and complex array of suicide risk factors, theoretical frameworks are critical to furthering our understanding of risk. This study prospectively examined several key constructs of the interpersonal-psychological theory of suicidal behavior (IPTS) in a large, geographically diverse sample of U.S. adolescents. METHOD: Conducted in collaboration with the Pediatric Emergency Care Applied Research Network, adolescents, ages 12 to 17, were recruited from emergency departments. Baseline and 6-month follow-up samples were comprised of 6,448 (59% female sex) and 2,009 (64% female sex) adolescents, with self-identified race/ethnicity as follows (baseline/follow-up): White (52%/54%), Black (22%/23%), Multiracial (6%/6%), American Indian (3%/3%), other/unknown race (15%/14%), and Latinx (25%/23%). Youth and parents completed adolescent suicide risk surveys at baseline and 6-month follow-up (retention, 69%). Latent class analysis was used to identify classes of painful and provocative events (PPE), considered a precursor to acquired capability. RESULTS: In keeping with IPTS tenets, thwarted belongingness (TB), perceived burdensomeness (PB), and the interaction between TB and PB were each significant predictors of suicidal ideation at baseline and follow-up. However, only PB and PPE were significant predictors of cross-sectional suicide attempts and only TB and PPE were significant predictors of prospective suicide attempts in models that adjusted for baseline suicidal ideation. The three-way interaction among PB, TB and PPE was nonsignificant. CONCLUSIONS: Results from this large-scale prospective study suggest the importance of TB, PB, and PPE to our understanding of suicidal thoughts and suicide attempts among adolescents, pointing to promising prevention and intervention targets.
Moderators of the Link Between Social Preference and Persistent Peer Victimization for Elementary School Children.
Steggerda JC, Kiefer JL, Vengurlekar IN … +6 more , Hernandez Rodriguez J, Pastrana Rivera FA, Gregus Slade SJ, Brown M, Moore TF, Cavell TA
J Clin Child Adolesc Psychol · 2026 · PMID 38530356 · Publisher ↗
OBJECTIVE: Current antibullying programs can reduce overall rates of victimization but appear to overlook processes that give rise to persistent peer victimization. Needed are studies that delineate the interplay between...
OBJECTIVE: Current antibullying programs can reduce overall rates of victimization but appear to overlook processes that give rise to persistent peer victimization. Needed are studies that delineate the interplay between social contextual and individual difference variables that contribute to persistent peer victimization. We examined the extent to which two individual-difference variables - internalizing symptoms (IS) and anxiety sensitivity (AS) - moderated the link between children's average social preference score across the school year and their status as persistent victims. METHOD: Participants included 659 4-grade students (M = 9.31 years, SD = 0.50, 51.8% girls; 42.3% Latinx, 28.9% non-Hispanic White, 10.2% Pacific Islander, 7.7% Bi/Multiracial, 1.9% Black, 1.7% Asian, 1.7% Native American, and 3.4% unreported) from 10 public elementary schools in the U.S. RESULTS: As expected, higher social preference scores predicted a decreased likelihood of being persistently victimized. Conversely, IS and AS were positively linked to persistent victim status. AS significantly moderated the link between social preference and persistent victim status such that for children with high AS, compared to those with AS scores at or below the mean, the negative association between social preference and persistent victim status was attenuated. CONCLUSIONS: Findings provide evidence that children who experience high levels of IS and AS are at risk for being persistently victimized by peers and that high AS could signal increased risk for persistent victimization even when children are generally liked by peers. We discuss the implications of these findings for efforts to develop focused interventions for chronically bullied children.
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