Co-occurrence of linguistic and behavioural difficulties in early childhood: a developmental psychopathology perspective.

Three hypotheses have been posited as competing explanations for the comorbidity or co-occurrence of language difficulties and behavioural problems among children: (1) language difficulties confer risk for behaviour problems, (2) behaviour problems confer risk for language difficulties, and (3) shared risk factors account for their co-occurrence. We use a developmental psychopathology perspective to propose a model that integrates these explanations, and incorporates several potential moderating, mediating, and shared risk factors. We propose that temperamental negative emotionality and working memory deficits operate to initiate the pathway that may culminate in comorbid language and behaviour problems. We hypothesise that contextual factors (e.g. parent-child interactional processes) and child-specific factors (e.g. adaptive communication) may exacerbate or offset this risk and thus contribute to multiple developmental pathways. The proposed model underscores the importance of considering transactional processes from multiple domains to understand how configurations of risk and protective factors translate into different patterns of children's linguistic and behavioural functioning.

Parental engagement and barriers to participation in a community-based preventive intervention.

This study examined parent characteristics and barriers to participation in a community-based preventive intervention with a sample of 201 parents from low-income and predominantly ethnic minority backgrounds. Person-centered analyses revealed five subgroups of parents who demonstrated variability in their parent characteristics, which included psychological resources and level of parental involvement in education. Group membership was associated with differences in school involvement and use of the psychoeducational intervention at home, after accounting for the number of barriers to engagement. For the intervention attendance variable, greater number of barriers was associated with decreased attendance only for parents in the resilient subgroup and the psychologically distressed subgroup. Attendance remained constant across levels of barriers for the other three subgroups of parents. The results of the study inform theory and practice regarding how to tailor preventive interventions to accommodate subgroups of parents within populations that experience barriers to accessing mental health services.

Cognitive-behavioral therapy for adolescents with inflammatory bowel disease and subsyndromal depression.

OBJECTIVE: To examine the feasibility and efficacy of a manual-based cognitive-behavioral therapy (CBT) in reducing depressive symptomatology in adolescents with inflammatory bowel disease (IBD). Primary and Secondary Control Enhancement Therapy-Physical Illness (PASCET-PI) modified for youths with IBD was compared to treatment as usual (TAU), plus an information sheet about depression, without therapist contact using assessable patient analysis. METHOD: Following assessment, participants 11 to 17 years old with IBD and mild to moderate subsyndromal depression were randomly assigned to PASCET-PI (n = 22) or comparison treatment (n = 19). Primary outcome measures at baseline (T1) and 12 to 14 weeks posttreatment (T2) were Children's Depression Inventory (child/parent report), Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS), Children's Global Assessment Scale, and Perceived Control Scale for Children. RESULTS: The PASCET-PI group showed significantly greater improvement in Children's Depression Inventory (child/parent report), Children's Global Assessment Scale, and Perceived Control Scale for Children posttreatment than the comparison group. CONCLUSIONS: Screening and treatment of depressive symptoms in pediatric settings is feasible. PASCET-PI may be an efficacious intervention for subsyndromal depression in adolescents with IBD, although comparison with a more active treatment is necessary to attribute the improvement to PASCET-PI. CLINICAL TRIAL REGISTRATION INFORMATION: URL: http://clinicaltrials.gov. Unique identifier: NCT00446238.

Case study: longitudinal treatment of adolescents with depression and inflammatory bowel disease.

OBJECTIVE: To assess longitudinal maintenance of improvements in depression, anxiety, global functioning, and physical health perception in 11 adolescents at 6 and 12 months following completion of manual-based cognitive-behavioral therapy. METHOD: Standardized instruments assessed follow-up changes in depression, anxiety, physical health, and global psychological functioning. RESULTS: At both assessments, 10 adolescents did not meet criteria for mood disorders. Improvements in depression, anxiety, global functioning, and physical health perceptions at completion of the cognitive-behavioral therapy were maintained during the 12-month period. Additional cognitive-behavioral therapy sessions (mean = 4.36; SD = 4.37) and psychopharmacology (n = 5) were required during the follow-up period. CONCLUSIONS: CBT with maintenance sessions and medication offers promise to adolescents facing comorbid depressive and physical disorders.