Pilot Effectiveness and Acceptability of Partial Hospitalization Treatment Incorporating Transdiagnostic, Cognitive-Behavioral Intervention.

Acute mental health treatment (e.g., partial hospitalization or PHP) is a critical component of the mental health services landscape for youth whose symptoms are too acute for a typical outpatient setting, but for whom inpatient psychiatric hospitalization is not recommended or desired. Very few interventions have been developed, adapted for, or evaluated in these fundamentally different delivery contexts. Transdiagnostic treatments may be ideal for addressing the comorbidity, complexity, and heterogeneity typical of acute mental health settings. Our aim was to examine initial acceptability and effectiveness of an adaptation of the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C/A; Ehrenreich-May, Kennedy, et al., 2017), delivered as part of comprehensive therapeutic programming in a general psychiatric PHP. We recruited 152 youths (M age = 13.1 years, 62.5% female) and caregivers, who participated in an average of 11 days of intensive UP-C/A intervention. Participants rated symptoms and functioning at baseline, weekly, posttreatment, and 1-month follow-up. Latent growth curve modeling was used to examine patterns of change and evaluate the impact of potential demographic and treatment-related covariates. For all outcomes, a quadratic model best fit the data, with symptoms and emotional reactivity decreasing significantly during treatment and then leveling off during follow-up. There was a medium-sized change in functional impairment from baseline to the 1-month follow-up, and ≥90% of participants reported treatment as acceptable and helpful. Results provide initial support for use of a transdiagnostic, cognitive-behavioral intervention in acute mental health settings and suggest important future directions, including controlled trials and investigation of implementation supports.

Impact of Sibling Victimization on Child Internalizing Symptoms.

The current study examined associations between sibling victimization and anxiety and depression symptoms while also considering peer victimization within time and six months later among elementary school-age youth. Both sibling and peer victimization were associated with depression symptoms within as well as across time when considered independently. However, when examined together, peer victimization was only uniquely associated with depression symptoms within time and sibling victimization was only uniquely associated with depression symptoms across time. Sibling and peer victimization were associated with anxiety symptoms within, but not across, time when examined independently, and no associations were evident when sibling and peer victimization were examined simultaneously. No interactive effects of sibling and peer victimization were evident for depression or anxiety symptoms, indicating unique rather than cumulative contributions. Findings suggest that the impact of sibling victimization on depression symptoms is more robust than effects of peer victimization over time.

Varying Experiences of Cyber Victimization among Middle and High School Students.

BACKGROUND: Although cyber victimization (CV) occurs in both middle school (MS) and high school (HS)-and these experiences appear to differ between boys and girls-to our knowledge, no studies have directly examined these differences across specific acts of CV. Further, limited research has examined school environment factors, such as school safety and attachment, as they relate to CV. OBJECTIVES: The current study compared CV experiences reported by boys and girls in both MS and HS as well as examined CV's association with perceived school safety and school attachment. METHOD: Participants were 286 MS and 304 HS students (52% boys) from a small, rural Midwestern community in the United States. Self-reported measures were collected. RESULTS: HS girls reported experiencing more CV than MS girls on 5 of the 6 CV acts examined. Additionally, HS girls reported experiencing more CV on 3 of the acts compared to MS boys. In general, HS boys and HS girls report similar rates of CV, with the exception of HS girls experiencing higher levels of "people saying mean and nasty things about them." Regression analyses indicated that youth who report higher CV feel less connected to school, but their CV experiences do not appear to be related their perceived school safety when also considering traditional forms of victimization. CONCLUSIONS: CV experiences are higher for HS girls for the majority of different types of CV acts compared to MS youth but similar to HS boys, and experiencing these acts is associated with less school connectedness.

Violence Exposure and Psychopathology in Latino Youth: The Moderating Role of Active and Avoidant Coping.

Despite high rates of exposure to community violence among Latino youth in urban communities, there is considerable variability in individual outcomes. This study examined (a) associations between coping and indices of Latino culture, (b) main effects of active/avoidant coping on psychopathology, and (c) whether coping moderates the impact of violence exposure on mental health in Latino youth. Participants included 168 Latino youth (56% female; ages 11-14) that took part in a short-term longitudinal study. Results indicate that youth acculturation was positively associated with active coping, but enculturation level and immigrant status were not associated with coping. Structural equation models suggested that active coping was negatively associated with internalizing problems (p = .046) while avoidant coping was positively associated with internalizing problems (p = .013) and posttraumatic stress symptoms (p = .024). Moderation analyses revealed that violence exposure was more strongly associated with internalizing problems as reliance on avoidance coping increased. However, at high levels of violence exposure, a greater reliance on active coping was related to increased posttraumatic stress problems. Findings suggest that consideration of the specific stressor, level of stress exposure, and mental health problem-type may be crucial in determining the effectiveness of a coping strategy. Implications for future research and intervention are discussed.

Anxiety and Atopic Disease: Comorbidity in a Youth Mental Health Setting.

Anxiety frequently co-occurs with atopic diseases (e.g., allergies) in community samples, although data are limited to community and pediatric medical samples. Little work has examined atopy rates among mental health treatment seeking youth or whether youth with comorbid anxiety and atopy present similarly to non-comorbid youth. Using initial intake data from a University-based specialty youth clinic for anxiety and depressive disorders (n = 189), rates of atopic comorbidity were benchmarked against lifetime prevalence estimates in epidemiological samples. Anxiety severity and parental stress were compared between youth with and without atopy. Results indicated high rates of atopy in the clinical sample (51.3 %) relative to population atopy estimates (34.5 %). Anxious youth with atopy exhibited more overall and generalized anxiety symptoms relative to non-atopic youth (ps < .05); parental stress was comparable between atopic and non-atopic anxious youth. This suggests potentially heightened clinical severity for youth with co-occurring anxiety and atopy.