Parent perspectives from participating in a family component for CBITS: Acceptability of a culturally informed school-based program.

This study explored parents' responses to a family component developed as an addition to the Cognitive Behavioral Intervention for Trauma in Schools (CBITS). The family component was developed to improve engagement and participation in CBITS and to support parents' own skill-building. To evaluate the acceptability and feasibility of the family component from the perspective of parents who participated, qualitative interviews were conducted with 15 low-income, Latino parents (80% female; 80% immigrants; average age = 38.07). Themes emerged across 3 primary categories: Need for CBITS + Family, Results of Participating in CBITS + Family, and Implications for Feasibility. Parents agreed that there was a need for programs like CBITS and expressed a firm belief in the importance of parental involvement with their children and schools. Parents reported a high level of satisfaction with the family component and indicated that it was beneficial to them, culturally relevant, and that they would recommend it to others. Still, some logistical barriers to participation and areas for improvement were noted. Overall, the results of this study indicate that CBITS + Family is an appropriate, acceptable, and feasible intervention for Latino families. Supplemental data from children whose parents participated in the program provide further support for the value of the family component. Clinical implications for implementing culturally sensitive, school-based interventions with parents are discussed. (PsycINFO Database Record

Resilience and Disruption in Observed Family Interactions in Youth With and Without Spina Bifida: An Eight-Year, Five-Wave Longitudinal Study.

OBJECTIVE: To examine differences between families of youth with spina bifida (SB) and families of typically developing (TD) youth on family-, parent-, and youth-level variables across preadolescence and adolescence. METHODS: Participants were 68 families of youth with SB and 68 families of TD youth. Ratings of observed family interactions were collected every 2 years at 5 time points (Time 1: ages 8-9 years; Time 5: ages 16-17 years). RESULTS: For families of youth with SB: families displayed less cohesion and more maternal psychological control during preadolescence (ages 8-9 years); parents presented as more united and displayed less dyadic conflict, and youth displayed less conflict behavior during the transition to adolescence (ages 10-13 years); mothers displayed more behavioral control during middle (ages 14-15 years) and late (ages 16-17 years) adolescence; youth displayed less engagement and more dependent behavior at every time point. CONCLUSIONS: Findings highlight areas of resilience and disruption in families of youth with SB across adolescence.

Observed differences in social behaviors exhibited in peer interactions between youth with spina bifida and their peers: neuropsychological correlates.

OBJECTIVE: To identify differences in social behaviors in observed peer interactions between children with spina bifida (SB) and peers, and to examine neuropsychological correlates of these differences. METHOD: A total of 100 youth (aged 8-15 years) with SB and peers participated in video-recorded interaction tasks, which were coded for interaction style, affect, and collaboration. Children with SB also completed a neuropsychological test battery. RESULTS: Children with SB demonstrated less adaptive social behaviors in peer interactions, particularly within the interaction style domain. Observational items found to be different between children with SB and their peers were best predicted by social language and attention abilities. CONCLUSIONS: Children with SB exhibit a less adaptive interaction style and lower levels of social dominance but are comparable with typically developing peers on other social behaviors. The observed group differences may have a neuropsychological basis.

Longitudinal study of neuropsychological functioning and internalizing symptoms in youth with spina bifida: social competence as a mediator.

OBJECTIVE: To examine the longitudinal relationship between neuropsychological functioning and internalizing symptoms, as mediated by social competence in youth with spina bifida (SB). METHODS: A total of 111 youth (aged 8-15 years, M = 11.37) with SB, their parents, and teachers completed questionnaires regarding attention, social competence, and internalizing symptoms. Youth also completed a battery of neuropsychological tests. RESULTS: An indirect-only mediation model revealed that social competence mediated the relation between neuropsychological functioning and subsequent levels of teacher-reported internalizing symptoms, but not parent or youth report of internalizing symptoms. Specifically, better neuropsychological functioning was associated with better social competence, which, in turn, predicted fewer internalizing symptoms 2 years later. CONCLUSIONS: Youth with SB with lower levels of neuropsychological functioning may be at risk for poorer social competence and, as a result, greater internalizing symptoms. Interventions that promote social competence, while being sensitive to cognitive capacities, could potentially alleviate or prevent internalizing symptoms in these youth.

Examining the impact of a family treatment component for CBITS: when and for whom is it helpful?

This study compared the Cognitive Behavioral Intervention for Trauma in Schools (CBITS), as it is typically delivered, to CBITS-plus-family treatment component (CBITS + Family), developed through a community partnership. This study used a quasi-experimental design, capitalizing on ongoing CBITS implementation within a school system. In total, 32 parent/student dyads were recruited in CBITS groups and 32 parent/student dyads were recruited in CBITS + Family groups. Parents and students in both conditions completed pre- and posttreatment measures, in addition to a 6-month posttreatment follow-up assessing symptoms. Families were low-income and predominately Latino. Children were 59% female with an average age of 11.70. Participating parents were 84% female with an average age of 38.18. The majority of parents (80%) were immigrants and 70% reported not finishing high school. Parents who received CBITS + Family showed significant improvements in attitudes toward mental health, school involvement, and primary control coping, while demonstrating significant reductions in involuntary engagement and inconsistent discipline. CBITS + Family appears to be most beneficial for children with high symptom severity in terms of reducing posttraumatic stress disorder symptoms and disengagement coping. Finally, greater improvements in parent variables predicted larger symptom reductions among children within the CBITS + Family group. This study suggests that CBITS + Family is beneficial for parents of children exposed to trauma and may be especially helpful for children with high initial symptom severity. Children in CBITS + Family appear to benefit most when their parents show larger improvements in school involvement and greater reductions in parental inconsistency and involuntary engagement.

The influence of social adjustment on normative and risky health behaviors in emerging adults with spina bifida.

OBJECTIVE: To understand the rates of normative and risky health behaviors and the influence of prior and current social adjustment on health risk behaviors in emerging adults with spina bifida (SB). METHOD: These data are part of a larger longitudinal study of youth with SB; at ages 18-19, 50 emerging adults with SB and 60 typically developing (TD) youth participated. Social adjustment was measured at ages 12/13, 14/15, 16/17, and 18/19. Substance use and sexual activity were self-reported by emerging adults. RESULTS: The SB group reported similar frequencies (i.e., number of days in the previous month) of cigarette and marijuana use. Fewer individuals with SB reported initiation of both alcohol use (i.e., ever used) and sexual activity (i.e., ever had sex) compared to TD peers. The SB group also reported less frequent alcohol use and fewer sexual partners. Better social adjustment during early adolescence (ages 12/13) predicted more frequent alcohol use and a greater number of sexual partners for all youth. Social adjustment also mediated the effect of group status on health risk behaviors. CONCLUSIONS: Emerging adults with SB lag behind TD peers in terms of normative initiation of alcohol use and sexual activity. However, this population participates in some risky health behaviors at similar rates compared to their TD peers (e.g., smoking). Youths' health risk behaviors may be influenced by their level of social adjustment. A challenge for future interventions for this population will be finding methods of improving social functioning without increasing the rate of health risk behavior.

A longitudinal assessment of early pubertal timing as a predictor of psychosocial changes in adolescent girls with and without spina bifida.

OBJECTIVE: A longitudinal comparison of adolescent girls with and without spina bifida (SB), regarding the effects of early pubertal timing on girls' depressive symptoms, mother-daughter conflict, and emotional distancing. METHODS: 62 mother-daughter dyads (31 with SB and 31 without) reported on psychosocial outcomes at 5 time points (ages 8/9 to 16/17 years). RESULTS: A pubertal timing × SB status interaction predicted emotional distancing (T2), conflict (T2, T5), and depressive symptoms (T4), such that early maturing girls without SB reported the greatest increase in each outcome. Main effects of pubertal timing predicted emotional distancing (T4), conflict (T4), and depressive symptoms (T2, T3, T5). Findings were not always consistent across reporters, assessments of pubertal timing, and time-points. CONCLUSIONS: Although early maturing girls in both groups may experience greater psychosocial difficulties, early maturing girls without SB may be most at-risk. The somewhat reduced impact of early pubertal timing in girls with SB is discussed.