A comparison of development-matched and age-matched targets on play skills of children with autism spectrum disorder.

Although neurotypical children often spend the majority of their time engaged in play activities, children with autism spectrum disorder (ASD) can present with substantial delays in the development of play skills, requiring intensive intervention. Although targets for language and basic learning skills are often selected based on the development of neurotypical children (e.g., Sundberg, 2008), little research has been conducted on methods for selecting play skill targets. The current study compared acquisition of play skills that were development-matched (DM) and age-matched (AM) with 4 children diagnosed with ASD. Targets were selected based on the results of the Developmental Play Assessment (DPA; Lifter, 2008). No contrived prompts or consequences were used to teach play skills in either condition. Generalization was programmed for by teaching with 3 sets of toys in both conditions. All participants demonstrated acquisition of DM play targets and generalization to novel toys; none of the participants acquired AM play targets.

Teaching Children With Autism Spectrum Disorder to Mand "Why?"

For most children with autism spectrum disorder (ASD), manding for information is an important skill that must be systematically taught. Although previous studies have evaluated interventions for teaching other mands for information, to date no studies have demonstrated effective procedures for teaching the mand "why?" The purpose of the present study was to teach 3 children with ASD to mand "why?" under relevant establishing operation conditions in 3 distinct scenarios. A trial-unique multiple-exemplar procedure was used to promote generalization and increase the value of information provided across trials. All 3 participants learned to mand "why?" in all 3 scenarios within a mean of 18 sessions (range 14-21 sessions), demonstrated generalization to novel stimuli and settings, and maintained this skill over time. Social validity for the intervention had an overall mean of 5.88 (range 1-7).

Evaluating function-based Social Stories™ with children with autism.

Social Stories™ are often used with children with autism to provide information about appropriate behaviors in specific contexts. Although Social Stories™ often target reduction of problem behavior, there is limited research evaluating function-based Social Stories™ based on the results of experimental functional analyses. This study used a brief functional analysis to assist in developing a Social Story™ that matched the function of the target behavior for two boys with autism. The differential effects of a Social Story™ that matched the function of the behavior, a Social Story™ that did not match the function of the behavior, and a Social Story™ that described baseline were compared in an alternating treatments design. Results indicated that (a) the function-based Social Story™ plus functional communication training (FCT) was effective in decreasing target problem behavior and increasing target mands for both participants, (b) both participants selected the function-based Social Story™ during treatment preference evaluations, and (c) both participants maintained low levels of target problem behavior and maintained target mands when the Social Stories™ were removed.

Major depression in mothers predicts reduced ventral striatum activation in adolescent female offspring with and without depression.

Prior research has identified reduced reward-related brain activation as a promising endophenotype for the early identification of adolescents with major depressive disorder (MDD). However, it is unclear whether reduced reward-related brain activation constitutes a true vulnerability for MDD. One way of studying vulnerability is through a high-risk design. Therefore, the aim of the current study was to determine whether reward-related activation of the ventral striatum is reduced in nondepressed daughters of mothers with a history of MDD (high-risk) similarly to currently depressed adolescent girls, compared with healthy controls. By directly comparing groups with a shared risk profile during differing states, we aimed to shed light on the endophenotypic nature of reduced reward processing for adolescent depression. We compared reward-related neural activity through functional magnetic resonance imaging (fMRI) between three groups of female biological offspring (N = 52) of mothers with differential MDD status: (a) currently depressed daughters of mothers with a history of MDD (MDD group; n = 14), (b) age- and socioeconomic status (SES)-matched never-depressed daughters of mothers with a history of MDD (high-risk group; n = 19), and (c) age- and SES-matched control daughters of mothers with no past or current psychopathology in either the mother or the daughter (healthy control group; n = 19). For the outcome phase of the reward task, right-sided ventral striatum activation was reduced for both currently depressed and high-risk girls compared with healthy controls. This ventral striatal activity correlated significantly with maternal depression scores. These findings provide further evidence of aberrant functioning for the United States Department of Health & Human Services, National Institutes of Health, National Institute of Mental Health (NIMH) Research Domain Criteria (RDoC)-defined domain of positive valence systems as a vulnerability factor for MDD and a potential endophenotype for the development of depression.

Multisystemic therapy for child non-externalizing psychological and health problems: a preliminary review.

Multisystemic therapy (MST) is effective for decreasing or preventing delinquency and other externalizing behaviors and increasing prosocial or adaptive behaviors. The purpose of this project was to review the literature examining the efficacy of MST for other child psychological and health problems reflecting non-externalizing behaviors, specifically difficulties related to child maltreatment, serious psychiatric illness [Serious psychiatric illness was defined throughout the current review paper as the "presence of symptoms of suicidal ideation, homicidal ideation, psychosis, or threat of harm to self or others due to mental illness severe enough to warrant psychiatric hospitalization based on the American Academy of Child and Adolescent Psychiatry (Level of care placement criteria for psychiatric illness. American Academy of Child and Adolescent Psychiatry, Washington, DC, 1996) level of care placement criteria for psychiatric illness" (Henggeler et al. in J Am Acad Child Psy 38:1331-1345, p. 1332, 1999b). Additionally, youth with "serious emotional disturbance (SED)" defined as internalizing and/or externalizing problems severe enough to qualify for mental health services in public school who were "currently in or at imminent risk of a costly out-of-home placement" (Rowland et al. in J Emot Behav Disord 13:13-23, pp. 13-14, 2005) were also included in the serious psychiatric illness category.], and health problems (i.e., obesity and treatment adherence for diabetes). PubMed, Web of Science, MEDLINE, and PsycINFO databases; Clinicaltrials.gov; DARE; Web of Knowledge; and Cochrane Central Register of Controlled Trials were searched; and MST developers were queried to ensure identification of all relevant articles. Of 242 studies identified, 18 met inclusion criteria for review. These were combined in a narrative synthesis and critiqued in the context of review questions. Study quality ratings were all above mean scores reported in prior reviews. Mixed support was found for the efficacy of MST versus other treatments. In many cases, treatment effects for MST or comparison groups were not sustained over time. MST was efficacious for youth with diverse backgrounds. No studies discussed efficacy of MST provided in different treatment settings. Four studies found MST more cost-effective than a comparison treatment, leading to fewer out-of-home placements for youth with serious psychiatric illness or lower treatment costs for youth with poorly controlled diabetes.

Theory of mind and emotion regulation difficulties in adolescents with borderline traits.

OBJECTIVE: Dysfunctions in both emotion regulation and social cognition (understanding behavior in mental state terms, theory of mind or mentalizing) have been proposed as explanations for disturbances of interpersonal behavior in borderline personality disorder (BPD). This study aimed to examine mentalizing in adolescents with emerging BPD from a dimensional and categorical point of view, controlling for gender, age, Axis I and Axis II symptoms, and to explore the mediating role of emotion regulation in the relation between theory of mind and borderline traits. METHOD: The newly developed Movie for the Assessment of Social Cognition (MASC) was administered alongside self-report measures of emotion regulation and psychopathology to 111 adolescent inpatients between the ages of 12 to 17 (mean age = 15.5 years; SD = 1.44 years). For categorical analyses borderline diagnosis was determined through semi-structured clinical interview, which showed that 23% of the sample met criteria for BPD. RESULTS: Findings suggest a relationship between borderline traits and "hypermentalizing" (excessive, inaccurate mentalizing) independent of age, gender, externalizing, internalizing and psychopathy symptoms. The relation between hypermentalizing and BPD traits was partially mediated by difficulties in emotion regulation, accounting for 43.5% of the hypermentalizing to BPD path. CONCLUSIONS: Results suggest that in adolescents with borderline personality features the loss of mentalization is more apparent in the emergence of unusual alternative strategies (hypermentalizing) than in the loss of the capacity per se (no mentalizing or undermentalizing). Moreover, for the first time, empirical evidence is provided to support the notion that mentalizing exerts its influence on borderline traits through the mediating role of emotion dysregulation.

Identifying differences in biased affective information processing in major depression.

This study investigates the extent to which participants with major depression differ from healthy comparison participants in the irregularities in affective information processing, characterized by deficits in facial expression recognition, intensity categorization, and reaction time to identifying emotionally salient and neutral information. Data on diagnoses, symptom severity, and affective information processing using a facial recognition task were collected from 66 participants, male and female between ages 18 and 54 years, grouped by major depressive disorder (N=37) or healthy non-psychiatric (N=29) status. Findings from MANCOVAs revealed that major depression was associated with a significantly longer reaction time to sad facial expressions compared with healthy status. Also, depressed participants demonstrated a negative bias towards interpreting neutral facial expressions as sad significantly more often than healthy participants. In turn, healthy participants interpreted neutral faces as happy significantly more often than depressed participants. No group differences were observed for facial expression recognition and intensity categorization. The observed effects suggest that depression has significant effects on the perception of the intensity of negative affective stimuli, delayed speed of processing sad affective information, and biases towards interpreting neutral faces as sad.