Study protocol for a non-randomized controlled trial of the effects of internet-based parent training as a booster to the preschool edition of PATHS®: Universal edition of the Parent Web.

Well implemented, universal parental support is often effective in families with younger children, but research on their effects on families with adolescent children is scarce. In this study, a trial of the universal parent training intervention "Parent Web" in early adolescence is added to the social emotional learning intervention Promoting Alternative Thinking Strategies (PATHS®), completed in early childhood. The Parent Web is a universal online parenting intervention based on social learning theory. The intervention aims to promote positive parenting and family interaction through five weekly modules completed over 6-8 weeks. The main hypothesis is that participants in the intervention group will exhibit significant pre- to post- intervention-related benefits relative participants in the comparison group. The aims of this study are: 1) provide Parent Web as a booster aimed at improving parenting support and practices at the transition into adolescence to a cohort of parents whose children have previously participated in preschool PATHS, and 2) examine the effects of the universal edition of Parent Web. The study has a quasi-experimental design with pre- and post-testing. The incremental effects of this internet-delivered parent training intervention are tested in parents of early adolescents (11-13 years) who participated in PATHS when 4-5 years old compared to a matched sample of adolescents with no prior experience of PATHS. The primary outcomes are parent reported child behavior and family relationships. Secondary outcomes include self-reported parent health and stress. The proposed study is one of the few trials to test the effects of universal parental support in families of early adolescents and will therefore contribute to the understanding of how mental health in children and young people can be promoted across developmental periods through a continuum of universal measures. Trial registration: Clinical trials.gov (NCT05172297), prospectively registered on December 29, 2021.

Neighborhood conditions in a Swedish context-Two studies of reliability and validity of virtual systematic social observation using Google Street View.

Introduction: The goal of these studies was to investigate the reliability and validity of virtual systematic social observation (virtual SSO) using Google Street View in a Swedish neighborhood context. Methods: This was accomplished in two studies. Study 1 focused on interrater reliability and construct validity, comparing ratings conducted in-person to those done using Google Street View, across 24 study sites within four postal code areas. Study 2 focused on criterion validity of virtual SSO in terms of neighborhoods with low versus high income levels, including 133 study sites within 22 postal code areas in a large Swedish city. In both studies, assessment of the neighborhood context was conducted at each study site, using a protocol adapted to a Swedish context. Results: Scales for Physical Decay, Neighborhood Dangerousness, and Physical Disorder were found to be reliable, with adequate interrater reliability, high consistency across methods, and high internal consistency. In Study 2, significantly higher levels of observed Physical Decay, Neighborhood Dangerousness, and signs of garbage or litter were observed in postal codes areas (site data was aggregated to postal code level) with lower as compared to higher income levels. Discussion: We concluded that the scales within the virtual SSO with Google Street View protocol that were developed in this series of studies represents a reliable and valid measure of several key neighborhood contextual features. Implications for understanding the complex person-context interactions central to many theories of positive development among youth were discussed in relation to the study findings.

Children's social emotional competence in Pakistan and Sweden: Factor structure and measurement invariance of the Social Competence Scale (teacher edition).

Introduction: Social emotional competence is fundamental to the positive development of children and youth. Accurately understanding and assessing children's social emotional competencies, using psychometrically sound instruments, are essential to global efforts to support children's social emotional learning, academic achievements, and health. This study examined the psychometric properties of a teacher-reported measure of young children's social emotional competence, the Social Competence Scale - Teacher edition (SCS-T), in two samples of children growing up with varied economic resources/conditions, cultural norms, and educational experiences, namely Pakistan (N = 396) and Sweden (N = 309). Methods: Participants were aged 4-6 years old. The study design was cross-sectional. Results and Discussion: Using structural equation modelling, bi-factor confirmatory factor analysis models implying shared variance, among all items and domain-specific shared variance, among the prosocial items, emotion regulation items, and academic skills items resulted in good fitting models in each respective sample. Invariance testing across samples revealed a subset of items from each factor structure with partial scalar invariance, whereby five items had equal thresholds and could be comparable across the two samples. Thus, results provided partial support for hypotheses 1, 2, and 3, in that the posited three factor model (H1) was not clearly supported and a bi-factor model evidenced the best fit, among tested models, for both samples. Further, partial scalar invariance (H3) was found for five items out of 25 items, concerning social competence and academic skills. In regards, to the posited research question, the results of Z-tests showed significant (p < 0.001) latent mean differences between the samples. Compared to the Swedish sample, the Pakistani sample was 1.80 units lower on social competence (z = -6.41, p < 0.001) and 1.86 units lower on academic skills (z = -7.87, p < 0.001). The implications of these findings in light of efforts to promote positive child development in diverse parts of the world are considered.

A Cluster Randomized Trial of Promoting Alternative Thinking Strategies (PATHS®) With Swedish Preschool Children.

The preschool edition of Promoting Alternative THinking Strategies (PATHS®) is a school-based, teacher implemented universal intervention developed in the United States designed to promote social emotional competence (SEC) in children as a foundation for improved mental health. PATHS is delivered as a curriculum and it is based on theories and research regarding SEC, brain development, and optimal school environments. A majority of children in Sweden attend preschool, which is government-subsidized and follows a national curriculum focusing on both academic and social emotional learning. However, there is not so much focus on formal instruction nor manual-based lessons. The purpose of this study was to assess the short-term (pre- to post-test) effects of PATHS in the Swedish preschool setting. Using a two-wave cluster randomized trial with multi-method and informant assessment (N = 285 4 and 5-year-old Swedish children; n = 145 wait-list control; n = 140 intervention; K = 26 preschools; k = 13 intervention; k = 13 control) we assessed changes in child emotional knowledge, emotional awareness, social problem solving, prosocial play, inhibitory control, and working memory using structural equation modeling (SEM). We included schools with at least one classroom of 4-5-year-old children from three municipalities. We excluded open preschools, parent cooperative preschools, and family day homes. After random assignment, schools were informed of condition assignment. Research team members were not blind to assignment. We hypothesized that relative to children in control schools, children in intervention schools would evidence improvements in social emotional competence as well as other outcomes. Children in PATHS, relative to children in the control, evidenced improvements in working memory and prosocial play, but also showed an increase in hyperactive behaviors. Girls in PATHS, relative to girls in the control, showed improvement in emotional knowledge and reduced anxiety. These results are considered in light of efforts to promote positive development and mental health. The trial registration number at ClinicalTrials.gov is NCT04512157. Main funding was from Swedish Council for Working Life and Social Research, the Swedish Research Council, Formas, and VINNOVA (dnr: 259-2012-71).

The heterogeneity of attention-deficit/hyperactivity disorder symptoms and conduct problems: Cognitive inhibition, emotion regulation, emotionality, and disorganized attachment.

This study examined the contributions of several important domains of functioning to attention-deficit/hyperactivity disorder (ADHD) symptoms and conduct problems. Specifically, we investigated whether cognitive inhibition, emotion regulation, emotionality, and disorganized attachment made independent and specific contributions to these externalizing behaviour problems from a multiple pathways perspective. The study included laboratory measures of cognitive inhibition and disorganized attachment in 184 typically developing children (M age = 6 years, 10 months, SD = 1.7). Parental ratings provided measures of emotion regulation, emotionality, and externalizing behaviour problems. Results revealed that cognitive inhibition, regulation of positive emotion, and positive emotionality were independently and specifically related to ADHD symptoms. Disorganized attachment and negative emotionality formed independent and specific relations to conduct problems. Our findings support the multiple pathways perspective on ADHD, with poor regulation of positive emotion and high positive emotionality making distinct contributions to ADHD symptoms. More specifically, our results support the proposal of a temperamentally based pathway to ADHD symptoms. The findings also indicate that disorganized attachment and negative emotionality constitute pathways specific to conduct problems rather than to ADHD symptoms.

Advancing school-based interventions through economic analysis.

Commentators interested in school-based prevention programs point to the importance of economic issues for the future of prevention efforts. Many of the processes and aims of prevention science are dependent upon prevention resources. Although economic analysis is an essential tool for assessing resource use, the attention given economic analysis within school-based prevention remains cursory. Largely, economic analyses of school-based prevention efforts are undertaken as secondary research. This limits these efforts to data that have been collected previously as part of epidemiological and outcomes research. Therefore, economic analyses suffer from gaps in the knowledge generated by these studies. This chapter addresses the importance of economic analysis for the future of school-based substance abuse prevention programs and highlights the role of prevention research in the development of knowledge that can be used for economic analysis.

Cognitive functioning and family risk factors in relation to symptom behaviors of ADHD and ODD in adolescents.

OBJECTIVE: In this study, the authors investigated whether ADHD and oppositional defiant disorder (ODD) behaviors share associations with problems in cognitive functioning and/or family risk factors in adolescence. This was done by examining independent as well as specific associations of cognitive functioning and family risk factors with ADHD and ODD behaviors. METHOD: A sample of 120 adolescents from the general population was assessed on various cognitive tasks. ADHD and ODD behaviors were measured through parental and teacher ratings based on Diagnostic and Statistical Manual of Mental Disorders (4th edition) criteria. Parents and adolescents provided information regarding measures of family risk factors. RESULTS: The results show that only cognitive functioning was associated with ADHD behaviors, and family risk factors were, independent of cognitive functioning, associated with ODD behaviors. CONCLUSION: These results suggest that cognitive performance bears a specific significance for ADHD behaviors, whereas family risk factors have specific importance for ODD behaviors.

Disorganized attachment and inhibitory capacity: predicting externalizing problem behaviors.

The aim of the present study was to investigate whether attachment insecurity, focusing on disorganized attachment, and the executive function (EF) component of inhibition, assessed at age 5, were longitudinally related to general externalizing problem behaviors as well as to specific symptoms of ADHD and Autism spectrum disorder (ASD), and callous-unemotional (CU) traits. General externalizing problem behaviors were also measured at age 5 to allow for a developmental analysis. Outcome variables were rated by parents and teachers. The sample consisted of 65 children with an oversampling of children with high levels of externalizing behaviors. Attachment was evaluated using a story stem attachment doll play procedure. Inhibition was measured using four different tasks. The results showed that both disorganized attachment and poor inhibition were longitudinally related to all outcome variables. Controlling for initial level of externalizing problem behavior, poor inhibition predicted ADHD symptoms and externalizing problem behaviors, independent of disorganized attachment, whereas for ASD symptoms no predictive relations remained. Disorganized attachment independently predicted CU traits.

The relation between working memory components and ADHD symptoms from a developmental perspective.

The objective was to examine the relations between attention deficit hyperactivity disorder (ADHD) symptoms and four working memory (WM) components (short-term memory and central executive in verbal and visuospatial domains) in 284 6-16-year-old children from the general population. The results showed that verbal and visuospatial short-term memory and verbal central executive uniquely contributed to inattention symptoms. Age interacted with verbal short-term memory in predicting inattention, with the relation being stronger in older children. These findings support the notion of ADHD as a developmental disorder, with changes in associated neuropsychological deficits across time. The results further indicate ADHD-related deficits in several specific WM components.

Interrelations between executive function and symptoms of hyperactivity/impulsivity and inattention in preschoolers: a two year longitudinal study.

The present study, including children at risk for developing Attention Deficit Hyperactivity Disorder (ADHD), examined the idea that complex executive functions (EFs) build upon more simple ones. This notion was applied in the study of longitudinal interrelations between core EF components - simple and complex inhibition, selective attention, and working memory (WM) - at age 5 and 6 as well as their predictive relations to ADHD symptoms at age 7. The results showed that simple inhibition and selective attention at age 5 independently predicted complex inhibition and WM at age 6. In addition, EFs primarily predicted symptoms of inattention rather than hyperactivity/impulsivity even at this young age. Finally, age 6 complex inhibition was shown to act as a mediator in the relations between simple inhibition and selective attention at age 5 and symptoms of inattention at age 7. These findings provide novel longitudinal support for the theory that fundamental EF components show a progression with age toward more complex executive control (see Garon et al. Psychological Bulletin 134(1):31-60 2008). Further, complex inhibition, implicating both inhibition and WM, seems to be a particularly strong correlate of ADHD symptoms in young children and should as such be the focus of future studies examining the relation between cognitive function and ADHD symptoms from a developmental perspective.

Childhood executive function inventory (CHEXI): a promising measure for identifying young children with ADHD?

The present study investigated whether the Childhood Executive Function Inventory (CHEXI) can discriminate between young children fulfilling the diagnostic criteria for attention-deficit/hyperactivity disorder (ADHD) and normally developing children. Unlike other executive function rating instruments, the CHEXI focuses specifically on inhibitory control and working memory, without including items that overlap with the diagnostic criteria of ADHD. The CHEXI was found to discriminate very well between children fulfilling the criteria for ADHD and normally developing children, also when controlling for the effect of IQ and socioeconomic status (SES). Both sensitivity and specificity of the two CHEXI subscales were shown to be high using either parent or teacher ratings. The highest overall classification rate was found for parent ratings on the inhibition subscale, with sensitivity and specificity reaching 93.3. To summarize, the CHEXI should be considered a promising measure for identifying young children with ADHD, although it is for future research to determine whether the CHEXI can be successfully used to also discriminate between different psychopathological groups.