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1.
Artigo em Inglês | MEDLINE | ID: mdl-38615279

RESUMO

Since the onset of the COVID-19 pandemic, consultation/liaison (C/L) psychologists had to drastically shift their practices to care for psychiatrically acute pediatric patients admitted to medical settings. The aim of the current study was to provide an updated state of the field surrounding these changes and their implications for clinical practice. Psychologists and psychology post-doctoral fellows completed an anonymous, 51-item survey distributed via a national professional organization listserv. The results review responses, by percentages, about C/L team composition and practice patterns, as they relate to suicide risk assessments, transfers to inpatient psychiatric and other levels of care, intervention for boarding patients, and disposition and safety planning. Thematically coded qualitative responses regarding impact and management of high acuity patients are also summarized. The state of the field outlined by this survey suggests an increase in C/L assessments and interventions delivered to pediatric patients with acute psychiatric needs, as well as a reverberating effects on provider wellness. Ensuring providers establish competency for this subset of patients is vital to the continued provision of optimal patient care and to sustained provider wellness. Considerations for the field are explored.

2.
J Pediatr Psychol ; 49(6): 413-420, 2024 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-38591792

RESUMO

OBJECTIVE: Automated insulin delivery (AID) systems show great promise for improving glycemic outcomes and reducing disease burden for youth with type 1 diabetes (T1D). The current study examined youth and parent perspectives after using the insulin-only iLet Bionic Pancreas (BP) during the 13-week pivotal trial. METHODS: Parents and youth participated in focus group interviews, with questions assessing participants' experiences in a variety of settings and were grounded in the Unified Theory of Acceptance and Use of Technology. Qualitative analysis was completed by 3 authors using a hybrid thematic analysis approach. RESULTS: Qualitative analysis of focus groups revealed a total of 19 sub-themes falling into 5 major themes (Diabetes Burden, Freedom and Flexibility, Daily Routine, Managing Glucose Levels, and User Experience). Participants' overall experience was positive, with decreased burden and improved freedom and flexibility. Some participants reported challenges in learning to trust the system, adjusting to the user interface, and the system learning their body. CONCLUSION: This study adds to the growing literature on patient perspectives on using AID systems and was among the first to assess caregiver and youth experiences with the BP system over an extended period (13 weeks). Patient feedback on physical experiences with the device and experiences trusting the device to manage glucose should inform future development of technologies as well as approaches to education for patients and their families.


Assuntos
Diabetes Mellitus Tipo 1 , Grupos Focais , Sistemas de Infusão de Insulina , Insulina , Pâncreas Artificial , Pais , Pesquisa Qualitativa , Humanos , Diabetes Mellitus Tipo 1/tratamento farmacológico , Diabetes Mellitus Tipo 1/terapia , Diabetes Mellitus Tipo 1/psicologia , Adolescente , Criança , Feminino , Masculino , Insulina/uso terapêutico , Adulto , Hipoglicemiantes/uso terapêutico
3.
J Pediatr Psychol ; 49(5): 340-347, 2024 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-38452291

RESUMO

OBJECTIVE: Eating disorders among children and adolescents have increased in prevalence, and mortality rates for anorexia nervosa are among the highest for any psychiatric disorder. Our current study aimed to (a) examine the cross-sectional relationship between body composition and anxiety/depressive symptoms among 97 adolescents and young adults who have been diagnosed with anorexia nervosa, (b) examine the longitudinal changes in body composition and anxiety/depressive symptoms over three months (from baseline to follow-up visit), and (c) examine the longitudinal relationship between change in body composition and change in anxiety/depression over three months. METHOD: A retrospective chart review was conducted within an interdisciplinary eating disorder clinic between August 2019 and December 2021. In total, 97 adolescents aged 11-20 years old with diagnoses of anorexia nervosa were included in the analyses. Body composition data were collected at each visit along with parent- and youth-report measures of symptoms of anxiety/depression symptoms. RESULTS: Findings indicated adolescents demonstrated some improvement in body composition, as well as parent-reported reductions in anxiety/depression symptoms. Based on parent reports, increased BMI percentile was associated with improvements in anxiety/depression symptoms. On the other hand, youth did not report significant changes in anxiety/depressive symptoms. Additionally, there were no associated improvements with body composition measures, which may be associated with continued body dissatisfaction or symptoms of anxiety and depression predating the eating disorder. CONCLUSIONS: These results suggest the importance of including interventions addressing depression, anxiety, and body image as part of treatment.


Assuntos
Anorexia Nervosa , Ansiedade , Composição Corporal , Depressão , Humanos , Adolescente , Anorexia Nervosa/psicologia , Composição Corporal/fisiologia , Feminino , Estudos Transversais , Depressão/psicologia , Masculino , Ansiedade/psicologia , Criança , Estudos Longitudinais , Adulto Jovem , Estudos Retrospectivos , Adulto
4.
Endocrinol Metab Clin North Am ; 53(1): 107-122, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38272590

RESUMO

The intensive demands of diabetes care can be difficult for youth with type 1 diabetes and their families to integrate into daily life. Standards of care in pediatric diabetes highlight the importance of evidence-based psychosocial interventions to optimize self-management behaviors and psychological well-being. The current review summarizes select systematic reviews and meta-analyses on evidence-based behavioral health interventions in pediatric diabetes. Interventions include strategies to strengthen youth psychosocial skills, improve family dynamics and caregiver mental health, enhance health and mental health equity, and address psychosocial factors related to diabetes technology use.


Assuntos
Diabetes Mellitus Tipo 1 , Reabilitação Psiquiátrica , Autogestão , Humanos , Criança , Adolescente , Diabetes Mellitus Tipo 1/terapia , Diabetes Mellitus Tipo 1/psicologia , Terapia Comportamental
5.
J Pediatr Psychol ; 49(6): 394-404, 2024 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-38216126

RESUMO

OBJECTIVES: Adolescents with type 1 diabetes (T1D) and their caregivers endorse high diabetes distress (DD). Limited studies have documented the impact of DD on Black youth. The aims of the present study were to (1) describe DD among a sample of Black adolescents with T1D and their caregivers, (2) compare their DD levels with published normative samples, and (3) determine how DD relates to glycemic outcomes, diabetes self-management, parental monitoring of diabetes, and youth depressive symptoms. METHODS: Baseline data from a multicenter clinical trial were used. Participants (N = 155) were recruited from 7 Midwestern pediatric diabetes clinics. Hemoglobin A1c (HbA1c) and measures of DD, parental monitoring of diabetes care, youth depression and diabetes management behaviors were obtained. The sample was split into (1) adolescents (ages 13-14; N = 95) and (2) preadolescents (ages 10-12; N = 60). Analyses utilized Cohen's d effect sizes, Pearson correlations, t-tests, and multiple regression. RESULTS: DD levels in youth and caregivers were high, with 45%-58% exceeding either clinical cutoff scores or validation study sample means. Higher DD in youth and caregivers was associated with higher HbA1c, lower diabetes self-management, and elevated depressive symptoms, but not with parental monitoring of diabetes management. CONCLUSIONS: Screening for DD in Black youth with T1D and caregivers is recommended, as are culturally informed interventions that can reduce distress levels and lead to improved health outcomes. More research is needed on how systemic inequities contribute to higher DD in Black youth and the strategies/policy changes needed to reduce these inequities.


Assuntos
Negro ou Afro-Americano , Cuidadores , Depressão , Diabetes Mellitus Tipo 1 , Controle Glicêmico , Comportamentos Relacionados com a Saúde , Humanos , Diabetes Mellitus Tipo 1/psicologia , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/terapia , Adolescente , Feminino , Cuidadores/psicologia , Masculino , Negro ou Afro-Americano/psicologia , Criança , Depressão/psicologia , Depressão/etnologia , Controle Glicêmico/psicologia , Hemoglobinas Glicadas , População Urbana , Autogestão/psicologia , Angústia Psicológica , Estresse Psicológico/psicologia
6.
Fam Syst Health ; 2023 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-37589690

RESUMO

INTRODUCTION: Depression and anxiety among youth with Type 1 diabetes (T1D) are associated with poor diabetes management. Further guidance regarding psychosocial screening measures would benefit pediatric integrated care clinics. The purpose of this exploratory study was to examine whether screening for anxiety, assessing caregiver reports, and screening children 12 years old and younger could identify a larger percentage of youth who may benefit from behavioral health support compared to the standard approach of only screening youth 13 and older for depression. METHOD: Sixty-five youth 8-17 years old with T1D (N = 65; M = 13.2 years; 55.4% females) and their caregivers (75% mothers) completed validated self-report and proxy-report depression and anxiety screeners during routine clinic visits between 2019 and 2021. Twenty-seven youth aged 13-17 also completed a measure of diabetes-related distress. RESULTS: The standard approach of screening youth aged 13-17 for depression via self-report identified 25.6% of participants, whereas screening youth ages 8-17 for depression and anxiety via self- and proxy-reports identified 47.7%. Screening for depression/anxiety identified unique portions of youth independent of diabetes distress. DISCUSSION: Utilizing anxiety and proxy-report measures may identify youth likely to benefit from behavioral health support who are not identified when only a self-report depression measure is used in screening. Research should evaluate whether utilizing multiple measures and screening children under 13 years old improve detection and connection to care for youth experiencing difficulty managing diabetes. Early identification and intervention could subsequently mitigate the negative impacts of social-emotional difficulties on diabetes management. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

7.
Int J Eat Disord ; 56(1): 257-262, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-35906993

RESUMO

OBJECTIVE: We aimed to identify trends of patients with eating disorders (EDs) requiring hospitalization before and during the pandemic at a children's hospital in the southeastern United States. METHOD: A retrospective chart review was completed for 71 adolescents and young adults (ages 10-21 years; M = 14.61, SD = 2.121). RESULTS: Results indicated a 188% increase in ED hospital admissions since the pandemic, with patients presenting with increased rates of comorbid mental health diagnoses (p = .009). During COVID-19, the development of temporary outpatient multidisciplinary discharge plans (i.e., "bridge plans") were utilized more often due to difficulties accessing the appropriate level of care (p = .039). DISCUSSION: Results suggest a significant increase in youth requiring medical stabilization for EDs since the start of the COVID-19 pandemic (2.9 times more than prepandemic), as well as a need for greater advocacy to increase specialized mental health services along the full continuum of care. PUBLIC SIGNIFICANCE STATEMENT: This study brings awareness to the significant increase in patients needing medical stabilization secondary to restrictive EDs and increased rates of comorbid mental health diagnoses in this patient population since the onset of the COVID-19 pandemic. Patients during COVID-19 were less likely to directly transition to treatment likely secondary to the strain COVID-19 placed on mental health systems/treatment centers. Increased advocacy for specialized care for eating disorder patients.


Assuntos
COVID-19 , Transtornos da Alimentação e da Ingestão de Alimentos , Criança , Adulto Jovem , Humanos , Adolescente , Adulto , Pandemias , Estudos Retrospectivos , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Acessibilidade aos Serviços de Saúde
8.
Pediatr Clin North Am ; 69(5): 905-916, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36207101

RESUMO

The care of youth managed within pediatric endocrine clinics is complex and requires a multi- or interdisciplinary approach. Psychosocial aspects of chronic health conditions are well-documented. Clinical practice guidelines outline the importance of routine psychosocial screening and support for youth with diabetes and obesity. This article outlines the diverse role of psychologists in pediatric endocrinology, including screening, in-clinic intervention, outpatient psychological services, and inpatient consultation. Although research exists documenting the effectiveness of behavioral interventions to improve adherence and health-related quality of life, cost analysis research is emerging.


Assuntos
Endocrinologia , Qualidade de Vida , Adolescente , Assistência Ambulatorial , Terapia Comportamental , Criança , Humanos , Obesidade
9.
J Clin Psychol Med Settings ; 29(4): 840-848, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-35083617

RESUMO

Coronavirus (COVID-19) has affected opportunities available to psychology interns and postdoctoral fellows completing capstone training experiences during culminating training years. While research supports COVID-19 has increased the use of telepsychology services amongst psychologists, there is a paucity of research regarding how COVID-19 has altered training and use of telepsychology by psychology trainees. The current study includes survey responses from 59 psychology training directors and 58 psychology internship and postdoctoral fellowship trainees at pediatric sites throughout the United States. Results support changes in telepsychology training provided during COVID-19, including increased use of telepsychology for clinical service delivery and increased use of telesupervision for training. As expected, findings suggest novel training experiences in telepsychology for trainees within the last two years as a result of COVID-19. Given ongoing need for telepsychology services to assure access to psychological care during the pandemic and beyond, results provide support for graduate and advanced training programs to provide formal training in best-practices for utilization of telepsychology and telesupervision.


Assuntos
COVID-19 , Internato e Residência , Adolescente , Criança , Estados Unidos , Humanos , Pandemias , Bolsas de Estudo , Família
10.
Pediatr Diabetes ; 22(7): 1081-1091, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34455658

RESUMO

OBJECTIVE: Type 1 diabetes (T1D) is one of the most common pediatric chronic illnesses and increasing worldwide in prevalence. Physical activity has been positively linked with better glycemic control in youth with T1D. Although not yet studied, children's social self-efficacy may be a parameter related to physical activity in youth with diabetes. The current study investigated associations among social self-efficacy, physical activity, diabetes quality of life, and hemoglobin A1c (HbA1c) among youth with T1D utilizing mediation and serial mediation models. RESEARCH DESIGN AND METHODS: Participants were 144 youth (M age = 14.95) with T1D (53.5% girls) and their caregivers. Youth completed the PedsQL Diabetes Module, the Physical Activity Questionnaire for Older Children and Adolescents and the Self-Efficacy Questionnaire for Social Skills for Children. Youths' HbA1c values were also measured. RESULTS: Physical activity significantly mediated the relationship between greater youth social self-efficacy and better diabetes quality of life. Diabetes quality of life mediated the relationship between greater physical activity and lower HbA1c. The serial mediation model demonstrated greater social self-efficacy is related to greater physical activity, which in turn is related to better diabetes quality of life and ultimately resulting in lower HbA1c. CONCLUSIONS: Physical activity, social self-efficacy, and diabetes-related quality of life may be modifiable factors related to HbA1c for youth with T1D. Findings indicate a need for healthcare providers to consider youth physical activity, quality of life, and social self-efficacy when evaluating and intervening in youth diabetes treatment adherence.


Assuntos
Diabetes Mellitus Tipo 1/psicologia , Diabetes Mellitus Tipo 1/terapia , Exercício Físico/fisiologia , Hemoglobinas Glicadas/análise , Autoeficácia , Interação Social , Adolescente , Criança , Diabetes Mellitus Tipo 1/sangue , Escolaridade , Feminino , Humanos , Sistemas de Infusão de Insulina , Masculino , Qualidade de Vida , Inquéritos e Questionários
11.
Pediatr Diabetes ; 22(6): 924-932, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34173308

RESUMO

OBJECTIVE: Among adolescents with type 1 diabetes, research has found that their perception of their diabetes management is an important predictor of actual diabetes management. There is a need for measures that assess adolescents' perception of their ability to independently complete daily diabetes self-care tasks. The current study examined the psychometric properties of the Diabetes Skills Checklist Teen-Report (DSC-T) and DSC Parent of Teen-Report (DSC-PT), which assess perceived independence in diabetes self-care skills. RESEARCH DESIGN AND METHODS: Data were from 1450 adolescents aged 12 to 18 years and their parents who participated in the Diabetes Camp Matters Study. Families completed the DSC as well as other questionnaires online assessing demographic and diabetes-related information, diabetes strengths, and diabetes-specific emotional distress. RESULTS: Exploratory factor analysis revealed a 14-item DSC-T and 12-item DSC-PT, both with excellent internal consistency and concurrent validity. Both the DSC-T and DSC-PT were found to be positively correlated with diabetes strengths and negatively correlated with HbA1c, and the DSC-PT was significantly correlated with parent-reported diabetes distress. Adolescents who used insulin pumps and continuous glucose monitoring reported higher perceived independence in diabetes self-care skills compared to adolescents who used insulin pens/syringes or blood glucose meters. No differences were found based on demographic characteristics. CONCLUSIONS: The DSC-T and DSC-PT have strong potential to be used during diabetes clinic visits to spark discussion regarding adolescents' self-care, which would allow for a more successful transfer of diabetes care from parent to adolescent, and eventually, the transition from pediatric to adult healthcare.


Assuntos
Diabetes Mellitus Tipo 1/psicologia , Autocuidado/psicologia , Autoeficácia , Adolescente , Feminino , Humanos , Masculino , Pais/psicologia , Psicometria , Reprodutibilidade dos Testes
12.
Endocrinol Metab Clin North Am ; 49(1): 127-141, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31980113

RESUMO

This article offers a systematic review of the literature on psychosocial aspects of technology use in children and adolescents with type 1 diabetes and their families, searching for relevant articles published the past 5 years. Topics included continuous subcutaneous insulin infusion, continuous glucose monitoring, predictive low-glucose suspend, and artificial pancreas systems. The review indicates there are positive and negative psychosocial aspects to diabetes technology use among youth and their families. Although consistent findings were revealed, contradictions exist. Discussed are recommendations for future research and implications for how health care providers can collaborate with families to discuss and manage diabetes technology.


Assuntos
Diabetes Mellitus Tipo 1/psicologia , Diabetes Mellitus Tipo 1/terapia , Equipamentos e Provisões , Percepção , Adolescente , Automonitorização da Glicemia/instrumentação , Automonitorização da Glicemia/psicologia , Criança , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/tratamento farmacológico , Família/psicologia , Controle Glicêmico/instrumentação , Controle Glicêmico/psicologia , Humanos , Sistemas de Infusão de Insulina/psicologia , Invenções , Pâncreas Artificial/psicologia , Relações Pais-Filho
13.
J Pediatr Psychol ; 45(3): 247-265, 2020 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-31710671

RESUMO

OBJECTIVE: Youth with chronic illness are at higher risk for psychosocial difficulties, leading to a call for screening via patient-reported outcomes (PROs). The purpose of the current review is to summarize PRO implementation in pediatric medical specialty settings. A literature review of PRO implementation in these settings, conceptual issues, value and approach, legal and ethical concerns, as well as a case example of PROA in type 1 diabetes are presented. METHODS: A systematic review was conducted to identify relevant articles published since the most recent Journal of Pediatric Psychology Special Issue on Evidence-Based Assessment in Pediatric Psychology (2008). RESULTS: Thirty-two articles were identified and reviewed. The majority of studies reported that PROA was feasible, did not disrupt clinic flow, identified psychosocial issues warranting intervention, and was acceptable to families and providers. Response to elevated scores and impact on behavioral health referrals varied. CONCLUSION: While many evidenced-based assessment measures are well-validated within pediatric chronic illness groups, the literature regarding implementation of PROs is still emerging. Research findings are promising, with PROs being feasible, acceptable, and leading to increased discussion of psychosocial issues when integrated into pediatric medical settings. Additional research is needed to evaluate the longitudinal impact of PROs and the optimal manner of responding to assessment data, particularly when clinically-elevated. Ultimately, identifying psychosocial issues in pediatric medical settings can promote optimal health and well-being of youth with chronic illness and their families.


Assuntos
Doença Crônica/psicologia , Diabetes Mellitus Tipo 1/psicologia , Medidas de Resultados Relatados pelo Paciente , Adolescente , Adulto , Ansiedade/diagnóstico , Criança , Pré-Escolar , Depressão/diagnóstico , Feminino , Humanos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Qualidade de Vida , Adulto Jovem
14.
Fam Syst Health ; 36(3): 357-367, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29999340

RESUMO

INTRODUCTION: This study examined concordance and discordance between parent-adolescent report of diabetes-specific emotional distress and associations with A1c and diabetes-related strengths. Diabetes strengths refer to adaptive behaviors and attitudes that enhance resilience in living with diabetes. METHOD: One thousand two hundred sixteen adolescent-parent dyads completed measures of diabetes distress and adolescent-reported diabetes strengths. Polynomial regression with response surface analysis assessed concordant and discordant reports of adolescent-parent distress and independent associations of each reporter's distress on measures of diabetes strengths and A1c. RESULTS: A1c was lower in concordantly lower distress dyads compared to concordantly higher distress dyads. For discordant dyadic reports, A1c was higher when distress was higher for parents and lower for adolescents compared to low-parent-high-adolescent distress. Greater diabetes-related strengths were reported when distress was concordantly low among dyads and fewer strengths were reported when distress was concordantly higher. Greater strengths were reported when distress was lower for adolescents and higher for parents compared to high-adolescent/low-parent distress. Dyadic distress for both A1c and diabetes strengths were robust when adjusted for significant demographic predictors of outcome including age, race, income, pump use, and continuous glucose monitoring use. DISCUSSION: A1c and diabetes strengths are associated with degree of concordant and discordant reports of diabetes distress among adolescent-parent dyads. Programmatic interventions should target parents and adolescents, particularly when diabetes distress is higher among both adolescents and their parents. (PsycINFO Database Record


Assuntos
Diabetes Mellitus/psicologia , Relações Familiares/psicologia , Relações Pais-Filho , Adolescente , Criança , Estudos Transversais , Feminino , Hemoglobinas Glicadas/análise , Humanos , Renda/estatística & dados numéricos , Masculino , Análise de Regressão , Estresse Psicológico/complicações , Estresse Psicológico/psicologia
15.
Curr Diab Rep ; 18(3): 15, 2018 02 19.
Artigo em Inglês | MEDLINE | ID: mdl-29457190

RESUMO

PURPOSE OF REVIEW: A systematic review was conducted of family-based interventions to improve glycemic control, adherence, and psychosocial outcomes in children and adolescents with type 1 diabetes (T1D). Electronic databases were searched for randomized controlled trials (RCTs) published since the seminal Diabetes Control and Compliance Trial (DCCT). Interventions are summarized and findings reviewed to help guide clinical practice and future research. RECENT FINDINGS: Twenty-five RCTs are reviewed. The majority of studies (n = 15) focused on interventions targeting both children and adolescents and their caregivers and were delivered in diabetes clinics, outpatient settings, mental health clinics, or participants' homes. Family-based interventions for youth with T1D appear effective at improving diabetes and family-centered outcomes. Additional research is needed to examine the pathways to improvement in glycemic control, as outcomes were mixed. Future research should also involve measures beyond HbA1c given new markers for sustained health improvement and outcomes are being explored.


Assuntos
Cuidadores , Diabetes Mellitus Tipo 1/terapia , Autocuidado , Adolescente , Criança , Humanos
16.
J Pediatr Psychol ; 41(10): 1091-1109, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27289069

RESUMO

OBJECTIVE : To examine the classification accuracy of measures of overall psychopathology recommended for pediatric primary care screening. METHOD : A systematic review identified relevant instruments described in the literature. Subsequent systematic reviews identified studies of sensitivity (SE) and specificity (SP) of each measure for various cutoffs and different criteria for disorder (e.g., caseness determined by structured interview, exceeding a cutoff score, referral for psychiatric evaluation). RESULTS : Measures include the Child Behavior Checklist (CBCL), Pediatric Symptom Checklist (PSC), Strengths and Difficulties Questionnaire (SDQ), Brief Infant-Toddler Social Emotional Assessment (BITSEA), and the Ages and Stages Questionnaire: Social-Emotional scale (ASQ:SE). For three measures (CBCL, PSC, and SDQ) studied extensively, achieving relatively high SE and SP values (≥ .70) simultaneously occurred in only 30-55% of the studies reviewed. There are relatively few studies of the ASQ:SE and BITSEA, or of relatively new measures. DISCUSSION : Documented utility of these measures as screening instruments is limited.


Assuntos
Serviços de Saúde da Criança , Serviços Comunitários de Saúde Mental/métodos , Prestação Integrada de Cuidados de Saúde/métodos , Programas de Rastreamento/métodos , Transtornos Mentais/diagnóstico , Atenção Primária à Saúde/métodos , Escalas de Graduação Psiquiátrica , Criança , Serviços de Saúde da Criança/organização & administração , Serviços Comunitários de Saúde Mental/organização & administração , Humanos , Atenção Primária à Saúde/organização & administração , Psicometria , Sensibilidade e Especificidade , Estados Unidos
17.
J Pediatr Psychol ; 41(10): 1081-1090, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27289070

RESUMO

OBJECTIVE: The Affordable Care Act has stimulated interest in screening for psychological problems in primary care. Given the scale with which screening might occur, the implications of a problem known as the base rate fallacy need to be considered. METHODS: The concepts of sensitivity and specificity, positive and negative predictive value, and the base rate fallacy are discussed. The possibility that a screening program may not improve upon random selection is reviewed, as is the possibility that sequential screening might be useful. RESULTS AND DISCUSSION: Developing effective screening programs for pediatric mental health problems is highly desirable, and properly addressing the high rate of false positives may improve the likelihood that such programs can be sustained. Consideration needs to be given to the use of sequential screening, which has both advantages and disadvantages, depending upon the type of problem to be screened for and the availability of resources for follow-up evaluations.


Assuntos
Serviços de Saúde da Criança , Serviços Comunitários de Saúde Mental/métodos , Prestação Integrada de Cuidados de Saúde/métodos , Programas de Rastreamento/métodos , Transtornos Mentais/diagnóstico , Atenção Primária à Saúde/métodos , Criança , Serviços de Saúde da Criança/organização & administração , Serviços Comunitários de Saúde Mental/organização & administração , Prestação Integrada de Cuidados de Saúde/organização & administração , Humanos , Programas de Rastreamento/organização & administração , Atenção Primária à Saúde/organização & administração , Escalas de Graduação Psiquiátrica , Sensibilidade e Especificidade , Estados Unidos
18.
Infant Ment Health J ; 35(6): 555-64, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25798505

RESUMO

Low levels of attendance and implementation of strategies in behavioral parent-training programs may limit their impact. The purpose of this study was to examine attendance and implementation across a behavioral parent-training program delivered in English and Español. Participants included parents (n = 739) of young children who attended a behavioral parent-training program. The mean number of sessions attended for the entire sample was 4.46 (SD = 1.66, range = 1-6) of six sessions, and the mean number of strategies implemented was 17.66 (SD = 11.43, range = 0-35) of a possible 35. There were no significant differences across the number of sessions attended among the participants in the English (M = 4.45) and Español versions (M = 4.48) of the course, t(737) = -0.20, p = .85. There also were no significant differences between the English (M = 17.97) and Español (M = 16.87) versions for the number of Tip Trackers completed, t(737) = 1.18, p = .24. Only child diagnosis predicted parent attendance in the English group. Implications for research and practice are discussed.


Assuntos
Educação não Profissionalizante/métodos , Etnicidade/estatística & dados numéricos , Idioma , Pais/educação , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Autorrelato , Participação Social , Inquéritos e Questionários , Adulto Jovem
19.
Child Dev ; 82(6): 1921-37, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-22023144

RESUMO

In accord with increasing recognition of the situation specificity of childhood social behaviors, individual and contextual differences in children's responses to potential peer conflict were examined (hostile attribution, behavioral strategies, and affective reactions; N = 367, 9-12 years, 197 girls). Situational cues from 2 sources, the antagonist and a witnessing best friend, were designed to suggest the antagonist's intentions. Multilevel modeling indicated that children's responses generally varied more according to cues from the antagonist than friend, but the latter also affected responses, especially when conflicting with other situational information. Cognitive and affective responses were also influenced by gender, social goals, friendship quality, and self-efficacy for peer interaction. Findings provide theoretical insight on the context of peer conflict.


Assuntos
Conflito Psicológico , Sinais (Psicologia) , Amigos/psicologia , Relações Interpessoais , Grupo Associado , Agressão/psicologia , Hostilidade , Humanos , Individualidade , Meio Social
20.
CBE Life Sci Educ ; 5(2): 128-36, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-17012203

RESUMO

The National Science Education Standards recommend that science be taught using inquiry-based approaches. Inspired by the Dana Alliance for Brain Initiatives, we examined whether undergraduate students could learn how to conduct field research by teaching elementary school children basic neuroscience concepts in interactive workshops. In an inquiry-based learning experience of their own, undergraduate psychology students working under the close supervision of their instructor designed and provided free, interactive, hour-long workshops focusing on brain structure and function, brain damage and disorders, perception and illusions, and drugs and hormones to fifth-graders from diverse backgrounds, and we assessed the effectiveness of the workshops using a pretest-post-test design. The results suggest that the workshops enhanced the children's knowledge of neuroscience concepts as measured using pre- and post-open-ended assessments. The undergraduates also found their learning experience engaging and productive. The article includes detailed descriptions of the workshop activities, procedures, the course in which the undergraduates implemented the workshops, and guidance for future university-school collaborations aimed at enhancing science literacy.


Assuntos
Neurociências/educação , Instituições Acadêmicas , Ensino/métodos , Universidades , Adolescente , Adulto , Criança , Fundações , Humanos , Relações Interpessoais , Estudantes , Estados Unidos
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