COVID-19 and children's behavioral health: An overview.

The paper reviews the impact of the COVID-19 pandemic on children's and adolescents' well-being. A trauma-informed framework is employed to discuss the emerging evidence of notable changes in youth's psychological, developmental, academic, and social well-being since the start of the COVID-19 pandemic. Children and adolescents have been uniquely affected based on their age at the start of the pandemic. Despite multiple resiliency factors, COVID-19 and its ramifications have had an adverse effect on youth in general and have exacerbated preexisting racial and socioeconomic disparities. This review concludes with recommendations for child health clinicians.

Addressing Suicide Risk in Primary Care: Cost Savings Associated with Diverting Patients From Emergency Departments.

INTRODUCTION: Integrating behavioral health into primary care ambulatory clinics can improve management of patients presenting with suicidality in medical practices. To date, financial outcomes associated with managing suicidality in integrated care have not been documented. OBJECTIVE: This study sought to evaluate both course of treatment (e.g., the patient is discharged home and referred to emergency departments [EDs]) and financial outcomes (e.g., cost to medical center) for patients presenting with suicidality in integrated pediatric primary care. METHODS: Medical record review was conducted across a 6-month period. Demographics, course of treatment, and financial data were collected. Financial data were extracted using EPSi software using a cost accounting model. We documented the amount in dollars billed to the patient/insurance company and the amount reimbursed to the medical center and then calculated net margins associated with each course of treatment. RESULTS: Participants were 103 youth (aged 7-24 years). The results demonstrate that the integrated model of care diverted 93% of participants from the ED and that the highlighted model of care yielded cost savings for the medical center. After reimbursement, patients seen in the ED for suicide evaluations cost the medical center an average of 16 times more than patients who were managed in the primary care setting. CONCLUSION: The results document the magnitude of cost savings associated with an integrated care model for treating high-risk youth.

Effectively Supporting Youth with Chronic Illness in Schools: External Partnerships and Training Recommendations.

Across Western countries, approximately 15% to 20% of school-aged children and adolescents have a health-related disorder, with incidence rates of childhood chronic health conditions (CHCs) increasing. This contribution comprehensively reviews disease-level, school-level, and systems-level issues related to effectively supporting children with CHCs succeed from both psychosocial and educational perspectives. This article also delineates training needs as they pertain to graduate preparation and/or professional development to equip school personnel to appropriately address students' needs. The article concludes with recommendations for evidence-based prevention and intervention strategies and potential avenues for interdisciplinary collaboration and models of coordinated care for these medically compromised youth.

Integrating Behavioral Health in Primary Care: Lessons from Interdisciplinary Collaboration in School Mental Health.

Integrating behavioral health care into pediatric primary care (PPC) settings can increase access to behavioral health promotion services and treatment. Efficient models for integrated PPC are emerging. Recent reviews call for integrated PPC research to better identify efficient teaming and processes, particularly in areas of building integrated PPC team member capacity and adopting practices that promote "upstream" behavioral wellness specific to community needs. Research in integrating behavioral health in schools has identified key practices relevant to these gaps in integrated primary care (IPC) research. This article discusses possibilities to apply findings from integrated school behavioral health research to IPC settings.

Indirect effect of family climate on adolescent depression through emotion regulatory processes.

Adolescent depression is a serious public health concern, warranting examination of its development. A negative family emotional climate (NFEC) is one risk factor for the development of depressive symptoms. The specific emotion regulatory processes linking NFEC and depression, however, remain unclear. Cognitive reappraisal, a strategy that entails shifting one's thoughts about an emotion eliciting situation before the emotion is generated, expressive suppression, an emotion regulation strategy where individuals push down their expressions of an emotion after it is generated, and emotional inertia, the process of remaining in a given emotional state for a longer period compared to other individuals, were tested as potential emotion processes through which NFEC might be indirectly related to depressive symptoms. Adolescents (N = 92; ages 11-18; 62% girls, 80% White) participated in a multimethod two-time-point study (∼6 months apart). NFEC was measured at Time 1; cognitive reappraisal, expressive suppression, emotional inertia, and depressive symptoms, at Time 2. Emotional inertia scores for negative affect (NA) and positive affect (PA) were obtained through continuous coding of affect during 2 parent-child interactions. Codes were analyzed second-by-second, and multilevel logistic regression was used to extract each participant's emotional inertia score. NFEC was directly related to depressive symptoms. NFEC was also indirectly related to depressive symptoms via cognitive reappraisal and expressive suppression (for girls, not boys) but not emotional inertia (for either NA or PA). Results suggest that both emotion regulation and the family emotional climate should be considered as targets for intervention. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Family environment moderates the relation of sluggish cognitive tempo to attention-deficit/hyperactivity disorder inattention and depression.

OBJECTIVES: The current study investigated whether a maladaptive family environment would moderate the strength of the relations of sluggish cognitive tempo (SCT) to attention-deficit/hyperactivity disorder inattention (ADHD-IN) and to depressive symptoms in a large sample of college students. METHODS: Participants (n = 3,172), between the ages of 18-29 (M ± SDage = 19.24 ± 1.52; 69.8% women; 80.4% White) and enrolled in five universities in the United States completed self-report measures of symptomatology, interparental conflict, and family expressiveness of emotions. RESULTS: A negative emotional climate strengthened relations of SCT with ADHD-IN and depressive symptoms. Moreover, the lack of a positive emotional climate strengthened the co-occurrence of SCT with depressive symptoms, though not with ADHD-IN. CONCLUSIONS: The current study is the first to demonstrate that the family environment moderates the association between SCT and co-occurring symptomatology in young adults.

Dimensionality of Helicopter Parenting and Relations to Emotional, Decision-Making, and Academic Functioning in Emerging Adults.

The current study tests the underlying structure of a multidimensional construct of helicopter parenting (HP), assesses reliability of the construct, replicates past relations of HP to poor emotional functioning, and expands the literature to investigate links of HP to emerging adults' decision-making and academic functioning. A sample of 377 emerging adults (66% female; ages 17-30; 88% European American) were administered several items assessing HP as well as measures of other parenting behaviors, depression, anxiety, decision-making style, grade point average, and academic functioning. Exploratory factor analysis results suggested a four-factor, 23-item measure that encompassed varying levels of parental involvement in the personal and professional lives of their children. A bifactor model was also fit to the data and suggested the presence of a reliable overarching HP factor in addition to three reliable subfactors. The fourth subfactor was not reliable and item variances were subsumed by the general HP factor. HP was found to be distinct from, but correlated in expected ways with, other reports of parenting behavior. HP was also associated with poorer functioning in emotional functioning, decision making, and academic functioning. Parents' information-seeking behaviors, when done in absences of other HP behaviors, were associated with better decision making and academic functioning.

Dyadic Affective Flexibility and Emotional Inertia in Relation to Youth Psychopathology: An Integrated Model at Two Timescales.

The current review examines characteristics of temporal affective functioning at both the individual and dyadic level. Specifically, the review examines the following three research questions: (1) How are dyadic affective flexibility and emotional inertia operationalized, and are they related to youth psychopathology? (2) How are dyadic affective flexibility and emotional inertia related, and does this relation occur at micro- and meso-timescales? and (3) How do these constructs combine to predict clinical outcomes? Using the Flex3 model of socioemotional flexibility as a frame, the current study proposes that dyadic affective flexibility and emotional inertia are bidirectionally related at micro- and meso-timescales, which yields psychopathological symptoms for youth. Specific future directions for examining individual, dyadic, and cultural characteristics that may influence relations between these constructs and psychopathology are also discussed.

Valence-specific emotion transmission: Potential influences on parent-adolescent emotion coregulation.

The current study tested if proximal transmission of positive and negative affect occurs bidirectionally between mothers and their adolescent children in valence-specific patterns (e.g., maternal positive affect to adolescent positive, but not negative, affect) across a period of 7 minutes and between minutes. Whether adolescent gender moderated transmission effects was also explored. One hundred thirty-5 mothers (29-60 years old) and their children (12-16 years old, 49% female) independently completed questionnaires and then jointly engaged in a naturalistic 7-min problem-solving discussion. Transmission was examined by testing how 1 person's expressed affect (assessed observationally) changed the other person's self-reported state affect across the task. In path analyses, support for bidirectional transmission of negative affect emerged. Transmission was valence-specific, however, evidence for transmission of positive affect was not found. Results also supported cross-valence transmission of negative affect specifically from adolescents to their mothers, such that adolescent expressed negative affect predicted reduced maternal self-reported positive affect. Utilizing cross-lagged path analyses to further examine these findings between minutes revealed that transmission did not occur between specific minutes. Results largely support previous theoretical work on the orthogonal structure of affect and the bidirectionality of parent-adolescent affective interactions. Given this evidence for reciprocal transmission of affect across (not between) minutes in a microsocial context, implications for successful emotion coregulation in parent-adolescent interactions and how these mechanisms may predict long-term outcomes are discussed. (PsycINFO Database Record