Searched for: Department/Unit:Child and Adolescent Psychiatry
A randomized controlled trial of technology-enhanced behavioral parent training: sustained parent skill use and child outcomes at follow-up
Parent, Justin; Anton, Margaret T; Loiselle, Raelyn; Highlander, April; Breslend, Nicole; Forehand, Rex; Hare, Megan; Youngstrom, Jennifer K; Jones, Deborah J
BACKGROUND:Early-onset (3-8 years old) disruptive behavior disorders (DBDs) have been linked to a range of psychosocial sequelae in adolescence and beyond, including delinquency, depression, and substance use. Given that low-income families are overrepresented in statistics on early-onset DBDs, prevention and early-intervention targeting this population is a public health imperative. The efficacy of Behavioral Parent Training (BPT) programs such as Helping the Noncompliant Child (HNC) has been called robust; however, given the additional societal and structural barriers faced by low-income families, family engagement and retention barriers can cause effects to wane with time. This study extends preliminary work by examining the potential for a Technology-Enhanced HNC (TE-HNC) program to improve and sustain parent skill proficiency and child outcomes among low-income families. METHODS:A randomized controlled trial with two parallel arms was the design for this study. A total of 101 children (3-8-years-old) with clinically significant problem behaviors from low-income households were randomized to HNC (n = 54) or TE-HNC (n = 47). Participants were assessed at pre-treatment, post-treatment, 3-month, and 6-month follow-ups. Primary outcomes were parent-reported and observed child behavior problems. Secondary outcomes included observed parenting skills use (ClinicalTrials.gov Identifier: NCT02191956). RESULTS:Primary analyses used latent curve modeling to examine treatment differences in the trajectory of change during treatment, maintenance of treatment gains, and levels of outcomes at the 6-month follow-up. Both programs yielded improvements in parenting skills and child problems at post-treatment. However, TE-HNC families evidenced greater maintenance of parent-reported and observed child behavior and observed positive parenting skills at the 6-month follow-up. CONCLUSIONS:Our findings contribute to an ongoing line of work suggesting that technology-enhanced treatment models hold promise for increasing markers of engagement in BPT and sustaining long-term outcomes among low-income families.
PMCID:9177891
PMID: 34888861
ISSN: 1469-7610
CID: 5401242
Retransitioning: The experiences of youth who socially transition genders more than once
Durwood, Lily; Kuvalanka, Katherine A; Kahn-Samuelson, Shira; Jordan, Ashley E; Rubin, Jennifer D; Schnelzer, Pauline; Devor, Aaron H; Olson, Kristina R
PMCID:9621273
PMID: 36324883
ISSN: 2689-5277
CID: 5401152
Clinical Presentation and Treatment of Early-Onset Behavior Disorders: The Role of Parent Emotion Regulation, Emotion Socialization, and Family Income
Highlander, April; Zachary, Chloe; Jenkins, Kaeley; Loiselle, Raelyn; McCall, Madison; Youngstrom, Jennifer; McKee, Laura G; Forehand, Rex; Jones, Deborah J
Parent emotion regulation and socialization have been linked to various aspects of child functioning. In the case of early-onset behavior disorders in particular, parent emotion regulation may be an important correlate of the coercive cycle implicated in early-onset behavior disorders thus, symptom presentation at baseline. Further, emotion socialization may be complicated by a pattern of parent-child interactions in which both supportive or unsupportive parenting behaviors in response to behavioral dysregulation may increase vulnerability for problem behavior in the future. Some work suggests standard Behavioral Parent Training may impact parent emotion regulation and socialization. Still little is known, however, about how such processes may vary by family income, which is critical given the overrepresentation of low-income children in statistics on early-onset behavior disorders. This study explored parent emotion regulation, socialization, and family income in a sample of socioeconomically diverse treatment-seeking families of young (3-8 years old) children. Findings suggest relations between parental emotion regulation, socialization, and child behavior although the pattern of associations differed at baseline and post-treatment and varied by family income. Clinical implications and future directions are discussed.
PMCID:9364231
PMID: 34378434
ISSN: 1552-4167
CID: 5401222
Reciprocal relationships between sleep and smell
Gaeta, Giuliano; Wilson, Donald A
Despite major anatomical differences with other mammalian sensory systems, olfaction shares with those systems a modulation by sleep/wake states. Sleep modulates odor sensitivity and serves as an important regulator of both perceptual and associative odor memory. In addition, however, olfaction also has an important modulatory impact on sleep. Odors can affect the latency to sleep onset, as well as the quality and duration of sleep. Olfactory modulation of sleep may be mediated by direct synaptic interaction between the olfactory system and sleep control nuclei, and/or indirectly through odor modulation of arousal and respiration. This reciprocal interaction between sleep and olfaction presents novel opportunities for sleep related modulation of memory and perception, as well as development of non-pharmacological olfactory treatments of simple sleep disorders.
PMCID:9813672
PMID: 36619661
ISSN: 1662-5110
CID: 5400412
National Suicide Prevention Lifeline 2020 In-State Answer Rates, Stratified by Call Volume Rates and Geographic Region
Purtle, Jonathan; Lindsey, Michael A; Raghavan, Ramesh; Stuart, Elizabeth A
PMID: 35833253
ISSN: 1557-9700
CID: 5396062
The role of trauma-informed practices and individual factors on perceptions of safety among staff in secure juvenile detention settings
Baetz, Carly Lyn; Surko, Michael; Bart, Amanda; Guo, Fei; Alexander, Ava; McCann, Alison; Havens, Jennifer; Horwitz, Sarah Mc Cue
Despite an increased focus on trauma-informed care within the juvenile justice system, we still know very little about the impact of trauma on juvenile justice professionals or their perceptions of trauma-informed interventions. To fill this gap, this study used an organizational assessment to examine perceptions of trauma-informed care among juvenile professionals in a juvenile detention setting. Participants included 204 staff members in two secure juvenile detention facilities. Staff who reported greater availability of trauma-informed practices were more likely to perceive that youth and families felt safe and those who reported that the facility was taking steps to address secondary trauma were more likely to report a sense of staff safety. Regarding individual factors, only age and gender were related to perceptions of youth and family safety. Frontline staff were more likely than supervisory staff to feel they had received adequate training in trauma and had the skills necessary to deescalate youth. These findings suggest that staff are open to trauma-informed practices in juvenile detention, but a greater focus on supervisory staff is needed. Shifting from individual-level strategies to facility-level improvements could have a greater impact on enhancing staff members"™ perceptions of safety, which improves their ability to care for youth.
SCOPUS:85144218543
ISSN: 0735-648x
CID: 5393672
Hippocampal mossy cells exhibit some of the earliest signs of increased excitability in the Tg2576 model of Alzheimer"™s disease neuropathology
Alcantara-Gonzalez, David; Criscuolo, Chiara; Botterill, Justin J.; Lisgaras, Christos; Kennedy, Meghan; Scharfman, Helen E.
Background: Alzheimer"™s disease (AD) is a neurodegenerative illness characterized by progressive accumulation of amyloid beta (Aβ) and neurofibrillary tangles, with cognitive impairment and altered neural activity. Hyperexcitability in the early stages of AD contribute to Aβ accumulation and cognitive impairment, aggravating the progression of AD. However, the hyperexcitability origin is not clear. This study aimed to test whether mossy cells (MCs), an excitatory cell of the hippocampal dentate gyrus, show increased excitability at early stages of AD and contribute to the increased network excitability generation. Indeed, alterations of MCs contribute to hyperexcitability and cognitive impairment in epilepsy. However, the role of MCs in AD has not been substantially explored. Methods: Intrinsic and synaptic properties of MCs and granule cells (GCs) from WT and Tg2576 mice at early ages (1-2 m.o.) were characterized by whole-cell patch-clamp recordings. Synaptic properties included the frequency and amplitude of spontaneous excitatory postsynaptic potentials (EPSPs) and excitatory and inhibitory postsynaptic currents (EPSCs and IPSCs). Deterioration in MCs morphology was evaluated using Nissl staining and GluR2/3 labeling by light- and confocal microscopy. Aβ deposition was evaluated using the McSA1 antibody. Results: Tg2576 GCs did not have any significant difference in their intrinsic properties, as we shown previously in mice ∼3 m.o. However, an enhanced excitatory and inhibitory input to GCs, depicted by augmented IPSC (7.16 vs 14.04 events/s) and NMDA-mediated EPSC frequencies (0.81 vs 1.41 events/s) were found. Interestingly, Tg2576 MCs had an augmented EPSP frequency (5.75 vs 9.44 events/s), and their intrinsic properties showed a depolarized RMP (-72.88 vs -58.36 mV), and reduced rheobase (145.56 vs 47.14 pA), AP amplitude (98.14 vs 76.66 mV), time-to-peak (552.75 vs 266.16 ms) and maximum rise (171.44 vs 88.68 mV/ms) and decay slopes (-61.17 vs -42.38 mV/ms). The correlation between #APs and current injected showed Tg2576 MCs fired significantly more APs (SEZD = 0.34; z = 2.48). Tg2576 MCs showed robust intracellular Aβ aggregation without any significant morphological change. Conclusions: MCs changes in excitability and early accumulation of Aβ suggest that MCs could be the cause of increased excitability occurring later in GCs. In this manner, MCs could be an important contributor to AD.
SCOPUS:85144472472
ISSN: 1552-5260
CID: 5393942
Postural Orthostatic Tachycardia Syndrome (POTS): Characteristics of Youth Enrolled in an Outpatient Interdisciplinary Pediatric Chronic Pain Program [Meeting Abstract]
Amirniroumand, Roya; Salamon, Katherine S.
ISI:000792497000191
ISSN: 1526-5900
CID: 5392072
Flexibility in action: Development of locomotion under overhead barriers
Rachwani, Jaya; Herzberg, Orit; Kaplan, Brianna E; Comalli, David M; O'Grady, Sinclaire; Adolph, Karen E
Behavioral flexibility-the ability to tailor motor actions to changing body-environment relations-is critical for functional movement. Navigating the everyday environment requires the ability to generate a wide repertoire of actions, select the appropriate action for the current situation, and implement it quickly and accurately. We used a new, adjustable barrier paradigm to assess flexibility of motor actions in 20 17-month-old (eight girls, 12 boys) and 14 13-month-old (seven girls, eight boys) walking infants and a comparative sample of 14 adults (eight women, six men). Most participants were White, non-Hispanic, and middle class. Participants navigated under barriers normalized to their standing height (overhead, eye, chest, hip, and knee heights). Decreases in barrier height required lower postures for passage. Every participant altered their initial walking posture according to barrier height for every trial, and all but two 13-month-olds found solutions for passage. Compared to infants, adults displayed a wider variety of strategies (squat-walking, half-kneeling, etc.), found more appropriate solutions based on barrier height (ducked at eye height and low crawled at knee height), and implemented their solutions more quickly (within 4 s) and accurately (without bumping their heads against the barrier). Infants frequently crawled even when the barrier height did not warrant a low posture, displayed multiple postural shifts prior to passage and thus took longer to go, and often bumped their heads. Infants' improvements were related to age and walking experience. Thus, development of flexibility likely involves the contributions of multiple domains-motor, perception, and cognition-that facilitate strategy selection and implementation. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
PMCID:9050859
PMID: 35311311
ISSN: 1939-0599
CID: 5387672
A single-index model with a surface-link for optimizing individualized dose rules
Park, Hyung; Petkova, Eva; Tarpey, Thaddeus; Ogden, R Todd
This paper focuses on the problem of modeling and estimating interaction effects between covariates and a continuous treatment variable on an outcome, using a single-index regression. The primary motivation is to estimate an optimal individualized dose rule and individualized treatment effects. To model possibly nonlinear interaction effects between patients' covariates and a continuous treatment variable, we employ a two-dimensional penalized spline regression on an index-treatment domain, where the index is defined as a linear projection of the covariates. The method is illustrated using two applications as well as simulation experiments. A unique contribution of this work is in the parsimonious (single-index) parametrization specifically defined for the interaction effect term.
PMCID:9306450
PMID: 35873662
ISSN: 1061-8600
CID: 5387832