Download CLINICAL PSYCHOLOGY Current Awareness Bulletin

CLINICAL PSYCHOLOGY
Current Awareness Bulletin
Issue 23
2014
Click on the heading below to move to that section of the bulletin
Library News
Guidelines
Reports
Hitting the Headlines
Pain
Social Services
Critical/Community
Psychology
Children’s Clinical
Psychology
Looked After/Adopted
Children
Autism/Asperger’s
Syndrome
Children’s Mental Health
Addictions
Children, Diabetes and
Psychology
Attachment & Related
Issues
Somatic/Psychosomatic
illnesses
Conversion Disorders
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1
Clinical Psychology Current Awareness Bulletin No: 23 2014
GUIDELINES
 Title: National Guidance for Child Protection in Scotland
Author: Scottish Government
View: http://www.scotland.gov.uk/Resource/0045/00450733.pdf
National Guidance for Child Protection in Scotland was published in 2010 and refreshed in 2014 to
ensure that it remains relevant and up to date for local agencies and practitioners working together
to safeguard and promote the wellbeing of children.
 Title: National Guidance for Child Protection in Scotland. Additional notes for practitioners:
protecting disabled children from abuse and neglect
Author: Scottish Government
View: http://www.scotland.gov.uk/Resource/0045/00450942.pdf
These practice notes are for all practitioners including those working in: children and family social
work; health; education; residential care; early years; youth services; youth justice; police;
independent and third sector; and adult services who might be supporting parents with disabled
children or involved in the transition between child and adult services.
 Title: NSPCC Inform
Author: NSPCC
View:
http://www.nspcc.org.uk/Inform/resourcesforprofessionals/children_with_disabilities_home_wda8049
1.html
Updated pages on safeguarding disabled children.
 Title: Child death overview panels: contacts
Author: Department for Education
View:
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/311922/CDOP_sprea
dsheet_May_updates.xls
[MS Excel Spreadsheet, 116KB]
Since 1 April 2008 all local safeguarding children boards (LSCBs) are required to review the deaths
of all children in their area, as outlined in chapter 5 of the 2013 guidance, ‘Working together to
safeguard children.
The overall principle of the child death review process is to learn lessons and reduce the incidence
of preventable child deaths in the future. It is a statutory requirement in the Children and Young
Persons Act 2008 that each LSCBmust make arrangements for the receipt of notifications from
registrars and to publish those arrangements. The Coroners (Amendment) Rules 2008 also place a
duty on coroners to inform an LSCB for the area in which the child died that there will be an inquest
or post-mortem.
In addition, in order for LSCBs to fulfil their responsibilities for reviewing deaths, every LSCB should
be informed of all deaths of children normally resident in its geographical area.
To assist those responsible for carrying out these tasks, contact details are provided for the child
death overview panels in England.
 Title: Tackling Drug Use
Author: NICE
View: http://publications.nice.org.uk/tackling-drug-use-lgb18
Recently published NICE guidance has urged local authorities to prioritise drug abuse support for
young people from the age of 10 to ensure their problems do not escalate and bring them in contact
with the criminal justice system.
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2
Clinical Psychology Current Awareness Bulletin No: 23 2014
REPORTS

Title: Everyone’s business: Improving the police response to domestic abuse
Author: HMIC – Her Majesty’s Inspectorate of Constabulary
View: http://www.hmic.gov.uk/publication/improving-the-police-response-to-domestic-abuse/
[National report, press release, and Force reports.]

Title: Care Act 2014
Author: Parliamentary Bill
View: http://services.parliament.uk/bills/2013-14/care.html
The Care Act 2014 has received royal assent. The Act includes a duty for local authorities to
consider the needs of children living in households where there is a disabled adult who needs care,
as part of a 'whole family assessment.'

Title: EU Kids Online Network
Author: LSE
View: http://www.lse.ac.uk/media@lse/research/EUKidsOnline/Home.aspx
The EU Kids Online Network has published a comparative analysis of internet safety policy
implementation in 25 European countries. It has developed a four cluster classification of countries
based on the activities undertaken, the exposure to risk and harm, and types of internet safety
mediation experienced by young people across Europe.
Further Resource: A Comparative Analysis of Internet Safety Policy Implementation

Title: Ending Female Genital Mutilation – where do we stand in Europe?
Author: End FGM with Amnesty International
View:
http://www.endfgm.eu/content/assets/ENDFGM_Where_do_we_standinEurope_June2013_light_wit
h_links.pdf

Title: Stop it now! Evaluation interim report - UK and Netherlands summary (PDF)
Author: Stop it now!
View: http://www.stopitnow-evaluation.co.uk/media/827951/temp%20stop%20file.pdf
Further information: Overview of findings

Title: Shock figures show extent of self-harm in English teenagers
Author: Guardian
View: http://www.theguardian.com/society/2014/may/21/shock-figures-self-harm-england-teenagers
Further information: Health behaviour in school aged children: World Health Organization
collaborative cross-national survey

Title: Face to face service: impact and evidence series (PDF)
Author: NSPCC
View: http://www.nspcc.org.uk/Inform/research/findings/evaluation/face-to-faceinterim_wdf102622.pdf

Title: CAFCASS Care Application Statistics
Author: CAFCASS
View: http://www.cafcass.gov.uk/news/2014/may/april-2014-care-demand-statistics.aspx

Title: Which type of parenting programme best improves child behaviour and reading?
Follow-up of the Helping Children Achieve trial
Author: Nuffield Foundation
View: http://www.nuffieldfoundation.org/sites/default/files/files/HCA_follow_up_report_13_05_14.pdf
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Clinical Psychology Current Awareness Bulletin No: 23 2014

Title: Support and services available to family and friends caring for a child who is unable to
live with their parents
Author: Department for Education
View:
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/307849/family_and_fri
ends_leaflet.pdf
HITTING THE HEADLINES

Title: Got Autism? Learn About the Link Between Dairy Products and the Disorder
Author: PETA
View: http://www.peta.org/features/got-autism-learn-link-dairy-products-disease/
PETA spark outrage by linking Autism and dairy products.
Further Resource [Daily Telegraph]:
http://blogs.telegraph.co.uk/news/damianthompson/100273636/the-scaremongering-witchdoctors-ofpeta-are-trying-to-link-autism-and-dairy-products-there-is-no-link/

Title: NSPCC reports rise in child emotional abuse calls
Author: BBC
View: http://www.bbc.co.uk/news/uk-27631523
Also: http://www.bbc.co.uk/news/uk-27625958

Title: Paedophiles' brains are 'abnormally tuned' to children's faces, new study claims
Author: The Independent
View:
http://www.independent.co.uk/news/science/paedophiles-brains-are-abnormally-tuned-to-childrensfaces-new-study-claims-9405707.html

Title: Child Abduction – uncovering the reality behind child abduction
Author: Childabduction.org.uk
View: http://www.childabduction.org.uk/

Title: Improving access to education and employment for young adult carers
Author: NIACE
View:
http://www.niace.org.uk/news/improving-access-to-education-and-employment-for-young-adult-carers
Further Resources:
 WE Care! Improving Work and Education for Young Adult Carers: Case studies of effective
practice in supporting young adult carers to make positive transitions in learning and work
 Really Useful Book of Learning and Earning for Young Adult Carers

Title: Councils should prioritise support for young drug users
Author: Children & Young People Now
View:
http://www.cypnow.co.uk/cyp/news/1144211/councils-prioritise-support-drugusers?WT.rss_f=Joint+working++Disciplines&WT.rss_a=Councils+should+prioritise+support+for+young+drug+users

Title: Fostering early childhood communication: Researchers identify 10 key strategies
Author: News Magazine Network
View:
http://www.newsmagazinenetwork.com/2014052047716/fostering-early-childhood-communicationresearchers-identify-10-key-strategies/
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Clinical Psychology Current Awareness Bulletin No: 23 2014
Further resource: More Than Baby Talk: 10 Ways to Promote the Language and Communication
Skills of Infants and Toddlers

Title: Care Act offers hope of better support for young carers
Author: Children & Young People Now
View:
http://www.cypnow.co.uk/cyp/news/1144058/care-act-offers-hope-support-carers?WT.rss_f=Health++Disciplines&WT.rss_a=Care+Act+offers+hope+of+better+support+for+young+carers

Title: Child protection services too important to be privatised
Author: The Guardian
View: http://www.theguardian.com/society/2014/may/16/child-protection-privatised

Title: Sign up to Child Rescue Alert text scheme, Home Secretary urges
Author: Home Office
View: https://www.gov.uk/government/news/sign-up-to-child-rescue-alert-text-scheme-homesecretary-urges

Title: Child social services ‘stretched’
Author: BBC News website
View: http://www.bbc.co.uk/news/education-26792599#

Title: ’Cinderella’ cruelty law considered
Author: BBC News website
View: http://www.bbc.co.uk/news/uk-26814427#

Title: Police fail domestic abuse victims
Author: BBC News website
View: http://www.bbc.co.uk/news/uk-26758565

Title: Autism ‘begins long before birth’
Author: BBC News website
View: http://www.bbc.co.uk/news/health-26750786

Title: Children admitted to adult mental health wards ‘rising’
Author: BBC News website
View: http://www.bbc.co.uk/news/health-26528396
 Title: Could robots help children with autism?
Author: BBC News website
View: http://www.bbc.co.uk/news/technology-26511354

Title: Young mental health service in Wales in crisis, say experts
Author: BBC News website
View: http://www.bbc.co.uk/news/uk-wales-26505314

Title: Childhood nightmares may point to looming health warning
Author: BBC News website
View: http://www.bbc.co.uk/news/health-26385274

Title: Brain development may be affected by chemicals
Author: NHS Choices
View: http://www.nhs.uk/news/2014/02February/Pages/Brain-development-may-be-affected-bychemicals.aspx
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Clinical Psychology Current Awareness Bulletin No: 23 2014
CHILDREN’S CLINICAL PSYCHOLOGY
Anneliese A. Singh, Sarah E. Meng and Anthony W. Hansen. 2014. “I Am My Own Gender”:
Resilience Strategies of Trans Youth. Journal of Counseling & Development 92:2, pp. 208-218
Nineteen trans youth participated in a phenomenological study of their resilience strategies for
navigating stressors in their lives. The authors identified 5 supports and 6 threats to participants’
resilience. The 5 themes of resilience were: (a) ability to self-define and theorize one's gender, (b)
proactive agency and access to supportive educational systems, (c) connection to a trans-affirming
community, (d) reframing of mental health challenges, and (e) navigation of relationships with
family and friends. The 6 major threats to participants’ resilience were: (a) experiences of adultism,
(b) health care access challenges, (c) emotional and social isolation, (d) employment
discrimination, (e) limited access to financial resources, and (f) gender policing.
Marina Post, Gerri Hanten, Xiaoqi Li, Adam T. Schmidt, Gunes Avci, Elisabeth A. Wilde and
Stephen R. McCauley. 2014. Dimensions of trauma and specific symptoms of complex
posttraumatic stress disorder in inner-city youth: a preliminary study. Violence and victims,
29(2) pp. 262-279
Examines the relationship between post-traumatic stress symptoms (PTSS) and domestic versus
community trauma in a sample of 65 inner city youth. Findings include: the sample experienced
high levels of PTSS and trauma; females reported higher levels of domestic traumas and had
higher PTSS scores than males. Highlights the limitations of the study and calls for more studies
on types of trauma and impacts on function and behaviour in life and school.
S. Scott, J. Lewsey, L. Thompson and P. Wilson. 2014. Early parental physical punishment and
emotional and behavioural outcomes in preschool children. Child: care, health and
development, 40(3) pp 337-345
Looks at whether there is an association between being smacked by your main caregiver in the
first two years and emotional and behavioural problems at age 4. Finds that children who had been
smacked in the first two years were twice as likely to have emotional and behavioural problems as
measured by parental assessment. Concludes that parental use of physical punishment in the first
two years may be a modifiable risk factor for emotional and behavioural difficulties in preschool
children.
Noemí Pereda and David Gallardo-Pujol. 2014. One hit makes the difference: the role of
polyvictimization in childhood in lifetime revictimization on a southern European sample.
Violence and victims, 29(2) pp 217-231
Presents statistics on child victimisation, polyvictimisation and revictimisation from a sample of
university students in southwestern Europe. Explores the relationship between victimisation in
childhood and later revictimisation in adulthood. Examines interpersonal violence including sexual
abuse, physical abuse and witnessing domestic abuse and intimate partner violence in childhood.
Suggests the study contributes to the body of research showing that some children experience
more violence than others and that this can become an ongoing condition over time.
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Clinical Psychology Current Awareness Bulletin No: 23 2014
CRITICAL/COMMUNITY PSYCHOLOGY
Tran, A.G. 2014. Family Contexts: Parental Experiences of Discrimination and Child Mental
Health. American Journal of Community Psychology, 53(1-2) pp37-46
Research on the mental health correlates of discrimination traditionally has been intra-individual,
focusing exclusively on the individual directly experiencing discrimination. A small number of
studies have begun to consider the links between parental experiences of discrimination and child
mental health, but little is known about potential underlying mechanisms. The present study tested
the independent mediating effects of parent mental health and household socioeconomic status on
the associations between parental experiences of discrimination (past-year perceived
discrimination and perceptions of being unaccepted culturally) and child mental health
(internalizing and externalizing symptoms) using a bootstrapping analytic approach. Data were
drawn from racial/ethnic minority (n = 383) and White (n = 574) samples surveyed in an urban
Midwestern county. For all measures of discrimination and child mental health, findings supported
an association between parental experiences of discrimination and child mental health. Whereas
parent mental health served as a significant mediator in all analyses, socioeconomic status did not.
Mediation findings held for both the White and racial/ethnic minority samples. Results suggest that
parental experiences of discrimination and mental health may contribute to child mental health
concerns, thus highlighting the role of family contexts in shaping child development.
PAIN
oOo
SOCIAL SERVICES
Holland, S. 2014. Trust in the Community: Understanding the Relationship between Formal,
Semi-Formal and Informal Child Safeguarding in a Local Neighbourhood. Br J Soc Work, 44
(2) pp. 384-400
This paper explores the concept of safeguarding children being ‘everybody's business’ as it is
experienced in one neighbourhood in south Wales, UK. Safeguarding is defined here as the
protection of children and the enhancement of their well-being. A qualitative case study design
engaged residents of all ages, community sector workers and statutory sector workers in
discussions about children's safeguarding in their neighbourhood. The analysis focuses on three
overlapping spheres of safeguarding: the informal sphere, the community sphere and the formal
sphere. Enablers and barriers to relationships between these spheres are identified. The findings
explore attributes associated with proximity, time, biographies, style and scope. It is noted that,
while these relationships are enacted within the specific social and geographical space of this
neighbourhood, this case study provides a potential insight into broader relationships between the
statutory services, community groups and neighbourhood residents. It is concluded that the
community sector's vital role should be recognised and enhanced and the formal sector
encouraged to adopt some of its attributes. Above all, it is recommended that statutory children's
social workers be closely located within their local communities, socially and physically, to better
understand children's experiences and to work with interventions that recognise community
strengths.
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Clinical Psychology Current Awareness Bulletin No: 23 2014
Hines, L. 2014. Children’s Coping with Family Violence: Policy and Service
Recommendations. Child and Adolescent Social Work Journal March 2014 DOI
10.1007/s10560-014-0333-9
This qualitative synthesis describes the successful coping strategies and service needs of children
exposed to family violence using the evidenced based meta-synthesis approach. Social services
abstracts, academic search premiere, PubMed, and Google scholar database searches were
conducted. 17 studies published between 1991 and 2012 were included in the meta-synthesis. The
17 studies included in the synthesis is not an exhaustive list of studies published on the topic.
Findings suggest that social support, resilience, and hope are important factors in helping children
successfully cope with exposure to family violence. Child serving agencies can assist children cope
with family violence by developing programs that include family mentors, increase children’s
knowledge about available services, and encourage children to tell someone about their
experiences. Child welfare practice and policy recommendations are provided by the author.
Malove, Shirley C. 2014. Using Relational Theory to Treat Adolescent Girls Victimized by
Social Aggression. Clinical Social Work, 42(1) pp1-12
While much has been written on social aggression in adolescent girls, less has been written on the
clinical treatment for victims of such bullying. This paper will look at social aggression in girls from
relational and psychodynamic perspectives. Further, the interplay of trauma dynamics which are
integral to the social aggression paradigm will be reviewed. Using a clinical example, the author
will show how victim/victimizer/bystander roles inherent in trauma dynamics were enacted in the
clinical dyad. Enactments were discussed in the treatment process leading to a new and different
outcome. Implications for practice with girls who experience social aggression will be discussed.
Lauren Polvere. 2014. Agency in institutionalised youth: a critical inquiry. Children and
society, 28(3) pp 182-193
Qualitative study using semi-structured interviews conducted with youth with psychiatric disabilities
who had spent time in mental health institutions. Examines their perspectives on institutional
practices. Identifies four central themes of agency: agency through resistance, for example
violating rules; agency through compliance, for example behaving well in order to get out; agency
through self-advocacy, for example learning about their rights; and agency through dialectical
thinking, for example imagining alternatives. Concludes that mental health services should be
recovery-oriented.
Kara L. Sabalauskas, Charles L. Ortolani and Matthew J. McCall. 2014. Moving from pathology
to possibility: integrating strengths-based interventions in child welfare provision. Child
care in practice, 20(1) pp 120-134
Describes a Boston child welfare agency's efforts to apply a strengths-based practice model, using
cognitive behaviour therapy (CBT), across its treatments and interventions. Identifies challenges
around: creating a shared training programme across a large and diverse workforce, managing
staff members' resistance to change and conflicting theoretical outlooks and developing the
documentation required to integrate CBT into assessments, notes and plans.
Tony Stanley and Marion Russell. 2014. The principal child and family social worker: a Munro
recommendation in practice. Practice (Vol.26, Iss.2) April 2014 pp 81-96
Summary: Discusses the setting up and delivery of the new role of principal child and family social
worker in two different English local authorities - Cornwall and Tower Hamlets. Considers the
successes and challenges. Explores the opportunities of the role for bridging front line practice and
senior management, supporting professional understanding of how social work is delivered and
experienced.
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Clinical Psychology Current Awareness Bulletin No: 23 2014
Susan Young, Margaret McKenzie, Liv Schjelderup, Cecilie Omre and Shayne Walker. 2014. What
can we do to bring the sparkle back into this child's eyes?: child rights/community
development principles: key elements for a strengths-based child protection practice. Child
care in practice, 20(1) pp 135-152
Summary: Describes and explains the theory behind a child welfare framework developed by
social work educators. Uses practice examples to demonstrate the application of the framework.
Identifies elements of social work practice needed to work with a strengths-based perspective, and
emphasises the importance of encouraging child and family participation in social work practice.
Swanston, J. et al. 2014. Towards a richer understanding of school-age children’s
experiences of domestic violence: The voices of children and their mothers. Clin Child
Psychol Psychiatry, 19(2) pp. 184-201
Millions of children are exposed to domestic violence. How children negotiate and make sense of
living with domestic violence is still under-researched. This study sought to capture the dualperspectives of school-aged children and their mothers, to develop a richer understanding of
children’s experiences of domestic violence, using a community-based sample. A qualitative
research design was employed, with interpretative phenomenological analysis used to interpret the
data. Five school-aged children and three of their mothers participated in the study. Two master
themes are discussed from the analysis of the children’s perspective: domestic violence through
the eyes of children; and learning from children’s experiences. Two master themes are discussed
from the analysis of the mothers’ perspective: reflecting on the child in the context of domestic
violence; and learning from mothers: insights, support and services. The crucial importance of the
mother-child relationship in shaping children’s experience of domestic violence was illustrated in
both the perspectives; a finding which may have important implications for the development of
interventions. It was also evident that children as young as eight were able to powerfully articulate
their experiences of domestic violence.
LOOKED AFTER/ADOPTED CHILDREN
Appleton, J. et al. 2014. Implementing the Strengthening Families Approach to Child
Protection Conferences. Br J Soc Work doi: 10.1093/bjsw/bct211 First published online: March
27, 2014
The Strengthening Families (SF) child protection conference model attempts to address some of
the weaknesses of traditional conferences by helping families participate more easily and by
enhancing risk assessment. This study examined the impact and feasibility of implementing the SF
model across one local authority. A mixed-methods design was adopted. Data collection included:
semi-structured interviews with professionals and parents; non-participant observation of SF and
traditional conferences; and anonymised child protection plans. Interviews and observation data
were analysed thematically using NVivo8 software. Study findings indicated problems with the rollout of training for the SF approach, yet model fidelity was largely adhered to during SF
conferences. Most professionals reported initial child protection conferences (ICPCs) to be working
well and they were perceived as constructive places for addressing child protection issues. While
the majority of parents described their pre-conference preparation as good, many still felt
disempowered by the child protection process. Thought is needed about how to tackle the
perception amongst families that they are judged and that they are powerless during the ICPC
process, particularly as our observations of SF conferences revealed that parents were active in
their contributions to meetings.
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Winter, K. 2014. Understanding and Supporting Young Children's Transitions into State
Care: Schlossberg's Transition Framework and Child-Centred Practice. Br J Soc Work, 44(2)
pp. 401-417
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Clinical Psychology Current Awareness Bulletin No: 23 2014
There is a growing body of research regarding children and young people in state care that is
organised around the concept of transition. Focusing mainly on young people leaving care, the
research highlights their experiences of multiple transitions that can contribute to poor long-term
outcomes in terms of emotional and psychological well-being, educational attainment and
employment prospects. The smaller body of research that focuses on young children shows that
their journeys before and when in state care are also marked by multiple and fragmented
transitions. Despite the growing knowledge base, there are two areas that remain underdeveloped—research that draws attention to the lived experiences of young children regarding
their transitions into state care; and the development of conceptual frameworks that centralise
young children's perspectives to support the development of practice. This article begins to
address these gaps by applying Schlossberg's transition framework to a case study of a young
child regarding their transition into state care. The article highlights, through the child's
perspectives, the multiple impacts of the transition and considers the implications for the
development of better child-centred practice.
Roesch-Marsh, A. 2014. ‘Out of Control’: Making Sense of the Behaviour of Young People
Referred to Secure Accommodation. Br J Soc Work, 44(2) pp. 197-213
In social work practice, there are often concerns raised about young people who are felt to be
beyond the control their parent(s) or carer(s). However, few studies have attempted to unpick what
practitioners mean when they describe young people as being ‘out of control’. Drawing on the
findings of a study of secure accommodation decision making in Scotland, this article explores the
significance managers, practitioners and young people attached to the notion of ‘out of control’
behaviour. Developmental and socio-cultural perspectives are explored to tease out the dilemmas
of exercising control, through the use of secure accommodation, in such cases. The findings
suggest that managers tend to focus on quantifying the risks associated with ‘out of control’
behaviour, while practitioners tend to focus on the way previous experiences such as abuse have
shaped ‘out of control’ behaviour. In contrast, young people suggest their ‘out of control’ behaviour
is related to unhappiness about care placements and relationships with family. It is argued that, in
order to find a balance in our responses to ‘out of control’ behaviour, we need to understand the
multiple meanings of this behaviour and be willing to be go further in our attempts to involve young
people in decision making.
Laura Kerr and Jill Cossar. 2014. Attachment Interventions with Foster and Adoptive Parents:
A Systematic Review. Child Abuse Review, Article first published online: 14 MAR 2014 | DOI:
10.1002/car.2313
Children who have been adopted or fostered are at high risk of experiencing interpersonal
difficulties and placement breakdown may occur if these difficulties are not addressed through
interventions. The aim of this review was to identify the impact of attachment interventions with
foster and adoptive parents on children's behavioural, emotional and relational functioning. A
systematic search process was undertaken; electronic databases were searched; key journals
were hand searched; reference lists of included articles were searched; and authors who have
published work in the field were contacted. Ten studies met the inclusion criteria. There is some
evidence to support the positive impact of these interventions for children, particularly young
children aged six months to six years. However, overall, the studies were of relatively poor
methodological quality, making conclusions about the efficacy of these interventions difficult.
Further research is therefore required to draw clearer conclusions about the impact of attachment
interventions for fostered and adopted children.
‘Ten studies met the inclusion criteria’
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Key Practitioner Messages
A number of the reviewed studies reported positive outcomes in child behavioural functioning and
to a lesser degree in emotional and relational functioning following intervention.
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Clinical Psychology Current Awareness Bulletin No: 23 2014
Interventions focused on constructs such as parental sensitivity, attunement to the child and the
impact of abuse and neglect on attachment to new caregivers.
When quality criteria were applied, two studies focused on children aged six months to six years
were found to be methodologically strong, providing some evidence for the benefit of early
attachment-based interventions within this population.
‘Two studies focused on children aged six months to six years were found to be methodologically
strong’
Shea, Sarah E. 2014. Finding Parallels: The Experiences of Clinical Social Workers
Providing Attachment-Based Treatment to Children in Foster Care. Clinical Social Work
Journal, March 2014 DOI 10.1007/s10615-014-0488-z
Clinical practice with children in foster care often focuses on the attachment-based trauma
experienced by many children who enter the foster care system. Attachment-based treatment
requires that the clinician be able to form relationships with both the child and caregivers, including
foster and biological parents. Given the complex nature of the relational matrix that surrounds
children in foster care, clinicians providing attachment-based treatment may have experiences of
helplessness and hopelessness that parallel those of the children whom they are treating. This
exploratory qualitative study surveyed 42 clinical social workers regarding their experiences of
providing attachment-based treatment to children in foster care. Findings indicate that such
clinicians do have experiences of helplessness and hopelessness that parallel those of the children
in foster care and that such experiences are attributed to issues surrounding relationships with
caregivers as well as interagency collaboration and communication between clinicians and child
welfare professionals. Such findings suggest specific practice implications for clinicians providing
attachment-based treatment to children in foster care including the increased involvement of
biological and foster care parents in the treatment context and more systematic means of
establishing collaborative relationships between clinicians, foster care and child welfare workers,
and the court system.
Hillen, T. & Gafson, L. 2014. Statutory health assessments for pre-school foster children fail
to screen accurately for mental health disorders. Clin Child Psychol Psychiatry, 19(2) pp. 313327
The aim of this study was to determine the diagnostic accuracy of statutory health assessments in
identifying existing mental health disorders in pre-school foster children. It was examined whether
a foster carer completed screening instrument could enhance accuracy. A representative sample
of 43 pre-schoolers under the care of one inner-city local authority underwent comprehensive
multidimensional mental health assessments as the reference standard. Statutory health
assessments gave false negative results for 65% (95% confidence interval (CI) 44–82%) of
children diagnosed with at least one mental health disorder according to the reference standard
and 18% (95% CI 3–52%) of children with developmental delay. The Ages & Stages Questionnaire
completed by the foster carers failed to identify 65% (95% CI 44–82%) of the children with
diagnosed mental health disorders. There was no evidence of selective underreporting by foster
carers in relation to specific diagnostic categories. In conclusion, statutory health assessments in
their current form may fail to identify the majority of pre-school foster children with mental health
disorders. Adding a screening instrument to the assessment process may not be adequate to
improve diagnostic accuracy.
Gabriel Tobin Smith, Valerie B. Shapiro, Rachel Wagner Sperry and Paul A. LeBuffe. 2014. A
strengths-based approach to supervised visitation in child welfare. Child care in practice
20(1) pp 98-119.
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Describes a supervised visitation system used in the United States which gives parents accused of
abuse or neglect the opportunity to spend time with their children. Details six aspects of the Joan
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Clinical Psychology Current Awareness Bulletin No: 23 2014
Sherman program for resilient children's strengths-based approach. Looks at the programme's
successes and failures and suggests that a comprehensive evaluation of the system is required.
AUTISM/ASPERGER’S SYNDROME
Jeremy W. Murphy, John J. Foxe, Joanna B. Peters and Sophie Molholm. Susceptibility to
Distraction in Autism Spectrum Disorder: Probing the Integrity of Oscillatory Alpha-Band
Suppression Mechanisms. Autism Online, article first published online: 27 MAR 2014
When attention is directed to one information stream over another, the brain can be configured in
advance to selectively process the relevant stream and suppress potentially distracting inputs. One
key mechanism of suppression is through the deployment of anticipatory alpha-band (∼10 Hz)
oscillatory activity, with greater alpha-band power observed in cortical regions that will ultimately
process the distracting stream. Atypical attention has been implicated in autism spectrum disorder
(ASD), including greater interference by distracting task-irrelevant inputs. Here we tested the
integrity of these alpha-band mechanisms in ASD using an intersensory attention task.
Electroencephalography (EEG) was recorded while participants were cued on a trial-by-trial basis
to selectively deploy attention to the visual or auditory modality in anticipation of a target within the
cued modality. Whereas typically developing (TD) children showed the predicted alpha-band
modulation, with increased alpha-band power over parieto-occipital scalp when attention was
deployed to the auditory compared with the visual modality, this differential pattern was entirely
absent at the group level in the ASD cohort. Further, only the ASD group showed impaired
performance due to the presence of task-irrelevant sensory information. These data suggest that
impaired modulation of alpha-band activity plays a role in increased distraction from extraneous
sensory inputs in ASD.
Georgina Warner, Joanna Moss, Patrick Smith and Patricia Howlin. Autism Characteristics and
Behavioural Disturbances in ~ 500 Children with Down's Syndrome in England and Wales.
Autism Research, article first published online: 24 MAR 2014 | DOI: 10.1002/aur.1371
Recent research shows that a significant minority of children with Down's syndrome (DS) also
meet diagnostic criteria for an autism spectrum disorder (ASD). The present study investigated
what proportion of children aged 6–15 years with a confirmed diagnosis of DS in England and
Wales display autistic-type behaviours, and explored the characteristics of this group of children.
The Social Communication Questionnaire (SCQ) was used to screen for autism characteristics and
the Strengths and Difficulties Questionnaire (SDQ) to explore behavioural difficulties. The
proportion of children who met the cut-off score for ASD on the SCQ (total score ≥ 15) was 37.7%
(95% CI: 33.4–42.0%); for autism (total score ≥ 22) the proportion was 16.5% (95% CI:
13.2–19.8%). Children who met the cut-off for ASD were significantly more likely to be reported as
having emotional symptoms, conduct problems and hyperactivity on the SDQ than children who
scored well below cut-off (total score < 10). However, the profile of their autism characteristics on
the SCQ was atypical compared with individuals with idiopathic ASD. The pervasiveness of ASD in
children with DS in England and Wales is substantially higher than in the general population.
These children also experience significantly greater behavioural problems than children with DS
only. Early detection of autism characteristics is important for appropriate intervention. However,
the unusual profile of autism characteristics in this group may affect the recognition of the disorder
and hinder the implementation of appropriate interventions.
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Alison E. Lane, Cynthia A. Molloy and Somer L. Bishop. Classification of Children With Autism
Spectrum Disorder by Sensory Subtype: A Case for Sensory-Based Phenotypes. Autism
Research, article first published online: 17 MAR 2014 | DOI: 10.1002/aur.1368
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Clinical Psychology Current Awareness Bulletin No: 23 2014
This study examines whether sensory differences can be used to classify meaningful subgroups of
children with autism spectrum disorder (ASD). Caregivers of children with ASD aged 2–10 years
(n = 228) completed the Short Sensory Profile. Model-based cluster analysis was used to extract
sensory subtypes. The relationship of these subtypes to age, gender, autism symptom severity,
and nonverbal intelligence quotient (IQ) was further explored. Four distinct sensory subtypes were
identified: (a) sensory adaptive; (b) taste smell sensitive; (c) postural inattentive; and (d)
generalized sensory difference. The sensory subtypes differ from each other on two dimensions:
(a) the severity of reported sensory differences; and (b) the focus of differences across auditory,
taste, smell, vestibular and proprioceptive domains. Examination of the clinical features of each
subtype reveals two possible mechanisms of sensory disturbance in autism: (a) sensory
hyperreactivity; and (b) difficulties with multisensory processing. Further, the sensory subtypes are
not well explained by other variables such as age, gender, IQ, and autism symptom severity. We
conclude that classification of children using sensory differences offers a promising method by
which to identify phenotypes in ASD. Sensory-based phenotypes may be useful in identifying
behavioral features responsive to specific interventions thereby improving intervention
effectiveness. Further validation of the sensory-based phenotypes by establishing neural and
physiological correlates is recommended.
Matthew J. Hollocks, Catherine R.G. Jones, Andrew Pickles, Gillian Baird, Francesca Happé, Tony
Charman and Emily Simonoff. The Association Between Social Cognition and Executive
Functioning and Symptoms of Anxiety and Depression in Adolescents With Autism
Spectrum Disorders. Autism Research, article first published online: 12 MAR 2014 | DOI:
10.1002/aur.1361
While high levels of anxiety and depression are now recognized as major co-occurring problems in
children and young people with an autism spectrum disorder (ASD), research examining possible
associations with individual differences in neurocognitive functioning has been limited. This study
included 90 adolescents with an ASD aged 14–16 years with a full-scale IQ > 50. Using structural
equation modeling, we examined the independent relationships between multiple measures of
executive functioning and social cognition on severity of anxiety or depressive symptoms. Results
indicated a significant association between poorer executive functioning and higher levels of
anxiety, but not depression. In contrast, social cognition ability was not associated with either
anxiety or depression. This study is the first to report significant associations between executive
functions and anxiety in ASD. This may suggest that poor executive functioning is one factor
associated with the high prevalence of anxiety disorder in children and adolescents with ASD.
Audrey M. Carson, Nicole M. G. Salowitz, Robert A. Scheidt, Bridget K. Dolan and Amy V. Van
Hecke. Electroencephalogram Coherence in Children With and Without Autism Spectrum
Disorders: Decreased Interhemispheric Connectivity in Autism. Autism Research, article first
published online: 12 MAR 2014 | DOI: 10.1002/aur.1367
Electroencephalogram coherence was measured in children with autism spectrum disorders (ASD)
and control children at baseline and while watching videos of a familiar and unfamiliar person
reading a story. Coherence was measured between the left and right hemispheres of the frontal,
parietal, and temporal-parietal lobes (interhemispheric) and between the frontal and parietal lobes
in each hemisphere (intrahemispheric). A data-reduction technique was employed to identify the
frequency (alpha) that yielded significant differences in video conditions. Children with ASD
displayed reduced coherence at the alpha frequency between the left and right temporal-parietal
lobes in all conditions and reduced coherence at the alpha frequency between left and right frontal
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lobes during baseline. No group differences in intrahemispheric coherence at the alpha frequency
emerged at the chosen statistical threshold. Results suggest decreased interhemispheric
connectivity in frontal and temporal-parietal regions in children with ASD compared to controls.
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Clinical Psychology Current Awareness Bulletin No: 23 2014
Carla A. Mazefsky, Xenia Borue, Taylor N. Day and Nancy J. Minshew. Emotion Regulation
Patterns in Adolescents With High-Functioning Autism Spectrum Disorder: Comparison to
Typically Developing Adolescents and Association With Psychiatric Symptoms. Autism
Research, article first published online: 7 MAR 2014 | DOI: 10.1002/aur.1366
Autism spectrum disorder (ASD) is often associated with poor emotional control and
psychopathology, such as anxiety and depression; however, little is known about the underlying
mechanisms. Emotion regulation (ER) is a potential contributing factor, but there has been limited
research on ER and its role in comorbid psychopathology in ASD. In this study, we compared selfreported ER with self- and parent reports of psychopathology in 25 high-functioning adolescents
with ASD and 23 age- and Intelligence Quotient (IQ)-matched typically developing controls.
Contrary to expectations, both groups reported similar levels of adaptive, voluntary forms of ER
(problem solving, acceptance, etc.). However, the ASD group reported significantly greater use of
involuntary forms of ER that are typically maladaptive, including remaining focused on the stressor
(e.g. rumination and emotional arousal) and shutting down (e.g. emotional numbing and being
unable to think or act). Associations between ER and psychopathology were generally more robust
using self-report rather than parent report. For both groups, greater endorsement of involuntary ER
strategies was associated with higher ratings of psychopathology, whereas voluntary ER strategies
focused on changing or adapting to the situation were significantly associated with lower levels of
psychopathology. The magnitude and direction of association between ER types and
psychopathology were similar for measures of depression and anxiety. These findings can help
guide the development of psychosocial treatments targeting dysfunctional ER in adolescents with
ASD. Interventions focused on ER as a transdiagnostic process may be a more robust method to
improve emotional control and decrease emotional distress in ASD than disorder-specific
interventions.
Laura Sparaci, Silvia Stefanini, Lidia D'Elia, Stefano Vicari and Giacomo Rizzolatti. What and Why
Understanding in Autism Spectrum Disorders and Williams Syndrome: Similarities and
Differences. Autism Research, article first published online: 6 MAR 2014 | DOI: 10.1002/aur.1370
Children with autism spectrum disorders (ASD) and children with Williams syndrome (WS) show
divergent social phenotypes, but also several similarities in their socio-cognitive deficits. Crosssyndrome direct comparisons could lead to a better understanding of mechanisms that determine
deficits in social cognition in the two syndromes. A fundamental factor for social cognition is the
ability to understand and predict others' actions (e.g. what action is being done and why it is being
done when observing a goal-related act). Here we compared the understanding of others' actions
in children with ASD, WS and in children with typical development. Comprehension of what motor
act was being done and of why it was being done was assessed with or without contextual cueing
using a computer-based task. The results showed that what understanding was impaired in the WS
group, but not in the ASD group, which showed mental-age appropriate performance. Why
understanding was impaired in both experimental groups.
Lopata, C. et al. Community Trial of a Comprehensive Psychosocial Treatment for HFASDs.
Focus on Autism & other Developmental Disabilities, published online before print March 26, 2014,
doi: 10.1177/1088357614525662
This community effectiveness trial examined the feasibility and efficacy of a comprehensive
psychosocial treatment for 28 children, aged 7 to 10 years with high-functioning autism spectrum
disorders (HFASDs). Treatment included instruction and therapeutic activities targeting social
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skills, face-emotion recognition skills, interest expansion, and interpretation of non-literal language
skills. A behavioral program was instituted to foster skills acquisition and reduce ASD symptoms
and problem behaviors. Feasibility was supported in high levels of fidelity and satisfaction.
Significant improvements were found for the children’s non-literal language skills and parent
ratings of target social and communicative skills, broader social performance, and ASD symptoms.
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Clinical Psychology Current Awareness Bulletin No: 23 2014
Secondary staff ratings corroborated parent ratings. Results suggest that the treatment, when
administered by a community agency, was feasible and yielded positive outcomes similar to prior
randomized clinical trials (RCTs).
Witmer, Sara E. et al. Using Parents and Teachers to Monitor Progress Among Children With
ASD. A Review of Intervention Research. Focus on Autism & other Developmental Disabilities,
published online before print March 24, 2014, doi: 10.1177/1088357614525659
Despite growing knowledge of the effectiveness of various interventions for children with autism
spectrum disorders (ASD), it is never clear whether a particular intervention will be effective for a
specific child with ASD. Careful monitoring of an individual child’s progress is necessary to know
whether an intervention is effective. In this review, we examined intervention research studies
focused on children with ASD in Grades K–12 that involve parents, teachers, and other school staff
as data collectors. We describe the strategies that have been used in the 40 identified research
studies to monitor progress in the areas of behavior and social communication. The results
highlight monitoring strategies that may be helpful for parents and teachers to apply, and the
discussion provides related suggestions to guide future research and practice.
Wolfe, K. et al. Promoting Behavioral Variability in Individuals With Autism Spectrum
Disorders: A Literature Review. Focus on Autism & other Developmental Disabilities, published
online before print March 24, 2014, doi: 10.1177/1088357614525661
Repetitive behavior is a hallmark feature of autism spectrum disorders (ASD), and can have
adverse consequences related to social stigma and low rates of skill acquisition. Basic research
suggests that variability, or the extent to which one response differs from previous responses, is
amenable to antecedent and consequence manipulations. This article describes the concept of
variability, synthesizes the findings of 14 recent studies on interventions to increase the variability
of behavior in individuals with ASD, and proposes preliminary guidelines for practitioners that focus
on building response repertoires, implementing contingencies to produce and maintain variability,
and incorporating prompts to vary responding.
Bader, S. et al. The Relation Between Parental Expressed Emotion and Externalizing
Behaviors in Children and Adolescents With an Autism Spectrum Disorder. Focus on Autism
& other Developmental Disabilities, published online before print March 10, 2014, doi:
10.1177/1088357614523065
The current study examined the relation between parental expressed emotion, a construct of the
quality and amount of emotion expressed within the family environment that is a well-established
predictor of symptom relapse in various psychological disorders, with externalizing behaviors in
children and adolescents with an autism spectrum disorder (ASD). Participants were 111 parents
of 6- to 18-year-old children and adolescents with an ASD who completed questionnaires
measuring family environment variables (including parental expressed emotion, parental distress,
and parenting practices), as well as assessing their child’s autism symptoms and emotional and
behavioral functioning. Results of regression analyses indicated that parental expressed emotion,
specifically criticism/hostility, accounted for 18.7% of the variance in child externalizing behaviors
beyond that accounted for by demographic control variables, over-involvement, parental distress,
and parenting practices. Findings highlight a possible point of intervention for parents of children
and adolescents with an ASD with concomitant externalizing behaviors.
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Virues-Ortega, J. et al. 2014. The TEACCH program for children and adults with autism: A
meta-analysis of intervention studies. Clinical Psychology Review, 33(8), pp940-953
The intervention program for autism known as Treatment and Education of Autistic and Related
Communication Handicapped Children (TEACCH) is considered an emerging practice for autism.
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Clinical Psychology Current Awareness Bulletin No: 23 2014
In the present study we used state-of-the-art meta-analytical procedures to examine the pooled
clinical effects of TEACCH in a variety of outcomes. A total of 13 studies were selected for metaanalysis totaling 172 individuals with autism exposed to TEACCH. Standardized measures of
perceptual, motor, adaptive, verbal and cognitive skills were identified as treatment outcomes. We
used inverse-variance weighted random effects meta-analysis supplemented with quality
assessment, sensitivity analysis, meta-regression, and heterogeneity and publication bias tests.
The results suggested that TEACCH effects on perceptual, motor, verbal and cognitive skills were
of small magnitude in the meta-analyzed studies. Effects over adaptive behavioral repertoires
including communication, activities of daily living, and motor functioning were within the negligible
to small range. There were moderate to large gains in social behavior and maladaptive behavior.
The effects of the TEACCH program were not moderated by aspects of the intervention such as
duration (total weeks), intensity (hours per week), and setting (home-based vs. center-based).
While the present meta-analysis provided limited support for the TEACCH program as a
comprehensive intervention, our results should be considered exploratory owing to the limited pool
of studies available.
Geraldine Hannon and Emily P. Taylor. 2013. Suicidal behaviour in adolescents and young
adults with ASD: Findings from a systematic review. Clinical Psychology Review, 33(8)
pp1197-1204
Suicide is a major problem in Western society. However we have very little understanding of
suicidal behaviour among individuals with autism spectrum disorders. The purpose of this review is
to synthesise primary research on suicidal behaviour among adolescents and young adults with
autism spectrum disorders in order to estimate prevalence and to identify and critically evaluate
risk factors for suicidal behaviour in this population. Four primary research studies were identified
for this review following a comprehensive literature search. The available research provides little
empirical evidence for the processes underlying suicidal behaviour in adolescents and young
adults with autism.
Javier Virues-Ortega , Víctor Rodríguez , C.T. Yu. 2013. Prediction of treatment outcomes and
longitudinal analysis in children with autism undergoing intensive behavioral intervention.
International Journal of Clinical & Health Psychology, 13(2) pp91-100
Outcome prediction is an important component of treatment planning and prognosis. However,
reliable predictors of intensive behavioral intervention (IBI) have not been clearly established. IBI is
an evidence-based approach to the systematic teaching of academic, social, verbal, and daily
living skills to individuals with autism spectrum disorder. Incorporating longitudinal analysis to IBI
outcome studies may help to identify outcome predictors of clinical value. Twenty-four children with
autism underwent on average two years of IBI and completed language, daily living skills,
cognitive, and motor assessments (Early Learning Accomplishment Profile and the Learning
Accomplishment Profile-Diagnostic, 3rd edition) every six months. We used multilevel analysis to
identify potential longitudinal predictors including gender, age, intervention intensity, intervention
duration, total intervention time, and pre-intervention functioning. Results indicated that total
intervention time, pre-intervention functioning, and age caused the greatest increase in goodnessof-fit of the longitudinal multilevel models. Longitudinal analysis is a promising analytical strategy to
identify reliable predictors of the clinical outcome of IBI.
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Julie D. Henry et al. A Virtual Week study of prospective memory function in autism
spectrum disorders. Journal of Experimental Child Psychology. Available online 26 March 2014
Prospective memory (PM) refers to the implementation of delayed intentions, a cognitive ability that
plays a critical role in daily life because of its involvement in goal-directed behavior and
consequently the development and maintenance of independence. Emerging evidence indicates
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Clinical Psychology Current Awareness Bulletin No: 23 2014
that PM may be disrupted in autism spectrum disorders (ASDs), potentially contributing to the
functional difficulties that characterize this group. However, the degree, nature, and specificity of
ASD-related impairment remains poorly understood. In the current study, children between 8 and
12years of age who were diagnosed with ASDs (n =30) were compared with typically developing
children (n =30) on a child-appropriate version of the Virtual Week board game. This measure
provides an opportunity to investigate the different sorts of PM failures that occur. The ASD group
showed significant PM impairment on measures of time-based (but not event-based) prospective
remembering. However, only a subtle difference emerged between regular and irregular PM tasks,
and group differences were consistent across these tasks. Because regular and irregular tasks
differentially load retrospective memory, these data imply that the PM difficulties seen in ASDs may
primarily reflect a monitoring deficit and not an encoding and memory storage deficit. PM
performance was poorer under conditions of high ongoing task absorption, but the magnitude of
this effect did not vary as a function of group. In both groups, time-based (but not event-based) PM
difficulties were associated with functional outcomes in daily life, but only an inconsistent
association with executive control emerged.
CHILDREN’S MENTAL HEALTH
Johanna B. Folk, Janice L. Zeman, Jennifer A. Poon and Danielle H. Dallaire. A longitudinal
examination of emotion regulation: pathways to anxiety and depressive symptoms in urban
minority youth. Child & Adolescent Mental Health Article first published online: 15 MAR 2014 |
DOI: 10.1111/camh.12058
Difficulty regulating emotions is a symptom of many psychological disorders yet little research has
examined the longitudinal relations of particular facets of emotion regulation (ER) that may
differentiate between internalizing symptoms.
At-risk youth (n = 102; 44.1% boys, 77.5% Black; Mage = 9.65) and caregivers (n = 74; 87.1%
mothers) participated in a 2-year longitudinal study. Children reported on their ER, and children
and caregivers on symptomatology.
Different patterns, varying by emotion facet (dysregulation, inhibition, coping) and type (anger,
sadness, worry), predicted anxiety and depression symptoms.
Anxiety and depression are entities with distinct patterns of emotion-related antecedents.
Anna Brazier. 2014. Creature Comfort? Animal assistance in therapeutic work with children
and young people. Clin Child Psychol Psychiatry, 19 pp. 165 [Editorial]
[First paragraphs]
As new editors, Michael and I are keen to understand the interests of our readership. One way of
doing this has been to look at which papers are our most popular downloads.
I noticed recently that two papers about Animal-Assisted Therapy (AAT) appear among the top
10 on the site list, and I was prompted to explore the topic further. My reading led me to consider
how involvement with animals and creature talk has been an unacknowledged and little-explored
part of my own clinical practice and personal history. I have enjoyed taking a look at the literature
and reflecting on aspects of my own history and clinical work that had hitherto passed my notice.
I hope readers will be prompted to do likewise[…]
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Emanuel, R. et al. Implementing an aim-based outcome measure in a psychoanalytic child
psychotherapy service: Insights, experiences and evidence. Clin Child Psychol Psychiatry,
19(2) pp. 169-183
In this paper, we describe the use of an aim-based outcome measure used in routine outcome
monitoring of child and adolescent psychotherapy within a child and adolescent mental health
service. We aim to explore the clinical feasibility and implications of the routine use of this
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Clinical Psychology Current Awareness Bulletin No: 23 2014
measure. We argue that use of the measure provides a simple and useful way of clarifying the
focus of the clinical work and reflecting its progress, while also having the potential to illuminate the
clinical picture by contributing an additional source of clinical information from a collaborative
process with the patient, parents or both. We argue that while there are some cases where use of
the measure may be impossible, or even perverse, in general it enhances rather than detracts from
clinical work.
Moldavsky, M. et al. 2014. Primary school teachers’ attitudes about children with attention
deficit/hyperactivity disorder and the role of pharmacological treatment. Clin Child Psychol
Psychiatry, 19(2) pp. 202-216
Background: Clinical experience and research suggest that teachers’ attitudes about attention
deficit/hyperactivity disorder (ADHD) are an important factor influencing access to specialist
assessment and treatment, including medication.
Methods: We performed a thematic analysis of comments written by primary school teachers who
participated in a case-vignette study investigating the ability of teachers to recognise ADHD.
Teachers read one of four types of vignette describing the behaviour of a nine-year-old child who
met diagnostic criteria for ADHD (either a boy or a girl with inattentive or combined subtype of
ADHD). They answered questions (identical for all types of vignette) about their views regarding
the problems and their management. Teachers were invited to add their own comments.
Results: Altogether 496 teachers from 110 schools completed the questionnaire: 250 (50%)
teachers from 94 schools wrote at least one comment, adding up to 341 comments. Regarding
their views on the need to refer the child to specialist services, 32 teachers made comments that
reflected caution. The most frequent comments were that it was too early to say whether a referral
was necessary, the problems were not severe enough or the main support would come from
school. Teachers also reported a lack of knowledge about specialist services or criticised them.
When asked whether medication might be beneficial for the child, 125 teachers expressed hesitant
or negative views: that it was premature to express an opinion about medication or too soon to give
medication to the child; that medication was not necessary or should not be used at all; or that the
problems were not severe enough or were emotional in nature. Only five teachers reported having
a positive experience of the effect of medication.
Conclusion: Teachers’ comments suggested a strong preference in using within-school strategies
for the management of children with ADHD. Teachers were reluctant to endorse medication for
DHD and expressed negative views about its use. Health services should support teachers’
management of ADHD-related behaviours in school and provide information to increase teachers’
ability to identify the need for a referral to specialist health services.
Pearce, P. et al. 2014. Use of narratives to assess language disorders in an inpatient
pediatric psychiatric population. Clin Child Psychol Psychiatry, 19(2) 244-259
A large proportion of child psychiatry patients have undiagnosed language disorders. Adequately
developed language is critical for psychotherapy and cognitive-behavioral therapies. This study
investigated (1) whether assessment of oral narratives would identify language impairments in this
population undetected by assessment of only core language abilities, and (2) the extent to which
measures of cognition, working memory, emotional distress, and social function differentially
predict core language and narrative development. Results showed that (1) more than twice as
many children were identified with language impairment when both narrative and core language
assessment were used, and (2) core language comprehension and complex verbal working
memory were the strongest predictors of narrative production, while core language
comprehension, a less complex working-memory task, and social skills best predicted narrative
comprehension. Emotional distress did not predict either. The results emphasize the importance of
evaluating child psychiatry patients’ language, using both core language and narrative measures.
Fuggle, P. et al. 2014. The Adolescent Mentalization-based Integrative Treatment (AMBIT)
approach to outcome evaluation and manualization: adopting a learning organization
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Clinical Psychology Current Awareness Bulletin No: 23 2014
approach. Clin Child Psychol, published online before print March 3, 2014, doi:
10.1177/1359104514521640
AMBIT (Adolescent Mentalization-Based Integrative Treatment) is a developing team approach to
working with hard-to-reach adolescents. The approach applies the principle of mentalization to
relationships with clients, team relationships and working across agencies. It places a high priority
on the need for locally developed evidence-based practice, and proposes that outcome evaluation
needs to be explicitly linked with processes of team learning using a learning organization
framework. A number of innovative methods of team learning are incorporated into the AMBIT
approach, particularly a system of web-based wiki-formatted AMBIT manuals individualized for
each participating team. The paper describes early development work of the model and illustrates
ways of establishing explicit links between outcome evaluation, team learning and manualization
by describing these methods as applied to two AMBIT-trained teams; one team working with young
people on the edge of care (AMASS — the Adolescent Multi-Agency Support Service) and another
working with substance use (CASUS – Child and Adolescent Substance Use Service in
Cambridgeshire). Measurement of the primary outcomes for each team (which were generally very
positive) facilitated team learning and adaptations of methods of practice that were consolidated
through manualization.
Mian, Nicholas D. 2014. Little Children with Big Worries: Addressing the Needs of Young,
Anxious Children and the Problem of Parent Engagement. Clin Child & Family Psychology
Review, 17(1) pp 85-96
Anxiety disorders in preschool-age children represent an important clinical problem due to high
prevalence, substantial impairment, persistence, and associated risk for later emotional problems.
Early intervention may mitigate these problems by capitalizing on a strategic developmental period.
Elevated neuroplasticity, availability of screening tools, and the potential to modify parenting
practices position anxiety as a good candidate for early intervention and preventive efforts. While
some novel interventions show promise, the broad success of such programs will largely depend
on parent engagement. Since parents are less likely to identify and seek help for anxiety problems
compared to other childhood behavior problems, especially in a preventive manner, methods for
understanding parents’ decisions to participate and enhancing levels of engagement are central to
the success of early childhood anxiety prevention and intervention. Understanding these processes
is particularly important for families characterized by sociodemographic adversity, which have been
underrepresented in anxiety treatment research. This review summarizes the developmental
phenomenology of early emerging anxiety symptoms, the rationale for early intervention, and the
current state of research on interventions for young, anxious children. The roles of parent
engagement and help-seeking processes are emphasized, especially among economically
disadvantaged and ethnic minority communities who are acutely at risk. Evidence-based strategies
to enhance parent engagement to facilitate the development and dissemination of efficacious
programs are offered.
Muris, P. & Meesters, C. 2014. Small or Big in the Eyes of the Other: On the Developmental
Psychopathology of Self-Conscious Emotions as Shame, Guilt, and Pride. Clinical Child &
Family Psychology Review, 17(1) pp 19-40
The self-conscious emotions of guilt, shame, and pride typically occur when people evaluate their
own self through the eyes of another person. This article will first of all discuss the nature and
function of self-conscious emotions, and describe their developmental course in children and
adolescents. Then, a number of variables are discussed that are thought to increase young
people’s proneness to experience self-conscious emotions. Following this, the empirical evidence
on the relationships between guilt, shame, and pride and various types of psychopathology in
children and adolescents will be summarized. A model is presented to explain why these selfconscious emotions are associated with a diversity of psychopathological outcomes. Finally,
recommendations for clinical practice are made in terms of assessment and interventions targeting
the origins and sequelae of self-conscious emotions.
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Lindhiem, O. et al. 2014. Skill Acquisition and Utilization During Evidence-Based
Psychosocial Treatments for Childhood Disruptive Behavior Problems: A Review and Metaanalysis. Clinical Child & Family Psychology Review, 17(1) pp 41-66
We review 85 empirical articles published since 2000 that measured the acquisition and/or
utilization of parent management skills and/or child cognitive-behavioral skills in the context of an
evidence-based treatment (EBT) for childhood behavior problems. Results showed that: (1) there
are no standardized measures of skill acquisition or skill utilization that are used across treatments,
(2) little is known about predictors, correlates, or outcomes associated with skill acquisition and
utilization, and (3) few studies systematically examined techniques to enhance the acquisition and
utilization of specific skills. Meta-analytic results from a subset of 68 articles (59 studies) showed
an overall treatment–control ES = .31, p < .01 for skill acquisition and ES = .20, p = ns for skill
utilization. We recommend that future research focus on the following three areas: (1) development
of standardized measures of skill acquisition and utilization from a “common elements” perspective
that can used across EBTs; (2) assessment of the predictors, correlates, and outcomes associated
with skill acquisition and utilization; and (3) development of innovative interventions to enhance the
acquisition and utilization of cognitive-behavioral and parent management skills.
del Mar Bernad, M. et al. A Cross-Sectional and Longitudinal Investigation of the External
Correlates of Sluggish Cognitive Tempo and ADHD-Inattention Symptoms Dimensions.
Journal of Abnormal Child Psychology, March 2014 DOI 10.1007/s10802-014-9866-9
The objective was to determine if the external correlates of sluggish cognitive tempo (SCT) and
ADHD-inattention (IN) dimensions were the same in cross-sectional and longitudinal analyses.
Teachers and aides rated SCT, ADHD-IN, ADHD-hyperactivity/impulsivity (HI), oppositional defiant
disorder (ODD), and depression along with academic impairment in 758 Spanish children (55 %
boys) on three occasions (twice at the end of the first grade year [6-week separation] and then
again 12-months later at the end of the second grade year). Three of eight SCT symptoms showed
substantial loadings on the SCT factor and substantially higher loadings on the SCT factor than the
ADHD-IN factor for teachers and aides at each assessment (seems drowsy, thinking is slow, and
slow moving). Cross-sectional and longitudinal analyses yielded similar results with SCT and
ADHD-IN factors having different and unique external correlates (higher scores on SCT predicted
lower scores on ADHD-HI and ODD while higher scores on ADHD-IN predicted higher scores on
ADHD-HI and ODD with SCT and ADHD-IN both uniquely predicting academic impairment and
depression). Developmental and methodological reasons are discussed for the failure to find an
inconsistent alertness SCT factor (daydreams, alertness fluctuates, absent-minded, loses train of
thought, and confused).
Loth, A. et al. Do Childhood Externalizing Disorders Predict Adult Depression? A MetaAnalysis. Journal of Abnormal Child Psychology March 2014 DOI 10.1007/s10802-014-9867-8
Childhood externalizing disorders have been linked to adult affective disorders, although some
studies fail to substantiate this finding. Multiple longitudinal cohort studies identifying childhood
psychopathology and their association with adult psychiatric illness have been published. To
examine the association between childhood externalizing symptoms or disorders and the
development of adult depression across cohorts, a meta-analysis was performed. Potential studies
were identified using a PubMed search through November 2013. All published, prospective,
longitudinal, community-sampled cohort studies of children (≤ 13 years) with externalizing
symptoms or disorders (aggression, conduct problems, oppositional defiant disorder, conduct
disorder), reassessed in adulthood (≥ 18 years) for depressive disorders (major depressive
disorder, depressive disorder NOS, or dysthymic disorder) were included. A random effects model
was used to summarize the pooled effect sizes. Ancillary analyses considered covariates that
could account for variance among studies. Ten studies representing eight cohorts of children
initially assessed at age 13 or younger (N = 17,712) were included in the meta-analysis. Childhood
externalizing behavior was associated with adult depressive disorders (OR = 1.52, 95 %
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Clinical Psychology Current Awareness Bulletin No: 23 2014
confidence interval = 1.27–1.80, p < 0.0001). Utilizing Orwin’s Fail-safe N approach, 263 studies
with a mean odds ratio of 1.0 would have to be added to the analysis before the cumulative effect
would become trivial. Externalizing psychopathology in childhood is associated with the
development of unipolar depressive disorders in adulthood.
Olino, T. et al. Testing Models of Psychopathology in Preschool-aged Children Using a
Structured Interview-based Assessment. Journal of Abnormal Child Psychology March 2014
DOI 10.1007/s10802-014-9865-x
A number of studies have found that broadband internalizing and externalizing factors provide a
parsimonious framework for understanding the structure of psychopathology across childhood,
adolescence, and adulthood. However, few of these studies have examined psychopathology in
young children, and several recent studies have found support for alternative models, including a
bi-factor model with common and specific factors. The present study used parents’ (typically
mothers’) reports on a diagnostic interview in a community sample of 3-year old children (n = 541;
53.9 % male) to compare the internalizing-externalizing latent factor model with a bi-factor model.
The bi-factor model provided a better fit to the data. To test the concurrent validity of this solution,
we examined associations between this model and paternal reports and laboratory observations of
child temperament. The internalizing factor was associated with low levels of surgency and high
levels of fear; the externalizing factor was associated with high levels of surgency and disinhibition
and low levels of effortful control; and the common factor was associated with high levels of
surgency and negative affect and low levels of effortful control. These results suggest that
psychopathology in preschool-aged children may be explained by a single, common factor
influencing nearly all disorders and unique internalizing and externalizing factors. These findings
indicate that shared variance across internalizing and externalizing domains is substantial and are
consistent with recent suggestions that emotion regulation difficulties may be a common
vulnerability for a wide array of psychopathology.
Barber, B. et al. 2014. Acute Stress, Depression, and Anxiety Symptoms Among English and
Spanish Speaking Children with Recent Trauma Exposure. Journal of Clinical Psychology in
Medical Settings, 21(1) pp 66-71
A growing literature suggests the clinical importance of acute stress disorder symptoms in youth
following potentially traumatic events. A multisite sample of English and Spanish speaking children
and adolescents (N = 479) between the ages of 8–17, along with their caregivers completed
interviews and self-report questionnaires between 2 days and 1 month following the event. The
results indicate that children with greater total acute stress symptoms reported greater depressive
(r = .41, p < .01) and anxiety symptoms (r = .53, p < .01). Examining specific acute stress
subscales, reexperiencing was correlated with anxiety (r = .47, p < .01) and arousal was correlated
with depression (r = .50, p < .01) and anxiety (r = .55, p < .01). Age was inversely associated with
total acute stress symptoms (r = −.24, p < .01), reexperiencing (r = −.17, p < .01), avoidance
(r = −.27, p < .01), and arousal (r = −.19, p < .01) and gender was related to total anxiety
symptoms (Spearman’s ρ = .17, p < .01). The current study supports the importance of screening
acute stress symptoms and other mental health outcomes following a potentially traumatic event in
children and adolescents. Early screening may enable clinicians to identify and acutely intervene to
support children’s psychological and physical recovery.
Wolfe-Cristensen, C. et al. 2014. Factor Analysis of the Pediatric Symptom Checklist in a
Population of Children with Voiding Dysfunction and/or Nocturnal Enuresis. Journal of
Clinical Psychology in Medical Settings, 21(1) pp 72-80
The research objective was to identify the factor structure of the pediatric symptom checklist (PSC)
in children with voiding dysfunction and/or nocturnal enuresis who were seen in a pediatric urology
clinic. Retrospective chart reviews were conducted for 498 consecutive patients, ages 6–16, who
were seen over a 13-month period. The PSC, a 35-item measure used to screen for psychosocial
difficulties, was completed by the patient’s caregiver. Confirmatory factor analyses using three
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Clinical Psychology Current Awareness Bulletin No: 23 2014
previous models were conducted. A four factor model comprised of internalizing, externalizing,
attention problems, and chronic illness factors represented the best fit to the data. Within this
population, the PSC appears to capture internalizing and externalizing problems, difficulties with
attention, and possible side effects of a medical condition. This information could aid clinicians in
assessing adjustment difficulties within this population and concurrently allow researchers to
examine whether these specific factors are related to other relevant outcomes.
Sibley, M. et al. Pharmacological and psychosocial treatments for adolescents with ADHD:
An updated systematic review of the literature. Clinical Psychology Review, 34(3) pp. 218–232
Smith, Waschbusch, Willoughby, and Evans (2000) reviewed a small treatment literature on ADHD
in adolescents and concluded that methylphenidate stimulant medication was a well-established
treatment and behavior therapy (BT) demonstrated preliminary efficacy. This review extends and
updates the findings of the prior one based on the previous 15 years of research. Studies
published since 1999 were identified and coded using standard criteria and effect sizes were
calculated where appropriate. Highlights of the last 15 years of research include an expansion of
pharmacological treatment options and developmentally appropriate psychosocial treatment
packages for adolescents with ADHD. Additionally, nonstimulant medications (e.g., atomoxetine)
are now approved for the treatment of ADHD in adolescence. The review concludes that
medication and BT produce a similar range of therapeutic effects on the symptoms of adolescents
with ADHD. However, results suggest that BT may produce greater overall benefits on measures
of impairment. There was no evidence that cognitive enhancement trainings, such as working
memory training or neurofeedback improved the functioning of adolescents with ADHD. Whether to
use medication, BT, or their combination to treat an adolescent with ADHD is complicated and we
provide evidence-informed guidelines for treatment selection. The reviewed evidence does not
support current American Academy of Pediatrics and American Academy of Child and Adolescent
Psychiatry professional guidelines, which state that stimulant medication is the preferred treatment
for adolescents with ADHD. Recommendations for assessment, practice guidelines, and future
research are discussed.
Ankie T.A. Menting , Bram Orobio de Castro , Walter Matthys. 2013. Effectiveness of the
Incredible Years parent training to modify disruptive and prosocial child behavior: A metaanalytic review. Clinical Psychology Review, 33(8) pp 901-1254
The present meta-analytic review examined effectiveness of the Incredible Years parent training
(IYPT) regarding disruptive and prosocial child behavior, and aimed to explain variability in
intervention outcomes. Fifty studies, in which an intervention group receiving the IYPT was
compared to a comparison group immediately after intervention, were included in the analyses.
Results showed that the IYPT is an effective intervention. Positive effects for distinct outcomes and
distinct informants were found, including a mean effect size of d =.27 concerning disruptive child
behavior across informants. For parental report, treatment studies were associated with larger
effects (d =.50) than indicated (d =.20) and selective (d =.13) prevention studies. Furthermore,
initial severity of child behavior revealed to be the strongest predictor of intervention effects, with
larger effects for studies including more severe cases. Findings indicate that the IYPT is successful
in improving child behavior in a diverse range of families, and that the parent program may be
considered well-established.
Ailish Hand , Emma McDonnell , Bahman Honari , John Sharry. 2013. A community led
approach to delivery of the Parents Plus Children's Programme for the parents of children
aged 6–11. International Journal of Clinical & Health Psychology, 13(2) pp. 87-90
Childhood internalising and externalising disorders tend to persist when left untreated and place
affected individuals at higher risk of compromised outcomes. The social costs include school
dropout, unemployment, family breakdown and substance abuse. Effective preventive
interventions require a public health approach. The aim of this experimental study was to evaluate
the effectiveness of the Parents Plus Children's Programme (PPCP) delivered in community and
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Clinical Psychology Current Awareness Bulletin No: 23 2014
school contexts by frontline professionals from diverse backgrounds. Participating parents with
children aged 6 to 11 were randomly assigned to a Treatment Group (n = 44) or a no treatment
Control Group (n = 31). The efficacy of training was assessed using self-report questionnaires
completed by participants in both Treatment and Control groups. Significant post treatment
improvements were recorded on measures of parenting-related stress, child problem behaviour
and parent satisfaction with medium to large effect sizes. Treatment group results were maintained
at six-month follow-up. These results support the efficacy of the PPCP as a community led
intervention with potential to prevent and interrupt child behaviour problems through supported
parenting practice, before problems become critical and entrenched
Brenner, S. et al. Mental Health Service Use Among Adolescents Following Participation in a
Randomized Clinical Trial for Depression. Journal of Clinical Child & Adolescent Psychology, 24
March 2014 Ahead of Print. DOI:10.1080/15374416.2014.881291
Major depressive disorder (MDD) is a common disorder among adolescents. The Treatment for
Adolescents with Depression Study (TADS) was a randomized controlled trial to examine the
efficacy of fluoxetine and cognitive-behavioral therapy (CBT), separately and together, compared
with placebo, in adolescents 12 to 17 years of age. The Survey of Outcomes Following Treatment
for Adolescent Depression (SOFTAD) was designed as a naturalistic follow-up of participants in
TADS. The aims of the current analyses are to describe mental health service use during the
SOFTAD period. There were 196 adolescents recruited from 12 TADS sites. The Schedule for
Affective Disorders and Schizophrenia for School-Age-Children-Present and Lifetime Version was
used for clinical diagnoses. Participants completed a psychiatric treatment log and the Child and
Adolescent Services Assessment to assess service use. 58% received psychotherapy or
nonstimulant psychotropic medication during SOFTAD. Youth with recurrent MDD had higher rates
of treatment compared to youth without recurrent MDD (71% vs. 45%). However, nearly one third
of the adolescents in the study did not receive treatment for a recurrent episode of depression.
Service use differed by gender for those with recurrent MDD, with female participants (79%)
receiving treatment at higher rates than male participants (55%), although there was no significant
difference in depression severity between genders. Younger participants with recurrent MDD had
higher odds of receiving psychotherapy. Use of psychotherapy and psychotropics following
recurrence of depression appears to be influenced by age and gender. Even when youth respond
well to treatment, a sizeable percentage are likely to experience a subsequent episode that may go
untreated.
Waller, R. et al. Callous-Unemotional Behavior and Early-Childhood Onset of Behavior
Problems: The Role of Parental Harshness and Warmth. Journal of Clinical Child & Adolescent
Psychology, 24 March 2014 Ahead of Print. DOI:10.1080/15374416.2014.886252
Youth with callous-unemotional (CU) behavior are at risk of developing more severe forms of
aggressive and antisocial behavior. Previous cross-sectional studies suggest that associations
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between parenting and conduct problems are less strong when children or adolescents have high
levels of CU behavior, implying lower malleability of behavior compared to low-CU children. The
current study extends previous findings by examining the moderating role of CU behavior on
associations between parenting and behavior problems in a very young sample, both concurrently
and longitudinally, and using a variety of measurement methods. Data were collected from a multiethnic, high-risk sample at ages 2 to 4 (N = 364; 49% female). Parent-reported CU behavior was
assessed at age 3 using a previously validated measure. Parental harshness was coded from
observations of parent–child interactions and parental warmth was coded from 5-min speech
samples. In this large and young sample, CU behavior moderated cross-sectional correlations
between parent-reported and observed warmth and child behavior problems. However, in crosssectional and longitudinal models testing parental harshness, and longitudinal models testing
warmth, there was no moderation by CU behavior. The findings are in line with recent literature
suggesting parental warmth may be important to child behavior problems at high levels of CU
behavior. In general, however, the results of this study contrast with much of the extant literature
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Clinical Psychology Current Awareness Bulletin No: 23 2014
and suggest that in young children, affective aspects of parenting appear to be related to emerging
behavior problems, regardless of the presence of early CU behavior.
Garland, A. et al. 2014. Searching for Elements of Evidence-Based Practices in Children's
Usual Care and Examining Their Impact. Journal of Clinical Child & Adolescent Psychology,
43(2) pp. 201-215
Most of the knowledge generated to bridge the research–practice gap has been derived from
experimental studies implementing specific treatment models. Alternatively, this study uses
observational methods to generate knowledge about community-based treatment processes and
outcomes. Aims are to (a) describe outcome trajectories for children with disruptive behavior
problems (DBPs), and (b) test how observed delivery of a benchmark set of practice elements
common in evidence-based treatments may be associated with outcome change while accounting
for potential confounding variables. Participants included 190 children ages 4 to 13 with DBPs and
their caregivers, plus 85 psychotherapists, recruited from six clinics. All treatment sessions were
videotaped and a random sample of 4 sessions in the first 4 months of treatment was reliably
coded for intensity on 27 practice elements (benchmark set and others). Three outcomes (child
symptom severity, parent discipline, and family functioning) were assessed by parent report at
intake, 4, and 8 months. Data were collected on several potential covariates including child, parent,
therapist, and service use characteristics. Multilevel modeling was used to assess relationships
between observed practice and outcome slopes while accounting for covariates. Children and
families demonstrated improvements in all 3 outcomes, but few significant associations between
treatment processes and outcome change were identified. Families receiving greater intensity on
the benchmark practice elements did demonstrate greater improvement in the parental discipline
outcome. Observed changes in outcomes for families in community care were generally not
strongly associated with the type or amount of treatment received.
Núria Voltas Moreso , Carmen Hernández-Martínez , Victoria Arija Val , Josefa Canals Sans. 2013.
Socio-demographic and psychopathological risk factors in obsessive-compulsive disorder:
Epidemiologic study of school population. International Journal of Clinical and Health
Psychology, 13(2) pp118–126
We assessed the presence of emotional disorders (obsessive-compulsive, anxiety and depressive)
in 1,514 Spanish non-referred children (8–12 years old) to investigate the predictive ability of
psychopathological and socio-demographic characteristics, and identify which of these were
possible correlates for clinical obsessive-compulsive disorder (OCD) and subclinical OCD. At one
year later, 562 subjects (risk group and without risk group) were re-assessed and we established
the OCD diagnoses or the subclinical OCD diagnoses. We found that 20 participants presented
clinical OCD and 46 participants presented subclinical OCD. Somatic and separation anxiety
symptomatology were good predictors for clinical OCD, and obsessive concern was a predictor for
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subclinical OCD. Clinical OCD was associated with order/checking/pollution symptoms and with a
lower socioeconomic status (SES). Subclinical OCD was associated with hyperactive and
impulsive manifestations, obsessive concern, and superstition/mental compulsion. An early
detection and the follow-up of anxiety or obsessive symptoms in children may be important for
preventing the course of OCD.
Kim S. Ménard and Aaron L. Pincus. 2014. Child maltreatment, personality pathology, and
stalking victimization among male and female college students. Violence and Victims, 29(2)
pp 300-316
Examines child maltreatment and borderline nacissistic personality characteristics to determine
their influence on the vulnerability for being stalked. Describes the results of self-report surveys
from college students. Emphasises the complexity of the interplay between personality disorders,
childhood abuse and later stalking victimisation.
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Clinical Psychology Current Awareness Bulletin No: 23 2014
Cheryl van Daalen-Smith, Simon Adam, Peter Breggin and Brenda A. LeFrancois. 2014. The
utmost discretion: how presumed prudence leaves children susceptible to electroshock.
Children and society, 28(3) pp 205-217
Looks at the use of electroconvulsive therapy (ECT or electroshock) treatment to children who are
undergoing psychiatric treatment. Argues against the legitimacy of this treatment, stating that it is
potentially damaging and against children's rights.
ADDICTIONS
Ingeborg Rossow and Thor Norström. Heavy episodic drinking and deliberate self-harm in
young people: a longitudinal cohort study. Addiction, Article first published online: 25 MAR
2014 | DOI: 10.1111/add.12527
Aim: To assess the association between heavy episodic drinking (HED) and deliberate self-harm
(DSH) in young people in Norway.
Design, setting, participants and measurements: We analysed data on past-year HED and DSH
from the second (1994) and third (1999) waves of the Young in Norway Longitudinal Study
(cumulative response rate: 68.1%, n = 2647). Associations between HED and DSH were obtained
as odds ratios and population-attributable fractions (PAF) applying fixed-effects modelling, which
eliminates the effects of time-invariant confounders.
Findings: An increase in HED was associated with an increase in risk of DSH (OR = 1.64,
P = 0.013), after controlling for time-varying confounders. The estimated PAF was 28% from fixedeffects modelling and 51% from conventional modelling.
Conclusion: Data on Norwegian youths show a statistically significant association between heavy
episodic drinking and deliberate self-harm.
Tore Tjora, Jørn Hetland, Leif Edvard Aarø, Bente Wold, Nora Wiium and Simon Øverland. The
association between smoking and depression from adolescence to adulthood. Addiction,
Article first published online: 25 MAR 2014 | DOI: 10.1111/add.12522
Background and Aims: The association between depression and smoking is firmly established, but
how the association develops remains unclear. The aim of this study was to examine development
of the smoking–depression association from early adolescence to adulthood.
Design: Cross-sectional and longitudinal analyses of the smoking–depression association from
adolescence to adulthood.
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Setting: Hordaland, Norway.
Participants: A cohort of adolescents (initially, 924 pupils) in the Norwegian Longitudinal Health
Behaviour Study (NLHB) was followed over nine data collection waves from ages 13 to 30 years.
Measurements: Daily smoking and depressed mood were measured in each wave.
Findings: In the cross-sectional analyses, daily smoking and depression were significantly
associated (P-value range from P < 0.01 to 0.04) in eight of nine waves. In the final longitudinal
model, after controlling for the time-invariant effects of smoking and depression and of tertiary
factors, the only significant paths were early adolescent smoking prediction of early adolescent
depression (waves 1–2: β = 0.07, P < 0.05; waves 2–3: β = 0.12, P < 0.05) and vice versa (waves
1–2: β = 0.10, P < 0.05; waves 2–3: β = 0.08, P < 0.05).
Conclusions: The inter-relationship between depression and smoking seems to be due to the
reciprocal causal effects between smoking and depression that are established in early
adolescence and maintained into adulthood.
Giuseppe N. Giordano, Henrik Ohlsson, Kenneth S. Kendler, Kristina Sundquist and Jan
Sundquist. Unexpected adverse childhood experiences and subsequent drug use disorder: a
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Clinical Psychology Current Awareness Bulletin No: 23 2014
Swedish population study (1995-2011). Addiction, Accepted manuscript online: 11 MAR 2014
03:12AM EST | DOI: 10.1111/add.12537
Aims: Exposure to extraordinary traumatic experience is one acknowledged risk factor for drug
use. We aim to analyse the influence of potentially life-changing childhood stressors, experienced
second-hand, on later drug use disorder in a national population of Swedish adolescent and young
adults (aged 15-26 years).
Design: We performed Cox Proportional Hazard regression analyses, complemented with corelative pair comparisons.
Setting: Sweden
Participants: All individuals in the Swedish population born 1984 to 1995, who were registered in
Sweden at the end of the calendar year they turned 14 years of age. Our follow-up time (Mean: 6.2
years; Range 11 years) started at the year they turned 15 and continued to December 2011
(N=1,409,218).
Measurements: Our outcome variable was drug use disorder, identified from medical, legal and
pharmacy registry records. Childhood stressors, as per DSM-IV stressor criteria, include death of
an immediate family member and second-hand experience of diagnoses of malignant cancer,
serious accidental injury, and victim of assault. Other covariates include parental divorce, familial
psychological well-being, and familial drug and alcohol use disorders.
Findings: After adjustment for all considered confounders, individuals exposed to childhood
stressors ‘parental death’ or ‘parental assault’ had over twice the risk of drug use disorder than
those who were not (HR = 2.63 (2.23-3.09) and 2.39 (2.06-2.79), respectively).
Conclusions: Children under 15 who experience second-hand an extraordinary traumatic event
(such as a parent or sibling being assaulted, diagnosed with cancer, or dying) appear to have
approximately twice the risk of developing a drug use disorder than those who do not.
Funk, M. et al. Non-medical use of prescription medications among middle school students:
a qualitative analysis. Journal of Substance Use, Ahead of Print, Posted online on March 28,
2014
Non-medical use of prescription medication (NMUPM) has surpassed all other drugs abused by
adolescents with the exception of marijuana. One third of adolescents aged 12–17 have reported
using a prescription medication for non-medical purposes in their lives. Twenty-five middle school
students participated in in-depth interviews about their experience with NMUPM. Interviews were
recorded, transcribed and downloaded to Nvivo 10 for analysis. Researchers identified 11 common
themes among participants. Middle school students did not recognize prescription medications as
potentially dangerous when used non-medically compared to using street drugs. Obtaining
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prescription medications for non-medical purposes was perceived as relatively easy and parents,
friends’ parents and friends were major sources for obtaining them. NMUPM occurred at school
even with teachers present and at parties and private homes with and without parents at home.
Some students described using prescription medications as a means to satisfy desires for
sensation and to deal with life problems. Practitioners can use these results to inform healthcare
professionals, pharmaceutical companies, parents and adolescents of the prevalence and serious
risks involved with NMUPM.
O’Keefe, S. et al. 2014. Sister-brother Incest: Data from Anonymous Computer Assisted Self
Interviews. Sexual Addiction & Compulsivity: The Journal of Treatment & Prevention, 21(1) p1-38
Retrospective data were entered anonymously by 1,178 adult men using computer-assisted selfinterview. Twenty-seven were victims of sister-brother incest (SBI), 119 were victims of child
sexual abuse by an adult female (CSA-AF) before 18 years of age, 1,032 were controls. SBI was
often the first sexual experience for the victim. Our findings were consistent with other reports of
early and persistent hyper-eroticization of incest victims. SBI increased the likelihood of engaging
in behaviors as an adult consistent with a co-existing or primary male-male sexual orientation, and
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Clinical Psychology Current Awareness Bulletin No: 23 2014
SBI and CSA-AF had deleterious impacts on adult men's sexual adjustment with their adult
partners.
Timothy E. Wilens, Amy Yule, MaryKate Martelon, Courtney Zulauf and Stephen V. Faraone.
Parental history of substance use disorders (SUD) and SUD in offspring: A controlled family study
of bipolar disorder. The American Journal on Addictions, Article first published online: 15 MAR
2014 | DOI: 10.1111/j.1521-0391.2014.12125.x
Background and Objectives: Adolescents with bipolar disorder (BPD) have been previously shown
to be at very high risk for substance use disorders (SUD). We now examine the influence of a
parental history of substance use disorders on SUD risk in offspring with and without BPD.
Methods: We studied 190 parents ascertained through 104 adolescent BPD probands and 189
parents ascertained through 98 control probands using structured interviews. We compared the
prevalence of SUD using logistic regression.
Results: While adjusting for BPD in our combined sample, probands with a parental history of SUD
were more likely to have an alcohol use disorder compared to probands without a parental history.
Probands with a parental history of SUD were not more likely to have a drug use disorder or overall
SUD compared to probands without a parental history. BPD in the offspring did not pose any
additional risk between parental history of SUD and offspring SUD.
Conclusion: Alcohol use disorders were more common in the offspring of parents with a SUD
history compared to parents without SUD and the risk was not influenced by offspring BPD.
Scientific Significance: Clarifying the mechanisms linking parental SUD to offspring SUD,
particularly in children and adolescents with BPD, would help clinicians to educate and monitor
high-risk families, which would facilitate strategies to mitigate risks associated with parental
substance abuse.
Pasold, T. et al. 2014. Binge eating in obese adolescents: Emotional and behavioral characteristics
and impact on health-related quality of life. Clin Child Psychol Psychiatry, 19(2) pp. 299-312
Purpose: This study explored binge eating among an adolescent obese population to ascertain the
prevalence of bingeing, the relationship between binge eating and body mass index (BMI), and to
evaluate significant relationships between binge eating, emotional/behavioral functioning, and
health-related quality of life.
Methods: Participants included 102 overweight adolescents aged 12–17 years presenting to a
multidisciplinary outpatient obesity clinic. Data obtained included height, weight, and self-report
questionnaire data on emotional and behavioral functioning.
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Results: Binge eating prevalence included 33% moderate to severe binge eating. Binge eating was
significantly positively related to BMI and depression, negative mood, feelings of ineffectiveness,
negative self-esteem and significantly negatively related to somatic complaints and all aspects of
health-related quality of life. Important demographic differences emerged with regard to the impact
of binge eating on health-related quality of life with Caucasians, females, and older groups
experiencing more pervasive impact.
Conclusions: This research suggests that bingeing behaviors have pervasive and important
implications for health-related quality of life for obese adolescents.
Paloma González-Castro , Celestino Rodríguez , Ángel López , Marisol Cueli , Luis Álvarez. 2013.
Attention Deficit Hyperactivity Disorder, differential diagnosis with blood oxygenation,
beta/theta ratio, and attention measures. International Journal of Clinical and Health
Psychology, 13(2), pp101-109
Attention Deficit Hyperactivity Disorder (ADHD) is one of the disorders causing the greatest impact,
conditioning academic learning, quality of concentration, and capacity for self-regulation and
control. The Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV-TR) establishes the
most commonly accepted criteria for diagnosis (Inattentive: ADHD-I, Hyperactive/impulsive: ADHD-
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Clinical Psychology Current Awareness Bulletin No: 23 2014
HI, and Combined: ADHD-C), but currently, diverse studies disagree about whether to address it
as a continuum with different degrees of intensity (subtype structure) or as specific disorders
(counterposed profiles). Prior research has tested the hypothesis of differential categories with
performance measures and cortical activation. The goal proposed herein is to confirm these
results, incorporating a new measure, near-infrared hemoencefalography (nir-HEG), in order to
control cortical activation through levels of blood oxygenation. For this purpose, we used a sample
of 205 children between 8 and 13 years (105 control group, 28 with ADHD-I, 35 with ADHD-HI, and
37 with ADHD-C), administering a continuous performance test (TOVA), quantified
electroencephalogram (Q-EEG), and nir-HEG. Results reflect the counterposed profiles hypothesis
instead of the degrees of intensity, although the latter is more habitual and generalized
CHILDREN, DIABETES AND PSYCHOLOGY
Jane P Noyes et al. 2014. Developing and evaluating a child-centred intervention for diabetes
medicine management using mixed methods and a multicentre randomised controlled trial. Health
Services and Delivery Research, 2(8) March 2014. NHS National Institute for Health Research
(NIHR)
The aim of this study was to develop and evaluate an individually tailored age-appropriate diabetes
diary and information pack for children and young people aged 6–18 years with type 1 diabetes to
support decision-making and self-care with a specific focus on insulin management and blood
glucose monitoring, compared with vailable resources in routine clinical practice. It found that the
Evidence into Practice Information Counts packs and diabetes diaries were no more effective than
receiving diabetes information in an ad hoc way.
Marzelli, M. J. et al. Neuroanatomical Correlates of Dysglycemia in Young Children With Type
1 Diabetes. Diabetes, 63(1) pp. 343-353
Studies of brain structure in type 1 diabetes (T1D) describe widespread neuroanatomical
differences related to exposure to glycemic dysregulation in adults and adolescents. In this study,
we investigate the neuroanatomical correlates of dysglycemia in very young children with earlyonset T1D. Structural magnetic resonance images of the brain were acquired in 142 children with
T1D and 68 age-matched control subjects (mean age 7.0 ± 1.7 years) on six identical scanners.
Whole-brain volumetric analyses were conducted using voxel-based morphometry to detect
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regional differences between groups and to investigate correlations between regional brain
volumes and measures of glycemic exposure (including data from continuous glucose monitoring).
Relative to control subjects, the T1D group displayed decreased gray matter volume (GMV) in
bilateral occipital and cerebellar regions (P < 0.001) and increased GMV in the left inferior
prefrontal, insula, and temporal pole regions (P = 0.002). Within the T1D group, hyperglycemic
exposure was associated with decreased GMV in medial frontal and temporal-occipital regions and
increased GMV in lateral prefrontal regions. Cognitive correlations of intelligence quotient to GMV
were found in cerebellar-occipital regions and medial prefrontal cortex for control subjects, as
expected, but not for the T1D group. Thus, early-onset T1D affects regions of the brain that are
associated with typical cognitive development
Hudson, J. et al. 2014. Exploring the relationship between cognitive illness representations
and poor emotional health and their combined association with diabetes self-care. A
systematic review with meta-analysis. Journal of Psychosomatic Research, 76(4) pp 265-274
Objective: Depression and anxiety are common in diabetes and are associated with lower diabetes
self-care adherence. How this occurs is unclear. Our systematic review explored the relationship
between cognitive illness representations and poor emotional health and their combined
association with diabetes self-care.
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Methods: Medline, Psycinfo, EMBASE, and CINAHL were searched from inception to June 2013.
Data on associations between cognitive illness representations, poor emotional health, and
diabetes self-care were extracted. Random effects meta-analysis was used to test the relationship
between cognitive illness representations and poor emotional health. Their combined effect on
diabetes self-care was narratively evaluated.
Results: Nine cross-sectional studies were included. Increased timeline cyclical, consequences,
and seriousness beliefs were associated with poorer emotional health symptoms. Lower perceived
personal control was associated with increased depression and anxiety, but not mixed anxiety and
depressive symptoms. Remaining cognitive illness representation domains had mixed statistically
significant and non-significant relationships across emotional states or were measured only once.
Effect sizes ranged from small to large (r = ±0.20 to 0.51). Two studies explored the combined
effects of cognitions and emotions on diabetes self-care. Both showed that cognitive illness
representations have an independent effect on diabetes self-care, but only one study found that
depression has an independent effect also.
Conclusions: Associations between cognitive illness representations and poor emotional health
were in the expected direction — negative diabetes perceptions were associated with poorer
emotional health. Few studies examined the relative effects of cognitions and emotions on
diabetes self-care. Longitudinal studies are needed to clarify directional pathways.
Miller, V. & Jawad, A. Relationship of Youth Involvement in Diabetes-Related Decisions to
Treatment Adherence. Journal of Clinical Psychology in Medical Settings March 2014 DOI
10.1007/s10880-014-9388-1
The aim of this study was to examine the relationship of youth’s involvement in diabetes-related
decisions to adherence. Children and adolescents (8–19 years) and their parents (N = 89)
completed the Decision Making Involvement Scale and the Self Care Inventory, a self-report
measure of adherence. After controlling for youth age, the degree to which youth expressed an
opinion and information to parents was associated with better parent- and youth-reported
adherence. The degree to which parents expressed an opinion and information to youth was
associated with worse parent-reported adherence. Joint decision-making behaviors (e.g.,
negotiation; provision of options) also were associated with better youth-reported adherence.
Encouraging youth to express opinions and share illness-related information with parents during
illness management discussions may improve adherence. Additional research is needed to identify
mechanisms of effect and determine associations between decision making involvement and
health behaviors and outcomes over time.
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ATTACHMENT & RELATED ISSUES
Leigh A. Shaw, Cecilia Wainryb and Judith Smetana. Early and Middle Adolescents' Reasoning
About Moral and Personal Concerns in Opposite-sex Interactions. Social Development. Article
first published online: 4 MAR 2014 | DOI: 10.1111/sode.12076
This study examined how adolescents coordinate personal and moral concerns in reasoning about
opposite-sex interactions. Sixty-four early and middle adolescents (Ms = 12.74, 16.05 years) were
individually interviewed about two hypothetical situations involving opposite-sex interactions
(commenting on appearance, initiating a date), presented in four conditions that varied the salience
of personal vs. moral concerns. Overall, participants viewed opposite-sex interactions as harmless
and acceptable in personal conditions, but as moral concerns became more salient, they were
viewed more negatively, as less contingent on the target's response, and as entailing humiliation,
coercion, and victimization. Age differences occurred primarily in reasoning about conditions
entailing mixed-personal and moral concerns. Implications for adolescents' understanding of
harassment and victimization are discussed.
Astrid M. G. Poorthuis, Sander Thomaes, Marcel A. G. van Aken, Jaap J. A. Denissen and Bram
Orobio de Castro. Dashed Hopes, Dashed Selves? A Sociometer Perspective on Self-esteem
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Clinical Psychology Current Awareness Bulletin No: 23 2014
Change Across the Transition to Secondary School. Social Development, Article first published
online: 4 MAR 2014 | DOI: 10.1111/sode.12075
The transition from primary to secondary school challenges children's psychological well-being. A
cross-transitional longitudinal study (N = 306; mean age = 12.2 years) examined why some
children's self-esteem decreases across the transition whereas other children's self-esteem does
not. Children's expected social acceptance in secondary school was measured before the
transition; their actually perceived social acceptance was measured after the transition. Selfesteem and Big Five personality traits were measured both pre- and posttransition. Self-esteem
changed as a function of the discrepancy between children's expected and actually perceived
social acceptance. Furthermore, neuroticism magnified self-esteem decreases when children's
‘hopes were dashed'—when they experienced disappointing levels of social acceptance. These
findings provide longitudinal support for sociometer theory across the critical transition to
secondary school
Amanda Lowell , Kimberly Renk , Amanda Havill Adgate. The role of attachment in the
relationship between child maltreatment and later emotional and behavioral functioning.
Child Abuse & Neglect Available online 14 March 2014
The experience of childhood maltreatment is an important predictor of unfavorable emotional and
behavioral outcomes. Because little research examined explanatory variables in the relationship
between childhood maltreatment experiences and later outcomes, this study examined the role
that attachment serves in this relationship. Four hundred twenty-four participants completed
questionnaires assessing the variables of interest for this study. Results indicated that both
childhood maltreatment experiences (particularly emotional abuse) and attachment (particularly to
mothers and peers) are significant predictors of later emotional and behavioral outcomes. Further,
attachment contributed unique and significant variance to the relationship between childhood
maltreatment experiences and later outcomes. Such findings suggested that secure attachment
may serve as a protective factor against maladaptive emotional and behavioral outcomes as
children reach emerging adulthood, even in the context of childhood maltreatment experiences.
The importance of studying the relationships among these variables is discussed.
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SOMATIC/PSYCHOSOMATIC ILLNESSES
Marsac, M. et al. 2014. Understanding recovery in children following traffic-related injuries:
Exploring acute traumatic stress reactions, child coping, and coping assistance. Clin Child
Psychol Psychiatry, 19(2) pp. 233-243
Millions of children incur potentially traumatic physical injuries every year. Most children recover
well from their injury but many go on to develop persistent traumatic stress reactions. This study
aimed to describe children’s coping and coping assistance (i.e., the ways in which parents and
peers help children cope) strategies and to explore the association between coping and acute
stress reactions following an injury. Children (N = 243) rated their acute traumatic stress reactions
within one month of injury and reported on coping and coping assistance six months later. Parents
completed a measure of coping assistance at the six-month assessment. Children used an
average of five to six coping strategies (out of 10), with wishful thinking, social support, and
distraction endorsed most frequently. Child coping was associated with parent and peer coping
assistance strategies. Significant acute stress reactions were related to subsequent child use of
coping strategies (distraction, social withdrawal, problem-solving, blaming others) and to child
report of parent use of distraction (as a coping assistance strategy). Findings suggest that
children’s acute stress reactions may influence their selection of coping and coping assistance
strategies. To best inform interventions, research is needed to examine change in coping
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Clinical Psychology Current Awareness Bulletin No: 23 2014
behaviors and coping assistance over time, including potential bidirectional relationships between
trauma reactions and coping.
Lievesley, K. et al. 2014. A review of the predisposing, precipitating and perpetuating factors
in Chronic Fatigue Syndrome in children and adolescents. Clinical Psychology Review, 34(3)
pp233-248
Chronic Fatigue Syndrome (CFS) is a condition characterised by severe mental and physical
fatigue coupled with profound disability. The purpose of this review was to investigate
psychological, social and physiological factors associated with fatigue and disability in CFS in
children and adolescents. The review aimed to gain an overview of the strength of evidence for the
relationship between these different factors and CFS in young people. Seventy-nine studies met
the inclusion criteria and were included in the review. A narrative synthesis of these studies was
conducted. The strongest and most consistent finding was that rates of psychiatric co-morbidity,
predominantly anxiety and depressive disorders, were higher in young people with CFS compared
to healthy controls or illness control groups. Studies suggested that many children and adolescents
with CFS reported that their illness began with an infection and there was some objective and
prospective evidence to support this. Preliminary evidence suggested a link between CFS and a
family history of CFS, high expectations from both the parent and child, personality traits such as
conscientiousness and physical illness attributions. The evidence was limited by methodological
problems. Few studies were prospective in nature and future research should address this. Clinical
implications of the findings are discussed and a hypothesised model of the factors associated with
CFS in children and adolescents is presented.
CONVERSION DISORDERS
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Edited by:
Jane Surtees
Clinical Librarian
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Liz Turner
Library Assistant
Library & Knowledge Service
Tel: 01332 789235
Email: [email protected]
Date:
02/06/2014
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Clinical Psychology Current Awareness Bulletin No: 23 2014