Kudinova, A.Y., Brick, L., Wolff, J., Ryan, S., Nugent, N., Armey, M., Maron, M., &
Carskadon, M.A. (2023, June) Diurnal variation in suicidal ideation and behavior in youth.
Late breaking abstract presented at the annual meeting of the Sleep Research Society (SRS) in
Indianapolis, IN.
Buitron, V., Maron, M., Kudinova, A.Y., & Wolff, J., (2023). Sleep disturbance and
suicidality in psychiatrically hospitalized adolescents: The role of specific emotion regulation
domains. Journal of Clinical Psychology, doi: 10.1002/jclp.23558, PMID: 37329572
Xin Zhao, Chelsea Dale, Megan Hare, Karissa DiMarzio, Timothy Hayes,
Nigela Ahemaitijiang, Zhuo Rachel Han, Justin Parent
Abstract:
Assessing parenting practices in a culturally informed manner is critical to clinical practice when working with families. Although many parenting measures have been translated into Chinese, limited evidence for measurement invariance is available. The present study aims to assess the measurement invariance of positive and negative parenting practices across Mandarin-speaking families living in Mainland China and English-speaking families living in the United States. Three thousand seven parents of children ages 6-12 years (770 English-speaking: parent M = 35.15 years, SD = 7.96; child M = 9.50 years, SD = 4.27; 2,237 Chinese-speaking: parent M = 38.46 years, SD = 4.42; child M = 9.40 years, SD = 1.78) completed the Multidimensional Assessment of Parenting Scale as a part of two separate research protocols. Multiple-group confirmatory factor analyses (CFAs) were used, and the source of invariance at the factor and item levels was examined. CFA revealed that a seven-factor solution was feasible across both samples, as evidenced by configural and metric invariance. We found a lack of scalar invariance; thus, we constructed a partial scalar invariance model and presented latent means, correlations, and variances of the seven subscales. Item-level parameter estimates and content analyses revealed potentially different item interpretations of the measure. The lack of scalar invariance suggests that researchers should not use mean differences (e.g., from simple t tests) for cross-cultural comparisons using common parenting questionnaires. Instead, we recommend analyzing data utilizing latent variable modeling (e.g., structural equation modeling) and future directions for improving measures as part of larger efforts for promoting inclusive parenting science. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Jennifer C. Wolf, Micaela Maron, Tommy Chou, Erik Hood, Sophia Sodano, Shayna Cheek, Elizabeth Thompson, Kathleen Donise, Emily Katz, Margaret Mannix
Abstract:
Over the past decade, healthcare providers nationwide have contended with a growing boarding crisis as pediatric patients await psychiatric treatment in emergency departments (EDs). COVID-19 has exacerbated this urgent youth mental health crisis, driving EDs to act as crisis units. Journey mapping is a robust methodology with which to examine strengths and challenges in patient care workflows such as boarding and emergency psychiatric care. Psychiatric, emergency medicine, and hospitalist providers serving patients boarding at a northeastern children’s hospital participated in semi-structured qualitative interviews. Investigators conducted directed content analysis with an inductive approach to identify facilitators, barriers, and persistent needs of boarding patients, which were summarized in a patient journey map. Findings were presented to participants for feedback and further refinement. Quantitative data showed a three-fold increase in the number of patients who boarded over the past three years and a 60% increase in the average time spent boarding in the ED. Emergent qualitative data indicated three stages in the boarding process: Initial Evaluation, Admitted to Board, and Discharge. Data highlighted positive and negative factors affecting patient safety, availability of beds in pediatric hospital and psychiatric inpatient settings, high patient-provider ratios that limited staffing support, and roadblocks in care coordination and disposition planning. Patient journey mapping provided insight into providers’ experiences serving patients boarding for psychiatric reasons.
Findings described bright points and pain points at each stage of the boarding process with implications for psychiatric care and systemic changes to reduce boarding volume and length of stay.
Lisa A Uebelacker, Jennifer C Wolff, Jenny Guo, Katherine Conte, Geoffrey Tremont,
Morganne Kraines, Bailey O’Keeffe, Mary A Fristad, Shirley Yen
Abstract:
Purpose: Given increasing rates of depression in adolescents, there is a clear need for innovative treatments. In this pilot randomized clinical trial, we assessed acceptability and feasibility of two group-based interventions: yoga and cognitive-behavioral therapy (CBT). The goal of this work is to prepare for a future fully powered randomized trial to test the hypothesis that yoga is not inferior to an established adolescent depression treatment, namely, group CBT.
Methods: We enrolled 42 adolescents with elevated depression symptoms. Participants were randomly assigned to a 12-week group-based intervention, yoga or CBT. We had a priori feasibility and acceptability targets, including for recruitment rate, retention rate, expectancy, credibility, program satisfaction, class attendance, engagement in home practice, and instructor/leader manual adherence. We assessed adverse events, and within-subject changes in outcomes (depression, anxiety, impairment, sleep disturbance) and possible mediators (mindfulness, self-compassion).
Results: Both interventions met most acceptability and feasibility targets. The only target not met related to low engagement in home practice. Participants within each study arm showed decreased depression symptoms over time and increased self-compassion.
Conclusions: A yoga intervention appears to be acceptable and feasible to adolescents with depression. However, it may be challenging for this group to engage in unstructured home practice.
Michaela Sisitsky, Megan Hare, Karissa DiMarzio, Adriana Gallat, Loreen Magariño, Justin Parent
Abstract:
Exposure to early life adversity (ELA) is associated with increased externalizing symptoms (e.g., aggression and oppositionality), internalizing symptoms (e.g., withdrawal and anxiety), and biological indicators of accelerated aging (e.g., telomere length) in childhood. However, little is known about how distinct dimensions of ELA, such as threat and deprivation, impact youth psychobiological outcomes. The present study includes data from the Future of Families and Child Wellbeing Study (FFCWS), a large population-based, birth cohort study of majority (approximately 75%) racial and ethnic minority youth born between 1998 and 2000 across 20 large cities in the United States. The present study includes a subset of the original sample (N = 2,483, 51.6% male) who provided genetic data at age 9. First, confirmatory factor analyses were conducted, which revealed four distinct dimensions of ELA (home threat, community threat, neglect, and lack of stimulation) when children were age 3. Second, latent profile analyses identified an eight-profile solution based on unique patterns of the four ELA dimensions. Lastly, latent profiles were used to predict associations with child psychological and biological outcomes at age 9. Results suggest that exposure to specific combinations of ELA is differentially associated with internalizing and externalizing behaviors in childhood, but not with telomere length. Findings have implications for personalized early intervention and prevention efforts aimed at reducing ELA exposure to protect against downstream negative mental health outcomes for diverse youth.
Shepherd, B. F., Kelly, L. M., Brochu, P. M., Wolff, J. C., & Swenson, L. P
Abstract:
Social marginalization increases the risk of suicidal ideation (SI) among individuals with diverse identities, yet research examining the effects of marginalization has focused on one identity. Emerging adulthood is a critical period of identity development and the age group with the highest rates of SI. Considering the challenges of living in potentially heterosexist, cissexist, racist, and sizeist environments, we tested whether possessing multiple marginalized identities was associated with severity of SI through factors proposed in the interpersonal–psychological theory (IPT) and the three-step theory (3ST) of suicide and if mediation paths were moderated by sex. A sample of 265 college students completed a cross-sectional online survey assessing SI and constructs related to IPT and 3ST. The number of marginalized identities was generated by adding minoritized sexual orientation, race/ethnicity other than non-Hispanic White, body mass index >25 kg/m2, sexual attraction to same sex but identified as heterosexual, and gender-fluid identity. In IPT multiple mediation analyses, possessing more marginalized identities was associated with SI severity through burdensomeness and hopelessness, but not belonging. Indirect paths through burdensomeness and belonging were moderated by sex. For 3ST, possessing more marginalized identities was associated with SI severity through hopelessness and psychological pain, but not social connection or meaning in life. Future research should consider intersecting social identities and test mechanisms by which multiply marginalized college students develop resilience to SI risk factors, such as support within their marginalized groups, to inform suicide assessment and intervention efforts on college campuses. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
Violeta J Rodriguez, Geraldine De Jesus Cadet, Michaela Sisitsky, Cameryn Cooley,
Juliana Acosta, Erika Coles, Bianka Charity-Parker, Anne Walters, Anne Shaffer,
Justin Parent
Abstract:
The present study explored measurement invariance of the Multidimensional Assessment of Parenting Scale (MAPS; Parent & Forehand, 2017) across White, Hispanic, Black, and Asian American parents. Participants included 2,734 parents, 58% of whom were mothers. On average, parents were 36.32 years old (SD = 9.54); the parent sample was 66.9% White non-Hispanic, 10.1% Black, 5.3% Asian, and 17.7% Hispanic regardless of race. Child ages ranged from 3 to 17 years (M = 9.84, SD = 3.71), and 58% were identified as male. Parents completed a demographics questionnaire about themselves and their target child, and the 34-item MAPS. We explored measurement equivalence of the MAPS Broadband Positive and Negative parenting scales using item response theory to identify differential item functioning (DIF). Univariate analyses for Positive and Negative Parenting showed reliability was excellent. Twelve items assessing negative aspects of parenting exhibited bias by race/ethnicity. Specifically, when comparing racial and ethnic groups, three items had nonuniform DIF comparing Black and Asian participants, two items had nonuniform DIF comparing Black and Hispanic participants, and one item showed nonuniform DIF comparing Asian and Hispanic participants. When looking at Positive Parenting, no items showed evidence of DIF. Results from the present study suggest broadband Positive Parenting can be compared across ethnoracial groups, while findings raise concern about assessing Negative Parenting items when examining invariance across race and ethnicity. Findings from the present study imply that racial and ethnic comparisons are potentially invalid. These findings offer guidance for improving parenting assessment for racially/ethnically diverse populations. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Christie J. Rizzo, PhD, Charlene Collibee, PhD, David Barker, PhD, Christopher Houck, PhD, Kathleen Kemp, PhD, Marina Tolou-Shams, PhD, Caron Zlotnick, PhD, Larry K. Brown, MD
Abstract:
OBJECTIVE: The primary objective of this hybrid I clinical trial of Date SMART (Date Skills to abstract Manage Aggression in Relationships for Teens) was to reduce adolescent dating violence (ADV) among juvenile-justice involved females over 1 year. Secondary objectives were to determine if the intervention reduced sexual risk behavior and delinquency. Last, we evaluate system buy-in vis a vis mandated referrals to the program.
METHODS: Participants were females, ages 14 to 18 (N 5 240), involved in a family court in the Northeast United States. The Date SMART group intervention consisted of cognitive behavioral skill building, and the knowledge-only comparison group consisted of psychoeducation regarding sexual health, ADV, mental health and substance use.
RESULTS: Court mandates to intervention were common (41%). Among those with ADV
exposure, Date SMART participants reported fewer acts of physical and/or sexual ADV (rate ratio, 0.57; 95% confidence interval [CI], 0.33–0.99) and cyber ADV (rate ratio, 0.75; 95% CI, 0.58–0.96) at follow-up, relative to control. There were significant reductions in the number of vaginal and/or anal sex acts reported by Date SMART participants relative to control (rate ratio, 0.81; 95% CI 0.74–0.89). In the overall sample, within group reductions in some ADV behaviors and delinquency were observed in both conditions.
CONCLUSIONS: Date SMART was seamlessly integrated into the family court setting and received stakeholder buy-in. Although not superior to control as a primary prevention tool, Date SMART was effective in reducing physical and/or sexual ADV, and cyber ADV, as well as vaginal and/or anal sex acts, among females with ADV exposure over 1 year
Alexandria M. Reynolds, Andrea M. Spaeth, Lauren Hale, Ariel A. Williamson, Monique K. LeBourgeois, Sachi D. Wong, Lauren E. Hartstein, Jessica C. Levenson, Misol Kwon, Chantelle N. Hart, Ashley Greer, Cele E. Richardson, Michael Gradisar, Michelle A. Clementi, Stacey L. Simon, Lilith M. Reuter-Yuill, Daniel L. Picchietti, Salome Wild, Leila Tarokh, Kathy Sexton-Radek, Beth A. Malow, Kristina P. Lenker, Susan L. Calhoun, Dayna A. Johnson, Daniel Lewin
and Mary A. Carskadon
Abstract:
This White Paper addresses the current gaps in knowledge, as well as opportunities for future studies in pediatric sleep. The Sleep Research Society’s Pipeline Development Committee assembled a panel of experts tasked to provide information to those interested in learning more about the field of pediatric sleep, including trainees. We cover the scope of pediatric sleep, including epidemiological studies and the development of sleep and circadian rhythms in early childhood and adolescence. Additionally, we discuss current knowledge of insufficient sleep and circadian disruption, addressing the neuropsychological impact (affective functioning) and cardiometabolic consequences. A significant portion of this White Paper explores pediatric sleep disorders (including circadian rhythm disorders, insomnia, restless leg and periodic limb movement disorder, narcolepsy, and sleep apnea), as well as sleep and neurodevelopment disorders (e.g. autism and attention deficit hyperactivity disorder). Finally, we end with a discussion on sleep and public health policy. Although we have made strides in our knowledge of pediatric sleep, it is imperative that we address the gaps to the best of our knowledge and the pitfalls of our methodologies. For example, more work needs to be done to assess pediatric sleep using objective methodologies (i.e. actigraphy and polysomnography), to explore sleep disparities, to improve accessibility to evidence-based treatments, and to identify potential risks and protective markers of disorders in children. Expanding trainee exposure to pediatric sleep and elucidating future directions for study will significantly improve the future of the field