Highlights • A meta-analysis examined the association between maltreatment and diurnal cortisol. • Maltreatment was associated with low wake-up cortisol, in agency-referred samples. • Researchers ...should carefully attend to study design when incorporating salivary cortisol as an outcome measure of maltreatment exposure.
Young children who have experienced early adversity are at risk for developing disorganized attachments. The efficacy of Attachment and Biobehavioral Catch-up (ABC), an intervention targeting ...nurturing care among parents identified as being at risk for neglecting their young children, was evaluated through a randomized clinical trial. Attachment quality was assessed in the Strange Situation for 120 children between 11.7 and 31.9 months of age (M = 19.1, SD = 5.5). Children in the ABC intervention showed significantly lower rates of disorganized attachment (32%) and higher rates of secure attachment (52%) relative to the control intervention (57% and 33%, respectively). These results support the efficacy of the ABC intervention in enhancing attachment quality among parents at high risk for maltreatment.
In prevention trials, outcomes of interest frequently include data that are best quantified as proportion scores. In some cases, however, proportion scores may violate the statistical assumptions ...underlying common analytic methods. In this paper, we provide guidelines for analyzing frequency and proportion data as primary outcomes. We describe standard methods including generalized linear regression models to compare mean proportion scores and examine tools for testing normality and other assumptions for each model. Recommendations are made for instances when the assumptions are not met, including transformations for proportion scores that are non-normal. We also discuss more sophisticated analytical tools to model change in proportion scores over time. The guidelines provide ready-to-use analytical strategies for frequency and proportion data that are commonly encountered in prevention science.
Rates of behavioral health workforce turnover are chronically high, with detrimental effects on the agency and remaining staff, as well as hypothesized negative impacts on client care and outcomes. ...Turnover also creates challenges for studies investigating the effectiveness and/or implementation of behavioral health interventions. Research examining factors that precede and predict behavioral health staff turnover has become increasingly important, as have studies that include recommendations for preventing and reducing turnover. The current paper systematically reviews the body of research on factors associated with behavioral health staff turnover, synthesizes recommendations made for combating turnover, and identifies gaps in this important area of research.
Accuracy has several elements, not all of which have received equal attention in the field of clinical psychology. Calibration, the degree to which a probabilistic estimate of an event reflects the ...true underlying probability of the event, has largely been neglected in the field of clinical psychology in favor of other components of accuracy such as discrimination (e.g., sensitivity, specificity, area under the receiver operating characteristic curve). Although it is frequently overlooked, calibration is a critical component of accuracy with particular relevance for prognostic models and risk-assessment tools. With advances in personalized medicine and the increasing use of probabilistic (0% to 100%) estimates and predictions in mental health research, the need for careful attention to calibration has become increasingly important.
Questions persist in the parenting literature regarding how best to define positive and negative parenting behaviors. Are there optimal parenting behaviors shared by mothers and fathers, or among ...different racial and ethnic groups? This study draws from a nationally representative sample of US parents of school-age children, testing aspects of measurement invariance in the Alabama Parenting Questionnaire (APQ) full and short forms. Our goal was to highlight psychometric approaches to enhancing cultural sensitivity and inclusivity in parenting research, by assessing whether self-reported parenting behaviors have similar conceptual structure across groups. Tests of measurement invariance revealed that the factor structure of the APQ was the same across parent gender, race, and ethnicity. While partial invariance was found in some instances, we did not find metric and scalar invariance in comparisons among these groups. We conclude with research- and practice-based implications, and provide recommendations for future measurement development and use.
With so many promising digital therapeutics for anxiety and obsessive‐compulsive (OC) spectrum problems, there is an urgent need to consider how evolving regulatory oversight of digital therapeutics ...is poised to shift how these tools are developed, evaluated, reimbursed, and delivered. In this commentary, we discuss both opportunities and potential pitfalls associated with emerging government regulations of digital therapeutics for mental health, and we consider how applying the traditional ‘prescription‐based’ medical approval paradigm to digital therapeutics for mental health could ultimately undermine and limit the broad accessibility of these software‐based innovations that have been explicitly designed to expand the accessibility of care. For example, the vast majority of behavioural and mental health providers do not have ‘prescription privileges’ (a term originally rooted in pharmacologic practices), and as a result, under current regulations in the U.S. would not be authorized to make FDA‐cleared digital therapeutics available to their patients. This is particularly concerning given that most digital therapeutics for mental health are directly rooted in psychological and behavioural science, yet psychologists would not be authorized to incorporate these innovations into their practice. We consider how synchronizing regulatory standards across countries may prove useful, and we conclude by arguing that multidisciplinary teams making regulatory decisions concerning digital therapeutics for mental health must include representation from the discipline and practice of psychology.
Practitioner points
Emerging government regulations of digital therapeutics for mental health present both opportunities and potential pitfalls
Applying the traditional ‘prescription‐based’ medical approval paradigm to digital therapeutics for mental health could ultimately undermine the broad accessibility of these software‐based innovations.
Synchronizing regulatory standards across countries may prove useful.
Multidisciplinary teams making regulatory decisions concerning digital therapeutics for mental health must include representation from the field of psychology.
Anxiety and depressive disorders are global public health concerns, and research suggests that these disorders are common in parents and can adversely influence family functioning. However, little is ...known about normative levels of anxiety and depressive symptoms in parents of school-age children. The present study reports on generalized anxiety and depressive symptoms in 1570 parents and guardians of a nationally representative sample of children ages five to twelve years using two widely used and validated questionnaires: the eight-item variant of the Patient Health Questionnaire depression scale (PHQ-8) and the seven-item Generalized Anxiety Disorder scale (GAD-7). Moderate to severe levels of generalized anxiety symptoms were reported in 12.7% of the total sample and moderate to severe levels of depressive symptoms were reported in 14.1% of the sample; 17.7% of the sample reported moderate to severe levels of either generalized anxiety or depressive symptoms. This percentage was higher for females, younger parents and guardians, and parents and guardians reporting lower household incomes. These data, collected online in early 2018, may be useful for researchers and clinicians studying and treating anxiety and depression in parents. Further, these data provide a baseline for researchers currently studying the impact of changes related to the novel coronavirus (COVID-19) pandemic (e.g., school closures) on the mental health of parents of school-age children.
Highlights
Almost 18% of parents and guardians of school-age children in the United States report moderate to severe symptoms of generalized anxiety or depression.
Symptoms of generalized anxiety and depression are higher in younger parents and guardians and those reporting the lowest household incomes.
Normative levels of generalized anxiety and depressive symptoms are provided for researchers, clinicians, and other health professionals studying and treating parents of school-age children.
Young children who enter foster care experience disruptions in care and maltreatment at a point when maintaining attachment relationships is a key, biologically based task. In previous research, we ...have found that young children experience challenges as they form attachments with new caregivers. They tend to push their new caregivers away, even though such children are especially in need of nurturing care. Further, many caregivers do not respond in nurturing ways when their children are distressed, which we have found is problematic for young children in foster care. We developed an intervention that is designed to help caregivers provide nurturance even when children do not elicit it, and even when it does not come naturally to them. This paper presents preliminary findings of the effectiveness of this intervention on children’s attachment behaviors. Forty-six children were randomly assigned to either the experimental intervention or to an educational intervention. For three consecutive days, attachment behaviors were reported across three distress-eliciting situations. Children whose parents had received the experimental intervention showed significantly less avoidance than children whose parents had received the educational intervention. These preliminary results suggest that the intervention is successful in helping children develop trusting relationships with new caregivers.
We estimated norms and percentiles for the Pediatric Emotional Distress Scale (PEDS) in order to enhance its utility as a screening tool for emotional and behavioral distress following a major. The ...PEDS was administered to a nationally representative sample of parents of children ages 5–12 from all 50 states (
N
= 1,570). Approximately 15% of the parents reported a trauma/stress in the past 12 months. Results showed good internal consistency (α = .92) and concurrent validity, with significantly higher scores for the trauma/stress subsample compared to the no trauma/stress subsample. PEDS scores were also significantly higher in younger children (age 5–6) compared to older children (7–12), pointing to the need for separate clinical cut-off scores for younger versus older children. Finally, we examined the factor structure of the PEDS with results supporting a four factor solution in the trauma/stress subsample. For screening purposes, we recommend cut-off scores of 39 (ages 5–6) and 35 (ages 7–12) which correspond to the 90
th
percentile.
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