The rationale is synthesized for the urgency of empirical studies demonstrating the efficacy of eye movement desensitization and reprocessing (EMDR) therapy for children and adolescents with posttraumatic stress disorder (PTSD), symptoms of PTSD, or other trauma-related symptoms. This literature review examined 15 studies (including nine randomized clinical trials) that tested the efficacy of EMDR therapy for the treatment of children and adolescents with these symptoms. All studies found that EMDR therapy produced significant reductions in PTSD symptoms at posttreatment and also in other trauma-related symptoms, when measured. A methodological analysis identified limitations in most studies, reducing the value of these findings. Despite these shortcomings, the methodological strength of the identified studies has increased over time. The review also summarized three meta-analyses. The need for additional rigorous research is apparent, and in order to profit from experiences of the past, the article provides some guidelines for clinicians seeking to conduct future research in their agencies.
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Inherent in adolescent pregnancy and parenthood are problems related to mother/baby health, societal norms, and economic well-being. Adolescent parenting programs are available; no specific approach is most effective in improving maternal/child health and decreasing subsequent adolescent pregnancies. This study explored what it means to be a pregnant adolescent living in a group home in the United States. One-on-one interviews, using semistructured questions, were conducted with eight participants. Ages were 13–17 years. Three themes emerged: (a) the environment, (b) balancing adolescent expectations, and (c) defining motherhood. Nurses caring for pregnant adolescents are uniquely positioned to influence their development as mothers.
Parental responses to youth negative affect have been associated with social and emotional outcomes in youth. However, the association between such parenting behaviors and essential components of youth emotion regulation is not well studied, especially in youth with anxiety and depressive disorders. This investigation examined the influence of parents’ emotion regulation strategies and their responses to youth negative affect on adolescent-reported emotional awareness and emotional expression in a clinical sample of youth with anxiety disorders. In addition, this study examined the relationship between parent-reported use of emotion regulation strategies and parental reactions to youth negative affect. Questionnaires were completed by 67 adolescents (ages 12–18 years) and by one of their parents during an intake assessment at a university-based clinic. Adolescents had a primary anxiety or depressive disorder diagnosis. Results indicated a positive relationship between parent-reported use of suppression and youth report of poor emotional understanding in adolescents with a primary anxiety or depressive disorder. A positive relationship between parent-reported use of reappraisal and emotion-coaching responses to youth negative affect was also found. Clinical implications of these findings are discussed in the context of parental socialization of youth emotion regulation and in terms of prevention and intervention efforts.
- Go to article: Tailoring the Unified Protocol for Adolescents for a Stepped-Care Approach: Case Exemplars
Emotional disorders, including anxiety, depressive, and obsessive-compulsive spectrum disorders are prevalent and impairing for youth. Dissemination efforts have been implemented to address these disorders in youth, but these are limited by cost and barriers to accessing mental health services. Stepped care is a method of treatment delivery meant to be cost-effective and less time intensive than administering a full treatment manual. Much, if not all of the research, assessing the efficacy of stepped care delivery has utilized disorder-specific treatment manuals. However, transdiagnostic stepped care approaches may prove more efficacious given that youth commonly present to treatment with more than one disorder and that such problems are not always comprehensively assessed at intake. This manuscript provides details regarding the implementation of a transdiagnostic stepped-care delivery (UPA-SC) using three case examples. Youth evidenced significant improvement in anxiety, depression, and quality of life. Future work to investigate the efficacy of UPA-SC in a larger, more heterogeneous sample of youth may be warranted.
- Go to article: Information-Processing Biases in Children and Adolescents:An Introduction to the Special Issue
This special issue focuses on new developments in research on information-processing biases in children and adolescents. Prior research suggests that attention and interpretation biases in response to emotional stimuli may be associated with the etiology and maintenance of anxiety and depression in youth. Although our understanding of youth biases has burgeoned over the past decade, questions remain regarding mixed findings across studies, heterogeneity of biases across individuals, specific factors that contribute to and maintain biases, and how best to maximize the efficacy of interventions designed to modify biases. Through the use of innovative methods and technology, the articles in this special issue illustrate progress being made toward filling these gaps in our knowledge and showcase some of the exciting new developments in this area of research.
- Go to article: Cognitive Behavioral Therapy for Pediatric Chronic Pain: The Problem, Research, and Practice
The purpose of this article is to outline the rationale and use of cognitive behavioral therapy (CBT) for the treatment of pediatric chronic pain. The article begins by demonstrating the scope and impact of the problem of pediatric chronic pain. It then provides an overview of the framework of CBT for pediatric chronic pain and standard treatment components are outlined. A summary of the current state of research and its efficacy is provided. The article concludes by presenting outcome data from a specific example of a CBT group for pediatric recurrent abdominal pain. Future directions for research in this area are discussed.
- Go to article: Do Social Threat Cognitions Decrease With School-Based CBT and Predict Treatment Outcome in Adolescents With Social Anxiety Disorder?
Do Social Threat Cognitions Decrease With School-Based CBT and Predict Treatment Outcome in Adolescents With Social Anxiety Disorder?
Evidence suggests that Social Anxiety Disorder (SAD) is less responsive to cognitive behavioral treatment (CBT) compared to other anxiety disorders. Therefore, exploring what might facilitate clinical benefit is essential. Social threat cognitions, characterized by exaggerated perceptions of negative evaluation by others, may be one important avenue to examine. The current study investigated whether youths' social threat cognitions decreased with Skills for Academic and Social Success (SASS), a group, school-based CBT designed for SAD, and whether decreases predicted SAD severity and treatment response. Participants included 138 high school students with SAD randomly assigned to SASS, or a nonspecific school counseling intervention. SASS participants showed significantly decreased social threat cognitions at 5-month follow-up. Treatment responders had significantly greater reductions in social threat cognitions compared to nonresponders at post-intervention and follow-up. These findings suggest that social threat cognitions may be important to assess and monitor when treating youth with SAD.
- Go to article: Obsessive-Compulsive Symptoms and Beliefs in Adolescents: A Cross-Sectional Examination of Cognitive Models
Obsessive-Compulsive Symptoms and Beliefs in Adolescents: A Cross-Sectional Examination of Cognitive Models
Cognitive models of obsessive-compulsive disorder (OCD) posit that particular beliefs transform normal intrusions into disturbing obsessions. A wealth of data shows that such beliefs and obsessive-compulsive (OC) symptoms are related in adults. However, there is markedly less information regarding OCD-related beliefs in youth. The purpose of this study was to assess the relation between OCD-related beliefs and OC symptoms in unselected adolescents (ages 13–18 years; N = 159). Findings from questionnaires completed on the Internet were consistent with previous findings in adults. Increased levels of OCD-related beliefs were related to increased levels of OC symptoms. Perfectionism and certainty beliefs had a specific relation with symmetry and ordering symptoms. Contrary to expectation, levels of OCD-related beliefs in this unselected sample were similar to those found in prior studies of youth diagnosed with OCD. Implications, limitations, and future directions for the study of OCD-related beliefs in youth are discussed.
- Go to article: A Preliminary Investigation of Acceptance and Commitment Therapy for Adolescent Obsessive-Compulsive Disorder
A Preliminary Investigation of Acceptance and Commitment Therapy for Adolescent Obsessive-Compulsive Disorder
There is growing support for the use of acceptance and commitment therapy (ACT) as a treatment for adults with obsessive-compulsive disorder (OCD), but no research has been published on the use of ACT for adolescent OCD. This preliminary study investigated ACT for youth with OCD using a multiple baseline across participants design. Three adolescents, ages 12 or 13 years, were treated with 8–10 sessions of ACT (without in-session exposure exercises). The primary dependent variable was daily self-monitoring of compulsions. Results showed a 40% mean reduction in self-reported compulsions from pretreatment to posttreatment, with results maintained at 3-month follow-up, for a reduction of 43.8%. Pretreatment to posttreament reductions in Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS) ratings of OCD severity were 50.0%, 12.5%, and 22.0%; pretreatment to follow-up reductions were 54.0%, 12.5%, and 61.0%. Treatment procedures were rated by participants and parents as highly acceptable. Implications and future directions are discussed.
Attention to emotional stimuli has been associated with psychological health among adults and youth. In this study, we examined 2 putative functional psychophysiological correlates of attention to emotional information in a community sample of 135 youth (Mage=12 years, 7 months; SDage=1 year, 1 month; 50% girls). After measuring resting respiratory sinus arrhythmia (RSA), participants completed a 1,500 ms emotional faces dot probe task with eye tracking. We examined pupil dilation during angry, sad, and happy trials and predicted that lower resting RSA and greater pupil dilation would be associated with relatively greater attention to negative stimuli. Results partially confirmed our hypothesis. Lower resting RSA was associated with relatively greater attention to sad faces. Lower resting RSA was also associated with relatively greater attention to angry faces when pupil dilation was lower. RSA may be an important functional correlate of attention that should be explored further in future research.