J Am Acad Child Adolesc Psychiatry [journal]
- Erratum. [PUBLISHED ERRATUM]
- J Am Acad Child Adolesc Psychiatry 2016 Jul; 55(7):638.
- Yin and Yin. [Letter]
- J Am Acad Child Adolesc Psychiatry 2016 Jul; 55(7):632.
- A Gap in the Literature: Clinical Role for Smartphone Applications for Depression Care Among Adolescents? [Letter]
- J Am Acad Child Adolesc Psychiatry 2016 Jul; 55(7):630-1.
- Lessons Learned From Missed Treatment Opportunities: Lee Harvey Oswald. [Letter]
- J Am Acad Child Adolesc Psychiatry 2016 Jul; 55(7):629-30.
- Global Migration Flows and Child Mental Health: The Urgent Need of Care. [Letter]
- J Am Acad Child Adolesc Psychiatry 2016 Jul; 55(7):627-9.
- Salience Network Connectivity in Autism Is Related to Brain and Behavioral Markers of Sensory Overresponsivity. [Journal Article]
- J Am Acad Child Adolesc Psychiatry 2016 Jul; 55(7):618-626.e1.
The salience network, an intrinsic brain network thought to modulate attention to internal versus external stimuli, has been consistently found to be atypical in autism spectrum disorders (ASD). However, little is known about how this altered resting-state connectivity relates to brain activity during information processing, which has important implications for understanding sensory overresponsivity (SOR), a common and impairing condition in ASD related to difficulty downregulating brain responses to sensory stimuli. This study examined how SOR in youth with ASD relates to atypical salience network connectivity and whether these atypicalities are associated with abnormal brain response to basic sensory information.Functional magnetic resonance imaging was used to examine how parent-rated SOR symptoms related to salience network connectivity in 61 youth (aged 8-17 years; 28 with ASD and 33 IQ-matched typically developing youth). Correlations between resting-state salience network connectivity and brain response to mildly aversive tactile and auditory stimuli were examined.SOR in youth with ASD was related to increased resting-state functional connectivity between salience network nodes and brain regions implicated in primary sensory processing and attention. Furthermore, the strength of this connectivity at rest was related to the extent of brain activity in response to auditory and tactile stimuli.Results support an association between intrinsic brain connectivity and specific atypical brain responses during information processing. In addition, findings suggest that basic sensory information is overly salient to individuals with SOR, leading to overattribution of attention to this information. Implications for intervention include incorporating sensory coping strategies into social interventions for individuals with SOR.
- Transported Versus Homegrown Parenting Interventions for Reducing Disruptive Child Behavior: A Multilevel Meta-Regression Study. [Journal Article]
- J Am Acad Child Adolesc Psychiatry 2016 Jul; 55(7):610-7.
Children's disruptive behavior problems place children at high risk for oppositional defiant disorder and conduct disorder, and carry a high burden for individuals and society. Policy makers and service providers aiming to reduce children's disruptive behavior problems must often choose between importing an intervention developed abroad or instead developing or using a "homegrown" (i.e., local) intervention. No comprehensive comparison of these interventions exists.We performed a multilevel meta-regression of 129 randomized trials (374 effect sizes) of transported and homegrown parenting interventions. We identified trials by searching the included trials lists of systematic reviews, found through searches in 6 databases (e.g., MEDLINE, EMBASE). Trials that had not yet been reviewed were found by searching the same databases. Primary outcome was the mean difference in effectiveness between transported and homegrown interventions to reduce disruptive child behavior. We also compared this differential effectiveness for various intervention "brands" (e.g., Incredible Years and Triple P Positive Parenting Program) and geographical regions (e.g., North America and Europe).Transported and homegrown interventions did not differ in their effectiveness to reduce disruptive child behavior (d = 0.10, not significant). Results were robust across intervention brands and geographical regions. Six trials on transported interventions in Hong Kong, Iran, and Panama suggest promising results for transporting interventions to "nonwestern" countries, whereas one trial in Indonesia does not.Parenting interventions based on the same principles led to similar outcomes, whether transported or homegrown. This finding supports the selection of interventions based on their evidence base rather than on cultural specificity.
- Effect of Parent Training on Adaptive Behavior in Children With Autism Spectrum Disorder and Disruptive Behavior: Results of a Randomized Trial. [Journal Article]
- J Am Acad Child Adolesc Psychiatry 2016 Jul; 55(7):602-609.e3.
This study examined the impact of parent training on adaptive behavior in children with autism spectrum disorder (ASD) and disruptive behavior.This was a 24-week, 6-site, randomized trial of parent training versus parent education in 180 children with ASD (aged 3-7 years; 158 boys and 22 girls) and moderate or greater behavioral problems. Parent training included specific strategies to manage disruptive behavior over 11 to 13 sessions, 2 telephone boosters, and 2 home visits. Parent education provided useful information about autism but no behavior management strategies over 12 core sessions and 1 home visit. In a previous report, we showed that parent training was superior to parent education in reducing disruptive behavior in young children with ASD. Here, we test whether parent training is superior to parent education in improving daily living skills as measured by the parent-rated Vineland Adaptive Behavior Scales II. The long-term impact of parent training on adaptive functioning is also presented.At week 24, the parent training group showed a 5.7-point improvement from baseline on the Daily Living domain compared to no change in parent education (p = .004; effect size = 0.36). On the Socialization domain, there was a 5.9-point improvement in parent training versus a 3.1-point improvement in parent education (p = .11; effect size = 0.29). Gains in the Communication domain were similar across treatment groups. The gain in Daily Living was greater in children with IQ of >70. However, the interaction of treatment-by-IQ was not significant. Gains in Daily Living at week 24 were maintained upon re-evaluation at 24 weeks posttreatment.These results support the model that reduction in disruptive behavior can lead to improvement in activities of daily living. By contrast, the expected trajectory for adaptive behavior in children with ASD is often flat and predictably declines in children with intellectual disability. In the parent training group, higher-functioning children achieved significant gains in daily living skills. Children with intellectual disability kept pace with time. Clinical trial registration information-Randomized Trial of Parent Training for Young Children With Autism (RUBI); http://clinicaltrials.gov/; NCT01233414.
- Environmental Determinants of Aggression in Adolescents: Role of Urban Neighborhood Greenspace. [Journal Article]
- J Am Acad Child Adolesc Psychiatry 2016 Jul; 55(7):591-601.
Neighborhood greenspace improves mental health of urban-dwelling populations, but its putative neurobehavioral benefits in adolescents remain unclear. We conducted a prospective study on urban-dwelling adolescents to examine the association between greenspace in residential neighborhood and aggressive behaviors.Participants (n = 1,287) of the Risk Factors for Antisocial Behavior Study, a multi-ethnic cohort of twins and triplets born in 1990 to 1995 and living in Southern California, were examined in 2000 to 2012 (aged 9-18 years) with repeated assessments of their aggressive behaviors by the parent-reported Child Behavior Checklist. Normalized Difference Vegetation Index (NDVI) derived from satellite imagery was used as a proxy for residential neighborhood greenspace aggregated over various spatiotemporal scales before each assessment. Multilevel mixed-effects models were used to estimate the effects of greenspace on aggressive behaviors, adjusting for within-family/within-individual correlations and other potential confounders.Both short-term (1- to 6-month) and long-term (1- to 3-year) exposures to greenspace within 1,000 meters surrounding residences were associated with reduced aggressive behaviors. The benefit of increasing vegetation over the range (∼0.12 in NDVI) commonly seen in urban environments was equivalent to approximately 2 to 2.5 years of behavioral maturation. Sociodemographic factors (e.g., age, gender, race/ethnicity, and socioeconomic status) and neighborhood quality did not confound or modify these associations, and the benefits remained after accounting for temperature.Our novel findings support the benefits of neighborhood greenspace in reducing aggressive behaviors of urban-dwelling adolescents. Community-based interventions are needed to determine the efficacy of greenspace as a preemptive strategy to reduce aggressive behaviors in urban environments.
- The Effect of Exercise on Depressive Symptoms in Adolescents: A Systematic Review and Meta-Analysis. [Journal Article, Review]
- J Am Acad Child Adolesc Psychiatry 2016 Jul; 55(7):580-90.
The purpose of this review was to examine the treatment effect of physical exercise on depressive symptoms for adolescents aged 13 to 17 years.A systematic search of 7 electronic databases identified relevant randomized controlled trials. Following removal of duplicates, 543 texts were screened for eligibility. Screening, data extraction, and trial methodological quality assessment (using the Delphi list) were undertaken by 2 independent researchers. Standardized mean differences were used for pooling postintervention depressive symptom scores.Eleven trials met the inclusion criteria, 8 of which provided the necessary data for calculation of standardized effect size. Exercise showed a statistically significant moderate overall effect on depressive symptom reduction (standardized mean difference [SMD] = -0.48, 95% CI = -0.87, -0.10, p = .01, I(2) = 67%). Among trials with higher methodological scoring, a nonsignificant moderate effect was recorded (SMD = -0.41, 95% CI = -0.86, 0.05, p = .08). In trials with exclusively clinical samples, exercise showed a statistically significant moderate effect on depressive symptoms with lower levels of heterogeneity (SMD = -0.43, 95% CI = -0.84, -0.02, p = .04, I(2) = 44%).Physical exercise appears to improve depressive symptoms in adolescents, especially in clinical samples in which the moderate antidepressant effect, higher methodological quality, and lowered statistical heterogeneity suggest that exercise may be a useful treatment strategy for depression. Larger trials with clinical samples that adequately minimize the risk of bias are required for firmer conclusions on the effectiveness of exercise as an antidepressant treatment.