W. John Monopoli

During the COVID-19 pandemic, schools rapidly changed from in-class instruction to remote learning. Parent involvement and management of the home learning situation was greatly emphasized, and this presented challenges and opportunities for parents of children with attention-deficit/hyperactivity disorder (ADHD). There was an urgent need for effective parent support in the home learning situation, particularly for parents of youth with ADHD. The current study implemented a behavioral parent training (BPT) program, an evidence-based intervention for childhood ADHD, modified to target home learning and be delivered via telehealth. The intervention was evaluated in a multiple baseline trial across families of youth with ADHD (n = 3). The primary outcome was daily, parent-reported academic engagement during home learning. Parents also completed daily ratings of their child’s respectful and disruptive behavior, and remote, home observations of academic tasks were recorded at baseline and post-treatment. Based on visual analysis of baseline, treatment and post-treatment daily ratings, two of the three participants had a positive response to treatment indicated by improved academic engagement. These findings provide preliminary support for the home-learning, telehealth-delivered BPT program in supporting families during the COVID pandemic.

Research has identified at least three patterns of direct involvement in bullying and victimization: bullying, bullying-victimized, and predominantly victimized. However, little is known about risk and protective factors for these patterns. As such, the goals of the present study were to establish these patterns and examine risk and protective factors. Participants were 775 middle school students in grades 5–8. Latent profile analysis revealed three groups: a bullying-victimized group (5.2%), a predominantly victimized group (8.9%), and an uninvolved group (85.9%). Emotion dysregulation and beliefs in support of aggression conferred risk for membership in the bullying-victimized group, whereas internalizing problems conferred risk for membership in the predominantly victimized group. One aspect of school culture – willingness to seek help – buffered risk for membership only in the bullying-victimized group. Given these differential patterns, researchers and practitioners may wish to further consider the utility of targeted interventions and treatments.

Emotion dysregulation (ED) is a transdiagnostic risk factor for several forms of psychopathology. One established, integrative conceptualisation of ED that has informed our understanding of psychopathology (Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation : development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 41–54) was recently extended to account for state-level and specifically physiological aspects of ED. As such, the goal of the current study was to assess the degree to which this conceptualisation could be captured using a physiological, state-level index (i.e. the late positive potential; LPP). Participants (N=41; M_age=27.5 years, SD=11.0) completed a trait-based rating scale measure of the extended conceptualisation of ED and viewed a series of images that ranged in valence (i.e. unpleasant, pleasant, and neutral). Multilevel modelling indicated some points of convergence between rating scale scores and the LPP, and other points of divergence. Findings underscore the utility of a multi-method approach to improve understanding of key transdiagnostic characteristics across levels of analysis. Further, results are novel evidence supporting validity of the extended conceptualisation of ED.

Objective: The aim of this study was to examine the costs and cost-effectiveness of a school-based training intervention delivered at varying levels of intensity with adolescents with attention-deficit/hyperactivity disorder (ADHD). Costs were examined in relation to post-treatment and 6-month follow-up effects of the Challenging Horizons Program (CHP), a training intervention for adolescents with ADHD. Method: A total of 326 middle-school students (71% male; 77% White) with ADHD were randomized to an after-school version of the CHP (CHP-AS), a less-intensive mentoring version (CHP-M), or routine community care. Detailed time logs were maintained throughout the study and were used to estimate costs associated with each condition. Student grade point average (GPA) and parent-rated ADHD symptoms and organization skills were collected at post-treatment and 6-month follow-up. Results: The cost analysis revealed that CHP-AS was more costly per student than CHP-M, both in terms of overall costs and direct expenses to the school. However, CHP-AS was less costly per hour of intervention provided to the youth than CHP-M. Incremental cost-effectiveness ratios revealed that CHP-M may be the more cost-effective option for post-treatment effects, yet CHP-AS may be the more cost-effective option in the long term for sustained gains in organization skills and GPA. Conclusions: This study provides stakeholders important information to make decisions regarding allocation of finite monetary resources to meet their prioritized goals.

Objectives: Despite advances in understanding associations among attention‐deficit hyperactivity disorder (ADHD), emotion dysregulation (ED), and related outcomes, there is incongruity between ADHD‐relevant conceptualizations of ED and available measures of ED. To assess the psychometric properties of a parent‐report questionnaire of ED conceptualized as deficits in the ability to modulate the (a) speed/degree of emotion escalation; (b) expression intensity; and (c) speed/degree of de‐escalation.Methods: Participants were 209 adolescents with ADHD (78% male; 13.5–17.8 years old [M= 15.2SD= 0.91]). Questionnaire items were selected from parent‐report scales of ED and oppositional defiant disorder and subjected to exploratory factor analysis (EFA) and validity analyses.Results: The EFA revealed two factors, with speed/degree of escalation combined with intensity as factor one, and speed/degree of de‐escalation as factor two. Factor one scores were related to ADHD impulsivity symptoms but not to anxiety and depression symptoms and they remained predictors of impulsivity even in the presence of self‐report ED, evincing convergent, discriminant, and incremental validity. Factor two scores were related to anxiety and depression but not impulsivity, evincing convergent and discriminant validity.Conclusion: These results inform our understanding of ADHD‐relevant ED in adolescence and offer avenues for future research in measurement development, as well as for understanding ED and ADHD‐related impairment.

Youth with ADHD are more at-risk for peer victimization than their typically developing peers, and may not be benefiting from current interventions. Thus, we sought to examine risk (i.e., anxiety, depression, and forms of aggression) and protective (i.e., social skills and social acceptance) factors for peer victimization in this group. Participants were 123 young adolescents diagnosed with ADHD, who were attending grades six through eight. We found that relational aggression (i.e., excluding others from activities) and anxiety symptoms were among the strongest risk factors for victimization. Anxiety symptoms were associated with victimization over and above depressive symptoms. Social acceptance buffered risk conferred by the risk factors. Future work is needed to investigate the degree to which the relations among internalizing symptoms and victimization differ in youth with ADHD relative to typically developing youth, and assess causality of the relations.

Hospital-based violence intervention programs (HVIPs) engage individuals who have experienced violent victimization in postmedical care programming, with the goal of reducing the incidence and impact of future injuries. Although there is some empirical support for HVIPs’ impact on violence and crime-related outcomes, proper impact assessment is limited by a lack of systematized research on outcomes that relate to the proximal goals and activities of the programs themselves. To address this critical gap, we conducted a two-stage Delphi method to elicit and prioritize these outcomes using the wisdom and experience of those who are engaged in service delivery (i.e., HVIP community-based practitioners, program coordinators, and embedded researchers; N = 79). Through this process, respondents prioritized outcomes related to posttraumatic stress symptoms, beliefs about aggression, coping strategies, and emotional regulation, which have not been consistently measured using validated or standardized tools. Results suggest that, rather than limiting program outcomes to those related to repeat violent injury or criminality, hospital- and community-based violence prevention programs seek to improve and measure mental health and socioemotional outcomes as a benchmark for healing and recovery after a violent injury. Prioritization of these outcomes broadens the definition of recovery to include psychosocial health and well-being. In addition, inclusion of these outcomes in effectiveness studies will serve to bolster the relevance of findings, and provide support for continued development and refinement of HVIP practice.