Scholarly Works, Psychology

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Research articles, presentations, and other scholarship

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Detecting and addressing eating disorders among individuals experiencing food insecurity: considerations for dietetic practice
Davis, Heather A.; Myers, Emily; Serrano, Elena L.; Misyak, Sarah A. (Frontiers, 2025-09-12)
In the United States, almost 10% of Americans will experience an eating disorder in their lifetime. Despite evidence that eating disorders occur across socio-economic backgrounds, the stereotypes of eating disorders being a disease of affluence persist. The experience of food insecurity, defined as limited or inconsistent physical and economic access to a sufficient amount and variety of nutritious food needed for a healthy life, is significantly associated with greater eating disorder symptoms. There are several reasons eating disorder symptoms may develop in people experiencing food insecurity, including food/benefit distribution cycles, shame, and weight bias. This Perspective highlights the relationship between food insecurity and eating disorders and provides informed recommendations specific to dietetic practice. Guidance is provided for Registered Dietitian Nutritionists (RDNs) in settings that serve individuals at risk of, or experiencing, food insecurity. RDNs should be informed on best practices for screening for eating disorders and providing appropriate referrals to eating disorder specific care, as well as encouraging realistic, achievable health behaviors, and using non-stigmatizing language.
Operationalizing the Mind–Body Connection: Interoception via the Autonomic Nervous System
Nackley, Brittany; Friedman, Bruce H. (MDPI, 2026-02-12)
Traditional interoception research investigates cardioception, respiroception, or gastroception as a proxy for the sense of the body as a whole. These single-organ tasks sacrifice construct and ecological validity for a content validity that has been elusive. We propose that interoception is better captured by one’s sense of their own autonomic nervous system, or ANSception. The ANS integrates multimodal signals via lesser-myelinated neurons, making it an integral part of the interoceptive nervous system. Thirty-four participants moved a slider to reflect their perceived sympathetic activation (ANSception) while their physiology was monitored. Most participants reported integrating information from two or more organ systems during ANSception. The relationship between ANSception and physiology showed unique but often robust responses by condition and physiological measure. For example, one participant had a negative-to-positive-to-negative pattern for ANSception-EDA correlations from baseline to stimulus to recovery (r = −0.677; 0.657; −0.507, p < 0.001). Another participant had a strong positive correlation between their ANSception and blood pressure (r = 0.601, p < 0.001) during a five-minute reportedly meditative state. We propose that the role of interoception is to scan, integrate and manage information across organ systems, and we conclude that ANSception better captures this role than traditional single-organ tasks.
Underrepresentation and moderation of parent education levels in ADHD psychosocial treatment trials: A meta-analysis
Margherio, Samantha M.; Brockstein, Hannah; Bakhtiari, Azadeh; Evans, Steven W. (Elsevier, 2025-11-01)
Objective: We sought to ascertain the representativeness of psychosocial treatment trials for youth with ADHD in terms of parent education (PE) and race and to determine whether these study characteristics moderated treatment outcomes. Method: High-quality randomized controlled trials (RCTs) of psychosocial treatments for children and adolescents with ADHD conducted in the U.S. and published between 2007 and 2025 were included in this study if they reported PE (% of parents with a college degree or higher) and race/ethnicity. Results: A total of 46 studies were included, representing 5837 participants. Between 48 % and 52 % of parents had a college degree or higher, compared to 38 % in the U.S. population. Two-thirds of studies overrepresented highly educated parents. Samples were generally representative of diverse races and ethnicity, although this appeared driven by the 35 % of studies that oversampled racially minoritized youth whereas 26 % underrepresented racially minoritized youth. Subgroup meta-analyses indicated treatment was only superior to control conditions in reducing ADHD symptoms in samples with highly educated parents. For race, treatment was only associated with significant effects on hyperactivity/impulsivity symptoms among racially-representative samples who also had high PE. Conclusion: These findings question the effectiveness of psychosocial interventions for youth with ADHD for families of diverse educational backgrounds. There is a dire need to recruit more diverse samples in terms of PE, and to develop interventions that are effective for families across all educational backgrounds.
The Feasibility of Integrating Remote Breath Alcohol Monitoring into Ecological Momentary Assessment of Intimate Partner Violence among Young Adults with a History of Heavy Drinking and Aggression
Brem, Meagan J.; McCarthy, Denis M.; Shorey, Ryan C.; Lin, Muyao; Lozano, Alicia J.; Sjafii, Emily; Tobar-Santamaria, Allison (2026)
Aims: We examined the feasibility and acceptability of pairing portable breathalyzers to assess field alcohol use with mobile ecological momentary assessment (EMA) to assess intimate partner violence (IPV; psychological, cyber, physical, and sexual aggression) perpetration and victimization among undergraduates who drink heavily and were recently aggressive. Design, Setting, and Participants: We assessed EMA/breathalyzer completion rates, drinking captured via breathalyzer versus self-report, number of IPV events captured, procedural acceptability, and reactivity to assessment. Sex differences were examined. Undergraduates aged 18-25 (N = 103; M age = 21 years, SD = 2.0; 52% women; 80.6% heterosexual; 64.1% white; 93.2% non-Hispanic) recruited from a large Mid-Atlantic university in the United States completed a baseline survey then a 30-day EMA wherein they were prompted to complete one morning and three evening surveys (7PM, 9PM, 11PM) daily. After each evening survey, participants were prompted to submit a breath alcohol content (BrAC) sample to a breathalyzer linked to surveys. Participants could self-initiate surveys after drinking or IPV outside of assessment periods. Afterward, participants completed an exit survey. Measurements: Outcome variables were self-reported alcohol use and IPV assessed via EMA surveys, and BrAC assessed via breathalyzer. Self-reported procedural acceptability was assessed in the exit survey. Reactivity to assessment was assessed by analyzing daily trends in IPV and drinking by sex using generalized linear mixed effects models. Findings: Participants completed 80% of surveys and responded to 91% of breathalyzer prompts. BrAC was captured in 89.4% of self-reported drinking events, 91.4% of self-reported non-drinking events, and 95.8% of IPV events, with greater responsiveness to breathalyzer prompts as the evening progressed despite increasing intoxication. More IPV events were captured during evening and event triggered (358 combined total events) than morning surveys (245 events). Results were comparable across women and men. Each additional study day was associated with modest declines in odds of experiencing any IPV (odds ratio [OR] = 0.95, 95% confidence interval [CI]: 0.94-0.97, p < 0.001), IPV perpetration (OR = 0.94, 95% CI: 0.92-0.96, p < 0.001), IPV victimization (OR = 0.97, 95% CI: 0.96-0.99, p = 0.004), any drinking (OR = 0.99, 95% CI: 0.98-1.00, p = 0.01), and positive BrAC readings (OR = 0.99, 95% CI: 0.98-1.00, p = 0.052), suggesting minimal reactivity to assessment. Participants reported high overall satisfaction with study components. Conclusions: Pairing ecological momentary assessment with portable breathalyzers to capture data on drinking and intimate partner violence across 30 days among US undergraduates who were previously aggressive and who drink heavily appears to be both feasible and acceptable.
Beyond the Feature Level: A Cluster Analysis of Feature-Level Social Media Behaviour Patterns, Maladaptive Use, and Psychological Well-Being
Sramek, Zefan; Lokuge, Sachinthya; Sternat, Tia; Katzman, Martin; Yatani, Koji (ACM, 2025-11-28)
Maladaptive use of smartphones and social media is a growing issue that has received considerable attention from researchers both to map out its psychological and behavioural processes, and to develop interventions to help users regulate their use at either the device or app level. However, heterogeneous findings about the relationships between maladaptive use, mental health conditions, well-being, and patterns of smartphone use suggest the need for more nuanced examinations of feature-level usage patterns. In this study, we administered psychological self-report scales to 108 Instagram users, and tracked their use of the app for two weeks at the feature level. We found that participants overwhelmingly made use of content-consumption features and our cluster analysis revealed the existence of previously unidentified latent user groups with unique psychological and feature-use characteristics, calling into question the assumption that decreased use duration is necessarily associated with reduced maladaptive outcomes. Taken together, these findings suggest the need for a user profile-aware approach to studying maladaptive smartphone and social media use, as well as the need to investigate interventions that target outcomes beyond use-limiting.
The phenotype of recovery XI: associations of sleep quality and perceived stress with discounting and quality of life in substance use recovery
Yeh, Yu-Hua; Zheng, Michelle H.; Tegge, Allison N.; Athamneh, Liqa N.; Freitas-Lemos, Roberta; Dwyer, Candice L.; Bickel, Warren K. (Springer, 2024-06-01)
Purpose: Sleep and stress show an interdependent relationship in physiology, and both are known risk factors for relapse in substance use disorder (SUD) recovery. However, sleep and stress are often investigated independently in addiction research. In this exploratory study, the associations of sleep quality and perceived stress with delay discounting (DD), effort discounting (ED), and quality of life (QOL) were examined concomitantly to determine their role in addiction recovery. DD has been proposed as a prognostic indicator of SUD treatment response, ED is hypothesized to be relevant to the effort to overcome addiction, and QOL is an important component in addiction recovery. Method: An online sample of 118 individuals recovering from SUDs was collected through the International Quit and Recovery Registry. Exhaustive model selection, using the Bayesian Information Criterion to determine the optimal multiple linear model, was conducted to identify variables (i.e., sleep quality, perceived stress, and demographics) contributing to the total variance in DD, ED, and QOL. Results: After model selection, sleep was found to be significantly associated with DD. Stress was found to be significantly associated with psychological health, social relationships, and environment QOL. Both sleep and stress were found to be significantly associated with physical health QOL. Neither sleep nor stress was supported as an explanatory variable of ED. Conclusion: Together, these findings suggest sleep and stress contribute uniquely to the process of addiction recovery. Considering both factors when designing interventions and planning for future research is recommended.
Self-Reported ADHD Symptoms and Cognitive Performance in a National Sample of US Older Adults
Mansoor, Marrium; Breaux, Rosanna; Lee, Tae-Ho; Katz, Benjamin (SAGE Publications, 2025-12)
Objective: Although inattention symptoms have been previously linked to cognitive performance in younger samples, few studies have examined links between ADHD symptoms and cognitive performance for middle aged and older adults. Methods: In this study, we drew from a nationally representative sample from the Health and Retirement Study (HRS) of ~1,400 middle to older adults (M_age = 66.9, SD = 8.4; 41.4% male; 60.7% White) who completed a set of cognitive measures and an ADHD symptomatology questionnaire in the 2016 Wave of the HRS. A multigroup path model was run by examining the association between self-reported ADHD symptom subscale scores for inattention and hyperactivity/impulsivity as well as self-reported depressive symptoms and cognitive outcomes across three groups: middle age, young-old, and middle-old. Results: Inattention symptoms were significantly associated with Serial 7s and Immediate Recall, however the constrained model was the best fitting model, suggesting no differences in the associations between self-reported inattention symptoms and cognitive outcomes by age. Conclusion: These results are consistent with previous work on the links between ADHD symptoms and cognitive performance in younger populations and add to the literature on ADHD in later life. This may have implications for clinicians and practitioners as well as future research on older adults with ADHD.
Impacts of COVID-19 on the school experience of children and adolescents with special educational needs and disabilities
Dvorsky, Melissa R.; Shroff, Delshad; Bonds, W. Bianca Larkin; Steinberg, Amanda; Breaux, Rosanna; Becker, Stephen P. (Elsevier, 2023-08)
This review of research conducted between March 2020-April 2023 summarizes the impact of COVID-19 on the learning and school experiences of children and adolescents with special educational needs and dis/abilities (SENDs) including youth with neurodevelopmental disorders, learning differences, intellectual, developmental, and other disabilities. This research highlights the far-reaching consequences of COVID-19, with the most detrimental effects experienced by students of color, those from under-resourced communities, and those with multiple marginalized identities, whose struggles with systemic inequities have been amplified by the pandemic. To date, most studies have been cross-sectional and utilized qualitative methods. Future research should examine long-term impacts and ways to promote growth in learning and social-emotional functioning among students with SENDs.
A Preliminary Examination of Key Strategies, Challenges, and Benefits of Remote Learning Expressed by Parents During the COVID-19 Pandemic
Roy, Amy K.; Breaux, Rosanna; Sciberras, Emma; Patel, Pooja; Ferrara, Erica; Shroff, Delshad M.; Cash, Annah R.; Dvorsky, Melissa R.; Langberg, Joshua M.; Quach, Jon; Melvin, Glenn; Jackson, Anna; Becker, Stephen P. (American Psychological Association, 2022-03)
Among the many impacts of the Coronavirus disease (COVID-19) pandemic, one of the most dramatic was the immediate closure of in-person schooling in March/April 2020 when parents were faced with much greater responsibility in supporting their children’s learning. Despite this, few studies have examined parents’ own perspectives of this experience. The aims of this preliminary study were to (a) identify challenges, benefits, and useful strategies related to remote learning and (b) examine differences in findings across two countries, between parents of youth with and without attention-deficit/hyperactivity disorder (ADHD), and between parents of children and adolescents. To address these aims, parent responses to openended questions on the Home Adjustment to COVID-19 Scale (HACS; Becker, Breaux, et al., 2020) were examined across three studies conducted in the United States and Australia (N = 606, children: 68.5% male, ages 6–17 years). The challenges most frequently expressed by parents included the child’s difficulty staying on task (23.8% of parents), lack of motivation (18.3%), remote learning factors (17.8%), and lack of social interaction (14.4%). The most frequently expressed strategy related to using routines and schedules (58.2%) and the biggest benefit was more family time (20.3%). Findings were largely consistent across countries, ADHD status, and age, with a few notable group differences. Given that the most common challenges involved child- (e.g., difficulties with staying on task and motivation), parent- (e.g., balancing remote learning with work responsibilities), and school- (e.g., remote instruction difficulties) related factors, there is a need for improved support across these systems going forward.
Introduction to the Special Issue: Transdiagnostic Implications of Parental Socialization of Child and Adolescent Emotions
Breaux, Rosanna; McQuade, Julia D.; Musser, Erica D. (Springer, 2022-01)
Developmental research suggests that parent emotion socialization plays a critical role in children’s development of emotion-related skills and their risk for psychopathology. Adaptive emotion socialization practices can shape children’s capacities to understand and regulate their own emotions, and when maladaptive, these practices can confer risk for both internalizing and externalizing problems, suggesting transdiagnsotic significance. Yet, emerging work suggests that the effects of parent emotion socialization are not universal and may differ based on children’s unique vulnerabilities, highlighting the need to examine both parent and child factors within transactional models. Given the developmental shifts in emotion regulation capacities and autonomy across development, there is a great need for longitudinal emotion socialization research, as well as work that accounts for alternative interpretations, in this domain. Additionally, to-date much of the work in this regard has utilized parental report in isolation, making the need for cutting-edge, multi-method approaches highly salient. Further, translating scientific research into parent emotion socialization interventions is still in its infancy, with the majority of available treatments focusing on young children. As such, contributors to this special issue help address these gaps in the literature and examine the implications of a range of parent emotion socialization behaviors in the context of both adaptive and maladaptive child and adolescent emotional development. In this introduction, we highlight major themes of the special issue; further discussion and future directions are offered in the commentary accompanying this special issue.
Prospective Examination of Psychological Trauma Among Adolescents During the COVID-19 Pandemic
Lewis, Jasmine; Jayakumar, Srinidhi; Breaux, Rosanna; Dvorsky, Melissa R.; Langberg, Joshua M.; Becker, Stephen P. (American Psychological Association, 2023-03)
Objective: This longitudinal study investigated the predictors of and changes in psychological trauma during the COVID-19 pandemic. Method: Participants included 236 adolescents (130 males; Mage = 16.74 years in spring 2020; 49.6% diagnosed with attention-deficit hyperactivity disorder; 16.1% diagnosed with an anxiety or depressive disorder) in the United States who completed online questionnaires at four timepoints (spring 2020, summer 2020, fall 2020, spring 2021). Results: Repeated measures ANOVA showed that psychological trauma was highest during stay-at-home orders in spring 2020, and decreased for a majority of adolescents by the summer of 2020. However,~20% of adolescents exhibited moderate-to-clinical levels of psychological trauma at each timepoint. Four groups were identified based on the presence of psychological trauma symptoms: (a) resilient group (normal range across all timepoints; 60.6%); (b) moderate fluctuating group (moderate range at 1 or more timepoints; 18.2%); (c) severe fluctuating group (clinical range at 1 or more timepoints; 14.0%); and (d) chronic psychological trauma group (moderate or clinical range across all timepoints; 7.2%). Females, adolescents with preexisting internalizing disorders, and participants whose families were most impacted by the pandemic were more susceptible to experiencing psychological trauma symptoms. Conclusions: Findings highlight at-risk populations and suggest that the COVID-19 pandemic resulted in psychological trauma symptoms for approximately 20% of adolescents at some point during the first year of the pandemic. There is critical need to provide mental health services to adolescents, such as through school-based services, to reduce the negative long-term psychological impact of the pandemic.
Telehealth Delivery of the RELAX Intervention for Families of Adolescents Diagnosed with ADHD: Preliminary Treatment Outcomes and Evidence of Acceptability and Feasibility
Breaux, Rosanna; Shroff, Delshad M.; Cash, Annah R.; Swanson, Courtney S.; Carlton, Corinne; Bertollo, Jennifer R.; Dahiya, Angela V. (Taylor & Francis, 2021-11)
Regulating Emotions Like An eXpert (RELAX) is a group-based intervention that targets emotion dysregulation (ED) and interpersonal conflict among adolescents diagnosed with attention-deficit/hyperactivity disorder (ADHD). This study is a preliminary evaluation of the feasibility, acceptability, and efficacy of RELAX across in-person and telehealth groups, examining differences in treatment outcomes and feedback based on format. Participants included 32 families (18 in-person, 14 telehealth) with adolescents diagnosed with ADHD, ages 11–16. Caregiver-, clinician- and adolescent-report of adolescent ED, adolescent communication, and caregiver-adolescent/family conflict, as well as caregiver self-report of ED and emotion socialization were collected pre- and post-RELAX; caregivers and adolescents completed a feedback survey post-RELAX. Attendance was higher for telehealth (95% vs. 87%), but homework completion was higher for in-person (85% vs. 70%). Caregiver and adolescent feedback indicated very high rates of satisfaction with RELAX, with no significant differences in caregiver satisfaction and minimal differences in adolescent satisfaction between the in-person and telehealth groups. Large improvements were found for caregiver and clinician ratings of adolescent ED (η² = .18−.48) and family conflict (η² = .26 and.43), moderate decreases in non-supportive emotion socialization were found (η² = .11), and small improvements were found for caregiver ED (η² = .03). Treatment outcomes were similar for in-person and telehealth groups, with some evidence for larger improvement of adolescent ED for telehealth, whereas larger improvement in family conflict emerged for in-person. RELAX was successfully adapted to be administered via telehealth with similar feasibility, acceptability, and efficacy to the in-person intervention. Efforts to continue disseminating and evaluating ED-focused interventions are warranted and imperative.
Predictors of executive function trajectories in adolescents with and without ADHD: Links with academic outcomes
Shroff, Delshad M.; Dunn, Nicholas C.; Green, Cathrin D.; Breaux, Rosanna; Becker, Stephen P.; Langberg, Joshua M. (Cambridge University Press, 2024-08)
Changes in executive function (EF) occur during adolescence with several factors (e.g., parenting styles, socioeconomic status) influencing the development of EF abilities. These changes are important as EF has been strongly linked with a range of outcomes including academic achievement, job performance, and social-emotional well-being. However, few studies have examined variability in EF trajectories during this critical developmental period, or trajectories in samples known to have specific impairments with EF, such as adolescents diagnosed with attention-deficit/hyperactivity disorder (ADHD). The present study examined differential trajectories of three domains of parent-rated EF in 302 adolescents (167 males; Mage = 13.17 years) with and without ADHD (53.6% with ADHD) from grade 8 to 10. The study also explored whether adolescent ADHD, parent ADHD, and parents' own EF predicted EF trajectories in addition to the longitudinal relation between trajectories and academic outcomes. Findings suggest that adolescence is marked by significant variability in EF development due to factors such as ADHD status, parent ADHD, and parent EF ability. Additionally, adolescents who displayed poor EF abilities throughout middle and high school had significantly lower grade point averages and poorer parent-, teacher-, and self-reported academic outcomes. Implications for interventions targeting EF deficits among adolescents with and without ADHD are discussed.
Using a Mobile App to Support Parents of Children with Behavior Problems
Dahiya, Angela V.; Breaux, Rosanna; Pham, Stephanie N.; Martino, Daniele C.; Fok, Megan; Albright, Jordan; Shroff, Delshad M.; Scarpa, Angela (Springer, 2025-10)
Evidence-based mental health services are difficult to access; telehealth and mobile health hold promise by removing barriers to traditional clinic-based interventions and enabling broader access. Behavioral parent training (BPT) is an evidence-based treatment for child disruptive behaviors. This project examined the feasibility, acceptability, and preliminary efficacy of using a mobile BPT app, Treks, with families as a standalone treatment (Study 1) or in combination with brief clinician consultation (Study 2). Study 1 participants included 20 caregivers of children with challenging behaviors who engaged with Treks for four weeks. Study 2 participants included 26 caregivers of autistic children with behavioral concerns; all parents received a one-session telehealth consultation followed by random assignment to four weeks of Treks engagement (Treks; n = 14) or access to online resources (consultation control: CC; n = 12). Across both studies, Treks was rated positively and was reported by parents as acceptable and appropriate for their concerns, as well as adequately feasible. In Study 1, 60% of participants fully completed Treks and 83% of completers showed reliable improvement in at least one main outcome (parenting stress, parent sense of competence, and child behavior problems). In study 2, there were significant improvements in Treks but not CC participants, showing moderate-to-large decreases in child disruptive behaviors and parent stress and increases in parent-perceived competency. Mobile app-delivered BPT has the capacity to support families as a feasible and acceptable standalone treatment and should be considered as part of a stepped-care approach or for families who cannot access clinician-delivered BPT.
Family-of-Origin of Violence, Insecure Attachment, and Depression Symptoms in Emerging Adults: A Brief Report
Lewis, Jasmine; George, Brianna; Dike, Janey; Breaux, Rosanna; Brem, Meagan J. (Springer, 2025-03-24)
Purpose: Family-of-origin violence (FOV) has been linked to numerous deleterious consequences in adulthood, including depression. Many individuals who experience FOV display anxious (i.e., fear of abandonment) and avoidant (i.e., fear of interpersonal intimacy) attachment styles. Higher levels of insecure attachment confer vulnerability for depression following conflict, whereas more secure romantic attachment attenuates the effects of violence exposure. It follows that experiencing low levels of attachment anxiety and avoidance during an emerging adulthood relationship may offset consequences associated with childhood FOV. Thus, we hypothesized that college students’ childhood FOV exposure would positively relate to their current depression symptoms, but only among those with high levels of attachment anxiety and avoidance within their current relationship. Methods: Participants included 204 college students (75% women; Mage = 19.93 years; 86.6% white) who were in dating relationships for at least one week. Results: Anxious attachment emerged as a significant moderator and avoidant attachment was a marginally significant moderator of the association between childhood FOV and self-reported adult depression symptoms such that these associations were positive among participants with medium to high, but not low, levels of attachment anxiety and avoidant attachment. Conclusions: Findings highlight that childhood FOV exposure does not relate to depression symptoms among emerging adults who have lower levels of attachment anxiety within their current relationship. These results suggest that attachment anxiety and avoidance within current romantic relationships might be important intervention targets for emerging adults exposed to FOV.
Examining daily stimulant medication use and sleep in adolescents with ADHD
Wiggs, Kelsey K.; Breaux, Rosanna; Langberg, Joshua M.; Peugh, James L.; Becker, Stephen P. (Springer, 2024-03)
Research has been inconclusive as to whether stimulant treatment causes or exacerbates sleep problems in adolescents with ADHD. This study examined sleep differences in adolescents with ADHD as a function of stimulant use. Participants were adolescents with ADHD (N = 159, ages 12–14). Parents reported on receipt of stimulant treatment (n = 92, 57.86%; n = 47 amphetamines, n = 45 methylphenidate). Adolescents wore actigraphs and completed daily diaries assessing sleep and daily use of stimulants for 2 weeks. Sleep parameters included daily-reported bedtime, sleep onset latency (SOL), sleep duration, daytime sleepiness, and difficulty waking the following morning; and actigraphy-measured sleep onset time, total time in bed, and sleep efficiency. We estimated between- and within-individual associations between stimulant medication use and sleep indices with all stimulants, after removing adolescents using sleep aids and weekend days, and as a function of stimulant type. Adolescent sleep did not differ between those receiving and not receiving stimulant treatment. Within individuals using stimulants, we largely observed no significant differences between medicated and unmedicated days, though findings were most often significant for school days only. Small effects were found indicating longer SOL, later sleep onset time, and more daytime sleepiness related to medication use. In contrast, there were slight improvements to sleep duration and sleep efficiency related to methylphenidate use, though methylphenidate was also associated with later sleep onset time and more daytime sleepiness. Given the inconsistent and small effects, findings suggest that stimulant medication may impact sleep, but does not appear to be a primary contributor to sleep problems in adolescents with ADHD.
A Meta-Analytic Review of Emotion Regulation Focused Psychosocial Interventions for Adolescents
Eadeh, Hana-May; Breaux, Rosanna; Nikolas, Molly A. (Springer, 2021-12)
Emotion regulation (ER) is the ability to monitor, evaluate, and modify one’s emotional responses to be appropriate for environmental demands. Poor ER has been considered a transdiagnostic risk factor for a range of internalizing and externalizing disorders and overall decreased well-being in adolescents. A range of evidence-based interventions exist which may improve ER. However, much of the intervention research to date does not include a measure of ER to assess change pre and post treatment, with limited information about the efficacy of these interventions in youth across a range of sample types. There is a clear need for a comprehensive review of the literature examining ER-focused interventions in adolescents with a wide range of presenting disorders. A literature search was originally conducted in January 2020 and an updated search was conducted in February 2021 which elicited 1245 articles, of which 605 were duplicates and were removed. Abstracts of the remaining 640 articles were screened with 121 articles being reviewed in full. Of note, 16 additional articles were identified through references and other sources during this process and were also included in the full review. Of the 137 articles reviewed in full, 41 studies were ultimately included in the present review. The present paper provides a descriptive review of intervention approaches and findings from community prevention programs, programs for war-affected youth, programs for clinical populations, and programs for incarcerated and delinquent adolescents. The overall pooled effect was significantly different from zero based on the pre/post effects [Hedge’s g = 0.29, 95% CI (0.22, 0.36)] and the intervention/control effects [Hedge’s g = 0.19, 95% CI (0.06–0.32)]. Although neither sex nor age significantly accounted for heterogeneity in effect sizes, there were significant findings for population type (clinical vs. community), with community samples having significantly lower effect sizes on average. Impacts of the different ER measures used and significant methodological variability (e.g., use of control groups, length of intervention) across included studies are discussed. Implications and suggestions for future research are reviewed, specifically, that additional understanding of moderators of effects are needed and that measures used to assess change in ER, both dysregulation and adaptive skill use, may need to more directly align with the intervention’s focus and the strategies taught as part of the intervention.
The Importance of Practicing at Home During and Following Cognitive Behavioral Therapy for Childhood Anxiety Disorders: A Conceptual Review and New Directions to Enhance Homework Using Mhealth Technology
Klein, Anke M.; Hagen, Annelieke; Mobach, Lynn; Zimmermann, Robin; Baartmans, Jeanine M. D.; Rahemenia, Jasmin; de Gier, Erwin; Schneider, Silvia; Ollendick, Thomas H. (Springer/Plenum Publishers, 2024-06-01)
Practicing newly acquired skills in different contexts is considered a crucial aspect of Cognitive Behavioral Therapy (CBT) for anxiety disorders (Peris et al. J Am Acad Child Adolesc Psychiatry 56:1043-1052, 2017; Stewart et al. Prof Psychol Res Pract 47:303-311, 2016). Learning to cope with feared stimuli in different situations allows for generalization of learned skills, and experiencing non-occurrence of the feared outcome helps in developing non-catastrophic associations that may enhance treatment outcomes (Bandarian-Balooch et al. J Behav Ther Exp Psychiatry 47:138-144, 2015; Cammin-Nowak et al. J Clin Psychol 69:616-629, 2013; Kendall et al. Cogn Behav Pract 12:136-148, 2005; Tiwari et al. J Clin Child Adolesc Psychol 42:34-43, 2013). To optimize treatment outcome, homework is often integrated into CBT protocols for childhood anxiety disorders during and following treatment. Nevertheless, practicing at home can be challenging, with low motivation, lack of time, and insufficient self-guidance often listed as reasons for low adherence (Tang and Kreindler, JMIR Mental Health 4:e20, 2017). This conceptual review provides an overview of (1) how existing CBT childhood programs incorporate homework, and empirical evidence for the importance of homework practice, (2) evidence-based key elements of practice, and (3) how mHealth apps could potentially enhance practice at home, including an example of the development and application of such an app. This review therefore sets the stage for new directions in developing more effective and engaging CBT-based homework programs for childhood anxiety disorders.

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