Annette M. La Greca

Prediction of Posttraumatic Stress Symptoms in Children After Hurricane Andrew

The authors used an integrative conceptual model to examine the emergence of posttraumatic stress disorder (PTSD) symptoms in 568 elementary school-age children 3 months after Hurricane Andrew. The model included 4 primary factors: Exposure to Traumatic Events, Child Characteristics, Access to Social Support, and Childrens Coping. Overall, 62% of the variance in childrens self-reported PTSD symptoms was accounted for by the 4 primary factors, and each factor improved overall prediction of symptoms when entered in the analyses in the order specified by the conceptual model. The findings suggest that the conceptual model may be helpful to organize research and intervention efforts in the wake of natural disasters.

Social anxiety in children with anxiety disorders : Relation with social and emotional functioning

Investigated the psychometric properties of the Social Anxiety Scale for children-Revised (SASC-R) as well as relations between social anxiety and childrens social and emotional functioning. Participants were a clinic sample of children, ages 6–11 with anxiety disorders (N = 154) who completed the SASC-R. For a subset of these children, parent ratings of social skills, and self-ratings of perceived competence and peer interactions were also obtained. Factor analysis of the SASC-R supported the original three-factor solution and internal consistencies were in the acceptable range. Among children with simple phobia, scores on the SASC-R differentiated those with and without a comorbid social-based anxiety disorder. Social anxiety was also associated with impairments in social and emotional functioning. Specifically, highly socially anxious children reported low levels of social acceptance and global self-esteem and more negative peer interactions. Girls with high levels of social anxiety were also rated by parents as having poor social skills, particularly in the areas of assertive and responsible social behavior.

Helping children cope with disasters and terrorism.

General Conceptual and Key Issues Children Experiencing Disasters: Definitions, Reactions, and Predictors of Outcomes Assessment of Children and Adolescents Exposed to Disaster Intervention Approaches Following Disasters Multicultural Issues in the Response of Children to Disasters Natural Disasters Hurricanes and Earthquakes Wilderness Area and Wildfire Disasters: Insights from a Child and Adolescent Screening Program Floods Residential Fires Human-Made/Technological Disasters Toxic Waste Spills/Nuclear Accidents Mass Transportation Disasters Dam Break: Long-Term Follow-up of Children Exposed to the Buffalo Creek Disaster The Traumatic Impact of Motor Vehicle Accidents Acts of Violence Shootings and Hostage Takings The Aftermath of Terrorism Children Under Stress of War Exposure to Community Violence Conclusions and Implications Helping Children and Youth Cope After Disasters: Where Do We Go From Here?

Peer Victimization and Social Anxiety in Adolescents: Prospective and Reciprocal Relationships

This study used a 2-month prospective research design to examine the bi-directional interplay between peer victimization and social anxiety among adolescents. Participants included 228 adolescents (58% female) in grades 10–12. Three types of peer victimization were examined: overt (physical aggression or verbal threats), relational (malicious manipulation of a relationship, such as by friendship withdrawal), and reputational (damaging another’s peer relationships, such as through rumor spreading). Adolescents’ self-reported feelings of social anxiety and peer victimization experiences were assessed at two time points, in November and January of the same school year. Peer victimization was strongly related to adolescents’ social anxiety, and relational victimization explained additional unique variance. Moreover, peer victimization was both a predictor and consequence of social anxiety over time, with the most robust results found for relational victimization. Limited support was obtained for gender as a moderating variable. Findings highlight the deleterious effects of peer victimization, especially relational victimization, and suggest avenues for future research and clinical intervention for adolescents experiencing such victimization.

Peer Relations of Youth with Pediatric Conditions and Health Risks: Promoting Social Support and Healthy Lifestyles

ABSTRACT. Peer relations and close friendships play important roles in youngsters’ emotional development and take on special significance when a child or adolescent has a chronic disease. This article reviews the key ways that peer relations have been examined in youth with chronic pediatric conditions and specifically focuses on (1) the role of peers and close friends as a source of support, (2) friends’ influence on treatment adherence, and (3) peers’ and friends’ impact on health-promoting and health-risk behaviors. In general, youngsters with chronic conditions do not have more problems in their peer relations than other youth, although children with medical conditions that are stigmatizing or that involve the central nervous system (CNS) may encounter peer difficulties. Social support from friends and classmates appears to facilitate youngsters’ disease adaptation and may help with the lifestyle aspects of treatment regimens. Adolescent peer-crowd affiliations (e.g., “brains,” “jocks”) that are linked with health-promoting behaviors may prove beneficial to youngsters’ disease management and health. The findings underscore the need for helping children and adolescents disclose their medical condition to peers in positive ways and for including youngsters’ close friends in the treatment process and in school-reentry programs after extended medical care. Additional research is needed to develop strategies for incorporating youngsters’ peers and friends into the medical management of youth with chronic pediatric conditions.

Moving beyond Efficacy and Effectiveness in Child and Adolescent Intervention Research.

This Special Section of the Journal of Consulting and Clinical Psychology focuses on research that extends beyond documenting the efficacy and effectiveness of specific psychological treatments or preventive interventions for children and youths. In the past 30 years, there have been remarkable advances in the development and evaluation of psychological treatments and preventive interventions for a wide range of child and adolescent problems. At the same time, only a small percentage of youths who suffer from emotional and behavioral problems receive psychological services, and many of these services are not evidence-based. This article discusses key features of the Special Section studies, which examine important issues related to (a) disseminating treatments in diverse community settings (i.e., investigating the transportability of treatment), (b) personalizing mental health care (i.e., investigating predictors and moderators of treatment outcome), and (c) developing evidence-based explanations of treatment (i.e., investigating mediators of treatment). Key issues that are raised in the specific studies are discussed, and important considerations for future research are highlighted. Moving the field forward requires innovation, complex research designs, and a willingness to develop treatment models that reach beyond the current body of treatment outcome and prevention research.

The Social Status of Children with Learning Disabilities A Reexamination

Although the low social status of children with learning disabilities (LD) has been well documented, little is known about the specific types of peer status problems that characterize these children. The present study utilized current sociometric procedures in order to clarify the nature of social status difficulties encountered by children with LD. Consistent with previous studies, results revealed that children with LD obtain significantly lower sociometric scores relative to their nondisabled peers. Moreover, children with LD were found to be disproportionately overrepresented in the rejected and neglected sociometric groups, and underrepresented in the popular and average groups. Over half of the total LD sample was classified into one of the low status categories, with approximately equal numbers in the rejected and neglected groups. Implications of these findings and suggestions for future research are discussed.

Hurricane-Related Exposure Experiences and Stressors, Other Life Events, and Social Support: Concurrent and Prospective Impact on Children's Persistent Posttraumatic Stress Symptoms.

OBJECTIVE We investigated the influence of hurricane exposure, stressors occurring during the hurricane and recovery period, and social support on childrens persistent posttraumatic stress (PTS). METHOD Using a 2-wave, prospective design, we assessed 384 children (54% girls; mean age = 8.74 years) 9 months posthurricane, and we reassessed 245 children 21 months posthurricane. Children completed measures of exposure experiences, social support, hurricane-related stressors, life events, and PTS symptoms. RESULTS At Time 1, 35% of the children reported moderate to very severe levels of PTS symptoms; at Time 2, this reduced to 29%. Hurricane-related stressors influenced childrens persistent PTS symptoms and the occurrence of other life events, which in turn also influenced persistent PTS symptoms. The cascading effects of hurricane stressors and other life events disrupted childrens social support over time, which further influenced persistent PTS symptoms. Social support from peers buffered the impact of disaster exposure on childrens PTS symptoms. CONCLUSIONS The effects of a destructive hurricane on childrens PTS symptoms persisted almost 2 years after the storm. The factors contributing to PTS symptoms are interrelated in complex ways. The findings suggest a need to close the gap between interventions delivered in the immediate and short-term aftermath and those delivered 2 years or more postdisaster. Such interventions might focus on helping children manage disaster-related stressors and other life events as well as bolstering childrens support systems.

What Do Youth Referred for Anxiety Problems Worry About? Worry and Its Relation to Anxiety and Anxiety Disorders in Children and Adolescents

This study examined worry and the parameters of worry that may be associated with clinical anxiety in a sample of 119 children and adolescents referred to a childhood anxiety disorders specialty clinic. Using an interviewing procedure, results indicated that the types of worries reported by the children were similar to those reported in previous studies of nonreferred community children. Also similar to previous community studies were findings showing moderate but significant correlations between different indices of worry (i.e., number, intensity, and frequency of the worries) and childrens scores on self-rating scales of anxiety. Results further indicated that worry contributed additional variance beyond that of anxiety in predicting fear. In addition, intensity differentiated clinic childrens worries from nonreferred childrens. Intensity, and number of worries differentiated subsamples of children within the clinic-referred sample (i.e., children with overanxious disorder or generalized anxiety disorder and children with simple phobia). The importance of examining childrens worries to further understand anxiety and its disorders in youth is discussed.

Peer acceptance: The correspondence between children's sociometric scores and teachers' ratings of peer interactions

In view of the current interest in childrens peer relationships and social skills, and the need for valid assessment procedures for childrens peer problems, the intent of the present study was to examine the correspondence between peer ratings of acceptance and teacher ratings of a childs social behavior and likability. The 92 children were males and females from the third, fourth, and fifth grades. Classroom teachers rated each of the children on withdrawn, aggressive, and likable behavior using the Pupil Evaluation Inventory. Peer ratings of the childs acceptance in play and work situations were obtained from same-sex classmates. The teacher rating of likability was the best predictor of peer acceptance scores for males; withdrawn behavior was the best predictor of peer acceptance scores for females. Ratings of withdrawn and aggressive behavior contributed to the prediction of peer acceptance scores for males; for females, only withdrawn behavior contributed to the prediction of peer acceptance. In terms of the clinical utility of teacher ratings for assessing children with peer problems, the use of the withdrawn and/or aggressive ratings scales appeared to offer promise as a means of identifying such children. Implications for the area of childrens social skills and directions for future research were discussed.