Carl E. Paternite

Quality of Parent/Adolescent Attachment and Aggression in Young Adolescents.

A model of the association between adolescents’ perception of the quality of parent/adolescent attachment and adolescent aggression was examined, with social cognition and self-esteem as mediators. A total of 68 sixth graders, their parents, and their language arts teachers participated. Adolescents completed measures of attachment with mother and with father, self-esteem, social cognition, and aggressive tendencies. Mothers, fathers, and teachers each completed measures of adolescent aggressive and prosocial behavior. Evidence was obtained for social cognition and self-esteem both as mediators between adolescents’ perceived quality of mother/adolescent attachment and adolescent selfreport of aggression. Controlling for mother/adolescent and father/adolescent attachment and adolescent self-esteem, adolescent higher social cognition was associated with adolescent lower self-report of aggression. Controlling mother/adolescent and father/adolescent attachment and adolescent social cognition, adolescent higher self-esteem was associated with father-reported lower adolescent aggression and father-reported higher adolescent prosocial behavior. Implications for further research are discussed.

External validation of oppositional disorder and attention deficit disorder with hyperactivity.

Validity of the distinction between oppositional disorder (OD) and attention deficit disorder with hyperactivity (ADDH) was examined in a sample of 6- to 12-year-old boys with behavior problems. Problem identification, cognitive/attentional, family context, and behavioral symptom differences were examined among nine boys with OD only, 20 with ADDH, 40 with comorbid OD and ADDH, and 28 with neither disruptive behavior disorder. Systematic comparisons of groups including and excluding the OD and ADDH diagnoses were undertaken to determine the existence of pure OD and pure ADDH disorder effects. The most consistent result was the lack of evidence for either pure OD or pure ADDH effects. Most of the significant findings reflected differences between the nondisruptive (neither) and comorbid groups. The results support the importance of comorbidity, but they provide little support for disorder-specific distinctions between oppositional and attention deficit disorders.

A preliminary validation of subtypes of DSM-IV Attention-Deficit/Hyperactivity Disorder

Preliminary validity of DSM-IV ADHD was examined in a sample of 6- to 12-year-old boys with behavior problems. Problem identification, extent of impairment, cognitive/attentional, family context, and behavioral symptom differences were examined among 28 boys with ADHD, inattentive type; 9 with ADHD, hyperactive-impulsive type; 59 with ADHD, combined type; and 18 with no ADHD diagnosis. Some evidence for validity of ADHD was suggested, especially for the inattentive and combined subtypes, and on measures of impairment, mother-, father-, and teacher-rated disruptive symptoms, and observed playroom behavior. Few differences were obtained on measures of family context and age-corrected indices of cognitive/attentional functioning. Supplementary analyses of the boys with ADHD, combined type, subgrouped on the presence or absence of oppositional and conduct disorders, highlight the role of such diagnostic comorbidity in some of the dysfunctions attributed to ADHD.

Readiness and School Improvement: Strategies for Enhancing Dissemination and Implementation of Expanded School Mental Health Practices

The primary purpose of this paper is to describe efforts to promote effective dissemination and adoption of an evidence-based school improvement model that incorporates expanded school mental health practices. A systematic readiness and capacity assessment process was used to identify and select pilot schools and school districts for participation in the Ohio Community Collaboration Model for School Improvement (OCCMSI: Anderson-Butcher et al, 2004, in press). In this paper we describe efforts used to incorporate assessment of readiness into selection, training, and implementation of OCCMSI, an evidence-based school improvement initiative. Assessments were used to ensure that pilot sites were ‘ready’ for adoption of the initiative and to promote attention to readiness and capacity as an integral part of the aims of the intervention. Assessments were based on the A-VICTORY model (Davis & Salasin, 1975; Robbins et al, 2003). Results from each readiness assessment were used to inform delivery of training and technical assistance in support of the implementation of the school improvement model. Our experience suggests that ongoing collection of information related to organizational readiness assists in adoption and implementation of effective practices and initiatives.

Social Maladjustment and Special Education: State Regulations and Continued Controversy

The federal definition of emotional disturbance (ED) includes a social maladjustment (SM) exclusion clause that stipulates that students are not eligible for special education services if they are determined to be “socially maladjusted” and not also meeting criteria for ED. This clause has long been criticized for being ambiguous and confusing. Although the clause is not defined in federal regulations, it remains in each new reauthorization of the Individuals With Disabilities Education Act (most recent, Individuals With Disabilities Education Improvement Act [IDEIA], 2004). This study provides an updated review of state practices regarding the use and interpretation of the clause, which has not been conducted since 1994. We examined state definitions, clarifications to terminology, and assessment recommendations to determine whether inconsistencies continue to exist across states. We present the results of a national survey that examined state and local school professionals’ reported practices regarding the exclusion and compared it with the policy of the state in which each respondent resides. Results indicated that states are moving toward the adoption of the federal definition of ED, which includes the clause. This is the case even though state regulations, and staff-reported use and knowledge of the clause continue to be inconsistent across states.

From Thought to Action in School Mental Health Promotion

In the global mental health movement, school mental health (SMH) promotion is an increasingly prominent approach and emerging field. Here, we chronicle the development of three innovations in SMH in the United States, from the early idea stage through development, current status and future directions. The innovations are The Ohio Mental Health Network for School Success, a prominent state initiative that is attempting to build a cogent shared schoolfamily-community system agenda for SMH in one state, Expanded School Mental Health in Baltimore City, a prominent local initiative that has grown from involvement in four to 105 schools in 20 years, and the Mental Health Planning and Evaluation Template, an internet-based and user-friendly approach for quality assessment and improvement of mental health promotion in schools. Each example includes challenges and opportunities, and collectively they represent powerful ideas for moving school mental health promotion from thought to action.

Critical Factors and Strategies for Advancing Statewide School Mental Health Policy and Practice

The authors sought to identify factors and strategies critical to statewide advancement of school mental health (SMH) efforts from the perspective of states that have demonstrated innovation, achievement and investment in SMH practice and policy. The School Mental Health-Capacity Building Partnership (SMHCBP) 1 conducted three in-depth focus group discussions in each of four states with representatives from diverse stakeholders. Participants reported successes and challenges in developing and advancing local and state SMH policies, programs, and services. Qualitative analyses led to identification of ten critical factors to advancing SMH at state level. They included developing a vision and shared agenda for SMH, identifying feasible and sustainable funding models, and establishing effective accountability and outcomes monitoring of SMH efforts. Strategies to implement each factor were also identified by discussion group participants and SMH-CBP Steering Committee members. States and districts can employ the factors and strategies laid out in this paper as part of a planning and continuous quality improvement process to assess and advance school mental health.

Partnering with Youth in School Mental Health: Recommendations from Students

Strong partnerships involving schools, community systems, and families are critical in moving toward comprehensive and high-quality mental health programs and services for all students (Weist, 1997). Such partnerships are a foundational value in school mental health (SMH), with strong emphasis on the critical role of students in building, sustaining, and continuously improving programs and services (Christenson & Sheridan, 2001). There are many benefits to partnerships that emphasize strong family and youth participation in SMH, including enhanced collaborative decision-making, family engagement, and positive developmental outcomes for students (Epstein & Van Voorhis, 2010; Henderson & Mapp, 2002). Involving youth and families as partners in SMH is also consistent with federal priorities (U.S. Department of Education, Planning, & Evaluation, Policy Development, 2010), which emphasize consumer- and family-driven mental health care that encourages meaningful involvement of families in all aspects of service provision as recipients of care.

Pluralistic Professional Education: A Modular Curriculum in Clinical Psychology

We describe a pluralistic curriculum for doctoral education in clinical psychology. Two successful curricular innovations are highlighted. First, the usual courses in psychopathology, psychological assessment, and intervention are offered as 5-week modules. Each module covers a subtopic within the broader area (e.g., introduction to the Minnesota Multiphasic Personality Inventory as an assessment module and depression as a psychopathology module). Second, students are introduced to alternative psychotherapeutic approaches in practicum courses that integrate didactic material with supervised practice in a particular approach. Students select the modules and practica that meet their career goals. All students acquire a core but not necessarily the same core.

Stakeholders' Perspectives on the Recommendations of the President's New Freedom Commission on Mental Health

OBJECTIVE The purpose of this study was to understand stakeholder perspectives on school mental health and the mental health system as they relate to the goals identified by the Presidents New Freedom Commission on Mental Health. METHODS A total of 11 focus groups were held in Maryland, Ohio, and New Mexico with groups of parents, youths, school- and community-based providers and staff, and child and school mental health advocates and leaders. Across the three sites, 105 individuals participated in the focus groups. RESULTS The stakeholders provided several important recommendations to advance the field of mental health. They included addressing stigma, implementing culturally competent care, providing mental health training to school staff, and increasing collaboration between community providers. CONCLUSIONS Obtaining the views of key stakeholders is critical to transforming the mental health system and expanding the focus on mental health in schools.