Christina D. Adams

Parent vs. Self-Report: Contributions Toward Diagnosis of Adolescent Psychopathology

Assessment of psychopathology in adolescents can be complicated due to uncertainties about who should be considered the primary informant. While a multimethod, multiinformant approach to assessment allows for a thorough assessment, it can also result in contradictory findings. The purpose of this study was to use a sample of 121 adolescents to investigate issues of parent-adolescent agreement on behavior rating scales and a structured diagnostic interview. Additionally, this study evaluated whether adolescent report offers unique information to the assessment beyond the parents report. The sample included both normal controls and adolescents who met criteria for diagnosis of an Internalizing or Externalizing disorder based on the DSM-IV criteria. Agreement between parents and adolescents on the Diagnostic Interview for Children and Adolescents—Revised (DICA-R) was low for ADHD (39.4%) and Externalizing Disorders (41.1%) and moderate for Internalizing Disorders (56.6%). A significant difference was found between the number of ADHD symptoms reported, with parents reporting more symptoms (M = 9.42) than adolescents (M = 8.34). Regression analysis indicated that the adolescent completed Youth Self-report (YSR) contributed unique information beyond the parent completed measures in predicting both the adolescent and the parent interviews for Internalizing Disorders. This finding emphasizes the need to continue to collect self-report information, especially when assessing Internalizing disorders, which inherently contain symptoms indicating high-risk behaviors such as suicide ideation.

Going around transparent and grid‐like barriers: detour ability as a perception–action skill

Early detour ability may not generalize immediately across similar problems in different perception–action systems, but instead may reveal a pattern of developmental onset that is more domain-specific. To investigate this possibility, we examined how 10-month-old (n = 24) and 12-month-old (n = 24) infants performed detours via different action modes and around barriers that differed in transparency. Infants made reaching and locomotor detours to retrieve an object located behind either an upright transparent barrier or an upright transparent barrier overlaid with a grid pattern. The results indicated that infants were more likely to make reaching than locomotor detours and explored the transparent and grid barriers differently. Additionally, younger infants more often attempted to contact the object through the entirely transparent barrier than did older infants, especially when making a reaching detour. The results suggest that during detour development, infants learn to coordinate relevant perceptual information with emerging actions.

Parenting Stress, Difficult Child Behavior, and Use of Routines in Relation to Adherence in Pediatric Asthma

The main purpose of this study was to evaluate the role of child behavior problems, parenting distress, and child routines in relation to childrens adherence to daily medication in pediatric asthma. Participants included 45 asthmatic children and their families. Assessment included questionnaires, a medication dose-count monitor, and a brief telephone interview with the parent. Significant negative correlations were found between child care routines and both parenting distress and difficult child behavior. Medication adherence was significantly and positively correlated with both parental distress and difficult child behavior but was not significantly related to parent use of routines.

Providing dust mite-proof covers improves adherence to dust mite control measures in children with mite allergy and asthma

INTRODUCTION The most critical dust mite avoidance technique for asthmatic children with mite allergy is the use of dust mite-proof bedding covers. Adherence to allergen control measures is poor due to cost. The purpose of this study was to determine whether giving families mite-proof bedding encasings at the time of the diagnosis with mite allergy would improve adherence at a home visit 2 months later. METHODS Parents of children (mean age 7.7 years) with asthma and positive skin tests for dust mite were assigned either to an intervention group, which received dust mite covers upon enrollment or a comparison group, which did not. Both groups were instructed in dust mite control measures by a medical provider and told to invest in the covers as part of standard care. Two months after enrollment, parent report and observational measures from each family were obtained during a home visit. RESULTS The group provided allergen encasings was found to be significantly more likely to have used the casings at the home visit, t(22) = 2.77, P < 0.05. There were no differences between groups in adherence to other mite control strategies. Parenting stress was significantly related to poorer mite control compliance. The most common reason reported for nonadherence to control measures was cost. CONCLUSIONS Providing mite bedding encasings at the time of diagnosis significantly increases compliance at a 2-month home visit. Medicaid and insurance companies should be encouraged to pay for casings as a cost effective measure to improve asthma care in children with mite allergy.

Parental correlates of unintentional burn injuries in infancy and early childhood.

The main purpose of this paper is to review parental factors associated with unintentional burns in early childhood. The problem and characteristics of early childhood burns are discussed. Child injury prevention strategies and models are presented. Parental correlates of pediatric injuries in general and specific to burns are reviewed. In conclusion, the authors recommend greater examination of parental variables potentially amenable to treatment, such as psychological functioning, and improved methodology including the use of prospective analyses, multiple methods and informants, and comparison groups. These efforts should enable greater understanding of parental factors related and causal to early childhood burns and, in turn, guide prevention initiatives.

Validation of the Perkins Adolescent Risk Screen (PARS)

PURPOSE To examine the initial psychometric properties for the PARS, a brief interview used to screen for 16 items of adolescent risk and protective factors. METHODS Participants included 193 adolescents, attending public middle and high schools or a university-based Adolescent Clinic. Participants completed a PARS interview, as well as a battery of questionnaires. Approximately 31% of participants received a second PARS interview from an independent rater to assess inter-rater consistency. RESULTS Descriptive statistics revealed that participants, on average, were rated as low to moderate risk for health-related difficulties across all PARS items. Descriptive statistics also showed important risk patterns in this sample of adolescents (e.g., 1/5 of sample not exercising at all). Factor analysis yielded a total of five factors (Risk Factors, Protection Factors, Relationships/Mood, Motivation Issues, Weight Issues), accounting for 58% of the variance in PARS item scores. Satisfactory levels of internal consistency and inter-rater agreement for the PARS score were found. Convergent and divergent validity of PARS scores were supported by correlations obtained with similar and dissimilar measures, respectively. A significant age group difference was obtained in the total PARS score, with adolescents aged 17-19 years obtaining higher scores than did adolescents aged 14-16 years. No significant gender differences were found. CONCLUSIONS Our results support the initial psychometric properties (i.e., reliability, validity) of the PARS as a measure of health risk and protective factors in adolescents. The PARS is a brief, efficient means of obtaining important health risk information from adolescents throughout periodic routine health care visits.

Assessing the relationship between locus of control and social competence in pediatric burn survivors attending summer cAMP.

Previous research suggests that children with burn injuries often exhibit psychological and social difficulties. The areas of functioning that are affected most often include level of anxiety, social competence, and self-esteem. Those children having an internal locus of control (LOC) have been shown to react more positively to physical disorders and to have better psychological responding in nonburn populations. The purpose of this study was to determine whether there is a relationship between LOC and social competence in pediatric burn survivors. Participants were children aged 8 to 18 years who had been treated for a burn injury and attended a 1-week summer camp for pediatric burn survivors. Results indicated that the type of LOC was not a predictor of the overall level of social competence, as reported on three different measures of social competence. However, LOC significantly accounted for variability in the childs cooperation level, according to parent report. Other results are discussed, as well as implications for future research and clinical work in this area.

Mediation of Parent-Adolescent Conflict through the Combination of Problem-Solving Communication Training and Behavioral Exchange.

ABSTRACT Problem-Solving Communication Training (PSCT) is a treatment for parent-adolescent conflict based upon behavioral-family systems theory. Although research has demonstrated that PSCT is an effective and acceptable treatment for alleviating parent-adolescent conflict, researchers note some possible limitations of PSCT. Our primary purpose here is to evaluate both the PSCT literature for parent-adolescent conflict and the literature regarding Behavioral Exchange (BE) treatment. It is conjectured that BE may address some of the limitations of traditional PSCT leading to the argument that Behavioral Marital Therapy (BMT) can serve as a model for combining BE and PSCT procedures to enhance treatment for reducing parent-adolescent conflict.

Asthma Questionnaire: Psychometric Properties and Clinical Utility in Pediatric Asthma

We investigated youth and parent knowledge of asthma using the Asthma Questionnaire (AQ), a newly developed measure that targets general asthma-related knowledge and knowledge of techniques often utilized to manage asthma symptoms. Participants included 46 youth with asthma and 126 parents of children with asthma. Also participating in the study was a comparison group consisting of 19 youth and 20 parents with no familial history of asthma. Results provided support for internal consistency and discriminant validity. Unlike knowledge measures previously published, the AQ is supported by its multi-informant versions, item format, and satisfactory initial psychometric properties.

The use of functional assessment to facilitate treatment adherence: A case of a child with HIV and pill refusal

Inability or refusal to swallow medication is a serious problem for individuals with both chronic and acute illness. This and other forms of medication nonadherence are especially problematic for individuals diagnosed with human immunodeficiency virus (HIV), because medication is necessary to ward off the onset of other illnesses and to prolong life. We present the case of a 7-year-old boy with HIV and pill refusal. The purpose of this paper is twofold: (a) to illustrate the utility of a functional assessment to facilitate treatment for pill refusal in a boy diagnosed with HIV, and (b) to replicate other studies demonstrating the efficacy of stimulus-fading procedures.