Ingrid Obsuth

An attachment-based intervention for parents of adolescents at risk: mechanisms of change

Mechanisms that account for treatment effects are poorly understood. The current study examined processes that may underlie treatment outcomes of an attachment-based intervention (Connect) for parents of pre-teens and teens with serious behavior problems. Parents (N = 540) in a non-randomized trial reported on their teen’s functioning prior to and following treatment. Results confirmed significant decreases in parents’ reports of teens’ externalizing and internalizing symptoms, replicating prior evaluations of this program. Reductions in parents’ reports of teen attachment avoidance were associated with decreases in externalizing symptoms, while reductions in parents’ reports of teen attachment anxiety were associated with decreases in internalizing symptoms. Parents’ reports of improved teen affect regulation were also associated with decreases in both internalizing and externalizing symptoms. Results were comparable across gender and for parents of teens with pre-treatment externalizing symptoms in the clinical versus sub-clinical range. A model of therapeutic change in attachment-based parenting programs is discussed.

Sexual Victimization of Youth With a Physical Disability An Examination of Prevalence Rates, and Risk and Protective Factors

Children with disabilities have been shown to be at greater risk of victimization than those without. Although much of the research combines disability of any type into a single disability category, recent evidence suggests that not all types of disabilities are equally associated with victimization. To date, little knowledge exists about the victimization of youth with physical disabilities. This study used data from a national school-based survey of adolescents (n = 6,749, mean age = 15.41, SD = .66) in Switzerland to investigate sexual victimization (SV) among physically disabled youth. Two subtypes of SV were differentiated: contact SV, including penetration or touching/kissing, and non-contact SV, such as exhibitionism, verbal harassment, exposure to sexual acts, or cyber SV. A total of 360 (5.1%) youth self-identified as having a physical disability. Lifetime prevalence rates for contact SV were 25.95% for girls with a physical disability (odds ratio [OR] = 1.29 compared with able-bodied girls), 18.50% for boys with physical disability (OR = 2.78 compared with able-bodied boys), and 22.35% for the total sample with physical disability (OR = 1.74 compared with able-bodied youth). For non-contact SV, the lifetime prevalence was 48.11% for girls with a physical disability (OR = 1.44 compared with able-bodied girls), 31.76% for boys with physical disability (OR = 1.95 compared with able-bodied boys), and 40.28% for the total sample with physical disability (OR = 1.67 compared with able-bodied youth). After controlling for other risk factors, physical disability was a significant predictor of contact and non-contact SV for boys, but not for girls.

The developmental relation between aggressive behaviour and prosocial behaviour: a 5-year longitudinal study

BackgroundPast research has shown links between both children’s aggressive behaviour and a lack of prosocial behaviour to later maladaptation. Both types of behaviours have also been identified as crucial in children’s social and emotional development and later (mal)adaptation. However, little is known about the way they predict each other over time.MethodsWe utilised a large, ethnically diverse, longitudinal population sample of girls and boys (N = 1,334) to examine the bidirectional cross-lagged links between aggressive and prosocial domains of behaviour from age seven to eleven. Teacher, parent and child self-reports were utilised to assess aggressive behaviour and prosocial behaviour.ResultsThe results revealed that aggressive behaviour measured one year predicted decreases in prosocial behaviour in the following year. Conversely, prosocial behaviour did not predict changes in aggressive behaviour in the subsequent year. Furthermore, peer difficulties were examined and found to be an important mediator of the link between aggressive and prosocial behaviour. Specifically, peer difficulties mediated the links between aggressive behaviour and prosocial behaviour one year later, particularly during the first three years of school attendance.ConclusionsImplications of the findings for the design of intervention strategies to reduce children’s aggressive behaviour are discussed.

Evaluating Longitudinal Invariance in Dimensions of Mental Health Across Adolescence: An Analysis of the Social Behavior Questionnaire

Measurement invariance over time (longitudinal invariance) is a core but seldom-tested assumption of many longitudinal studies on adolescent psychosocial development. In this study, we evaluated the longitudinal invariance of a brief measure of adolescent mental health: the Social Behavior Questionnaire (SBQ). The SBQ was administered to participants of the Zurich Project on the Social Development of Children and Youths in up to four waves spanning ages 11 to 17. Using a confirmatory factor analysis approach, metric invariance held for all constructs, but there were some violations of scalar and strict invariance. Overall, intercepts tended to increase over time while residual variances decreased. This suggests that participants may become more willing or able to identify and report on certain behaviors over time. The noninvariance was not practically significant in magnitude, except for the Anxiety dimension where artifactual increases over development would be liable to occur if invariance is not appropriately modeled. Overall, results support the utility of the SBQ as an omnibus measure of psychosocial health across adolescence.

Developmental Relations Between ADHD Symptoms and Reactive Versus Proactive Aggression Across Childhood and Adolescence

Objective: Past research has provided some preliminary evidence that ADHD and reactive aggression have overlapping neurocognitive bases. Based on this, we tested the hypothesis that ADHD symptoms are closely coupled in developmental terms with reactive aggression, more so than with proactive aggression with which it has been postulated to be only indirectly linked. Method: We used latent growth curve analysis to estimate the developmental relations between ADHD symptoms and subtypes of aggressive behavior in a normative sample of 1,571 youth (761 female, 810 male) measured from ages 7 to 15. Results: Individual ADHD trajectories were significantly and substantially correlated with individual trajectories in both aggressive subtypes; however, consistent with our hypothesis, the relation with reactive aggression was significantly stronger. Conclusion: Our study provides some of the first evidence for a differential relation between ADHD symptoms and aggression subtypes not only cross-sectionally but also in terms of their longitudinal developmental trajectories.

Shifting Internal Parent—Child Representations among Caregivers of Teens with Serious Behavior Problems: An Attachment-Based Approach

Attachment theory provides a rich framework for the development of interventions for trauma. This study examined processes underlying treatment outcomes of an attachment-based program (Connect; Moretti, Braber, & Obsuth, 2009) for parents of teens with severe behavior problems. Caregivers completed the Parenting Representations Interview and the Child Behavior Checklist prior to and following treatment. Results confirmed significant reductions in teens’ problem behavior and changes in parental representations of the parent, teen, and parent—teen relationship. Shifts in parenting representation were significantly related to reductions in teen problem behavior, consistent with the view that changing attachment representations underlies therapeutic effects.

Identifying Early Markers of “Late Onset” Attention Deficit and Hyperactivity/Impulsivity Symptoms:

Objective: In recent years, there has been an increased focus on “late onset” ADHD, referring to the onset of symptoms beyond childhood, into adolescence and adulthood. We aimed to identify childhood predictors of ADHD symptom increases over development. Method: We used growth mixture modeling to evaluate predictors of a “late onset” symptom trajectories in a longitudinal cohort study of youth measured at eight points from ages 7 to 15. Results: Individuals with high levels of sensation seeking at age 7 were more likely to show a trajectory of ADHD symptoms characterized by increasing levels from age 7 than persistently low symptom levels. Conclusion: The late versus early onset distinction may align with the distinction between deficits in “bottom-up” versus “top-down” processes previously discussed in relation to ADHD. Results also raise the possibility that later onset symptoms could be predicted based on characteristics in childhood.

Situating violent ideations within the landscape of mental health: Associations between violent ideations and dimensions of mental health

Violent ideations occur more frequently in individuals with mental health problems. They may be of interest in clinical contexts as possible indicators of dangerousness, as corollaries of mental health problems, as candidate treatment targets and as potentially playing a role in perpetuation or onset of symptoms. In spite of their relevance to mental health, some fundamental questions about their place within the broader landscape of mental health problems remain unanswered. To provide a basic characterisation of the relations between violent ideations and dimensions of mental health and provide a foundation for future research in this area we factor analysed a measure of violent ideations and an omnibus measure of mental health dimensions in a normative sample of 1306 youth (at age 17). Results supported a separate dimension of violent ideations with a small to moderate correlation with five other dimensions of mental health: internalising, prosociality, ADHD, indirect/proactive aggression, and physical/reactive aggression. Controlling for comorbidity among mental health dimensions, all but ADHD had unique relations with violent ideations. This suggests that violent ideations are potentially of broad relevance to mental health and related behaviours and there should be a greater research effort aimed at understanding their possible role in mental health.

London Education and Inclusion Project (LEIP): Exploring negative and null effects of a cluster-randomised school-intervention to reduce school exclusion – findings from protocol-based subgroup analyses

This paper presents subgroup analyses from the London Education and Inclusion Project (LEIP). LEIP was a cluster-randomised controlled trial of an intervention called Engage in Education-London (EiE-L) which aimed to reduce school exclusions in those at greatest risk of exclusion. Pupils in the control schools attended an hour-long employability seminar. Minimisation was used to randomly assign schools to treatment and control following baseline data collection. The study involved 36 schools (17 in treatment—373 pupils; 19 in control—369 pupils) with >28% free school meal eligibility across London and utilised on pupil self-reports, teacher reports as well as official records to assess the effectiveness of EiE-L. Due to multiple data sources, sample sizes varied according to analysis. Analyses of pre-specified subgroups revealed null and negative effects on school exclusion following the intervention. Our findings suggest that the design and implementation of EiE-L may have contributed to the negative outcomes for pupils in the treatment schools when compared to those in the control schools. These findings call into question the effectiveness of bolt-on short-term interventions with pupils, particularly those at the highest risk of school exclusion and when they are faced with multiple problems. This is especially pertinent given the possibility of negative outcomes. Trial Registration: Controlled Trials: ISRCTN23244695

No Evidence That Substance Use Causes ADHD Symptoms in Adolescence

There is a robust association between attention-deficit hyperactivity disorder (ADHD) symptoms and elevated substance use. Several plausible causal pathways from ADHD to substance use have been articulated and supported empirically. In this study, we tested the recent suggestion that substance use could also influence levels of ADHD symptoms. Using the three most recent waves of data from the Zurich Project on the Social Development of Children and Youth (z-proso), we found significant and strong cross-lagged effects of ADHD symptoms on substance use but no significant effects in the opposite direction. This suggests that individual differences in substance use are not related to increases in ADHD symptoms in adolescence. Adolescent-onset symptoms of ADHD are thus unlikely to be caused by substance use, and targeting substance use problems is unlikely to reduce ADHD symptoms.