John-Paul Legerski

The Anger Expression Scale for Children: Initial Validation among Healthy Children and Children with Cancer

OBJECTIVE To evaluate the proposed structure of the Anger Expression Scale for Children (AESC) in samples of healthy children and those with cancer, and to examine correlations between AESC subscales and other indicators of anger and hostility. METHOD A total of 803 children from two independent studies of healthy and ill children (mean age = 12.7, SD = 3.1) completed the AESC and other measures of anger expression and hostility, and a sub-sample of 298 of their parents completed measures of anger expression and hostility. RESULTS Results provided initial support for the proposed four-factor model of the AESC (Trait Anger, Anger Expression, Anger In, and Anger Control). Measurement invariance was established across groups using a series of nested tests. Correlations between AESC subscales and parent- and child-reported indices of anger, hostility, and aggression support the convergent validity of the scales. CONCLUSIONS Analyses supported the construct validity of the AESC and generalization of the factor structure across healthy and chronically ill children.

A Qualitative Analysis of Barriers, Challenges, and Successes in Meeting the Needs of Hurricane Katrina Evacuee Families

Hurricane Katrina caused many individuals to evacuate to towns and cities throughout the United States. Psychological First Aid (PFA) is a treatment program designed to help clinicians and other disaster relief workers address the needs of adults, youth, and families immediately following disasters. We conducted focus groups with disaster relief and evacuee service providers in the Kansas City Metro Area as an exploratory study to identify their perceptions of the needs of evacuees. Participants identified a number of mental health needs, as well as displacement-related challenges, including loss of social support, material loss, unemployment, and other stressful life events that were secondary to the hurricane. Many of these needs are consistent with principles presented in the PFA manual. We also found that service providers faced unique challenges when attempting to assist evacuees. We discuss implications of these findings for treatment programs and provide suggestions for addressing barriers to care.

Adapting and Implementing Evidence-Based Interventions for Trauma-Exposed Refugee Youth and Families

Refugee youth routinely encounter difficult challenges related to past trauma, loss, and resettlement stressors. The recent surge in refugees resettling in the United States has made it increasingly likely that mental health service providers will receive referrals to work with refugee youth. It is thus essential to prepare the national mental health workforce to provide the best care possible. Although the current evidence base regarding the use of empirically-supported treatments with refugee youth living in Western countries is insufficiently developed to provide authoritative standards for evidence-based practice (EBP), sufficient advances have nevertheless been made to offer evidence-informed suggestions and guidance to practitioners who work with this unique population. We thus focus on three primary considerations for adapting and implementing evidence-based interventions with refugee youth by drawing on the American Psychological Association’s (Am Psychol 61:271–285, 2006) framework for EBP, which integrates (1) the best research available, (2) client characteristics, culture, and preferences; and (3) clinical expertise. We use this framework as a lens to selectively review research pertaining to the refugee youth experience and identify sound therapeutic practices. We recommend key factors to consider when seeking to provide culturally sensitive, developmentally appropriate trauma interventions to this at-risk yet underserved population in real-world settings. We discuss the promise of modularized interventions that integrate both common elements of evidence-based trauma interventions and common therapeutic factors, while also underscoring the importance of addressing extra-therapeutic factors within the broader ecology that can powerfully influence the well-being and functioning of refugee youth and their families.

Specificity of peer difficulties to social anxiety in early adolescence: categorical and dimensional analyses with clinical and community samples

ABSTRACT Background and Objectives: We investigated the specificity of social difficulties to social anxiety by testing associations of social anxiety and other anxiety presentations with peer acceptance and victimization in community and treatment-seeking samples of adolescents aged 12–14 years. Design: Cross-sectional, quantitative survey. Methods: Adolescents from the community (n = 116) and a clinical setting (n = 154) completed ratings of anxiety symptoms, perceived social acceptance, and peer victimization. Their parents also completed ratings of the adolescents’ anxiety and social acceptance. Results: Social acceptance was lowest among adolescents with social anxiety disorder (SAD) and lower among adolescents with other anxiety disorders than in the community sample. Anxiety symptoms were negatively correlated with social acceptance, but these associations were not unique to social anxiety symptoms. Girls in the community sample reported more overt victimization than girls with SAD and with other anxiety diagnoses. Relational victimization was associated with social and nonsocial anxiety symptoms only in the community sample. Conclusions: Our findings supplement recent laboratory-based observational studies on social functioning among adolescents with SAD and other anxiety disorders. Although social anxiety may be associated with unique social skill deficits and impairment, concerns about peer relations should also be considered among adolescents with other anxiety symptoms.

From Postimpact to Reconstruction: Considerations When Treating Traumatized Child and Adolescent Clients

Longitudinal data analyses have revealed that children and adolescents may encounter several distinct recovery stages and trajectories following exposure to a traumatic event. As recent dissemination efforts have increased the availability of training in various empirically-supported treatments, mental health service providers may struggle to identify among these approaches a treatment that is best suited to address the needs of an individual client. Treatment planning should take into consideration the severity of distress symptoms, as well as the timing, mode of delivery, and the setting of intervention. In this paper we provide an overview of assessment and emerging treatment approaches that can be used across various phases of recovery. We also identify a framework for making treatment decisions based on existing research. Finally, we propose next steps for research and practice in the area of treating traumatized children and adolescents.

Truth, Lies, and Recantation

Survey data indicate that, globally, 20 % of women and up to 10 % of men report experiencing sexual abuse during childhood (Stoltenborgh, van IJzendoorn, Euser, & Bakermans-Kranenburg, 2011). In 2012, US rates of sexual abuse reports were approximately 63,000 or 9.3 %. This is likely a low estimate given the stigma often associated with child sexual abuse (CSA) and reluctance to report abuse. It is clear that CSA occurs at a significant rate in both the United States and around the world. It poses a serious risk to children and adults, with the accompanying negative psychological effects and impact on health.