Julie Newman Kingery

Peer experiences of anxious and socially withdrawn youth: An integrative review of the developmental and clinical literature.

Prior research indicates that both anxious youth and socially withdrawn youth tend to experience challenges and difficulties in various aspects of their peer relationships and social functioning. While clinical psychology researchers have examined how anxiety relates to peer experiences using normative and clinically anxious samples, developmental psychologists have focused primarily on the peer experiences of shy and withdrawn children. Research from these two fields has progressed on related yet separate paths, producing similar results despite using different terminology and assessment techniques. The purpose of this review is to bring together the developmental and clinical bodies of literature on the peer experiences of anxious and socially withdrawn youth by identifying common themes and unique contributions of each discipline. Studies reviewed focus specifically on the peer constructs of acceptance, friendship, peer victimization, social skills, and social-cognitive processes. Limitations including methodological inconsistencies and insufficient examination of age-, gender-, and ethnicity-related issues are identified. Recommendations for future collaborations between developmental and clinical researchers as well as implications for interventions targeting the peer relations of anxious and withdrawn youth are discussed.

Predictors of Treatment Response in Pediatric Obsessive-Compulsive Disorder

OBJECTIVE To examine predictors of treatment response in pediatric obsessive-compulsive disorder (OCD). METHOD A literature review of psychotherapy (i.e., cognitive-behavioral therapy) and medication studies for pediatric OCD published from 1985 to 2007 was conducted using several databases. RESULTS The literature search produced a total of 21 studies (6 cognitive-behavioral therapy, 13 medication, and 2 combination studies) that met specific methodological criteria. Across studies, the following nine predictors were examined: child sex, child age, duration of illness/age at onset, baseline severity of obsessive-compulsive symptoms, type of obsessive-compulsive symptoms, comorbid disorders/symptoms, psychophysiological factors, neuropsychological factors, and family factors. Among all of the studies, there was little evidence that sex, age, or duration of illness (age at onset) was associated with treatment response. Baseline severity of obsessive-compulsive symptoms and family dysfunction were associated with poorer response to cognitive-behavioral therapy, whereas comorbid tics and externalizing disorders were associated with poorer response in medication-only studies. CONCLUSIONS Overall, there are limited data on predictors of treatment response for pediatric OCD. The majority of studies are plagued with methodological limitations and post hoc approaches. Additional research is needed to better delineate the predictors of treatment response in pediatric OCD with the goal of developing individualized treatment approaches.

Peer Experiences as Predictors of Adjustment across the Middle School Transition.

The role of peer acceptance, number of mutual friends, and friendship quality in predicting adjustment across the transition from elementary to middle school was examined. Participants were 146 students (68 boys, 78 girls) who participated in the Time 1 (spring of fifth grade) and Time 2 (fall of sixth grade) assessments. Peer acceptance and number of friends were assessed using sociometric rating scale and limited nomination procedures. Participants also completed measures that assessed feelings of loneliness, extent of involvement in school, and the quality of a specific mutual friendship. Results of repeated measures MANOVAs revealed a significant decrease in the average number of mutual friendships across time. Regression analyses indicated that peer acceptance and friendship quality and quantity play significant yet somewhat different roles in predicting loneliness and school involvement across the middle school transition. Implications for including a peer component in programs that prepare students for the middle school transition are discussed.

They're Not Just "Little Adults": Developmental Considerations for Implementing Cognitive-Behavioral Therapy With Anxious Youth

Developmental factors direct optimal implementations of cognitive-behavioral therapy (GBT) protocols with children and adolescents. Although chronological age can approximate level of development, youthful clients benefit v^rhen clinicians carefully assess each childs cognitive, social, and emotional skills and adjust manualized treatments accordingly. Using several components of manualized GBT for anxiety in youth (i.e., affective education, cognitive restructuring, exposure tasks) as a framework, this article reviews empirical literature and provides practical suggestions for modifying these aspects of treatment to fit a childs level of development. Important issues such as engaging youth in treatment, and involving school personnel and parents in this process are also discussed. This article concludes with a call for

Evaluation of BBL CHROMagar VanRE for Detection of Vancomycin-Resistant Enterococci in Rectal Swab Specimens

ABSTRACT A study was performed on 517 surveillance rectal swabs to evaluate a selective and differential chromogenic medium, the BBL CHROMagar VanRE (CVRE), which enables recovery and identification of VanA- and VanB-containing Enterococcus faecium (ENFM) and Enterococcus faecalis (ENFS) isolates. Compared to BBL Enterococcosel agar, a bile-esculin-azide-vancomycin (BEAV) agar, the initial overall sensitivity, specificity, and positive and negative predictive values of CVRE for the detection of vancomycin-resistant ENFM and ENFS were 99.1% and 94.8% and 84.2% and 99.7%, respectively. Among our patient population, more vancomycin-resistant enterococci (VRE) were recovered with CVRE than BEAV.

Somatic Symptoms and Anxiety Among African American Adolescents

Somatic symptoms are an associated feature of anxiety disorders that have received little research attention among non-White samples. In addition, the majority of previous studies have examined the influence of somatic symptoms in a cross-sectional rather than a prospective manner. This study examines the prevalence of 12 somatic symptoms, the association of somatic and anxiety symptoms (both concurrently and prospectively) with psychosocial functioning, and gender differences in somatic symptoms among a community sample of 114 African American adolescents (57 girls). In all, 83% of the sample reported at least one somatic symptom (some or most of the time within the past 2 weeks), and on average, adolescents reported 2.5 somatic symptoms. Somatic symptoms correlated positively with severity of anxiety symptoms and negatively with aspects of perceived competence. After the initial level of anxiety symptoms was controlled for, somatic symptoms were a unique predictor of perceived competence (at initial assessment) and anxiety symptoms (at 6-month follow-up). Overall, girls endorsed significantly more somatic symptoms than did boys. Findings replicate those of studies with White samples and suggest that somatic symptoms may be a risk factor for anxiety disorders among African American youth.

Factor structure and psychometric properties of the Children's Negative Cognitive Error Questionnaire with a clinically depressed adolescent sample.

The factor structure and psychometric properties of the Childrens Negative Cognitive Error Questionnaire (CNCEQ) were examined with 427 adolescents ages 12 to 18 (193 boys) with current major depressive disorder. Results of confirmatory factor analysis supported a four-factor model comprised of three content area factors (i.e., social, academic, athletic) and a general factor. Internal consistencies ranged between .84 and .94 for the total and three content area scores. Girls scored significantly higher than boys on all factors, but no age differences on the factors were found. Convergent and discriminant validity of the CNCEQ were supported. Results did not support the original subscales organized by type of cognitive distortion (e.g., catastrophizing, overgeneralizing). Findings indicated that the CNCEQ would be a useful clinical tool for assessing cognitive symptoms within relevant domains of functioning (e.g., social, academic) of depressed youth.

Evidence-based Practice for Childhood Anxiety Disorders

Anxiety disorders are among the most common psychiatric conditions in children and adolescents. Empirical evidence suggests that the majority of youth will show clinically meaningful benefits after a short-term course of cognitive-behavioral therapy (CBT). This article presents an update on the status of this treatment literature and provides clinicians with a description of specific CBT strategies. A case example illustrating the implementation of these strategies is also included. Tips for managing frequently encountered obstacles and a clinical algorithm for sequencing strategies are discussed.

Cognitive Measures of Adolescent Depression: Unique or Unitary Constructs?

The factor structure of several self-report questionnaires assessing depression-relevant cognitions frequently employed in clinical research was examined in a sample of 390 adolescents (M age = 14.54; 216 girls; 74% Caucasian) with current major depressive disorder enrolled in the Treatment of Adolescents with Depression Study. A four-factor solution resulted, accounting for 65% of the total variance. The factors were labeled (a) Cognitive Distortions and Maladaptive Beliefs, (b) Cognitive Avoidance, (c) Positive Outlook, and (d) Solution-Focused Thinking. Internal consistencies for the factor-based composite scores were .83, .85, .84, and .82, respectively. Girls endorsed more negative cognitions than boys on three of the four factors. Maladaptive cognitions were positively related to severity of depression and predicted treatment response. Taken together, findings indicated that there are four distinct domains of cognitions that are present among adolescents with depression that are tapped by several widely used self-report measures of cognitions.

A model-based cluster analysis of social experiences in clinically anxious youth: links to emotional functioning

Social difficulties are commonly associated with anxiety disorders in youth, yet are not well specified in the literature. The aim of this study was to identify patterns of social experiences in clinically anxious children and examine the associations with indices of emotional functioning. A model-based cluster analysis was conducted on parent-, teacher-, and child-reports of social experiences with 64 children, ages 7–12 years (M = 8.86 years, SD = 1.59 years; 60.3% boys; 85.7% Caucasian) with a primary diagnosis of separation anxiety disorder, social phobia, and/or generalized anxiety disorder. Follow-up analyses examined cluster differences on indices of emotional functioning. Findings yielded three clusters of social experiences that were unrelated to diagnosis: (1) Unaware Children (elevated scores on parent- and teacher-reports of social difficulties but relatively low scores on child-reports, n = 12), (2) Average Functioning (relatively average scores across all informants, n = 44), and (3) Victimized and Lonely (elevated child-reports of overt and relational victimization and loneliness and relatively low scores on parent- and teacher-reports of social difficulties, n = 8). Youth in the Unaware Children cluster were rated as more emotionally dysregulated by teachers and had a greater number of diagnoses than youth in the Average Functioning group. In contrast, the Victimized and Lonely group self-reported greater frequency of negative affect and reluctance to share emotional experiences than the Average Functioning cluster. Overall, this study demonstrates that social maladjustment in clinically anxious children can manifest in a variety of ways and assessment should include multiple informants and methods.