Michael L. Sulkowski

Rage Attacks in Pediatric Obsessive-Compulsive Disorder: Phenomenology and Clinical Correlates.

OBJECTIVE Rage attacks have been documented in youth with varied psychiatric disorders, but few data have been reported on the clinical characteristics and correlates of rage attacks among children with obsessive-compulsive disorder (OCD). METHOD Participants were 86 children (ages 6-16 years) with a primary diagnosis of OCD. Patients and their primary caregiver were administered clinician-rated measures of obsessive-compulsive severity and rage severity. Children completed the Center for Epidemiologic Studies Depression Scale and the Child Sheehan Disability Scale-Child, whereas parents completed the Rage Attacks Questionnaire, Aberrant Behavior Checklist-Irritability Scale, Childrens Affective Lability Scale, and Child Sheehan Disability Scale-Parent. RESULTS Rage was common among youth with OCD and was associated with varied clinical characteristics. Rage severity accounted for functional impairment beyond the influence of obsessive-compulsive symptom severity; however, these relations were explained by the impact of family accommodation. CONCLUSIONS These data suggest that rage attacks are relatively common, have a negative impact on illness presentation, and contribute to functional impairment above and beyond obsessive-compulsive symptom severity. Rage may contribute to family accommodation of symptoms, which may further affect obsessive-compulsive symptom severity and impairment.

Effects of stress and coping on binge eating in female college students

Limited research exists on the association between stress, coping, and binge eating. To address this paucity, this study explores these associations in a sample of 147 female college students, an at-risk population for binge eating. We hypothesized that emotional and avoidant coping would be positively associated with stress and binge eating. Conversely, we expected that rational and detached coping would be negatively related to stress and binge eating. Furthermore, we expected these coping styles to mediate the relationship between stress and binge eating. As predicted, emotion-focused and avoidant coping were positively associated with stress and binge eating. Additionally, emotion-focused coping partially mediated the relationship between stress and binge eating. However, no association was found between stress, rational or detached coping, and binge eating. These results are discussed within the context of a negative reinforcement model of binge eating. Lastly, the importance of providing evidence-based treatment for individuals with binge eating symptomology is discussed in light of our findings.

Teachers’ Responses to Bullying Incidents: Effects of Teacher Characteristics and Contexts

School is a critical context of bullying. This study investigated teacher responses to bullying incidents and the effects of individual and contextual variables on these responses. Participating teachers (N = 236) viewed streaming video vignettes depicting physical, verbal, and relational bullying and reported how they would respond to bullies and victims. Teachers were more likely to discipline bullies and to teach victims prosocial skills in physical bullying as opposed to relational or verbal. Teachers’ gender, perceived hostile school climate, and their childhood experiences with bullying were associated with their responses to bullying. Teachers were generally less likely to discipline bullies of a different ethnicity than of their own and more willing to discipline victims if their gender matched the gender of victims.

Contemporary Responses to Violent Attacks on College Campuses

In this article, the authors review efforts to increase the availability of crime data to students and parents, utilize security technologies on campus, allow members of campus communities to carry concealed weapons, use criminal or potential shooter profiling, employ threat assessment techniques, and implement emergency response plans to address attacks. Limited or no empirical support exists for efforts to increase the availability of data on campus crime, allow concealed weapons carriers on campus, increase security technologies on campus, and use criminal profiling techniques to identify threatening students. However, support exists for threat assessment procedures, strategies to increase threat reporting, and for emergency management plans. Although it is impossible to rid colleges completely of violence, this review underscores the importance of encouraging all members of the college community to commit to supporting safe, free, and open college communities.

Response to Intervention and Interdisciplinary Collaboration: Joining Hands to Support Children's Healthy Development.

School psychologists often are involved with the provision of services to students with chronic physical health conditions and mental health problems. However, collaborative efforts between school psychologists and the medical professionals who treat these youth often are lacking despite the benefits that may result from interdisciplinary collaboration. To address this disconnect, the authors discuss various ways school psychologists and medical professionals can collaborate to enhance the provision of services to youth with health and mental health problems in a response-to-intervention framework. Specifically, the authors discuss ways in which school psychologists can improve interdisciplinary collaboration across multiple tiers of service provision. In addition, the authors provide a case example to illustrate the benefits of interdisciplinary collaboration among school psychologists, allied health professionals, and physicians.

Obsessive-Compulsive Spectrum Disorder Symptoms in College Students

Abstract Objective: This study investigated the occurrence of obsessive-compulsive spectrum disorders (OCSDs) and associated symptomology in college students. Participants: Participants included 358 undergraduate students. Results: Results suggest that clinically significant levels of OCSD symptoms are relatively common. Additionally, OCSD symptoms co-occurred with each other and anxiety symptoms in general, yet not significantly with impulsivity symptoms. Conclusions: Given their prevalence in college students and potentially debilitating nature, it is important to increase awareness of OCSDs so that health professionals can better identify and treat symptoms of these disorders.

Peer victimization in youth from immigrant and non-immigrant US families

The phenomenology of peer victimization in youth from immigrant and non-immigrant US families was investigated in the current study. Specifically, differences in how youth were victimized, their responses to being victimized, and how peer bystanders responded to peer aggression incidents involving youth from these respective groups were investigated. Data were collected from two subsets of youth involved in a national research project. Results indicate that youth from immigrant families are more likely than their non-immigrant peers to report being victimized by physical aggression and to be victimized because of issues related to their race, religion, and family income. In addition, youth from immigrant families were more likely to report that their own responses to peer aggression were less likely to lead to positive outcomes and that peer bystander interventions did not benefit them as much as these interventions benefited their non-immigrant peers. Lastly, a concerning number of youth from immigrant families reported that both their own and bystander responses to peer aggression actually resulted in negative outcomes for them.

Validation of a classification system of obsessive–compulsive spectrum disorder symptoms in a non-clinical sample

Controversy surrounds the classification of obsessive-compulsive spectrum disorder (OCSD) symptoms. In this study, we tested whether a broad OCSD symptoms model consisting of obsessive-compulsive, body dysmorphic, health anxiety, trichotillomania, pathological skin picking, impulsivity, and anxiety symptoms displayed sufficient data fit. Alternatively, we tested whether a reduced OCSD symptoms model consisting of obsessive-compulsive, body dysmorphic, health anxiety, trichotillomania, and pathological skin picking symptoms demonstrated superior fit. The reduced OCSD symptoms model demonstrated good data fit. However, the broader OCSD symptoms model only displayed marginal data fit. In context with other findings, results of this study support an OCSD symptoms dimension that includes obsessive-compulsive, body dysmorphic, health anxiety, trichotillomania, and pathological skin picking symptoms. Implications of these findings are discussed as they relate to proposed changes in the forthcoming edition of the Diagnostic and Statistical Manual.

Temperament Styles of Zimbabwe and U.S. Children

Temperament styles of 600 Zimbabwe children are described and compared to those of 3,200 U.S. children. Gender and age differences are described for children in Zimbabwe and compared to U.S. children. Results indicate that Zimbabwe children generally prefer extroverted to introverted styles, practical to imaginative styles, feeling to thinking styles, and organized to flexible styles. Gender differences were found on one style: in contrast to males, females are more likely to prefer extroverted styles. Age differences are seen on extroversion-introversion, thinking-feeling, and organized-flexible styles. In contrast to U.S. children, those in Zimbabwe tend to express higher preferences for practical, feeling, and organized styles. Implications for practice are discussed.

First-Line Treatment for Pediatric Obsessive–Compulsive Disorder

Pediatric obsessive–compulsive disorder (OCD) is a common psychiatric disorder that impairs children’s functioning in home, school, and community settings. Once thought to be an untreatable or treatment refractory disorder, evidence-based treatments now exist for pediatric OCD. Various psychological treatment approaches for pediatric OCD have been investigated and research supports the use of cognitive-behavioral therapy (CBT) with exposure and response prevention (E/RP) and combined CBT/E/RP with serotonin reuptake inhibitor pharmacotherapy. This paper reviews these approaches and highlights the prominent role of CBT/E/RP as a first-line treatment for pediatric OCD.