Susan J. Simonian

Recognition of Facial Affect by Children and Adolescents Diagnosed with Social Phobia

This study compared the ability of children with social phobia and children with no psychiatric disorder to accurately judge facial affect. Fifteen children and adolescents with social phobia and 14 control children were asked to identify emotions depicted in slides from the Pictures of Facial Affect. In addition, they rated their level of anxiety on a pictorial Likert scale prior to and upon completion of the facial recognition task. The results indicated that children with social phobia had significantly poorer facial affect recognition skills than normal controls and reported greater anxiety upon completion of the recognition task. Multivariate analysis revealed significant differences between groups in the number of errors based on the type of facial affect. Post-hoc analysis indicated that deficits were most pronounced for facial representations of happiness, sadness, and disgust. The results are discussed in relation to an integrated model of social skills training that includes facial affect recognition training as a integral component in treatment programs for children and adolescents with social phobia. Directions for future research with larger samples of more ethnically diverse children and adolescents are presented.

Utility of the Pediatric Symptom Checklist for behavioral screening of disadvantaged children.

Investigated the utility of a parent report measure designed specifically for behavior screening in the pediatric primary care setting for use with disadvantaged children and families. Results indicated that the Pediatric Symptom Checklist was significantly related to scores derived from the Child Behavior Checklist. Receiver Operator Characteristic analysis indicated the need for modification of the cutting score previously established with middle-class children. A model for screening children for psychopathology within the structural-organizational constraints of the pediatric primary care setting is presented.

Screening and Identification in Pediatric Primary Care.

This article reviews issues related to behavioral screening in pediatric primary care settings. Structural-organizational issues affecting the use of pediatric primary care screening are discussed. This study also reviewed selected screening instruments that have utility for use in the primary care setting. Clinical and research issues related to screening for behavior problems in pediatric primary care are presented.

Craving, Cue Reactivity, and Stimulus Control Among Early-Stage Young Smokers: Effects of Smoking Intensity and Gender

INTRODUCTION Smoking initiation usually begins in adolescence, but how and for whom nicotine dependence emerges during this period is unclear. The cue-reactivity paradigm is well suited to examine one marker of dependence: craving-related stimulus control, i.e., the ability of environmental cues to elicit craving to smoke. This study examined the effects of both level of smoking involvement (daily vs. occasional smoking) and gender on reactivity to both smoking and alcohol cues. METHODS Young (age range 16-20; 42% female) daily (n = 55) and occasional (n = 52) smokers were exposed to each of three counterbalanced cues: (a) in vivo smoking (e.g., sight, smell, lighting of cigarette), (b) alcohol (e.g., opening, pouring, and smell of preferred beverage), and (c) neutral cue. RESULTS Daily smokers exhibited higher levels of tonic (i.e., noncue-elicited) craving than did occasional smokers. Both groups showed significant increases in craving in response to cues (i.e., cue-elicited craving), with little evidence that cue-elicited craving differed between groups. Females were more cue reactive to both the alcohol and smoking cues than males, particularly for the positively reinforced aspects of smoking (i.e., hedonic craving). There were no gender × group interaction effects in response to either the alcohol or the smoking cue. CONCLUSIONS Findings show the presence of cue-elicited craving even among occasional smokers and are consistent with literature demonstrating heightened sensitivity to environmental cues among females. Cue-elicited craving may be one mechanism that contributes to the maintenance of smoking behavior and perhaps to the development of nicotine dependence within early stage smokers.

An Introduction to Program and Research Initiatives of the STARBRIGHT Foundation

Media and technology-based interventions offer promise for helping children with chronic illness cope with physiological and psychosocial challenges of illness. Research evaluating the efficacy of such interventions is critical to their acceptance and implementation in clinical practice. This article provides an overview of 2 interventions developed by the STARBRIGHT(r) Foundation: STARBRIGHT World(tm), a private online network connecting children in hospitals in the United States and Canada, and STARBRIGHT Hospital Pals(tm), a program designed to ease the anxiety of preschool children undergoing radiation therapy treatment. Behavioral models for program design, as well foundations for research to assess program impact, are presented.

Vilazodone for cannabis dependence: A randomized, controlled pilot trial

BACKGROUND AND OBJECTIVES The purpose of this study was to evaluate the efficacy of vilazodone, a selective serotonin receptor inhibitor and partial 5-HT1A agonist, for treatment of cannabis dependence. METHODS Seventy-six cannabis-dependent adults were randomized to receive either up to 40 mg/day of vilazodone (n = 41) or placebo (n = 35) for 8 weeks combined with a brief motivational enhancement therapy intervention and contingency management to encourage study retention. Cannabis use outcomes were assessed via weekly urine cannabinoid tests; secondary outcomes included cannabis use self-report and cannabis craving. RESULTS Participants in both groups reported reduced self-reported cannabis use over the course of the study; however, vilazodone provided no advantage over placebo in reducing cannabis use. Men had significantly lower creatinine-adjusted cannabinoid levels and a trend for increased negative urine cannabinoid tests than women. DISCUSSION AND CONCLUSIONS Vilazodone was not more efficacious than placebo in reducing cannabis use. Important gender differences were noted, with women having worse cannabis use outcomes than men. SCIENTIFIC SIGNIFICANCE Further medication development efforts for cannabis use disorders are needed, and gender should be considered as an important variable in future trials.

New Directions in Research on STARBRIGHT Interventions

This special issue of Children’s Health Care focuses on a presentation of the preliminary database regarding interventions developed by the STARBRIGHT Foundation. The studies included in this issue help to establish baseline data for more definitive outcome evaluations, as well as to elucidate areas for future theoretical development regarding innovative approaches to facilitating optimal outcomes for children facing the challenges of hospitalization and chronic illness. Advances in medical management of childhood chronic illnesses have resulted in an increased focus on psychosocial factors mediating or otherwise impacting the course of, and adaptation to, hospitalization and illness. Recent emphasis within pediatric psychology has focused on the development of empirically validated treatment models for intervention in a number of childhood conditions. Furthermore, research has moved beyond the mere identification of adverse psychosocial outcomes for chronically ill children toward the development of complex, interactive, risk-resiliency models that include medical, temporal, developmental, and psychosocial factors. Efforts to help hospitalized children and children with chronic illnesses have moved beyond traditional service delivery to include program development, staff training, and policy formulation. Psychologists and other multidisciplinary health care providers also have become involved in the development of children’s media, including educational television programming; psychoeducational videotapes; and more recently, interactive psychoeducational software. During this CHILDREN’S HEALTH CARE, 31(1), 87–91 Copyright

Adolescent Swimmers: Breathing Complaints and Prescription Asthma Medication Use and Misuse

This study investigated the incidence of asthma and breathing difficulties in a sample of 103 competitive adolescent swimmers. In addition, the use and potential misuse of common asthma medications as well as other prescription medication was examined. Data indicated that adolescent female swimmers experienced exercise-related breathing difficulties more frequently than male swimmers. Older swimmers not only swam more often and for greater yardage than younger swimmers, they also participated in more structured competitions than did younger swimmers. Breathing difficulty was positively correlated with increased practice demands (number and length of practice) and stopping practice early due to breathing difficulties. Age-related patterns in seeking and stealing medication from peers was also evident, and this risky health behavior was inversely related to swimming participation. Data are discussed in relation to implications for pediatric psychologists and pediatric health care providers.