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Nugent N.R.,Bradley Hasbro Childrens Research Center | Browne L.,Medical College of Wisconsin | Ostrowski S.,Western Kentucky University | Delahanty D.L.,Kent State University
Journal of Traumatic Stress | Year: 2010

Initial research supports the use of propranolol to prevent posttraumatic stress disorder (PTSD); research has not examined pharmacological prevention for children. Twenty-nine injury patients (ages 10-18 years old) at risk for PTSD were randomized to a double-blind 10-day trial of propranolol or placebo initiated within 12 hours postadmission. Six-week PTSD symptoms and heart rate were assessed. Although intent-to-treat analyses revealed no group differences, findings supported a significant interaction between gender and treatment in medicationadherent participants, δR2 =.21. Whereas girls receiving propranolol reported more PTSD symptoms relative to girls receiving placebo, δR2 =.44, boys receiving propranolol showed a nonsignificant trend toward fewer PTSD symptoms than boys receiving placebo,δR2 =.32. Findings inform gender differences regarding pharmacological PTSD prevention in youth. © 2010 International Society for Traumatic Stress Studies.


Feldman J.M.,Yeshiva University | Perez E.A.,University of Puerto Rico at San Juan | Canino G.,University of Puerto Rico at San Juan | McQuaid E.L.,Bradley Hasbro Childrens Research Center | And 2 more authors.
Journal of Nervous and Mental Disease | Year: 2011

The goal of this study was to assess whether the association between asthma attacks and anxiety disorders in youth/young adults is reduced after adjusting for the caregivers' psychiatric disorders. An island-wide probability sample of 641 households in Puerto Rico with youth/young adults between ages 10 and 25 years participated along with their caregivers. The Diagnostic Interview Schedule for Children and the Composite International Diagnostic Interview were conducted to assess anxiety and depressive disorders. Youth/young adults with an anxiety disorder were more likely to have a lifetime history of asthma attacks versus youth/young adults without an anxiety disorder. Caregivers of participants with asthma attacks were more likely to have major depression than did the caregivers of participants without asthma attacks. The association between asthma attacks and anxiety disorders in youth was no longer significant after adjustment for caregiver major depression. It is important to consider the role of caregiver depression in asthma-anxiety comorbidity in youth/young adults. © 2011 by Lippincott Williams & Wilkins.


Feldman J.M.,Yeshiva University | Ortega A.N.,University of California at Los Angeles | Koinis-Mitchell D.,Bradley Hasbro Childrens Research Center | Kuo A.A.,University of California at Los Angeles | Canino G.,University of Puerto Rico at San Juan
Journal of Nervous and Mental Disease | Year: 2010

To examine associations among Puerto Rican children's physical health problems and children's internalizing disorders, parental psychopathology and acculturative stress, and family factors. A population-based probability sample of 2491 Puerto Rican children, aged between 5 and 13 years, and caregivers from the South Bronx and the U.S. Commonwealth of Puerto Rico participated in this study. The parent version of the Diagnostic Interview Schedule for Children-IV was used to assess children,s internalizing disorders. Children's anxiety disorders, parental psychopathology, and acculturative stress were associated with childhood asthma, abdominal pain, and headaches. Children's depressive disorders, maternal acceptance, and family functioning were associated with abdominal pain and headaches. Parents of children living in Puerto Rico were more likely to report physical health problems in their children than in the Bronx. Children's internalizing disorders, parental psychopathology, and acculturative stress may be important areas to target among Puerto Rican children with physical health problems. Copyright © 2010 by Lippincott Williams & Wilkins.


Koinis-Mitchell D.,Bradley Hasbro Childrens Research Center | Koinis-Mitchell D.,Bradley Hasbro Research Center | McQuaid E.L.,Bradley Hasbro Childrens Research Center | Jandasek B.,Bradley Hasbro Childrens Research Center | And 5 more authors.
Journal of Pediatric Psychology | Year: 2012

ObjectiveThe goal of this study is to identify individual, family/cultural, and illness-related protective factors that may minimize asthma morbidity in the context of multiple urban risks in a sample of inner-city children and families.MethodsParticipating families are from African-American (33), Latino (51) and non-Latino white (47) backgrounds. A total of 131 children with asthma (56 male), ages 6-13 years and their primary caregivers were included.ResultsAnalyses supported the relationship between cumulative risks and asthma morbidity across children of the sample. Protective processes functioned differently by ethnic group. For example, Latino families exhibited higher levels of family connectedness, and this was associated with lower levels of functional limitation due to asthma, in the context of risks.ConclusionsThis study demonstrates the utility of examining multilevel protective processes that may guard against urban risks factors to decrease morbidity. Intervention programs for families from specific ethnic groups can be tailored to consider individual, family-based/cultural and illness-related supports that decrease stress and enhance aspects of asthma treatment. © 2011 The Author. Published by Oxford University Press on behalf of the Society of Pediatric Psychology.


Lobato D.,Brown University | Lobato D.,Rhode Island Hospital | Kao B.,University of Rhode Island | Plante W.,Brown University | And 4 more authors.
Journal of Child Psychology and Psychiatry and Allied Disciplines | Year: 2011

Background: Siblings of children with disabilities are at risk for internalizing psychological disorders; however, little is known about how culture influences this effect. This study examined the psychological and school functioning of Latino siblings of children with intellectual disability (ID). Methods: Participants were 100 Latino (L) and nonLatino (NL) siblings (8-15 years) of children with ID (50 LID, 50 NLID) and 100 Latino and nonLatino control siblings (50 LC, 50 NLC). Siblings, parents, and teachers completed standard questionnaires regarding sibling emotional and behavioral functioning; sibling school report cards were obtained. Analyses of variance were conducted, controlling for parent age and family income; planned contrasts compared LID siblings to the other sibling groups. Results: LID siblings reported significantly more internalizing (t(1) = 2.41, p <.05) and emotional t(1) = 3.06, p <.05) symptoms, poorer awareness of (t(1) = 2.26, p <.01) and greater reluctance to express (t(1) = 3.12, p <.01) their emotions, and more problems in personal adjustment and relationships with parents (t(1) = -2.50, p <.05). Significantly higher percentages of LID siblings scored in the at-risk or clinical range for internalizing and emotional symptoms, and were more likely to score above the clinical cut-off for separation anxiety disorder and to endorse global impairment. LID siblings experienced more school absences and lower academic performance. There were no group differences in externalizing behavior problems, somatic symptoms, or teacher-reported internalizing symptoms. Conclusions: Latino siblings of children with ID are at greater risk for internalizing psychological disorders and greater impairment in personal and school functioning. Results are discussed in terms of their sociocultural significance and clinical implications. © 2011 Association for Child and Adolescent Mental Health.


Flessner C.A.,Brown University | Flessner C.A.,Bradley Hasbro Childrens Research Center
Child and Adolescent Psychiatric Clinics of North America | Year: 2011

This article provides an overview of cognitive-behavioral therapy (CBT) for repetitive behavior disorders. Because tic disorders and trichotillomania are the most often studied and most debilitating of these conditions, this article focuses on the efficacy of CBT for these 2 conditions. An overview of CBT for children presenting with these concerns is provided. This review focuses particularly on habit reversal training, which is at the core of most CBT-based interventions. Two recent empirical studies on the immense potential of CBT in treating childhood repetitive behavior disorders and future areas of research are also discussed. © 2011 Elsevier Inc.


Barker D.H.,Bradley Hasbro Childrens Research Center | Barker D.H.,Rhode Island Hospital | Barker D.H.,Brown University | Rancourt D.,Bradley Hasbro Childrens Research Center | And 5 more authors.
Journal of Pediatric Psychology | Year: 2014

Objective To introduce and illustrate recent advances in statistical approaches to simultaneous modeling of multiple change processes. Methods Provide a general overview of how to use structural equations to simultaneously model multiple change processes and illustrate the use of a theoretical model of change to guide selection of an appropriate specification from competing alternatives. The selected latent change score model is then fit to data collected during an adolescent weight-control treatment trial. Results A latent change score model is built starting with the foundation of repeated-measures analysis of variance and illustrated using graphical notation. Conclusions The assumptions behind using structural equations to model change are discussed as well as limitations of the approach. Practical guidance is provided on matching the statistical model to the theory underlying the observed change processes and the research question(s) being answered by the analyses. © Published by Oxford University Press on behalf of the Society of Pediatric Psychology 2013.


Holmbeck G.N.,Loyola University Chicago | Delucia C.,Nova Southeastern University | Essner B.,Loyola University Chicago | Kelly L.,Loyola University Chicago | And 3 more authors.
Journal of Consulting and Clinical Psychology | Year: 2010

Objective: As a follow-up to an earlier cross-sectional study (Holmbeck et al., 2003), the current multimethod, multi-informant investigation examined individual growth in psychosocial adjustment across the adolescent transition in 2 samples: young adolescents with spina bifida (SB) and typically developing adolescents (N = 68 in both groups at Time 1). Method: Growth curve modeling procedures were used to describe the developmental course of psychosocial adjustment across 4 waves of data collection from ages 8 to 15. Child gender was included in the models as a moderator of associations between illness status and adjustment trajectories. Results and Conclusions: Findings revealed that preadolescent differences between groups were maintained for several adjustment variables, indicating that adolescents with SB have enduring academic and attention problems and difficulties with social development (e.g., fewer friends and less influence during family interactions). For other outcomes, trajectories of adjustment levels for adolescents with SB converged on levels observed in comparison adolescents, indicating some areas of resilience. Girls with SB were at risk for increasing levels of social difficulties and negative perceptions of their physical appearance. Clinical implications are discussed. © 2010 American Psychological Association.


Koinis-Mitchell D.,Bradley Hasbro Childrens Research Center | Craig T.,Pennsylvania State University | Esteban C.A.,Bradley Hasbro Childrens Research Center | Klein R.B.,Bradley Hasbro Childrens Research Center
Journal of Allergy and Clinical Immunology | Year: 2012

Atopic diseases, such as asthma and allergic rhinitis, are common conditions that can influence sleep and subsequent daytime functioning. Children and patients with allergic conditions from ethnic minority groups might be particularly vulnerable to poor sleep and compromised daytime functioning because of the prevalence of these illnesses in these groups and the high level of morbidity. Research over the past 10 years has shed light on the pathophysiologic mechanisms (eg, inflammatory mediators) involved in many atopic diseases that can underlie sleep disruptions as a consequence of the presence of nocturnal symptoms. Associations between nocturnal symptoms and sleep and poorer quality of life as a result of missed sleep have been demonstrated across studies. Patients with severe illness and poor control appear to bear the most burden in terms of sleep impairment. Sleep-disordered breathing is also more common in patients with allergic diseases. Upper and lower airway resistance can increase the risk for sleep-disordered breathing events. In patients with allergic rhinitis, nasal congestion is a risk factor for apnea and snoring. Finally, consistent and appropriate use of medications can minimize nocturnal asthma or allergic symptoms that might disrupt sleep. Despite these advances, there is much room for improvement in this area. A summary of the sleep and allergic disease literature is reviewed, with methodological, conceptual, and clinical suggestions presented for future research. © 2012 American Academy of Allergy, Asthma & Immunology.


Tolou-Shams M.,Bradley Hasbro Childrens Research Center
Journal of pediatric psychology | Year: 2010

OBJECTIVE: To conduct a critical review of all HIV prevention intervention studies conducted with adolescents in juvenile justice settings to inform future intervention development. METHOD: PubMed and PsycInfo database searches were conducted for peer-reviewed, published HIV prevention intervention studies with juvenile offenders. RESULTS: Sixteen studies were identified (N = 3,700 adolescents). Half of the projects utilized rigorous methodologies to determine intervention effect on behavior change, such as conducting a randomized controlled trial (n = 8). Nine studies reported behaviors at least 3 months post-intervention and five out of nine showed decreases in sexual risk behavior. CONCLUSIONS: Several HIV prevention programs with juvenile offenders have led to sexual risk reduction, although effect sizes are modest. Most existing programs have neglected to address the impact of family, mental health, and substance use on HIV risk. More work is needed to develop evidence-based interventions that include HIV prevention strategies relevant and appropriate for the juvenile justice setting.

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