National Institute of Mental Health Follows Up Major Study of Treatments for Attention Deficit Hyperactivity Disorder

A group of researchers supported by the National Institute of Mental Health conducted a follow-up study of common treatments for children with Attention-Deficit/Hyperactivity Disorder (ADHD). In the initial treatment phase, children randomly assigned to medication management showed larger benefits than children assigned to behavior modification. Based on this follow-up study, titled “National Institute of Mental Health Multimodal Treatment Study of ADHD Follow-up: Changes in Effectiveness and Growth After the End of Treatment,' the investigators reported that 10 months after completing treatment, the large initial benefits of medication management decreased by 50 percent, but that the smaller initial benefits of behavior modification were maintained. Part of this was due to changes in the assigned treatment over time (i.e., starting or stopping medication).

The study also looked at growth delays associated with medication. The investigators concluded that during the first two years, children on medication may grow almost a half-inch per year slower than those children not on medication. They interpreted this as mild growth suppression, but acknowledged the possibility that the patients treated with medication may catch up over a period of time.

For more news from the journal Pediatrics , visit http://pediatrics.aappublications.org/ .

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The Dimensions, Pathways, and Consequences of Youth Reentry

One of the most profound challenges facing American society is the reintegration of more than 700,000 individuals—including 200,000 juveniles and young adults age 24 and under—who leave state and federal adult prisons and juvenile correctional facilities and return home each year. This publication from the Urban Institute shares the observations and lessons learned during a two-day meeting of the Youth Reentry Roundtable. The report describes youth reentry and its policy relevance to communities nationwide. Drawing liberally from the insights and comments of the authors and participants in the Youth Reentry Roundtable, the report identifies critical facts about youth reentry, including the specific programming and policy challenges that must be addressed. Recommendations for next steps in research and practice are provided.

To view the publication, visit http://www.urban.org/UploadedPDF/410927_youth_reentry.pdf .

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Juvenile Suicides from 1991 through 1998

The death of a child or adolescent is always a tragic event, particularly when a young person takes his or her own life. This bulletin examines mortality statistics compiled by the Centers for Disease Control and Prevention. The data show that suicide was the fourth leading cause of death for juveniles ages 7-17, behind accidental deaths (motor vehicle crashes, drownings, etc.), homicides, and cancer. More than 20,000 juveniles committed suicide between 1981 and 1998, almost as many as were victims of homicide during the same period. In addition, the bulletin shows that the rate and method of suicide varied by age, race, and gender.

To view this bulletin, visit http://www.ncjrs.org/pdffiles1/ojjdp/196978.pdf .

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Violence in Teen-Rated Video Games

This article explores children's exposure to violence in video games rated T for “Teen” by the Entertainment Software Rating Board. Content analysis suggests a significant amount of violence, injury, and death in T-rated video games. Given the large amount of violence involving guns and knives, the relative lack of blood suggests that many T-rated video games do not realistically portray the consequences of violence. Researchers believe that T-rated video games may be a source of exposure to violence and some unexpected content for children and adolescents, and that the majority of T-rated video games provide incentives to the players to commit simulated acts of violence.

To view this study in its entirety, visit http://www.medscape.com/viewarticle/468087?mpid=26085 .

(Medscape is a free service provided by WebMD; registration is required.)

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An Effective Model for College Students with Learning Disabilities (LD) and Attention Deficit Hyperactivity Disorders (ADHD)

This study provides initial results on the services and supports provided through a supported-education model for students with LD and ADHD and the impact on students' educational outcomes. The results of the study indicate that for some students experiencing academic problems, access to services and support through a supported-education model can be beneficial. However, personal issues still remain significant barriers for students with disabilities to fully participate in higher education. A majority of the students who did not fully participate in the study had personal issues that prohibited them from doing so. Further efforts are needed to a) prepare students with disabilities enrolled in postsecondary programs to manage their personal needs and supports; and b) explore institutional changes that will enhance the availability and delivery of services.

To view the complete article, visit http://www.ncset.org/publications/viewdesc.asp?id=1415 .

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A Whole-Family Approach to Medications

Growing concerns that some antidepressants may be linked to an increased risk of suicide and suicidal thinking in children and adolescents has raised the stakes for families struggling to help a depressed child. Connect for Kids interviewed two experts—Dr. Stanley Greenspan and Dr. Lawrence H. Diller—and found powerful similarities in the message each one has for parents. Both Greenspan and Diller were adamant about the need to see medication as just one potential tool in a treatment approach that should encompass the entire family, as well as a child's school and social environments.

To view this article, visit http://www.connectforkids.org/benton_topics1544/benton_topics_show.htm?doc_id=211133 .

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Psychiatric Aspects of Child and Adolescent Obesity: A Review of the Past 10 Years

Childhood obesity is currently a national epidemic with numerous pediatric and public health initiatives focused on diagnosis, prevention, and treatment. The authors of this review summarized the current research findings on the psychiatric aspects of obesity in children and adolescents. The review cited numerous causes for obesity, including possible neurobiological and neuroendrocrine dysregulations, genetics, decreased physical activity, increased fat intake, and social factors such as neglect, abuse, and environmental deprivation. The review concluded with guidelines for medical and psychiatric assessment.

To view this summary of the review and the abstract, visit http://www.medscape.com/viewarticle/470950_2 .

(Medscape is a free service provided by WebMD; registration is required.)

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Correlates of Firesetting in a Community Sample of Young Adolescents

The authors of this study sought to investigate the prevalence of self-report firesetting behaviors in a community sample of adolescents. The research literature implicates various risk factors for firesetting, including antisocial behavior, risk-taking behavior, substance use, and family dysfunction. The current study sought to further investigate these relationships. Results showed that firesetting and antisocial behaviors were highly correlated, with a prevalence 2-3 times greater in boys versus girls. Compared with nonfiresetters, the firesetting adolescents were more likely to endorse extreme antisocial acts, extreme drug use, suicidality, and perceived academic failure.

To view the complete summary and abstract of this study, visit http://www.medscape.com/viewarticle/470950?mpid=26294 .

(Medscape is a free service provided by WebMD; registration is required.)

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Data Trends: Tampa and Portland

Data Trends is produced to increase the dissemination of current research findings in children’s mental health services. Here are new releases:

Tampa

Parent/Caregiver Satisfaction with Their Child's Medicaid Plan and Behavioral Health Provider

This study is one of the first of its kind to focus on children with serious emotional disorders and examine the influence of managed care on parent/caregiver satisfaction ratings about their children's a) behavioral health provider; and b) behavioral health insurance plan through the Medicaid programs in three states. The study results reveal parents of children with serious emotional disorders in Medicaid fee-for-service plans were significantly more satisfied with their plans than those parents in Medicaid managed care plans.

To view this summary of the study, visit http://rtckids.fmhi.usf.edu/rtcpubs/datatrends/summary_95.pdf .

The Columbia SuicideScreen: Validity and Reliability of a Screen for Youth Suicide and Depression

According to the National Institute of Mental Health, suicide by youth ages 15-24 was the third leading cause of death among adolescents in 2002. It is also estimated that there may be 8-25 attempts for every adolescent suicide death. These statistics reveal the importance of identifying youth who are at risk of suicide and to provide them with treatment. This Data Trends summarizes an article that reports on the validity and test-retest reliability of the Columbia SuicideScreen (CSS). The CSS is a brief, 11-item self-report instrument designed to assess known risk factors for suicide among adolescents. The instrument was found to have “good sensitivity and reasonable specificity” (p. 71). However, youth who screen positive on the CSS for being at risk of suicide should be evaluated with a second instrument in order to reduce the number of false-positives (i.e., students who are not at risk of suicide) identified by the CSS.

For the full article summary, visit http://rtckids.fmhi.usf.edu/rtcpubs/datatrends/summary_96.pdf .

Portland

Treatment of Parental Stress to Enhance Therapeutic Change among Children Referred for Aggressive and Antisocial Behavior

This article describes a clinical trial examining the effectiveness of an evidenced-based treatment enhancement developed to reduce stress in parents of children referred for aggressive and antisocial behaviors. Results suggest that such an enhancement can improve therapeutic outcomes for children, parents, and families.

To view the summary of this article, click here.

Exploring Violence Exposure, Stress, Protective Factors and Behavioral Problems among Inner-city Youth

Exposure to violence is a significant public health concern. Several studies have shown the adverse impact of violence on young people living in urban areas. Among the effects documented are anxiety, depression, and post-traumatic stress disorder. In this paper, the authors examine the relationship between risk factors including exposure to violence, potential protective factors (family support and self-concept), and behavioral problems among urban adolescents referred for mental health treatment.

To view the summary of this paper, click here.

Saturday Morning at the Jail: Implications of Incarceration for Families and Children

In this paper, the authors explore ways in which incarceration of a parent affects the family. While most current research focuses on the offender rather than the whole family, there is some evidence to indicate that having a parent in jail increases the risk of a range of negative outcomes for children. These include poor academic performance, alcohol and drug abuse, and involvement of children with the criminal justice system themselves. A better understanding of how families are affected by incarceration is particularly important issues in the context of significant growth in the prison population.

To view the summary of this paper, click here.

Depictions of Mental Illnesses in Children's Media

In this article, the author reviews research on the depiction of mental illness in children's media. Although one in four people seeking health services has one or more mental, neurological, or behavioral disorders, research shows that mental illness is still widely misunderstood among the general public.

To view the summary of this article, click here.

Fidelity Criteria: Development, Measurement, and Validation

In this review article, the authors discuss the use of fidelity criteria in mental health, education, and other human services, and outline the steps involved establishing fidelity criteria. These three steps are:

1. Identify critical intervention components and define measurable indicators for the components.

2. Collect the data to measure the indicators.

3. Examine the reliability and validity of the fidelity criteria.

To demonstrate how each of these steps has been addressed in fidelity studies, the authors review research literature from various fields including mental health, substance abuse treatment, education, and social services.

To view the summary of this article, click here.

Self-determination for Students with Disabilities: Views of Parents and Teachers

A primary goal of the President's New Freedom Commission on Mental Health is to transform the existing mental health system into one that provides meaningful choices and is consumer- and family-centered. Self-determination is also a central tenet in the broader field of disability studies. If self-determination is to become a reality for high school students with mental health and other disabilities, it is important to understand how parents and teachers perceive students' choices in the school setting.

To view the summary of this article, click here.