The Impact of COVID-19, Mental Health Distress, and School-Based Sociocultural Protective Factors among Elementary-Aged Children and their Caregivers.

Given the individual and systemic stress endured by children and families during the COVID-19 pandemic, research examining culturally responsive school experiences and supports to enhance resilience is critical. This study examined the relationship between caregivers' perceptions of COVID-19 impact, mental health distress among children and caregivers, and school-based sociocultural protective factors, including culturally responsive practices in schools and the relationships between teachers and caregivers, concurrently and longitudinally. Data were collected from caregivers of elementary-aged children at two-time points from March to April 2020 (N = 174) and one year later in 2021 (N = 114). Regression analyses revealed that COVID-19 impact positively predicted and parent-teacher joining negatively predicted mental health concerns among children and families, concurrently and longitudinally. Furthermore, there was a positive relationship between caregivers' perceptions of teachers' social awareness and justice practices and mental health symptoms for children in 2020. Parent-teacher joining longitudinally moderated the relationship between COVID-19 impact and caregivers' mental health concerns. This study provides implications regarding sociocultural resilience factors that should be considered in schools amidst the COVID-19 pandemic.

Surveillance of Plasmodium falciparum pfcrt haplotypes in southwestern uganda by high-resolution melt analysis.

BACKGROUND: Chloroquine (CQ) resistance is conferred by mutations in the Plasmodium falciparum CQ resistance transporter (pfcrt). Following CQ withdrawal for anti-malarial treatment, studies across malaria-endemic countries have shown a range of responses. In some areas, CQ sensitive parasites re-emerge, and in others, mutant haplotypes persist. Active surveillance of resistance mutations in clinical parasites is essential to inform treatment regimens; this effort requires fast, reliable, and cost-effective methods that work on a variety of sample types with reagents accessible in malaria-endemic countries. METHODS: Quantitative PCR followed by High-Resolution Melt (HRM) analysis was performed in a field setting to assess pfcrt mutations in two groups of clinical samples from Southwestern Uganda. Group 1 samples (119 in total) were collected in 2010 as predominantly Giemsa-stained slides; Group 2 samples (125 in total) were collected in 2015 as blood spots on filter paper. The Rotor-Gene Q instrument was utilized to assess the impact of different PCR-HRM reagent mixes and the detection of mixed haplotypes present in the clinical samples. Finally, the prevalence of the wild type (CVMNK) and resistant pfcrt haplotypes (CVIET and SVMNT) was evaluated in this understudied Southwestern region of Uganda. RESULTS: The sample source (i.e. Giemsa-stained slides or blood spots) and type of LCGreen-based reagent mixes did not impact the success of PCR-HRM. The detection limit of 10- 5 ng and the ability to identify mixed haplotypes as low as 10 % was similar to other HRM platforms. The CVIET haplotype predominated in the clinical samples (66 %, 162/244); however, there was a large regional variation between the sample groups (94 % CVIET in Group 1 and 44 % CVIET in Group 2). CONCLUSIONS: The HRM-based method exhibits the flexibility required to conduct reliable assessment of resistance alleles from various sample types generated during the clinical management of malaria. Large regional variations in CQ resistance haplotypes across Southwestern Uganda emphasizes the need for continued local parasite genotype assessment to inform anti-malarial treatment policies.

Assessing teachers' intervention-related expectations and self-efficacy: An examination of the factor structure of the implementation beliefs assessment.

Individual-level determinants are hypothesized to enable or prevent successful implementation of evidence-based practices, yet there are limited options for measuring theory-informed, individual-level determinants that influence teachers' and other implementers' delivery of school-based interventions. The goal of this study was to develop a self-report scale that measures variables that have been associated with initial and sustained behavior change related to school-based intervention implementation according to the health action process approach (HAPA). Participants were a nationally representative sample of kindergarten through Grade 12 public school teachers, stratified by grade level and geographical region. Item generation was based on a systematic review of the literature on outcome expectations and self-efficacy, the core constructs related to initiating and sustaining behavior change from the HAPA and in consultation with the theory developer. The sample was randomly split; half of the sample was used for exploratory factor analysis (EFA), and the other half was used for confirmatory factor analysis (CFA). The EFA resulted in a final factor structure of three dimensions of the Implementation Beliefs Assessment (IBA): (a) implementation self-efficacy, (b) positive outcome expectations, and (c) negative outcome expectations. This structure was supported in the other half of the sample using CFA. Additional analyses supported the reliability of IBA data. The IBA represents a step forward toward psychometrically sound measurement of factors associated with initial and sustained behavior change. Implications for future research are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Cardiovascular and behavioral response to auditory stimuli in boys with fragile X syndrome.

OBJECTIVE: The aim of this study was to determine whether young boys with fragile X syndrome (FXS) exhibit abnormal physiological or behavioral responses to a moderately intense auditory stimulus, as heightened sensory reactivity is believed to contribute to problem behaviors in this population. METHODS: We examined the physiological basis, via heart activity, of auditory startle in young boys with FXS (n = 22) compared with typically developing controls (n = 27). Associations with mental age, behavioral reactivity, and chronological age were examined. RESULTS: Results suggest that older boys with FXS display increased cardiac reactivity to auditory input than younger boys with FXS that distinguishes them from typically developing controls. Higher mental age was associated with decreased latency to react. CONCLUSIONS: Results contribute to increased understanding of the pathology in sensory processing in boys with FXS, which can inform refinement of the phenotype in young children with FXS and aid in the development of efficacious psychopharmacological and/or behavioral interventions.

Profiles of teachers' classroom management style: Differences in perceived school climate and professional characteristics.

Teachers are tasked with not only delivering high-quality, evidence-based academic instruction, but they are also responsible for managing student behavior within the classroom and school. To manage these behaviors, teachers can use a variety of strategies that result in a range of outcomes on student and school-wide functioning. Although an overreliance on punitive strategies has been shown to worsen behavior problems, positive strategies and social-emotional learning (SEL) techniques are associated with more favorable outcomes for students' global functioning. In a sample of K-12 teachers (N = 111), we examined direct associations between teachers' use of behavior management techniques (i.e., punitive, positive, and SEL) and their self-reports of perceived school climate. Furthermore, latent profile analysis was used to identify teachers' behavior management styles and evaluate whether teachers' characteristics and perceived school climate predicted behavior management style. Findings not only replicate previous research examining direct associations between behavior management techniques and school climate, but also extend the theoretical understanding of teachers' behavior management approaches. Three profiles of teacher behavior management style emerged, including a (a) Moderate Proactive profile characterized by frequent use of positive strategies and SEL techniques and infrequent use of punitive strategies; (b) Moderate Reactive/Proactive profile characterized by moderate use of both punitive strategies and positive strategies, as well as slightly lower use of SEL techniques; and (c) High Proactive profile characterized by very frequent use of positive strategies and SEL techniques and very infrequent use of punitive strategies. Use of these profiles may enhance understanding of how school psychologists can support teachers' behavior management practices through consultation or professional development to promote effective school and classroom behavior management practices.

Pilot Evaluation of the Elementary Social-Emotional Learning Program Sources of Strength.

Schools and students have faced a variety of challenges during the 2020-2021 academic year as the COVID-19 pandemic continues. These issues have drawn attention to the increased need for robust social-emotional learning skills at the elementary level to address the deficits exacerbated by the pandemic. Sources of Strength is an evidence-based suicide prevention program for middle and high school students. In 2020, Sources of Strength launched an elementary school curriculum focused on promoting protective factors and resilience. Data were collected across 11 elementary schools (N = 1022; 3-5th graders) in the Great Plains region of the USA at two time points during the COVID-19 pandemic (T1: Fall of 2020, T2: Spring of 2021). We examine the effectiveness of the program using a pre- and post-test design measuring various student social-emotional outcomes including positive classroom climate, emotional problems, school belonging, help-seeking attitudes, bullying perpetration, peer victimization, student and teacher intervention, student well-being, and student resilience. The program was evaluated using multilevel regression models to examine the associations between self-reported student program exposure and student outcomes. Although comparisons between T1 and T2 indicated a worsening of several student outcomes, positive associations were found when accounting for the degree of student exposure to the program. Greater student exposure was associated with improved positive classroom climate, school belonging, help-seeking attitudes, student well-being, resiliency, and lower reports of emotional problems. Implications for research and practice are discussed. Supplementary Information: The online version contains supplementary material available at 10.1007/s12310-023-09567-0.

A roadmap to equitable school mental health screening.

Youth in the United States are experiencing mental health concerns at alarming rates. Considering the nation's legacy of racism and growing recognition of the impact of social determinants of health on educational and mental health inequities, it is imperative to re-envision how we approach mental health screening in schools to center equity. A focus on mental health screening for the sole purpose of identifying individual at-risk students ignores key contextual considerations, is ineffective in addressing health and educational inequities, and has the potential to perpetuate oppressive practices in schools. Equity-focused mental health screening requires a shift from individual- and deficit-focused approaches to systems- and holistic-focused approaches that (a) identify strengths and stressors among individuals, groups, and communities; (b) dismantle structural forms of oppression; and (c) promote positive mental health outcomes for minoritized youth. Integrating recommendations from the educational equity literature and critical school mental health frameworks, this paper identifies core considerations for equitable school mental health screening and provides guiding principles for each phase of the screening process, from screening readiness to execution to follow up. To implement these recommendations and transform school-based mental health care, schools should (a) incorporate multiple perspectives; (b) prioritize student, family, and community voices; and (c) build collaborative partnerships to co-construct a vision for equitable school mental health.

Teachers, Stress, and the COVID-19 Pandemic: A Qualitative Analysis.

The 2020-2021 academic year brought numerous challenges to teachers across the country as they worked to educate students amidst the COVID-19 pandemic. The current study is a secondary data analysis of qualitative responses collected as part of a teacher survey to evaluate a social emotional learning curriculum implemented during the 2020-2021 academic year. The lived experiences of teachers (N = 52) across 11 elementary schools in the Great Plains region were captured through open-ended questions as the teachers transitioned from in-person to remote learning. A phenomenological approach was utilized to analyze the challenges expressed by teachers as they faced instability and additional professional demands. Given that stress and other factors that strain mental health exist within multiple layers of an individual's social ecology, a modified social-ecological framework was used to organize the results and themes. Findings suggest that during the academic year, teachers experienced stressors related to their personal and professional roles, concerns for students' well-being which extended beyond academics, and frustrations with administration and other institutional entities around COVID safety measures. Without adequate support and inclusion of teacher perspectives, job-related stress may lead to teacher shortages, deterioration of teacher mental health, and ultimately worse outcomes for students. Implications for policy, research, and practice are discussed. Supplementary Information: The online version contains supplementary material available at 10.1007/s12310-022-09533-2.

Treatment Seeking for Anxiety and Depression Among Black Adults: A Multilevel and Empirically Informed Psycho-Sociocultural Model.

Black adults with anxiety and/or depressive disorders underutilize outpatient psychotherapy and pharmacological treatment compared to White adults. Notably, anxiety and depressive disorders tend to be chronic and Black individuals with these disorders experience greater functional impairment than White individuals. Documented racial disparities in mental health treatment initiation indicate a need for research that addresses culture-specific barriers to treatment. This review paper critically evaluates existing theoretical models of treatment seeking among Black adults to inform a novel integrated, culturally contextualized model. This model extends previous ones by incorporating factors relevant to treatment seeking among Black adults (e.g., racial identity, perceived discrimination, medical mistrust) and critically examines how these factors intersect with key factors at three levels of influence of the treatment seeking process: the individual level, the community level, and the societal level. We posit interactions among factors at the three levels of influence and how these may impact treatment seeking decisions among Black adults. This model informs suggestions for enhancing interventions designed to support outpatient service use among Black adults.

Brief report: Web-based management of adolescent chronic pain: development and usability testing of an online family cognitive behavioral therapy program.

OBJECTIVES: This study evaluates the usability and feasibility of a Web-based intervention (Web-MAP) to deliver cognitive behavioral therapy (CBT) to adolescents with chronic pain and their parents. METHODS: The Web site was evaluated in two stages. In stage one, recovered adolescents and parents (n = 5 dyads), who had completed office-based CBT through a pediatric pain management clinic, completed ratings of Web site content, usability, appearance, and theme. In stage two, treatment-seeking adolescents and their parents (n = 6 dyads) completed the full-length Web program. Program usage data were obtained to assess interaction with the Web site. RESULTS: Participants rated moderate to strong acceptability of the program. Usage data indicated that participants interacted with the site and used communication features. CONCLUSIONS: Feedback from usability testing provided important information in the process of designing a feasible Web-based treatment for adolescents with chronic pain for use in a randomized controlled trial.

Trajectories and predictors of the development of very young boys with fragile X syndrome.

OBJECTIVE: To describe the development of young boys with fragile X syndrome (FXS). METHODS: Fifty-five boys (aged 8-48 months at study entry) with the full mutation FXS received multiple developmental assessments. RESULTS: As expected, the boys' rate of development was significantly lower than chronological age expectations. No evidence of slowing in the rate of development was found. Autistic behavior was negatively associated with development, but maternal IQ was not. Developmental delays were evident in some domains as early as 9 months; however, initial detection of delays is complicated by measures and criteria used. Developmental age scores at 31 months of age were related to scores obtained at 61 months of age only in the global composite and visual reception domain. CONCLUSIONS: Developmental delays are evident in some infants with FXS as young as 9 months of age. Pediatric psychologists need to be informed about the developmental profiles in young children with FXS to accurately diagnose, treat, and support these children and their families.

Classroom management for ethnic-racial minority students: A meta-analysis of single-case design studies.

Diversification trends of U.S. schools make clear the need for evidence-based practices supporting ethnically-racially diverse students. Yet, there are significant hindrances to readily identifying and summarizing findings generated from diverse classroom contexts. The current meta-analytic review was designed to address this gap in the classroom management literature. This review includes single-case design studies conducted in majority ethnic-racial minority classrooms (≥50%) that included a direct comparison of baseline to treatment for behavior management strategies implemented at the whole class level. A total of 22 studies spanning from 1973 to 2014 met eligibility criteria for this review, including 838 students and 46 K-12 classrooms. Results indicate that classwide management approaches applied in diverse classrooms are heavily behavioral and highly effective in improving student behavior (Mτ = |.92|, MHedges's g = 2.52). Overall, interventions that included an individual or group contingency consistently demonstrated large effects and were the most frequently used strategies. However, other interventions displayed comparably high results but were less frequently studied. Findings further revealed significant gaps in the quality and diversity of research completed to date. Specifically, half of the studies did not include cases that met What Works Clearinghouse design standards for demonstrating methodological rigor. There were also few studies that included minority populations other than African American, and there was limited variation in educational settings and intervention designs. Of some concern was the heightened frequency of response cost procedures included in interventions for diverse classrooms, possibly running counter to recommendations that emphasize reinforcement-based strategies. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Brief report: using actigraphy to compare physical activity levels in adolescents with chronic pain and healthy adolescents.

OBJECTIVES: This study compared activity levels of adolescents with chronic pain and healthy adolescents, and investigated relations between actigraphy and subjective measures of activity limitations and depression. METHODS: Forty adolescents (n = 20 with chronic pain, n = 20 otherwise healthy; 12-17 years; 72.5% females) participated. Adolescents completed questionnaires regarding pain, activity limitations, and depression. Activity levels were assessed for 7 days using the Actiwatch 64 device, yielding mean and peak activity levels, and time spent in moderate and sedentary activity. RESULTS: Physical activity was lower in adolescents with chronic pain than in healthy peers. Adolescents with chronic pain reported significantly higher levels of activity limitations and depression. Age and gender were related to activity. Higher activity was inversely correlated with pain frequency and depression. Peak activity was also significantly inversely related to self-reported pain intensity and activity limitations. CONCLUSIONS: Actigraphy may be useful for examining physical activity outcomes in adolescents with chronic pain.

Evidence-based assessment of health-related quality of life and functional impairment in pediatric psychology.

OBJECTIVE: To provide an evidence-based review of measures of health-related quality of life (HRQOL) and functional impairment, with a specific focus on their use in the field of pediatric psychology. METHODS: As part of a larger survey of pediatric psychologists from the Society of Pediatric Psychology e-mail listserv (American Psychological Association, APA, Division 54), 16 measures were selected for this psychometric review. Measures that qualified for the review fell into one of the following three categories: (a) generic HRQOL scales, (b) disease-specific quality of life scales, and (c) functional impairment rating scales. RESULTS: Psychometric characteristics (i.e., three types of reliability, two types of validity) were strong for the majority of measures reviewed, with 12 of the 16 measures meeting "well-established" evidence-based assessment criteria. Strengths and weaknesses of existing measures were noted. CONCLUSIONS: Recommendations for future work in this area of assessment are presented, including suggestions that further validation and exploration of measure properties such as factor analysis and changes in HRQOL over time be conducted.

Effortful control as a moderator of the relation between contextual risk factors and growth in adjustment problems.

Effortful control was examined as a moderator of the relations of three domains of contextual risk factors to growth in internalizing and externalizing problems in a community sample (N = 189) of children (8-12 years at Time 1). Socioeconomic, maternal, and environmental risk factors were examined as predictors of initial levels and growth in children's adjustment problems across 3 years. The effects of the risk factors depended on children's level of effortful control. For children lower in effortful control, socioeconomic risk was related to significantly higher initial levels of internalizing and externalizing problems and decreases over time. However, children lower in effortful control had higher levels of problems at all three time points than children higher in effortful control. Maternal risk was associated with increases in internalizing for children lower in effortful control, and environmental risk was related to increases in internalizing and externalizing problems for children lower in effortful control, but not those higher in effortful control. Children who were lower in effortful control appeared to experience more adverse effects of contextual risk than those higher in effortful control, suggesting that interventions aimed at improving children's effortful control might serve to protect children from increased risk of adjustment problems associated with contextual risk factors.

The Influence of Race and Income on Community Mothers' Acceptance of Child Management Methods.

The consideration of diverse family factors on parents' acceptance of behavioral parent training (BPT) components aids in the development and delivery of culturally sensitive parenting programs. Perceptions of acceptability are particularly important to investigate among low-income and racial-minority families, as they are less likely to engage in nonadapted BPT programs. Therefore, the current study examines the synergistic effects of race and income on mothers' acceptance of five common child management methods relevant to BPT. The relationship between mothers' acceptability ratings and self-reported parenting practices was also explored. Participants were 106 White and Black mothers from different income levels who completed measures related to the acceptability of response cost, positive reinforcement, time-out, spanking, and medication. The results indicated that mothers from varying backgrounds differed in their acceptance of child management methods, particularly with regard to corporal punishment. Additionally, a relationship was found between parents' acceptability ratings and their self-reported parenting behavior. The findings support the consideration of parents' perceptions of child discipline methods when recommending and delivering BPT programs to diverse parents.

Willingness to Seek Treatment Among Black Students With Anxiety or Depression: The Synergistic Effect of Sociocultural Factors With Symptom Severity and Intolerance of Uncertainty.

Anxiety and depressive disorders are among the most commonly diagnosed psychiatric disorders, yet they remain largely undertreated in the U.S. and Black adults are especially unlikely to seek or receive mental health services. Symptom severity has been found to impact treatment-seeking behaviors as have sociocultural factors. Yet no known research has tested whether these factors work synergistically to effect willingness to seek treatment. Further, emerging data point to the importance of transdiagnostic risk factors such as intolerance of uncertainty (IU). IU may be negatively related to seeking treatment given that Black adults may be uncertain whether treatment might benefit them. Thus, the current study examined the relations between symptom severity/IU and willingness to seek treatment for anxiety/depression problems and the impact of key sociocultural variables (i.e., cultural mistrust-interpersonal relations [CMI-IR], perceived discrimination [PED]) on these relations among 161 (85% female) Black undergraduates. Consistent with prediction, symptom severity was positively related to willingness, but unexpectedly, IU was positively related. There was a significant Symptom Severity × CMI-IR interaction such that severity was positively related to willingness among students with lower cultural mistrust, but not higher mistrust. There were also significant IU × PED interaction such that IU was positively related to willingness among students with lower PED, but not higher PED. Results highlight the importance of considering the interplay between symptom severity, transdiagnostic vulnerability factors, and sociocultural variables when striving to identify factors related to treatment seeking behaviors among anxious and/or depressed Black students.

An exploratory investigation of teachers' intervention planning and perceived implementation barriers.

Increasingly teachers are the primary implementer responsible for providing evidence-based interventions to students. However, there is little knowledge regarding the extent to which teachers plan for intervention implementation, receive implementation support, or identify and address implementation barriers. This study explores survey data from over 1200 preschool through grade 12 teachers from 46 public school districts in a Northeastern state. Results indicate that teachers spend significant time engaging in intervention-related behavior and may be a primary source responsible for selecting student interventions. However, the current extent to which they plan for implementation and present levels of implementation support are inadequate to produce high levels of sustained intervention implementation. In addition, almost 60% of implementation barriers reported related to aspects of the intervention itself. Findings from this study provide guidance for future research and preliminary recommendations for ameliorating implementation barriers and proactively supporting treatment integrity in schools.

Assessing adolescents' positive psychological functioning at school: Development and validation of the Student Subjective Wellbeing Questionnaire.

This study reports on the initial development and validation of the Student Subjective Wellbeing Questionnaire (SSWQ) with a sample of 1,002 students in Grades 6-8. The SSWQ is a 16-item self-report instrument for assessing youths' subjective wellbeing at school, which is operationalized via 4 subscales measuring school connectedness, academic efficacy, joy of learning, and educational purpose. The conceptualization and development of the SSWQ's subscales and items are described, and results from a series of preliminary psychometric analyses are reported. Findings indicated that the SSWQ was characterized by 4 conceptually sound latent factors, that these 4 first-order factors were robust indicators of a single second-order factor (i.e., student subjective wellbeing), that all subscales and the composite scale demonstrated at least adequate construct reliability and internal consistency, and that the estimated latent-means for all first-order and second-order factors were invariant across gender. Moreover, results from bivariate correlations and a latent-variable path analysis provided evidence in support of the construct validity of the SSWQ's scales and latent factors, showing strong associations with other student wellbeing indicators (i.e., school prosociality and academic perseverance), while findings from binary logistic regressions demonstrated that overall student subjective wellbeing levels, based on composite scores from the SSWQ, were mildly to-strongly associated with a variety of self-endorsed risk factors (e.g., aggression and self-harm) and protective factors (e.g., social support and physical exercise). Implications for theory, research, and the practice of school psychology are discussed.

Assessing teachers' positive psychological functioning at work: Development and validation of the Teacher Subjective Wellbeing Questionnaire.

This study reports on the initial development and validation of the Teacher Subjective Wellbeing Questionnaire (TSWQ) with 2 samples of educators-a general sample of 185 elementary and middle school teachers, and a target sample of 21 elementary school teachers experiencing classroom management challenges. The TSWQ is an 8-item self-report instrument for assessing teachers' subjective wellbeing, which is operationalized via subscales measuring school connectedness and teaching efficacy. The conceptualization and development processes underlying the TSWQ are described, and results from a series of preliminary psychometric and exploratory analyses are reported to establish initial construct validity. Findings indicated that the TSWQ was characterized by 2 conceptually sound latent factors, that both subscales and the composite scale demonstrated strong internal consistency, and that all scales demonstrated convergent validity with self-reported school supports and divergent validity with self-reported stress and emotional burnout. Furthermore, results indicated that TSWQ scores did not differ according to teachers' school level (i.e., elementary vs. middle), but that they did differ according to unique school environment (e.g., 1 middle school vs. another middle school) and teacher stressors (i.e., general teachers vs. teachers experiencing classroom management challenges). Results also indicated that, for teachers experiencing classroom challenges, the TSWQ had strong short-term predictive validity for psychological distress, accounting for approximately half of the variance in teacher stress and emotional burnout. Implications for theory, research, and the practice of school psychology are discussed.