Schools as a Source of Mental Health Literacy: Adjusting and Validating a Mental Health Literacy Scale.

Over the last decade, there has been a growing interest in mental health literacy (MHL) in health promotion, largely motivated by increased awareness of MHL as a modifiable determinant of mental health. Accordingly, MHL has been associated with the health-promoting school approach emerging over the last 20 years. To succeed in promoting MHL, it is of vast importance to evaluate working strategies and interventions to address MHL using validated instruments. The current study describes the revision and psychometric testing of a modified version of the 10-item adolescents' positive MHL measure, the MHPK-10, the only identified instrument measuring adolescents' positive MHL. The MHPK-10 was adjusted to address the previously documented ceiling effects and was further optimized for use in schools by reworking it to measure learning rather than self-reported knowledge, becoming the new nine-item Mental Health Learning Scale (MHLS-9). The MHLS-9 was tested on a national sample of N = 2,012 Norwegian ninth graders. Data were analyzed by confirmatory factor analysis (CFA) and tests of reliability and validity. The revised CFA model for the MHLS-9 showed an improved fit over the original CFA model for the MHPK-10. The MHLS-9s' CFA model revealed excellent factor determinacy (.95) and scale reliability (ω = .91). Thus, the MHLS-9 is an improved measure for the positive component of MHL for use in school settings, enabling researchers and practitioners to evaluate and focus positive MHL interventions in schools using a short, reliable, and valid measure for adolescents' learning about the factors promoting good mental health.

Three Randomized Effectiveness Trials - One Question: Can Callous-Unemotional Traits in Children Be Altered?

Children with conduct problems and callous-unemotional (CU) traits are at risk for multiple problems. Outcome research and mediation analyses testing for mechanisms of change in CU traits have been limited. We examined whether parent training-in a short-term (Brief Parent Training; BPT) or a comprehensive format (Parent Management Training, Oregon Model; PMTO)-or child-directed social skills training (Individual Social Skills Training [ISST]) produced positive effects on CU traits. In mediation models we tested parenting practices as mechanisms of change for CU traits. We pooled data from three randomized effectiveness trials, and 551 families were included in this study. Families had children between 3 and 12 years of age and displayed emerging or present conduct problems at home, day care, or school (BPT M age = 7.28, 31.9% girls; PMTO M age = 8.56, 36.5% girls; ISST M age = 7.64, 19.7% girls). Assessments were completed preintervention, postintervention, and at follow-up (6 months following intervention). Both BPT (d = .32) and PMTO (d = .39) had positive effects on CU traits at posttest, whereas ISST did not (d = -.06). At follow-up, only PMTO produced a significant effect (d = .48) on CU traits. A significant indirect effect on CU traits emerged by positive parenting. Both parent training conditions outperformed ISST. Only PMTO maintained its effects at follow-up. The findings suggest that PMTO can reduce CU traits and that improved positive parenting is associated with positive outcomes for children's CU traits.

Maternal mental distress influences child outcomes in brief parent training.

BACKGROUND: Brief Parent Training (BPT) promotes effective parenting in parents of children with conduct problems. As previous research has provided inconsistent results, this study explored the impact of maternal mental distress on outcomes of BPT. METHOD: Participants included 216 families randomized to BPT or a comparison group. RESULTS: Maternal distress negatively predicted five of eight outcomes, regardless of intervention allocation. Low-maternal distress predicted lower conduct problems (parent- and teacher-reported), whereas high distress predicted higher teacher-reported conduct problems in BPT relative to comparisons. CONCLUSIONS: Refinement of interventions to help children with conduct problems and distressed mothers should be prioritized.

Functional family therapy for adolescent disruptive behavior in Norway: Results from a randomized controlled trial.

Disruptive behavior during adolescence is linked to severe problems for the youths later in life and poses challenges to the families, schools, and treatment systems these youths meet. This randomized controlled trial was conducted to examine the short- and long-term effectiveness of functional family therapy (FFT) for adolescents aged 11-17 referred for disruptive behavior to Child Welfare Services in Norway. One hundred sixty-one youths (Mage = 14.7, 45.9% female) were randomly assigned to FFT (n = 88) or treatment as usual (TAU, n = 73). Primary outcomes were parent- and teacher-reported youth aggressive behavior, rule-breaking behavior, internalizing problems, and social skills; youth self-reported delinquency (SRD) and negative peer involvement; and teacher-reported academic performance and adaptive functioning. Outcomes were collected before treatment (pretest), 6 months after pretest (posttest), and 18 months after pretest (follow-up). The results showed no intervention effect for FFT compared to TAU between pretest and posttest (p > .05). Significant improvements between pretest and posttest were found for youth receiving both FFT and TAU on parent-reported aggressive and rule-breaking behavior, internalizing problems, and social skills (ranging from d = 0.56 to -0.45) and youth SRD (d = 0.29). Between posttest and follow-up, however, a significant intervention effect in favor of TAU was found for parent-reported youth internalizing (d = 0.27). Significant improvements between posttest and follow-up were also found for youth receiving both FFT and TAU on parent- and teacher-reported aggressive behavior. Findings did not support the hypothesized superiority of FFT over TAU. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Achievement motives, self-efficacy, achievement goals, and academic achievement at multiple stages of education: a longitudinal analysis.

The present study investigated the joint effects of achievement motives, self-efficacy, and achievement goals as predictors of subsequent academic achievement among educational science students. A longitudinal research design allowed for measurement of motivational variables at several stages of education during bachelor courses (subsequent to the introductory courses), firstly by measuring achievement motives, secondly by self-efficacy and achievement goals. Subsequently, students' academic achievement level was measured at four different points in time, until they finished the last course for their bachelor degrees. A multivariate path analysis showed consistent relations between the motivational variables. The motive to avoid failure positively predicted the adoption of avoidance goals (both mastery and performance) and negatively predicted self-efficacy. Academic achievement was mainly predicted by the motive for success and performance-avoidance goals. The path analysis also showed strong relationships between the examination grades at different points in time.

Validation of a motivation-based typology of angry aggression among antisocial youths in Norway.

This article describes the validation of the Angry Aggression Scales (AAS), the Behavior Inhibition System and the Behavior Activation System (BIS/BAS) scales, the reactive aggression and proactive power scales in relation to a Norwegian sample of 101 antisocial youths with conduct problems (64 boys, 37 girls, mean age 15 ± 1.3 years) and 101 prosocial controls matched on age, gender, education, ethnicity, and school district. Maximum likelihood exploratory factor analyses with oblique rotation were performed on AAS, BIS/BAS, reactive aggression and proactive power scales as well as computation of Cronbach's alpha and McDonald's omega. Tests for normality and homogeneity of variance were acceptable. Factor analyses of AAS and the proactive/reactive aggression scales suggested a hierarchical structure comprising a single higher-order angry aggression (AA) factor and four and two lower-order factors, respectively. Moreover, results suggested one BIS factor and a single higher-order BAS factor with three lower-order factors related to drive, fun-seeking and reward responsiveness. To compare scores of antisocial youths with controls, t-tests on the mean scale scores were computed. Results confirmed that antisocial youths were different from controls on the above-mentioned scales. Consistent with the idea that anger is associated with approach motivation, AAS scores correlated with behavioral activation, but only explosive/reactive and vengeful/ruminative AA correlated with behavioral inhibition. Results generally validated the quadruple typology of aggression and violence proposed by Howard (2009).

Treatment outcomes and mediators of parent management training: a one-year follow-up of children with conduct problems.

This effectiveness study presents the results of a 1-year follow-up of a randomized controlled trial of Parent Management Training. Families of 112 Norwegian girls and boys with clinic-level conduct problems participated, and 75 (67%) families were retained at follow-up. Children ranged in age from 4 to 12 at intake (M = 8.44). Families randomized to the control group received an active treatment alternative as would be normally offered by participating agencies. Multi-informant, multisetting outcome measures were collected and results from both intention-to-treat and treatment-on-the-treated analyses are presented. In two separate indirect effects models, assignment to Parent Management Training-the Oregon model predicted greater effective discipline and family cohesion at postassessment, which in turn predicted improvements in several child domains at follow-up.

Possible Interventions for Preventing the Development of Psychopathic Traits among Children and Adolescents?

Individuals with the combination of psychopathy and severe conduct disorder often get in a lot of trouble from their early childhood, and can cause great suffering and problems for other people and their immediate environment. Their antisocial behaviour has a tendency to develop into a chronic pattern early in life, and the treatment prognosis in adulthood is poor. A large proportion of serious violent crimes in society can be attributed to this group of perpetrators. Until recently, it has been unclear whether traits of this type can be prevented or changed, so that these individuals and their surroundings can benefit from targeted treatments at an early stage. To reduce serious crime in a society, it is very important to develop effective measures for this particular group. A lack of empathy, indifference to others, and a lack of concern about their own performance appear to be key early signs in children and adolescents with persistent behavioural problems and more serious norm violations who continue into a criminal career upon reaching adulthood. These characteristics have been termed callous-unemotional (CU) traits, and they are considered to be a precursor to psychopathic traits in adulthood. In recent years, several studies have evaluated the degree to which treatments that have been proved effective for children and adolescents with severe behavioural problems also show effectiveness for children and adolescents with CU traits. Interventions specifically tailored to children with CU traits have also been developed with the aim of directly changing the ongoing development of this precursor to psychopathy. In this paper, we will address the extent to which current evidence-based treatment methods developed for children and adolescents with behavioural difficulties are equally effective when a child has CU traits. We will also take a closer look at the effects of interventions designed to change this trait. There will be a discussion regarding what seems relevant for a change in the trait itself, as well as a change in their antisocial behaviour.

Callous-Unemotional Traits Do Not Predict Functional Family Therapy Outcomes for Adolescents With Behavior Problems.

Despite the availability of evidence-based treatment models for adolescent behavior problems, little is known about the effectiveness of these programs for adolescents with callous-unemotional (CU) traits. Defined by lack of empathy, lack of guilt, flattened affect and lack of caring, CU traits have been linked to long-term anti-social behavior and unfavorable treatment outcomes and might be negatively related to outcomes in evidence-based programs such as Functional Family Therapy (FFT). This study used a single-group pre-post evaluation design with a sample of 407 adolescents (49.1% female, mean age = 14.4 years, SD = 1.9) receiving FFT to investigate whether outcomes in FFT are predicted by CU traits and to what extent reliable changes in CU traits can be observed. The results showed that although CU traits are related to increased problem severity at baseline, they predicted neither treatment dropout nor post-treatment externalizing behavior and family functioning. CU traits were related to diminished improvement ratings, in particular with respect to parental supervision. Reductions in CU traits were observed across the time of treatment, and these were most profound among adolescents with elevated levels of CU traits at baseline. Further research should investigate whether certain evidence-based treatment components are more suited for adolescents with CU, and if the addition of specific intervention elements for reducing CU-traits could further improve outcomes for this high-risk population.

Future time orientation and temperament: exploration of their relationship to primary and secondary psychopathy.

The present study combines Lykken's theory about the role of reward sensitivity and punishment insensitivity in the development of antisocial behavior with Gjesme's theory of future time orientation. 158 adolescents comprised a target group of 79 adolescents who had defined behavioral problems and a matched referential group of 79 adolescents who did not have notable behavioral problems. The results suggest that attributes related to primary psychopathy are associated with a relatively weak or hyporeactive behavioral inhibition system, behavioral approach reactivity, and low future time orientation. Moreover, attributes related to secondary psychopathy are related to an overly sensitive (hyper-reactive) behavioral approach system and low future time orientation. Robust positive associations for behavioral approach reactivity and low future time orientation with primary and secondary psychopathy suggest that high behavioral approach/low future time orientation may represent a core feature common to the two factors of psychopathy.

Motivation and temporal distance: effect on cognitive and affective manifestations.

The implications of temporal distance on motivation-related concepts were examined. The results of an experiment, based on 585 Grade 6 students, indicated that both positive (approach) and negative (avoidance) motivation increased as the future goal or event approached in time. This increase in approach and avoidance motivation influenced the performance of the pupils differently. For pupils with success orientation, the performance increased. For pupils with failure orientation, the performance remained about the same.

Observed callousness as a predictor of treatment outcomes in parent management training.

BACKGROUND: The goal of this study was to examine how observed Callous-Unemotional (CU) behavior influenced change in externalized and internalized problems, hyperactivity, social competence, and treatment satisfaction following parent management training. METHODS: Three hundred twenty-three children and their families received Parent Management Training-the Oregon model (PMTO). They were compared at intake and after treatment in order to examine differences in 14 treatment outcomes using hierarchical regression analyses. RESULTS: Children with low levels of observed CU showed the greatest gains after PMTO treatment. This was evident in parent, therapist, self, and teacher reports. CONCLUSIONS: The results indicate that it is possible to observe CU behavior among children with conduct problems, and that children with elevated levels of observed CU behavior may be in need of additional treatment or components of treatment or more intense versions of parent management treatment.

Children With Conduct Problems and Co-occurring ADHD: Behavioral Improvements Following Parent Management Training.

To scale up evidence-based treatment of conduct problems, parent management training, Oregon model (PMTO) has been disseminated throughout Norway. This study examined whether Attention Deficit Hyperactivity Disorder (ADHD) predicted the outcomes of PMTO. Of 253 children and families, 97 were reported to have an ADHD diagnosis. Although different at intake, the groups with and without ADHD had close to an equal change in behavioral status following treatment. Maternal depression and family income predicted the combined group's behavior following PMTO. The study indicates that reductions in conduct problems following PMTO are of the same magnitude in children with or without ADHD. However, some characteristics may differentially predict outcomes for children with combined problems.

Self-determined motivational predictors of increases in dental behaviors, decreases in dental plaque, and improvement in oral health: a randomized clinical trial.

OBJECTIVE: The present study tested the hypotheses that: (a) a dental intervention designed to promote dental care competence in an autonomy-supportive way, relative to standard care, would positively predict perceived clinician autonomy support and patient autonomous motivation for the project, increases in autonomous motivation for dental home care, perceived dental competence, and dental behaviors, and decreases in both dental plaque and gingivitis over 5.5 months; and (b) the self-determination theory process model with the intervention and individual differences in autonomy orientation positively predicting project autonomous motivation and increases in perceived dental competence, both of which would be associated with increases in dental behavior, which would, in turn, lead to decreased plaque and gingivitis. METHODS: A randomized two-group experiment was conducted at a dental clinic with 141 patients (Mage = 23.31 years, SD = 3.5), with pre- and postmeasures (after 5.5 months) of motivation variables, dental behaviors, dental plaque, and gingivitis. RESULTS: Overall, the experimental and hypothesized process models received strong support. The effect sizes were moderate for dental behavior, large for autonomous motivation for the project and perceived competence, and very large for perceived autonomy support, dental plaque, and gingivitis. A structural equation model supported the hypothesized process model. CONCLUSIONS: Considering the very large effects on reductions in dental plaque and gingivitis, promoting dental care competence in an autonomy-supportive way, relative to standard care, has important practical implications for dental treatment, home care, and health.

Measurement of implementation components ten years after a nationwide introduction of empirically supported programs--a pilot study.

BACKGROUND: Ten years after the nationwide dissemination of two evidence-based treatment programs, the status of the implementation components was evaluated in a cross-sectional study. The aim of the study was to pilot a standardized measure of implementation components by examining the factor structure, the reliabilities of the scores, and their association with implementation outcome variables. The aim was also to compare implementation profiles of the two evidence-based programs based on multi informant assessments. METHODS: The 218 participants in the study were therapists, supervisors, and agency leaders working with Parent Management Training, the Oregon model (PMTO), and Multisystemic Therapy (MST) in Norway. Interviewers filled in an electronic version of the Implementation Components Questionnaire during a telephone interview. RESULTS: The factor analysis of the eight one-dimensional subscales resulted in an individual clinical-level factor and an organizational system-level factor. Age, experience, and number of colleagues in the workplace were negatively correlated with positive ratings of the implementation process, but the number of colleagues working with the same program predicted positive ratings. MST and PMTO had different implementation profiles and therapists, supervisors, and managers evaluated some of the implementation drivers significantly differently. CONCLUSIONS: The psychometric quality of the questionnaire was supported by measures of internal consistency, factor analyses of the implementation components, and the comparisons of implementation profiles between programs and respondent groups. A moderate, but consistent association in the expected direction was found with the implementation outcome variables.

Achievement motives and emotional processes in children during problem-solving: Two experimental studies of their relation to performance in different achievement goal conditions.

In two studies, the influence of key emotional and motivational factors on performance in different achievement goal-type situations is examined. In study 1, based on 314 sixth-graders, two types of goal situations were induced; performance and mastery. The goals were examined with respect to important antecedents (e.g., motive dispositions) and several consequences (e.g., performance, satisfaction, pleasant affect, worry, and emotionality). The results showed that the motive to achieve success (M(s)) produced positive affects, satisfaction, and increased performance, whereas the motive to avoid failure (M(f)) produced worries and performance reduction. In study 2, based on 331 sixth-graders, three types of goal situations were induced; performance-approach, performance-avoidance, and mastery goals. The findings revealed that the most important single factors positively related to performance were M(s) and mastery-goal situation. In addition, high M(s) pupils performed better under mastery condition than under performance condition. Finally, avoidance-goal situation accentuate the negative effects of high M(f) on performance.