Validation of a classification system of obsessive-compulsive spectrum disorder symptoms in a non-clinical sample.

Controversy surrounds the classification of obsessive-compulsive spectrum disorder (OCSD) symptoms. In this study, we tested whether a broad OCSD symptoms model consisting of obsessive-compulsive, body dysmorphic, health anxiety, trichotillomania, pathological skin picking, impulsivity, and anxiety symptoms displayed sufficient data fit. Alternatively, we tested whether a reduced OCSD symptoms model consisting of obsessive-compulsive, body dysmorphic, health anxiety, trichotillomania, and pathological skin picking symptoms demonstrated superior fit. The reduced OCSD symptoms model demonstrated good data fit. However, the broader OCSD symptoms model only displayed marginal data fit. In context with other findings, results of this study support an OCSD symptoms dimension that includes obsessive-compulsive, body dysmorphic, health anxiety, trichotillomania, and pathological skin picking symptoms. Implications of these findings are discussed as they relate to proposed changes in the forthcoming edition of the Diagnostic and Statistical Manual.

The COVID-19 pandemic as a long-term school crisis: Impact, risk, resilience, and crisis management.

The coronavirus disease 2019 (COVID-19) pandemic presents school communities across the United States and world with an unpresented challenge. Virtually, all members of school communities have been impacted and the long-term ramifications of the pandemic remain unknown. However, despite being a novel virus, crisis management practices for other crisis (e.g., natural disasters, technological disasters, unexpected deaths) have utility for school safety promotion and helping affected individuals cope effectively with the monumental challenges they face during the pandemic. Such practices can reduce risk while fostering resilience concomitantly. This special issue, Perspectives on COVID-19: Addressing Diverse Needs of Children, Youth, Families, Educators, and Human Service Professionals, includes a diverse collection of conceptual, quantitative, and qualitative articles addressing the impact of COVID-19 pandemic on youth and their families, educators, allied human services professionals, and the systems in which they work. Consistent with a crisis management and risk and resilience perspectives, articles emphasize youth most vulnerable to the impact of COVID-19, including youth with disabilities, from minoritized backgrounds, and within underserved populations. Articles also have implications for coping, resilience, and intervention and focus on how service delivery can best meet the needs of those impacted by acute and chronic crisis events. The research and scholarship included in this special issue represents an important step forward with providing school psychologists and related professions with cutting-edge information that can help enhance their practice during the COVID-19 pandemic and beyond. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

When exposures go wrong: troubleshooting guidelines for managing difficult scenarios that arise in exposure-based treatment for obsessive-compulsive disorder.

Cognitive-behavioral therapy (CBT) with exposure and ritual prevention (ERP) is widely accepted as the most effective psychological treatment for obsessive compulsive disorder (OCD). However, the extant literature and treatment manuals cannot fully address all the variations in client presentation, the diversity of ERP tasks, and how to negotiate the inevitable therapeutic challenges that may occur. Within this article, we attempt to address common difficulties encountered by therapists employing exposure-based therapy in areas related to: 1) when clients fail to habituate to their anxiety, 2) when clients misjudge how much anxiety an exposure will actually cause, 3) when incidental exposures happen in session, 4) when mental or covert rituals interfere with treatment, and 5) when clients demonstrate exceptionally high sensitivities to anxiety. The goal of this paper is to bridge the gap between treatment theory and practical implementation issues encountered by therapists providing CBT for OCD.

The Affective Lives of Doubled-Up Latinx Youth: Influences of School Experiences, Familism, and Ethnic Identity Exploration.

Doubled-up Latinx youth experience many daily challenges associated with ethnic minority status and residential instability. Doubled-up youth share housing with non-custodial caregivers such as friends and/or extended family members primarily because of economic hardship and a breakdown in available parental support. Using data from baseline and 10 days of twice-a-day surveys, this study examined how in-school positive experiences, familism (i.e., a perspective that gives precedence to the family), and ethnic identity (i.e. affirmation, exploration, and resolution) influence after school positive (e.g. feeling joyful/happy) and negative (e.g., feeling stressed/anxious) affect among doubled up Latinx youth (70% female; M age = 16.5). Results indicate that in-school positive experiences were associated with more after school positive affect and less after school negative affect. Additionally, youth with higher levels of familism reported experiencing less after school negative affect. However, gender moderated the relation of ethnic identity exploration and experiences of after school positive affect. Specifically, females with higher levels of ethnic identity exploration reported relatively lower levels of after school positive affect compared to males. Overall, study findings highlight the importance of both person-level and varying contextual influences on the affective lives of doubled-up Latinx youth.

Hairstylists' experience with chronic hair pulling.

This study examined 88 hairstylists' awareness, exposure, and perceptions about treatment for people with trichotillomania (TTM). We investigated the influence of hairstylists' obtained educational level, years of experience, and understanding of TTM in relation to their willingness to refer clients for mental health treatment. Results indicate that hairstylists notice hair loss and discussed this with their clients. Hairstylists generally reported a favorable opinion of psychotherapy and a willingness to refer clients to mental health professionals. No measured variables (e.g. experience, education, or awareness of TTM) predicted willingness to refer clients for treatment. Overall, the results from this study suggest that hairstylists may aid in the early identification of TTM symptoms, particularly for females because a greater proportion of clients seen by hairstylists are females and females more commonly present with symptoms of TTM.

Daily social and affective lives of homeless youth: What is the role of teacher and peer social support?

Youth spend a significant amount of time in school surrounded by and interacting with teachers and peers. For doubled-up homeless youth (i.e., youth who share housing with a series of friends and/or extended family members), in-school relationships may be important for their emotional functioning. The current study captured dynamic processes by which in-school teacher and peer social support (i.e., baseline assessments of prior support and daily early-day reports of school day support) influence homeless youth's daily emotional well-being, as assessed by positive and negative affect later in the day. Specifically, a baseline survey was used in combination with a 10-day twice-a-day diary design to examine the competing influences of prior (i.e., between-person) and daily (i.e., within-person) social support from teachers and peers during the school day. Baseline teacher support and early-day peer support were associated with higher later-day positive affect. In contrast, baseline peer support was associated with lower later-day negative affect. Baseline peer support moderated the association between early-day peer support and later-day positive affect, in that there was a significant effect of early-day peer support and later-day positive affect for youth who reported medium and high levels of baseline peer support. However, the later-day positive affect of youth who reported low baseline levels of social support did not appear to benefit from early-day peer support. Results suggest that the source of support (i.e., teacher and peer) differently influences daily affect and that receiving daily in-school support can promote daily positive affect while mitigating negative affect for doubled-up homeless youth. Overall, study findings suggest that providing peer and teacher social support is a promising prevention and intervention approach for fostering resilience among doubled-up homeless youth.

Concurrent validity of the Yale-Brown Obsessive-Compulsive Scale-Symptom Checklist.

Despite the frequent use of the Yale-Brown Obsessive-Compulsive Scale-Symptom Checklist (Y-BOCS-SC; Goodman et al., 1989a) and the Obsessive-Compulsive Inventory-Revised (OCI-R; Foa et al., 2002), there are limited data on the psychometric properties of the two instruments. In the present research, clinician ratings on the Y-BOCS-SC for 112 patients with obsessive-compulsive disorder (OCD) were compared to their self-report ratings on the OCI-R. In addition, Y-BOCS-SC and OCI-R scores were compared to measures of OCD symptom severity and self-report measures of anxiety (State-Trait Anxiety Inventory-Trait Subscale [STAI-T]; Spielberger, Gorusch, & Lushene, 1970) and depression (Beck Depression Inventory-II [BDI-II]; Beck, Steer, & Brown, 1996). The six symptom scales of the OCI-R had good internal consistency reliabilities (alphas). For the Y-BOCS-SC, three of five scales had good reliabilities (alphas >.80), but alphas for symmetry/ordering and sexual/religious symptom scales were inadequate. Total scores for the two instruments were strongly correlated with their corresponding "checking" scales, but no individual symptoms scales were identified as indices of overall OCD symptom presence. Scales assessing washing/contamination, symmetry/ordering, and hoarding from the two OCD instruments correlated well, but lower correlations for the other scales suggested differences in symptom coverage by the two instruments. Most symptom scales from the Y-BOCS-SC and OCI-R had low correlations with the BDI-II and STAI-T, but the OCI-R obsessing scale was well correlated (r=.54) with the STAI-T. These findings reveal some of the strengths and weaknesses of these two OCD instruments, and the results provide guidance for selecting scales that are suitable for measuring OCD symptoms.

School-based service delivery for homeless students: relevant laws and overcoming access barriers.

Schools in the United States are facing a record number of homeless students. These students are highly at-risk for experiencing negative life outcomes, and they face considerable academic and social-emotional functional impairments. To help address the complex needs of homeless students, this article reviews the intersection of laws and practices that impact homeless students, as well as contemporary school-based service delivery efforts to support the academic and social-emotional needs of these students. In addition, this article also reviews several barriers to school-based service delivery for homeless students and ways to overcome these barriers. These barriers include confusion regarding consent and record-sharing procedures, ineffectively utilizing homeless liaisons, and misapplying tenants of Multitiered Systems of Support (MTSS), which is a school-based service-delivery framework that has been adopted by and implemented in many U.S. schools. Ultimately, this article aims to provide members of school communities with practical information that they can use to support the homeless youth they encounter and serve.

The Future of D-Cycloserine and Other Cognitive Modifiers in Obsessive-Compulsive and Related Disorders.

Variants of exposure therapy are effective for treating obsessive-compulsive and related disorders (OCRDs). However, significant numbers of patients do not respond adequately to exposure therapy resulting in continued distress and functional impairment. Therefore, novel approaches to augmenting exposure therapy are needed to adequately treat non- and partial-responders. Emerging research suggests that interventions that augment learning and memory processes associated with exposure therapy (i.e., extinction training) may display promise in enhancing treatment response in OCRDs. As the most studied example, d-cycloserine (DCS) is a relatively safe cognitive enhancer that appears to accelerate treatment gains associated with exposure therapy. This article reviews research on the use of DCS and other putative cognitive modifiers as they relate to the treatment (or prospective treatment) of obsessive-compulsive disorder and other OCRDs.

The phenomenology and clinical correlates of suicidal thoughts and behaviors in youth with autism spectrum disorders.

This study investigated the phenomenology and clinical correlates of suicidal thoughts and behaviors in youth with ASD (N = 102; range 7-16 years). The presence of suicidal thoughts and behavior was assessed through the Anxiety Disorders Interview Schedule-Child and Parent Versions. Children and parents completed measures of anxiety severity, functional impairment, and behavioral and emotional problems. Approximately 11 % of youth displayed suicidal thoughts and behaviors. Children with autism were more likely to have suicidal thoughts and behaviors whereas children with Asperger's disorder were less likely. Suicidal thoughts and behaviors were associated with the presence of depression and post-traumatic stress disorder. Overall, results suggest that suicidal thoughts and behaviors are common in youth with ASD, and may be related to depression and trauma.

Rage attacks in pediatric obsessive-compulsive disorder: phenomenology and clinical correlates.

OBJECTIVE: Rage attacks have been documented in youth with varied psychiatric disorders, but few data have been reported on the clinical characteristics and correlates of rage attacks among children with obsessive-compulsive disorder (OCD). METHOD: Participants were 86 children (ages 6-16 years) with a primary diagnosis of OCD. Patients and their primary caregiver were administered clinician-rated measures of obsessive-compulsive severity and rage severity. Children completed the Center for Epidemiologic Studies Depression Scale and the Child Sheehan Disability Scale-Child, whereas parents completed the Rage Attacks Questionnaire, Aberrant Behavior Checklist-Irritability Scale, Children's Affective Lability Scale, and Child Sheehan Disability Scale-Parent. RESULTS: Rage was common among youth with OCD and was associated with varied clinical characteristics. Rage severity accounted for functional impairment beyond the influence of obsessive-compulsive symptom severity; however, these relations were explained by the impact of family accommodation. CONCLUSIONS: These data suggest that rage attacks are relatively common, have a negative impact on illness presentation, and contribute to functional impairment above and beyond obsessive-compulsive symptom severity. Rage may contribute to family accommodation of symptoms, which may further affect obsessive-compulsive symptom severity and impairment.

Obsessive-compulsive spectrum disorder symptoms in college students.

OBJECTIVE: This study investigated the occurrence of obsessive-compulsive spectrum disorders (OCSDs) and associated symptomology in college students. PARTICIPANTS: Participants included 358 undergraduate students. RESULTS: Results suggest that clinically significant levels of OCSD symptoms are relatively common. Additionally, OCSD symptoms co-occurred with each other and anxiety symptoms in general, yet not significantly with impulsivity symptoms. CONCLUSIONS: Given their prevalence in college students and potentially debilitating nature, it is important to increase awareness of OCSDs so that health professionals can better identify and treat symptoms of these disorders.

Effects of stress and coping on binge eating in female college students.

Limited research exists on the association between stress, coping, and binge eating. To address this paucity, this study explores these associations in a sample of 147 female college students, an at-risk population for binge eating. We hypothesized that emotional and avoidant coping would be positively associated with stress and binge eating. Conversely, we expected that rational and detached coping would be negatively related to stress and binge eating. Furthermore, we expected these coping styles to mediate the relationship between stress and binge eating. As predicted, emotion-focused and avoidant coping were positively associated with stress and binge eating. Additionally, emotion-focused coping partially mediated the relationship between stress and binge eating. However, no association was found between stress, rational or detached coping, and binge eating. These results are discussed within the context of a negative reinforcement model of binge eating. Lastly, the importance of providing evidence-based treatment for individuals with binge eating symptomology is discussed in light of our findings.

Has cyber technology produced a new group of peer aggressors?

Cyber technology provides a new venue for the expression of aggression. However, whether cyber technology has produced a new group of peer aggressors or simply allowed aggressive peers new tools to victimize others is unclear. This study sampled 1,672 adolescents to assess their engagement in cyber aggression. Although "cyber," "overt," and "relational" represent distinct subtypes of aggressive behavior, our results indicate that adolescents' behaviors clustered according to their frequency-not type-of aggression. Thus cyber technology provides new tools for youth who already engage in aggressive behaviors in the physical world to victimize peers in cyberspace.

Treatment of comorbid anxiety and autism spectrum disorders.

Clinically significant anxiety occurs frequently among individuals with autism spectrum disorders (ASDs) and is linked to increased psychosocial, familial, behavioral and academic impairment beyond the core autism symptoms when present. Although efforts are underway to establish empirically supported treatments for anxiety among individuals with ASDs, this remains an emerging research area. This literature review summarizes available information on the efficacy of pharmacological and psychosocial approaches for treating anxiety and repetitive behaviors in children, adolescents and adults with ASDs. Specifically, we evaluate evidence for the use of cognitive-behavioral therapy and selective serotonin-reuptake inhibitors. Evidence is growing in support of using cognitive-behavioral therapy to treat anxiety in youths with ASDs; however, mixed evidence exists for its application in treating repetitive behaviors, as well as the use of selective serotonin-reuptake inhibitors for anxiety in youths with ASDs. We conclude the article with a discussion of the strength of current information and next steps in research.