The Clinical Assessment of Prosocial Emotions (CAPE): Initial tests of reliability and validity in a clinic-referred sample of children and adolescents.

Recent changes to diagnostic criteria for serious conduct problems in children and adolescents have included the presence of elevated callous-unemotional traits to define etiologically and clinically important subgroups of youth with a conduct problem diagnosis. The Clinical Assessment of Prosocial Emotions (CAPE) is an intensive assessment of the symptoms of this limited prosocial emotions specifier that uses a structured professional judgment method of scoring, which may make it useful in clinical settings when diagnoses may require more information than that provided by behavior rating scales. The present study adds to the limited tests of the CAPE's reliability and validity, using a sample of clinic-referred children ages 6-17 years of age, who were all administered the CAPE by trained clinicians. The mean age of the sample was 10.13 years (SD = 2.64); 54% of the sample identified as male and 46% identified as female; and 67% of participants identified as White, 29% identified as Black, and 52% identified as another race/ethnicity (i.e., Asian, Hispanic/Latinx, or other). The findings indicated that CAPE scores demonstrated strong interrater reliability. The scores also were associated with measures of conduct problems and aggression, even when controlling for behavior ratings of callous-unemotional traits. Further, when children with conduct problem diagnoses were divided into groups based on the presence of the limited prosocial emotions specifier from the CAPE, the subgroup with the specifier showed more severe conduct problems and aggression. The results support cautious clinical use of the CAPE, its further development and testing, and research into ways to make its use feasible in many clinical settings. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Evidence-Based Assessment of DSM-5 Disruptive, Impulse Control, and Conduct Disorders.

The assessment of oppositional defiant disorder, conduct disorder, antisocial personality disorder, and intermittent explosive disorder-the Disruptive, Impulse Control and Conduct Disorders-can be affected by biases in clinical judgment, including overestimating concerns about distinguishing symptoms from normative behavior and stigma associated with diagnosing antisocial behavior. Recent nosological changes call for special attention during assessment to symptom dimensions of limited prosocial emotions and chronic irritability. The present review summarizes best practices for evidence-based assessment of these disorders and discusses tools to identify their symptoms. Despite the focus on disruptive behavior disorders, their high degree of overlap with disruptive mood dysregulation disorder can complicate assessment. Thus, the latter disorder is also included for discussion here. Good practice in the assessment of disruptive behavior disorders involves using several means of information gathering (e.g., clinical interview, standardized rating scales or checklists), ideally via multiple informants (e.g., parent-, teacher-, and self-report). A commitment to providing a full and accurate diagnostic assessment, with careful and attentive reference to diagnostic guidelines, will mitigate concerns regarding biases.

Clinical utility of diagnosing limited prosocial emotions in young children using the Clinical Assessment of Prosocial Emotions (CAPE).

This study evaluated the interrater reliability, convergent and divergent validity, incremental validity, and clinical prognostic utility of the Clinical Assessment of Prosocial Emotions (CAPE; Frick, 2013) for assessing limited prosocial emotions (LPE). Participants were 232 young children (Mage = 3.94 years, SD = 1.46, range = 2-8; 74.6% boys) clinic-referred for conduct problems. We scored the CAPE using binary and dimensional scoring approaches and measured outcomes using parent-report and child laboratory measures. CAPE LPE symptom ratings had good interrater reliability. Children diagnosed with pretreatment LPE had more severe externalizing problems and lower empathy than children without LPE but did not differ in emotion recognition accuracy or anxiety. Dimensional CAPE symptom sum scores were associated with criterion variable scores in expected ways and offered incremental validity beyond scores on the parent-report Inventory of Callous-Unemotional Traits for predicting conduct problem severity, aggression, empathy deficits, and global emotion recognition accuracy. Among children who completed parent management training (n = 44), those diagnosed with LPE ended treatment with more severe aggressive behavior than those without LPE. Overall, children diagnosed with CAPE LPE have severe externalizing problems and achieve reduced benefits from standard parent management training, supporting the need for tailored and intensive interventions to maximize treatment outcomes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Validity of the Personality Assessment Inventory-Adolescent in Assessing Callous-Unemotional Traits in At-Risk Adolescents.

This study examines the validity of the Personality Assessment Inventory-Adolescent (PAI-A; Morey) in assessing callous-unemotional (CU) traits within two independent samples of at-risk adolescents from a residential intervention program. The study tests the extent to which CU traits are represented within PAI-A scales with respect to empirically- or theoretically-related indicators, such as antisociality, aggression, low warmth, low social connectedness, and subdued internalizing psychopathology. The PAI-A substantive scales statistically accounted for an average of 55.0% of the variance in total scores on the Inventory of Callous-Unemotional Traits (ICU; Frick) across samples. Broadly, PAI-A substantive scales evinced theoretically-consistent relations with CU traits. Consistent with expectations, CU traits were broadly related to PAI-A-assessed constructs of antisocial features, aggression, low warmth and social disconnection, but not to subdued internalizing symptoms. Moreover, some of the PAI-A clinical, treatment consideration, and interpersonal scales or subscales demonstrated differential relations across the traits. Implications for assessment of CU traits using the PAI framework are discussed. Overall, this research adds to the literature on CU traits in broadband personality assessment and provides a foundation for future research on CU traits using the PAI-A.

Comparing the potential causal influence of two indicators of early alcohol use on later alcohol use disorder symptoms.

Age of first drink (AFD) has repeatedly been found to be associated with alcohol use disorder (AUD); however, some studies suggest this is a noncausal effect that may be due to childhood risk factors or familial influences. In contrast to indicators of any early alcohol use, such as AFD, indicators of a pattern of repeated drinking may be more likely to be causally associated with later problematic alcohol use. The current study examined AFD and age of onset of regular drinking (ARD; defined as drinking at least once a month for 6 or more months) as quasicausal predictors of lifetime AUD symptoms. Participants were 3,005 adult Australian twins who reported having been regular drinkers in their lifetime. Semistructured interviews were conducted to assess AFD, ARD, AUD, externalizing symptomatology, and other substance use. Personality traits were assessed via questionnaire. Unadjusted and adjusted multilevel discordant twin models were conducted using data from 1,041 complete twin pairs; adjusted models included socioeconomic status, personality, conduct disorder, and early initiation of regular smoking and marijuana use as covariates. Results from fully adjusted models controlling for familial confounds provided evidence for a causal influence of ARD on AUD symptoms, whereby twins with an earlier age of regular drinking than their cotwin had more lifetime AUD symptoms. However, AFD did not significantly predict AUD symptoms after adjusting for confounds. These results suggest that early regular drinking may serve as a causal risk factor for future problems, while early initiation of any alcohol use may indicate genetic liability. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

A risk calculator to predict adult attention-deficit/hyperactivity disorder: generation and external validation in three birth cohorts and one clinical sample.

AIM: Few personalised medicine investigations have been conducted for mental health. We aimed to generate and validate a risk tool that predicts adult attention-deficit/hyperactivity disorder (ADHD). METHODS: Using logistic regression models, we generated a risk tool in a representative population cohort (ALSPAC - UK, 5113 participants, followed from birth to age 17) using childhood clinical and sociodemographic data with internal validation. Predictors included sex, socioeconomic status, single-parent family, ADHD symptoms, comorbid disruptive disorders, childhood maltreatment, ADHD symptoms, depressive symptoms, mother's depression and intelligence quotient. The outcome was defined as a categorical diagnosis of ADHD in young adulthood without requiring age at onset criteria. We also tested Machine Learning approaches for developing the risk models: Random Forest, Stochastic Gradient Boosting and Artificial Neural Network. The risk tool was externally validated in the E-Risk cohort (UK, 2040 participants, birth to age 18), the 1993 Pelotas Birth Cohort (Brazil, 3911 participants, birth to age 18) and the MTA clinical sample (USA, 476 children with ADHD and 241 controls followed for 16 years from a minimum of 8 and a maximum of 26 years old). RESULTS: The overall prevalence of adult ADHD ranged from 8.1 to 12% in the population-based samples, and was 28.6% in the clinical sample. The internal performance of the model in the generating sample was good, with an area under the curve (AUC) for predicting adult ADHD of 0.82 (95% confidence interval (CI) 0.79-0.83). Calibration plots showed good agreement between predicted and observed event frequencies from 0 to 60% probability. In the UK birth cohort test sample, the AUC was 0.75 (95% CI 0.71-0.78). In the Brazilian birth cohort test sample, the AUC was significantly lower -0.57 (95% CI 0.54-0.60). In the clinical trial test sample, the AUC was 0.76 (95% CI 0.73-0.80). The risk model did not predict adult anxiety or major depressive disorder. Machine Learning approaches did not outperform logistic regression models. An open-source and free risk calculator was generated for clinical use and is available online at https://ufrgs.br/prodah/adhd-calculator/. CONCLUSIONS: The risk tool based on childhood characteristics specifically predicts adult ADHD in European and North-American population-based and clinical samples with comparable discrimination to commonly used clinical tools in internal medicine and higher than most previous attempts for mental and neurological disorders. However, its use in middle-income settings requires caution.

Risk-Taking Behavior in Attention Deficit/Hyperactivity Disorder (ADHD): a Review of Potential Underlying Mechanisms and of Interventions.

PURPOSE OF REVIEW: Attention deficit/hyperactivity disorder (ADHD) is associated with several forms of risk-taking behavior (RTB). This paper aims to examine the scope of ADHD-related RTB, to highlight potential underlying mechanisms of this association, and to review initial evidence for interventions aimed to treat ADHD-related RTB. RECENT FINDINGS: Multiple lines of evidence indicate that ADHD is associated with real-life RTB across several domains (e.g., reckless driving, substance use, and unprotected sex), which is corroborated by evidence on laboratory risk-taking tasks. Several individual differences, some of them informed by decision theory, e.g., comorbid disorders, parental monitoring, and perceived enlarged benefits of RTB, may explain the link between ADHD and RTB. A number of studies showed that interventions designed for ADHD may reduce RTB. ADHD is linked to RTB across several domains. Decision theory may serve as a conceptual framework for understanding the underlying mechanisms, and thus may inform future research.

Assessment of the frequency criterion for the diagnosis of non-suicidal self-injury disorder in female adolescents with conduct disorder.

Recent studies suggest a higher threshold number of self-injuries during the past year than the one proposed in the DSM-5 criteria for non-suicidal self-injury disorder (NSSID). Therefore, we aimed to test a validity of the frequency criterion in girls with conduct disorder (CD) based on psychopathology and the level of functioning. Mixture modelling analysis revealed that the frequency of at least 8 self-harm behaviours in the previous year differentiated adolescents with CD. Thus, we divided adolescents into three subgroups: group 1: at least 8 self-harm acts; group 2: 1-7 self-harm behaviours and group 3: those who did not injure themselves during the last 12 months. Individuals from group 1 were significantly younger and had earlier age of self-harm onset. There were significant differences between groups 1 and 3 in terms of anxiety and depressive symptoms, self-esteem, aggression and the global functioning level. The group 1 scored significantly higher on depressive symptoms compared to the group 2. The group 2 scored significantly higher than the group 3 on the level of hostility. Our results provide further evidence supporting the need for modification of the NSSID frequency criterion.

Informant similarities, twin studies, and the assessment of externalizing behavior: A meta-analysis.

The purpose of this study was to examine similarity within informant ratings of the externalizing behavior of monozygotic (MZ) and dizygotic (DZ) twin pairs. To do this, we conducted a meta-analysis of correlations within ratings completed by mothers, fathers, teachers, and youth. We retrieved n=204 correlations for MZ twins and n=267 correlations for DZ twins from n=54 studies containing n=55 samples. Results indicated that all four informants were significant negative predictors of within-informant correlations in their ratings of MZ, but not DZ twins. In the case of longitudinal studies and as the age of MZ twins increased, similarity within ratings by mothers was significantly greater than similarity within ratings by fathers. Among participant characteristics, we found that (a) age was a significant negative predictor of similarity within ratings for MZ twins; (b) race was a significant predictor of similarity within ratings for both MZ and DZ twins, but in the opposite direction; and (c) DZ opposite sex twins were a significant negative predictor of within-rating similarity. Among study characteristics for MZ twins, participant group and longitudinal study were significant negative predictors of within-rating similarity, and for both MZ and DZ twin pairs, non-independence in the data was a significant negative predictor of within-rating similarity. For DZ twins, multiple informants were significant positive predictors of within-rating similarity, and in longitudinal studies with DZ twins, similarity within ratings by mothers was significantly greater than similarity within ratings by fathers, and similarity within ratings by fathers was significantly less than similarity within ratings by teachers and youth. For both MZ and DZ twins, the following study characteristics were significant positive predictors of similarity within ratings: study group, number of time points, and multiple constructs. All four informants appeared equally skilled at predicting within-informant correlations for MZ (but not DZ) twins, with participant characteristics having different predictive effects for MZ compared to DZ twins, and study characteristics having comparable predictive effects for both twin types. Overall, these findings suggest effective discrimination on the part of four informants who rated the externalizing behavior of MZ and DZ twins.

Prevalence of attention-deficit/hyperactivity and other disruptive behaviour disorder symptoms among primary school-age children in Kayseri, Turkey.

Objectives This study aimed to determine the prevalence of attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD), and their influencing factors on primary school-age children. Methods This cross-sectional study was conducted among 2045 students, 7-15 years old, who were randomly selected from seven schools in Kayseri, Turkey, in 2012. Participants were stratified by socioeconomic status. Data were collected using the Turgay DSM-IV-Based Child and Adolescent Behavioural Disorders Screening and Rating Scale (T-DSM-IV-S). For statistical analyses, the t-test and analysis of variance were used. Results Rates of disruptive behaviour disorders (DBDs) among children were as follows: ADHD, 6.2%; CD, 14.4%; and ODD, 6.7%. The prevalence of ADHD was higher in boys and children whose mothers were homemakers and from poorly-educated and low-income families, compared with their peers. CD was more prevalent among boys and children 13-15 years old, whose parents had low income levels and were separated. ODD was higher in boys and children whose mothers were homemakers. Conclusions Our findings suggest that the overall prevalence of DBDs in our study area is 27.4%, which is similar to the pooled worldwide prevalence. Adverse family factors are closely associated with the prevalence of DBDs.

TIGA-CUB - manualised psychoanalytic child psychotherapy versus treatment as usual for children aged 5-11 years with treatment-resistant conduct disorders and their primary carers: study protocol for a randomised controlled feasibility trial.

BACKGROUND: The National Institute for Health and Care Excellence (NICE) recommends evidence-based parenting programmes as a first-line intervention for conduct disorders (CD) in children aged 5-11 years. As these are not effective in 25-33% of cases, NICE has requested research into second-line interventions. Child and Adolescent Psychotherapists (CAPTs) address highly complex problems where first-line treatments have failed and there have been small-scale studies of Psychoanalytic Child Psychotherapy (PCP) for CD. A feasibility trial is needed to determine whether a confirmatory trial of manualised PCP (mPCP) versus Treatment as Usual (TaU) for CD is practicable or needs refinement. The aim of this paper is to publish the abridged protocol of this feasibility trial. METHODS AND DESIGN: TIGA-CUB (Trial on improving Inter-Generational Attachment for Children Undergoing Behaviour problems) is a two-arm, pragmatic, parallel-group, multicentre, individually randomised (1:1) controlled feasibility trial (target n = 60) with blinded outcome assessment (at 4 and 8 months), which aims to develop an optimum practicable protocol for a confirmatory, pragmatic, randomised controlled trial (RCT) (primary outcome: child's behaviour; secondary outcomes: parental reflective functioning and mental health, child and parent quality of life), comparing mPCP and TaU as second-line treatments for children aged 5-11 years with treatment-resistant CD and inter-generational attachment difficulties, and for their primary carers. Child-primary carer dyads will be recruited following a referral to, or re-referral within, National Health Service (NHS) Child and Adolescent Mental Health Services (CAMHS) after an unsuccessful first-line parenting intervention. PCP will be delivered by qualified CAPTs working in routine NHS clinical practice, using a trial-specific PCP manual (a brief version of established PCP clinical practice). Outcomes are: (1) feasibility of recruitment methods, (2) uptake and follow-up rates, (3) therapeutic delivery, treatment retention and attendance, intervention adherence rates, (4) follow-up data collection, and (5) statistical, health economics, process evaluation, and qualitative outcomes. DISCUSSION: TIGA-CUB will provide important information on the feasibility and potential challenges of undertaking a confirmatory RCT to evaluate the effectiveness and cost-effectiveness of mPCP. TRIAL REGISTRATION: Current Controlled Trials, ID: ISRCTN86725795 . Registered on 31 May 2016.

Racial/Ethnic Disproportionality in Psychiatric Diagnoses and Treatment in a Sample of Serious Juvenile Offenders.

Psychiatric disorder prevalence has been shown demonstrably higher among justice-involved adolescents than youth in the general population. Yet, among arrested juveniles, little is known regarding racial/ethnic differences in disorder prevalence, the role of trauma exposure in the diagnosis of behavioral disorders, or subsequent psychiatric treatment provided to adolescents with such diagnoses. The current study examines racial/ethnic disparity in psychiatric diagnoses and treatment of behavioral disorders associated with delinquency, controlling for traumatic experiences, behavioral indicators, and prior offending among serious juvenile offenders. Logistic regression is employed to explore the racial/ethnic disproportionality in behavioral disorder diagnoses and psychiatric treatment provision among 8763 males (57.7 % Black, 11.8 % Hispanic) and 1,347 females (53.7 % Black, 7.6 % Hispanic) admitted to long-term juvenile justice residential placements in Florida. The results indicate Black males are 40 % more likely, and Black females 54 % more likely to be diagnosed with conduct disorder than Whites, even upon considerations of trauma, behavioral indicators, and criminal offending. Black and Hispanic males are approximately 40 % less likely to be diagnosed with ADHD than White males, with no racial/ethnic differences for females. Importantly, Black males are 32 % less likely to receive psychiatric treatment than White males, with no differences between White and Hispanic males, or any female subgroups. Traumatic exposures increased the odds of oppositional defiant disorder and ADHD, but not conduct disorder for males, though adverse childhood experiences were unrelated to behavioral disorder diagnoses among females.

A Behavioral Measure of Costly Helping: Replicating and Extending the Association with Callous Unemotional Traits in Male Adolescents.

BACKGROUND: Some conduct-disordered youths have high levels of callous unemotional traits and meet the DSM-5's "with limited prosocial emotions" (LPE) specifier. These youths often do aggressive, self-benefitting acts that cost others. We previously developed a task, the AlAn's game, which asks participants to repeatedly decide whether to accept or reject offers in which they will receive money but a planned charity donation will be reduced. In our prior work, more "costly helping" (i.e., rejecting the offered money and protecting the donation) was associated with lower callous unemotional traits. Here we extend that prior work in a larger sample of adolescent male patients with serious conduct problems and controls, and test whether this association is mediated specifically by a Moral Elevation response (i.e., a positive emotional response to another's act of virtue). METHODS: The adolescent male participants were: 45 patients (23 with LPE) and 26 controls, who underwent an extensive phenotypic assessment including a measure of Moral Elevation. About 1 week later participants played the AlAn's game. RESULTS: All AlAn's game outcomes demonstrated significant group effects: (1) money taken for self (p = 0.02); (2) money left in the charitable donation (p = 0.03); and, (3) costly helping (p = 0.047). Controls took the least money and did the most costly helping, while patients with LPE took the most money and did the least costly helping. Groups also significantly differed in post-stimulus Moral Elevation scores (p = 0.005). Exploratory analyses supported that the relationship between callous unemotional traits and costly helping on the AlAn's game may be mediated in part by differences in Moral Elevation. CONCLUSIONS: The AlAn's game provides a standardized behavioral measure associated with callous unemotional traits. Adolescents with high levels of callous unemotional traits engage in fewer costly helping behaviors, and those differences may be related to blunting of positive emotional responses.

Positive and negative item wording and its influence on the assessment of callous-unemotional traits.

This study examined the item functioning of the Inventory of Callous-Unemotional Traits (ICU) in an ethnically diverse sample 1,190 of first-time justice-involved adolescents (mean age = 15.28 years, SD = 1.29). On elimination of 2 items, the total ICU score provided a reliable (internally consistent and stable) and valid (correlated with and predictive of measures of empathy, school conduct problems, delinquency, and aggression) continuous measure of callous and unemotional (CU) traits. A shortened, 10-item version of the total scale, developed from item response theory (IRT) analyses, appeared to show psychometric properties similar to those of the full ICU and, thus, could be used as an abbreviated measure of CU traits. Finally, item analyses and tests of validity suggested that the factor structure of the ICU reported in a large number of past studies could reflect method variance related to the ICU, including equal numbers of positively and negatively worded items. Specifically, positively worded items (i.e., items for which higher ratings are indicative of higher levels of CU traits) were more likely to be rated in the lower response categories, showed higher difficulty levels in IRT analyses (i.e., discriminated best at higher levels of CU traits), and were more highly correlated with measures of antisocial and aggressive behavior. On the basis of these findings, we recommend using the total ICU as a continuous measure of CU traits and do not recommend continued use of the subscale structure that has been reported in multiple past studies.

Mental Health Utilization Among Diverse Parenting Young Couples.

Mental health issues often become apparent as adolescents emerge into young adulthood. The use of mental health services is low among adolescents and young adults, and use is particularly low among minorities. In this study, we examine mental health utilization among diverse young parenting couples. The sample consisted of 296 couples. We used the social-personal framework to examine personal, family, partner relationship, and environmental predictors for using mental health services. We used the Actor-Partner Interdependence Model to assess actor and partner effects on mental health utilization. We also examined moderator effects for gender and internalizing and externalizing behaviors. We found that being female, being White, higher income, more conduct problems, and less anxious romantic attachment predicted mental health utilization. Significant moderator effects included depression × gender, depression × medical insurance, and stress × Latino. Implications for community mental health practice include conducting mental health assessments during medical visits and systematic mental health follow-up for individuals and couples with identified mental health and support needs. Future research should include married couples and the spouse's influence on mental health use and examine relevant parenting factors that may also predict mental health utilization among couples.

[School well-being of students with and without special educational needs--a comparison of students in inclusive and regular classes]. / Schulisches Wohlbefinden von SchülerInnen mit und ohne sonderpädagogischen Förderbedarf--Integrations- und Regelklassen im Vergleich.

OBJECTIVE: The present study examines the academic well-being of students with and without special educational needs (SEN) in inclusive classes compared to students from regular classes in which no child with SEN is taught. In addition, the relationships between the school well-being and emotional problems, conduct problems, hyperactivity/inattention, peer relationship problems and prosocial behavior are analyzed. METHOD: A total of 1115 students from the 4th and 7th grade (37 % 4th graders, 63 % 7th graders) participated in the survey, 126 of whom had been diagnosed as having SEN. The subscale Well-Being at School taken from the FEESS 3­4 (Rauer & Schuck, 2004) and the SDQ (Goodman, 1997) were used for measurement. RESULTS: Results indicate high reliabilities for the subscale Well-Being in School for students both with and without SEN for both grades 4 and 7. Furthermore, it could be shown that the variance explained for school well-being can be connected to elements on the students' individual level as well as on the class-specific level. Significant predictors of school well-being were sex, behavioral difficulties and strengths as well as the school grade. The SEN status (no SEN vs. SEN) and the class setting (regular vs. inclusive class) did not influence the school well-being significantly.

Maternal Health Status and Parenting Stress in Low-Income, Ethnic-Minority Mothers of Children with Conduct Disorder Problems: the Role of Daily Parenting Hassles.

OBJECTIVES: Minimal attention has been given to understanding parenting stress among low-income, ethnically diverse mothers of children with conduct problems. Maternal health and parenting hassles may serve as important risk factors for parenting stress. This study examined whether parenting hassles mediated the relations between maternal physical and mental health and parenting stress in a sample of low-income, ethnically diverse mothers of children with behavioral problems. METHODS: The sample included 177 low-income black, Latina, and white mothers of kindergartners with behavior problems. Path analysis was employed to assess the associations between maternal mental and physical health and parenting stress, as well as the moderating role of parenting hassles in this cross-sectional study. RESULTS: After adjusting for covariates, we found that parenting hassles mediated the relationship between social support and parenting stress as well as maternal health and parenting stress. CONCLUSION: Findings suggest that promoting coping resources for daily parenting hassles and supporting the physical and mental health of minority mothers may have important implications for parenting children with high behavior problems.

Gender, ethnicity and race in incarcerated and detained youth: services and policy implications for girls.

OBJECTIVE: While work has been conducted on gender differences to inform gender-specific programming, relatively little work has been done regarding racial and ethnic differences among incarcerated and detained girls in particular. This is an important gap, considering gender, race, and ethnicity may be important factors in responding to the needs of incarcerated and detained girls within the Risk-Needs-Responsivity (RNR) model. We hypothesize girls will show relatively more pathology than boys, and that White girls will show relatively more pathology as compared to girls of other groups. Implications of findings for services delivery and policy are presented. METHOD: Data were collected on N = 657 youth using structured interview and record review. Analyses included χ2 and t tests. RESULTS: As compared to boys, girls were older at first arrest yet younger during most lock-up, received poorer grades, experienced more family difficulty, and more were lesbian/bisexual. As compared to minority girls, White girls began hard drugs at a younger age, had more conduct disorder symptoms, and more frequently experienced parental difficulty and abuse. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Age-appropriate programming that addresses family difficulty and sexuality is needed for girls. As compared to White girls, reentry planning may more readily rely on family support for minority girls. Systems should consider use of actuarial methods in order to reduce bias in making placement decisions. (PsycINFO Database Record

Psychocultural Correlates of Mental Health Service Utilization Among African American and European American Girls.

Structural equation modeling was used to examine the effects of cultural factors (ethnic identity, perceived discrimination), family relations, and child problem type on mental health service utilization in a community sample of 1,480 adolescent girls (860 African American, 620 European American) between ages 15 and 17 years enrolled in the Pittsburgh Girls Study. Results revealed ethnic identity, caregiver attachment, and conduct disorder were related to service use among African American girls. Among European American girls, correlate patterns differed by clinical need. Findings highlight the need for research on health disparities to examine racially specific influences on service utilization.

Working together to solve disparities: Latina/o parents' contributions to the adaptation of a preventive intervention for childhood conduct problems.

Left untreated, conduct problems can have significant and long-lasting negative effects on children's development. Despite the existence of many effective interventions, U.S. Latina/o children are less likely to access or receive evidence-based services. Seeking to build the foundation to address these service disparities, the current study used a Community-Based Participatory Research approach to examine U.S. Latina/o parents' perceptions of the need for interventions to prevent childhood disruptive behaviors in their community in general, and of an existing evidence-based intervention-parent-child interaction therapy (PCIT)-in particular. Results suggest that parents recognize a need for prevention resources in their community and value most of the core features of PCIT. Nevertheless, important directions for potential adaptation and expansion of PCIT into a prevention approach were identified. Results point to several goals for future study with the potential to ameliorate the unmet mental health needs experienced by U.S. Latina/o families with young children at risk for developing conduct problems.