Advancing Antiracism in Community-Based Research Practices in Early Childhood and Family Mental Health.

Structural racism-the ways that institutional policies, practices, and other norms operate to create and sustain race-based inequities1-has historically been foundational to the operations of academic medical centers and research institutions. Since its inception, academic medicine has depended on the exploitation of vulnerable communities to achieve medical, educational, and research goals.2 Research practices have long ignored or taken advantage of the individuals purportedly benefiting from the research, a dynamic most manifestly true for Black, Indigenous, and People of Color (BIPOC) communities in the United States. Reflecting current practices in racial justice work, we intentionally use the term "BIPOC" to highlight shared experiences within racially and ethnically minoritized communities, given the history of White supremacy in the United States. We acknowledge limitations of this term, which collapses myriad unique communities and histories into one construct. Specifically, child and adolescent psychiatry has historically been driven by Eurocentric approaches, paradigms, and methodology. These nonparticipatory dominant research practices have contributed to a lack of culturally responsive interventions for BIPOC communities, a paucity of evidence-based practices with demonstrated effectiveness within BIPOC communities, and disparities in access and quality of care.3 Mental health research involving BIPOC communities has been replete with exploitation and inequality.2.

Individual and organizational factors associated with teacher self-reported implementation of the PATHS curriculum.

The current study examined a comprehensive set of individual and organizational factors as potential predictors of how the Promoting Alternative THinking (PATHS) Curriculum was implemented by teachers in an urban Midwestern school district. The study used data from a randomized trial of an implementation support model conducted in 28 urban elementary schools. All schools implemented PATHS in grades K-3. Program fidelity was assessed with teacher self-reported ratings of lesson dosage, frequency of supplemental material use, and quality of delivery over repeated time points. The initial levels of implementation and change over time were examined in a series of three level longitudinal hierarchical liner models (HLM). Over time, teachers reported somewhat lower levels of program use but maintained their quality of delivery. Teachers with more positive attitudes towards PATHS reported more frequent lesson delivery at the intercept (winter Year 1). Teachers from schools with a more positive culture for social-emotional learning (SEL) rated the quality of their PATHS delivery more positively than teachers from schools lacking SEL culture and reported more frequent supplemental materials use. Early career teachers initially described themselves as delivering PATHS with lower quality but improved similarly over time compared to more experienced teachers. Implications of the findings and recommendations for future research are discussed.

Applying Mindfulness-Based Practices in Child Psychiatry.

Mindfulness-based interventions for adults, children, and families have grown considerably, and burgeoning evidence supports use of these approaches for a range of clinical presentations, including anxiety, depression, ADHD, and addiction. Research into the mechanisms of mindfulness suggests improvements in key brain-based functions including attentional control and emotional regulation. Mindfulness may be relevant for improving emotional and behavioral symptoms in children and families presenting for psychiatric care and also may be an important universal strategy to promote brain health. Child psychiatrists should be familiar with mindfulness-based clinical programs and also may seek to develop mindfulness-based strategies to use in clinical practice.

Helping Head Start Parents Promote Their Children's Kindergarten Adjustment: The Research-Based Developmentally Informed Parent Program.

Head Start enhances school readiness during preschool, but effects diminish after children transition into kindergarten. Designed to promote sustained gains, the Research-based Developmentally Informed (REDI) Parent program (REDI-P) provided home visits before and after the kindergarten transition, giving parents evidence-based learning games, interactive stories, and guided pretend play to use with their children. To evaluate impact, two hundred 4-year-old children in Head Start REDI classrooms were randomly assigned to REDI-P or a comparison condition (mail-home math games). Beyond the effects of the classroom program, REDI-P promoted significant improvements in child literacy skills, academic performance, self-directed learning, and social competence, demonstrating the utility of the approach in promoting gains in cognitive and social-emotional skills evident after the transition into kindergarten.

Dimensions of Parenting Associated with Child Prekindergarten Emotion Regulation and Attention Control in Low-income Families.

Delays in emotion regulation and attention control are common among children growing up in poverty, and they contribute to significant socio-economic gaps in school readiness and later school attainment. In this study, the emotion regulation and attention control skills of 210 prekindergarten Head Start participants were assessed (M age = 4.80 years old). Home interviews and videotaped parent-child interactions were used to evaluate three aspects of parenting (e.g., warm-sensitive, directive-critical, and parenting stress). Structural equation models documented significant, unique associations linking directive-critical parenting and parenting stress with poor child emotion regulation skills. Directive-critical parenting was also uniquely associated with low levels of child attention control. Warm-sensitive parenting was not uniquely related to either emotion regulation or attention control at this age. The findings suggest that, by prekindergarten, parent stress management and reduced directiveness emerge as the primary correlates of child emotion regulation and attention control, whereas warm-sensitive parenting plays a diminished role.

Effects of Parent and Child Pre-Intervention Characteristics on Child Skill Acquisition during a School Readiness Intervention.

200 preschool children in Head Start (55% girls; 20% Hispanic, 25% African-American, 55% European American; M age = 4.80 years old) participated in a randomized-controlled trial of a home visiting intervention designed to promote their emergent literacy skills (the Research-based Developmentally Informed parent [REDI-P] program). This study explored concurrent changes in levels of parent support and child literacy skills that occurred over the course of the intervention, and examined the impact of pre-intervention parent support and child literacy skills as potential moderators of parent and child outcomes. Cross-lagged structural equation models and follow-up analyses indicated that intervention had the strongest impact on child literacy skills when parents were high on support at the pre-intervention assessment. Conversely, the REDI-Parent program promoted the greatest gains in parent support when parents entered the program with low levels. These findings suggest that families may benefit from home visit school readiness interventions in different ways: child skill acquisition may be greatest when parents are initially high in support, whereas parenting may improve most when parents are initially low in support.

The impact of mindfulness education on elementary school students: Evaluation of the Master Mind Program.

Children need to be equipped with the skills to respond effectively to stress and prevent poor decision-making surrounding alcohol and tobacco use. Training and practice in mindfulness is one possible avenue for building children's skills. Recent research has revealed that mindfulness education in the classroom may play a role in enhancing children's self-regulatory abilities. Thus, the goal of the current study was to extend existing research in mindfulness education in classrooms and conduct an assessment of the feasibility and effectiveness of a new mindfulness education, substance abuse prevention program for 4th and 5th grade children (Master Mind). Two elementary schools were randomly assigned to be an intervention group (N = 71) or waitlist control group (N = 40). Students in the intervention group were taught the four-week Master Mind program by their regular classroom teachers. At pre- and post-intervention time points, students completed self-reports of their intentions to use substances and an executive functioning performance task. Teachers rated students on their behavior in the classroom. Findings revealed that students who participated in the Master Mind program, as compared to those in the wait-list control condition, showed significant improvements in executive functioning skills (girls and boys), as well as a marginally significant increase in self-control abilities (boys only). In addition, significant reductions were found in aggression and social problems (girls and boys), as well as anxiety (girls only). No significant differences across groups were found for intentions to use alcohol or tobacco. Teachers implemented the program with fidelity; both teachers and students positively rated the structure and content of the Master Mind program, providing evidence of program satisfaction and feasibility. Although generalization may be limited by the small sample size, the findings suggest that mindfulness education may be beneficial in increasing self-regulatory abilities, which is important for substance abuse prevention.

How is this child feeling? Preschool-aged children's ability to recognize emotion in faces and body poses.

The study examined children's recognition of emotion from faces and body poses, as well as gender differences in these recognition abilities. Preschool-aged children (N = 55) and their parents and teachers participated in the study. Preschool-aged children completed a web-based measure of emotion recognition skills, which included five tasks (three with faces and two with bodies). Parents and teachers reported on children's aggressive behaviors and social skills. Children's emotion accuracy on two of the three facial tasks and one of the body tasks was related to teacher reports of social skills. Some of these relations were moderated by child gender. In particular, the relationships between emotion recognition accuracy and reports of children's behavior were stronger for boys than girls. Identifying preschool-aged children's strengths and weaknesses in identification of emotion from faces and body poses may be helpful in guiding interventions with children who have problems with social and behavioral functioning that may be due, in part, to emotional knowledge deficits. Further developmental implications of these findings are discussed.

Pharmacogenetic considerations for optimizing tacrolimus dosing in liver and kidney transplant patients.

The introduction of tacrolimus in clinical practice has improved patient survival after organ transplant. However, despite the long use of tacrolimus in clinical practice, the best way to use this agent is still a matter of intense debate. The start of the genomic era has generated new research areas, such as pharmacogenetics, which studies the variability of drug response in relation to the genetic factors involved in the processes responsible for the pharmacokinetics and/or the action mechanism of a drug in the body. This variability seems to be correlated with the presence of genetic polymorphisms. Genotyping is an attractive option especially for the initiation of the dosing of tacrolimus; also, unlike phenotypic tests, the genotype is a stable characteristic that needs to be determined only once for any given gene. However, prospective clinical studies must show that genotype determination before transplantation allows for better use of a given drug and improves the safety and clinical efficacy of that medication. At present, research has been able to reliably show that the CYP3A5 genotype, but not the CYP3A4 or ABCB1 ones, can modify the pharmacokinetics of tacrolimus. However, it has not been possible to incontrovertibly show that the corresponding changes in the pharmacokinetic profile are linked with different patient outcomes regarding tacrolimus efficacy and toxicity. For these reasons, pharmacogenetics and individualized medicine remain a fascinating area for further study and may ultimately become the face of future medical practice and drug dosing.

Does major depressive disorder with somatic delusions constitute a distinct subtype of major depressive disorder with psychotic features?

BACKGROUND: Among patients with major depression with psychotic features, little is known about the extent to which those with and without somatic delusions differ. METHODS: The first 183 participants in the STOP-PD study were divided into two groups based on the presence or absence of somatic delusions and were compared on multiple demographic and clinical characteristics. RESULTS: In the multivariate analysis, those with somatic delusions reported more somatic symptoms, rated their health as worse, and were less likely to have persecutory delusions. CONCLUSIONS: Based on the methods we used, we could not detect meaningful differences between subjects with and without somatic delusions. This suggests that the presence of irrational somatic ideation does not define a distinct clinical subgroup among patients with psychotic depression. This finding needs to be replicated.