Emotional and behavior problems in an urban pediatric primary care setting.

We sought to identify needs for behavioral health care in a large, urban pediatric primary care (PPC) clinic serving a population covered by Medicaid. Specifically, children (N = 197; 120 girls; 91 % African American) ages 8-17 years and their caregivers completed measures of internalizing and externalizing symptoms (RCADS, RCADS-P, MASC, and SDQ). Clinical elevations on all but one domain of the SDQ were significantly higher than expected. However, self-reported anxiety and depression symptoms were consistent with expectations. These findings suggest urban, low-income, primarily African American youth presenting at a PPC clinic demonstrate significant levels of behavioral and emotional symptoms. Implications of the findings include the need to ask both parents and children about child behavioral health problems and the possible influence of screening tool selection on detection.

Discrepancies in parents' and children's reports of child emotion regulation.

The ability to regulate one's emotions effectively has been linked with many aspects of well-being. The current study examined discrepancies between mothers' and children's reports of child emotion regulation. This investigation examined patterns of discrepancies for key aspects of emotion regulation (i.e., inhibition and dysregulated expression) and for three emotions (anger, sadness, worry). A total of 61 mother-child dyads (mean children's age=9.3 years) participated. As hypothesized, discrepancies for inhibition subscales were of a larger magnitude than those for dysregulated expression subscales. Furthermore, age was related to discrepancies in both anger subscales, parent reports of child externalizing symptoms were related to anger dysregulated expression discrepancies, and child reports of internalizing symptoms were related to sadness dysregulated expression discrepancies. Overall, the findings suggest that patterns of discrepant reports are not random but rather may provide meaningful and useful information about the nature of emotion regulation.

Characteristics of anxious and depressed youth seen in two different clinical contexts.

Previous research has revealed that youth seen at community clinics present with a higher frequency of externalizing problems and are demographically different from youth seen at research clinics. This study extends findings on these discrepancies by examining differences between youth at research and community clinics meeting criteria for two different primary disorders (anxiety and depression). Consistent with prior research, community clinic youth reported lower incomes, were more ethnically diverse, and had higher rates of externalizing problems compared to research clinic youth, regardless of primary diagnosis. Findings are discussed in terms of enhancing dissemination of evidence-based treatments for internalizing disorders in community settings.

Adapting evidence-based mental health treatments in community settings: preliminary results from a partnership approach.

This article describes the application of a university-community partnership model to the problem of adapting evidence-based treatment approaches in a community mental health setting. Background on partnership research is presented, with consideration of methodological and practical issues related to this kind of research. Then, a rationale for using partnerships as a basis for conducting mental health treatment research is presented. Finally, an ongoing partnership research project concerned with the adaptation of evidence-based mental health treatments for childhood internalizing problems in community settings is presented, with preliminary results of the ongoing effort discussed.