The effectiveness of Forensic Outpatient Systemic Therapy in the treatment of juvenile antisocial behavior: A study protocol of a Multiple Case Experimental Design.

BACKGROUND: Juvenile antisocial behavior can have long-lasting and devastating effects for juveniles themselves, victims, and society. Evidence-based treatment is vital. Forensic Outpatient Systemic Therapy (Forensische Ambulante Systeem Therapie; FAST) is a promising treatment for juveniles showing severe antisocial behavior including aggression, (domestic) violence, and delinquent behavior. FAST has a flexible intensity and length, addresses individual and systemic risk and protective factors, and is responsive to the abilities of the client (system), intervention characteristics all considered crucial for effective treatment. The current study will investigate whether FAST is effective in reducing aggression of the juvenile, reaching client formulated subgoals, and improving family functioning. Processes of change will be examined, as well as mediation by reaching client formulated subgoals and improved family functioning. METHODS: A Multiple Case Experimental Design (MCED) with an ABC design will be performed (A = baseline, B = intervention, and C = follow-up). Juveniles with primary aggression and/or anger problems (N = 15) and their caregiver(s) will be recruited. Data collection will consist of self-report questionnaires and case file analysis. Participants fill out frequent short self-report questionnaires (twice a week during phase A, every other week during phase B, and every week during phase C) and two main questionnaires at the start of the intervention and immediately after intervention end, thereby covering a period of 5 to 11 months. Both visual and statistical analyses will be performed. DISCUSSION: This study will generate robust knowledge and inform clinical practice on the effectiveness, processes of change, and mediating mechanisms of FAST, aiming to improve the treatment of future families within youth forensic care. TRIAL REGISTRATION: This trial was registered at ClinicalTrials.gov on 28/08/2023, protocol ID 60-63600-98-1138a.

Maternal personality change from pregnancy until 12 months postpartum: Associations with parenting.

Although many studies have shown that personality-as a relatively stable characteristic-is a predictor of parenting behavior, personality changes occur during adulthood. Therefore, we do not know whether previous findings based on personality assessed (long) after the birth of the child indicate that personality as assessed before the child is born predicts behaviors parents eventually display. Possibly, personality changes are additionally predictive for parenting behavior. With this three-wave longitudinal study, we aimed to examine whether mothers' personality change from pregnancy to postpartum predicts maternal parenting behavior above and beyond personality traits as assessed during pregnancy. A sample of 239 pregnant women participated in the study (Mage = 29.95 years, SD = 4.08, range 20-43; 53% primiparous; 95% of Dutch descent). Women reported their big five personality traits during pregnancy (T1), at six- (T2), and 12 months postpartum (T3). At the postpartum assessments, mothers also reported on their affectionate and hostile parenting behavior. Latent Difference Score models indicated that personality at T1 predicted hostile but not affectionate parenting behavior at T2. Changes in personality from T1 to T2 were associated with maternal hostile and affectionate parenting at T2, whereas changes from T2 to T3 were unrelated to parenting. Personality as assessed during pregnancy may thus be helpful in identifying mothers at risk of early hostile parenting behavior. Identifying predictors of personality change may inform preventive efforts aimed at reducing this risk, as personality changes from pregnancy to 6 months postpartum were more predictive of maternal parenting than initial levels. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Living Situation of Juveniles After Secure Residential Treatment: Exploring the Role of Family Centeredness, Child, and Family Factors.

To promote the return of juveniles to a home-like environment (e.g. living with (foster)parents) after secure residential treatment (SRT), it is important to know which factors are related to this outcome. The current study examined which characteristics of the juvenile, family, and SRT, including family centeredness and use of systemic interventions, are related to the living situation after discharge. For 259 juveniles (mean age 15.82 years, 127 girls) in SRT and their parents, questionnaires were administered at admission, discharge, and 6-months follow-up. Furthermore, information about the living situation before and after SRT was gathered. Higher likelihood of living in a home-like setting after SRT correlated with more furlough moments with parents, receiving a systemic intervention, and a shorter duration of the SRT. Systemic interventions during SRT and spending furlough moments with parents may have a positive impact on returning to a home-like situation after SRT for juveniles.

Online Delinquent Behaviors of Adolescents: Parents as Potential "Influencers"?

In this study we examined whether aspects of parental monitoring of adolescents' online behavior (rules regarding time spent on the internet, rules regarding content of internet use, frequency of communication, and quality of communication about internet use) are related to different kinds of online delinquent behaviors (sexting, spreading viruses, DDoS attacking, hacking, and online threatening) and whether the level of adolescents' problematic (addictive) internet use mediates these relations. In regular Dutch high schools 1,009 adolescents filled out an online questionnaire (with adjusted versions of the ISPP, PIUQ, and the Dutch Youth Crime Monitor). Descriptive statistics showed that, in general, parents do not seem to monitor adolescents' online behavior to a great extent. Furthermore, results of logistic regression analyses and mediation tests showed that fewer rules about online time, more rules about online content, and a good quality of parent-adolescent communication about online behavior are all associated with lower problematic internet use, which in turn is associated with lower odds of several online delinquent behaviors (mediation). Moreover, parental handling of rules about online content is also directly associated with lower odds of spreading viruses, hacking, and online threat.

The effectiveness of blended versus regular Forensic Outpatient Systemic Therapy in the treatment of juvenile antisocial behavior: a study protocol of a randomized controlled trial.

BACKGROUND: Antisocial behavior during adolescence can have long-lasting negative effects and leads to high societal costs. Forensic Outpatient Systemic Therapy (Forensische Ambulante Systeem Therapie; FAST) is a promising treatment for juveniles aged 12-21 showing severe antisocial behavior. The intensity, content and duration of FAST can be adjusted to the needs of the juvenile and their caregiver(s), which is considered crucial for effective treatment. Next to the regular version of FAST (FASTr), a blended version (FASTb) in which face-to-face contacts are replaced by minimally 50% online contacts over the duration of intervention was developed during the Covid-19 pandemic. The current study will investigate whether FASTb is equally effective as FASTr, and through which mechanisms of change, for whom, and under which conditions FASTr and FASTb work. METHODS: A randomized controlled trial (RCT) will be carried out. Participants (N = 200) will be randomly assigned to FASTb (n = 100) or FASTr (n = 100). Data collection will consist of self-report questionnaires and case file analysis, and include a pre-test at the start of the intervention, a post-test immediately after the intervention, and a six month follow-up. Mechanisms of change will be investigated using monthly questionnaires of key variables during treatment. Official recidivism data will be collected at two-year follow-up. DISCUSSION: This study aims to improve the effectiveness and quality of forensic mental health care for juveniles with antisocial behavior by studying the effectiveness of blended care, which has not been studied before in treatment of externalizing behavior. If found to be at least as effective as face-to-face treatment, blended treatment can help meet the urgent need for more flexible and efficient interventions in this field. In addition, the proposed study aims to unravel what works for whom, knowledge urgently needed in mental health care for juveniles with severe antisocial behavior. TRIAL REGISTRATION: This trial was registered at ClinicalTrials.gov on 07/11/2022, registration number NCT05606978.

Adding Structured Components to Home Visitation to Reduce Mothers' Risk for Child Maltreatment: a Randomized Controlled Trial.

Purpose: Home visitation program effects are generally small, which may be caused by flexible intervention content leading to inconsistent outcomes. In this study we therefore examined whether the effectiveness of a Dutch home visitation program (i.e., Supportive Parenting) can be improved by adding structured intervention components targeting key risk factors for child maltreatment: parental sense of competence, perceived stress, parental anger, and PTSD symptoms. Method: Participants were randomly assigned to an experimental group (n = 74) that received four additional intervention components in two home visits, or a control group (n = 60) that received regular Supportive Parenting. Outcomes were assessed before (T1) and after (T2) the first, and before (T3) and after (T4) the second home visit. Effects were examined using ANCOVA for primary outcomes: parental sense of competence, perceived stress, parental anger, and PTSD symptoms, and secondary outcomes: risk of child maltreatment, parental warmth, and negative parenting. Moderation effects were examined for T1 scores, child temperament and life events. Results: Mothers who received the intervention components showed less stress compared to the control group at T3 and T4. There were no differences between groups on other outcomes and no moderation effects, although parental sense of competence reduced and anger increased within the experimental group specifically. Conclusion: The structured components may enhance the effectiveness of Supportive Parenting to reduce parenting stress. Future research into how other outcomes can be improved is needed. Supplementary Information: The online version contains supplementary material available at 10.1007/s10896-023-00509-7.

The Effectiveness of School-Based Skills-Training Programs Reducing Performance or Social Anxiety: Two Randomized Controlled Trials.

Background: Given that high levels of stress during adolescence are associated with negative consequences, it is important that adolescents with psychological needs are supported at an early stage, for instance with interventions at school. However, knowledge about the potential of school-based programs targeting adolescents with psychological needs, aimed at reducing school or social stress, is lacking. Objective: The current study aimed to investigate the effectiveness of two targeted school-based skills-training programs, addressing either skills to deal with performance anxiety or social skills. Methods: Two randomized controlled trials were performed with participants who self-selected to one of the programs. The sample comprised of N = 361 adolescents (M age = 13.99 years, SD = 0.83) from various educational levels and ethnic identity backgrounds. The performance anxiety program included N = 196 participants (N = 95 in the experimental group), while the social skills program included N = 165 participants (N = 86 in the experimental group). MANCOVA's were performed. Results: The performance anxiety program had a small effect on reducing adolescents' test anxiety. Furthermore, for adolescents who attended more than half of the sessions, the program had small effects on reducing test anxiety and fear of failure. The program did not improve adolescents' coping skills or mental health. The social skills program was not effective in improving social skills, social anxiety, and mental health. Conclusions: A relatively short, targeted program addressing skills to deal with performance anxiety can have the potential to reduce adolescents' performance anxiety. Trial registration: International Clinical Trials Registry Platform (Netherlands Trial Register, number NTR7680). Registered 12 December 2018. Study protocol van Loon et al., (2019). Supplementary Information: The online version contains supplementary material available at 10.1007/s10566-023-09736-x.

Parental Discipline Techniques and Changes in Observed Temper Tantrum Severity in Toddlers.

Although temper tantrums are considered a normal part of emotional development in toddlerhood, for some they foreshadow more serious behavioral and emotional problems. Parental discipline techniques may play a role in explaining why this behavior worsens for some children whereas for others it fades away. With this three-wave longitudinal study, we examined bidirectional associations between specific discipline techniques - ignoring, power assertion, and consistency - and intra-individual changes in the severity of tantrum behavior. We observed tantrum behavior in a standardized clean-up task, overcoming the limitation of most earlier work that relied on parent-report for associated changes in parenting and child behavior over time. For 94 children (53 boys; Mage = 30 months, range 20-43 months), mothers filled out the Parenting Dimensions Inventory, and temper tantrum severity (i.e., duration and aggressiveness) was coded three times across one year. Random Intercept Cross-Lagged Panel Models suggested parent-effects rather than child-effects: more maternal power assertion and less consistency predicted increases in tantrum severity over time (ignoring did not), but temper tantrum severity did not predict changes in parenting over time. Results indicate that reducing power assertion and increasing consistency may be especially helpful in reducing temper tantrums in children. Findings add to previous findings indicating that mothers' parenting may be driven less by objective child behavior than by her own perceptions of her child's behavior.

Ramping Up Detention of Young Serious Offenders: A Safer Future?

When youth commit serious violent or sexual offenses, this often generates a call for more severe punishments and longer detention sentences. An important question is whether (long) detention sentences are effective in decreasing recidivism among serious young offenders. To estimate recidivism rates in serious young offenders and elucidate the link between sentencing (in terms of custodial vs. non-custodial and length of imprisonment) and recidivism, three multilevel meta-analyses were conducted. With a systematic literature search, 27 studies and four datasets were traced, involving N = 2,308 participants, yielding 90 effect sizes for overall recidivism, 24 for specifically violent recidivism, and 23 for the association between length of imprisonment and recidivism. The average weighted overall recidivism rate was 44.47% (95% confidence interval [CI]: 37.59-51.46%) over an average period of 8.68 years. The rate of violent recidivism was estimated at 30.49% (95% CI: 20.92-40.52%), over an average period of 11.45 years. Recidivism rates were higher when recidivism was defined as an arrest for any new offense rather than for a specific offense and in studies conducted in the United States versus European studies. Violent recidivism rates were higher in studies with longer follow-up periods. Based on the limited available studies, no difference in recidivism rates following custodial and non-custodial sentences were found, nor an association between length of imprisonment and recidivism. To increase rehabilitation chances for youth offenders, further research is warranted to better understand the impact of sentencing and to ascertain what is needed to make custodial and non-custodial sentences more effective.

Just as they expected: How parents' expectations about their unborn child's characteristics provide a context for early transactions between parenting and child temperament.

Prenatal expectations about what children will be like after birth may provide a context for how parents perceive their infant's actual temperament. We examined how these expectations and perceptions are associated and together predict early parenting behavior, with parenting behavior in turn predicting changes in temperament. Reports of 125 families (N = 122 fathers; N = 123 mothers; sample 1) about their expectations of their unborn child's temperament (negative affectivity, surgency, regulation, T1), their infant's temperament at 4 and 12 months post-partum (T2 and T3), and their hostile, responsive, warm, and overprotective parenting (T2) were included. We also included data from an independent sample of 168 mothers (sample 2), with the same measures, except that mothers reported on Big Five personality traits at T1. Results indicated that in both samples, parents' expectations were positively associated with perceptions of infant temperament. Prenatal expectations and newborn temperament independently predicted parenting behavior, and maternal and paternal parenting in turn predicted infant temperament at T3, controlling for infant temperament at T2. Although overall findings indicated associations between (expectations of) a more difficult temperament and more negative/less positive parenting, significant combinations of specific traits and parenting behaviors were sample-specific-indicating that more research is necessary to draw a conclusion about specific links. Both maternal and paternal expectations about their unborn child's temperament appear to carry over into the postpartum reality and provide a context for shaping early interactions between caregivers and their children, which may further shape the developing temperament of the child.

Trajectories of adolescent perceived stress and symptoms of depression and anxiety during the COVID-19 pandemic.

Adolescents might be particularly affected by the drastic social changes as a consequence of the COVID-19 pandemic, given the increased stress-sensitivity and importance of the social environment in this developmental phase. In order to examine heterogeneity during the pandemic, the current study aimed to identify whether subgroups of adolescents could be distinguished based on their levels of perceived stress and symptoms of depression and anxiety. In addition, we examined which prepandemic factors predicted these trajectories. Adolescents were assessed before the pandemic (N = 188, Mage = 13.49, SD = 0.81) and at three timepoints during the pandemic (i.e., eight, ten, and 15 months after the start of the pandemic in the Netherlands). Results showed no support for distinct trajectories of perceived stress, adolescents experienced stable moderate levels during the pandemic. In contrast, results showed three trajectories for depression and anxiety. The majority of adolescents reported stable low or moderate levels and one small subgroup reported high levels of depression and anxiety that decreased during the pandemic. Certain prepandemic factors predicted higher initial levels of stress and symptoms of depression and anxiety during the pandemic. To support adolescents with prepandemic vulnerabilities, strategies could be developed, for instance enhancing adolescents' social support.

A Friend in Prison: Human-Animal Bond, Stress and Self-Esteem of Detained Juveniles in Dutch Cell Dogs.

This study examined to what extent the human-animal bond (HAB) had a positive impact on stress and self-esteem among detained juveniles participating in the prison-based dog training program Dutch Cell Dogs (DCD). Participants were 75 detained juveniles (mean age = 19.5, 86.7% male). Self-reported stress and self-esteem were assessed before the start of DCD (T1), after four weeks (halfway training/T2) and after eight weeks (end training/T3). Structured interviews and questionnaire items were used to measure the HAB quality and perceived reciprocity in the HAB at T2 and T3. Data were analyzed using Structural Equation Modeling. In the variable-centered approach analyses, only the cross-sectional positive association between HAB quality and self-esteem at T2 was significant in the cross-lagged panel models. None of the cross-lagged paths between the HAB and stress or self-esteem were significant. In the person-centered approach analyses, growth mixture modeling identified two patterns of self-esteem ("high stable" and "high decreasing"); however, these patterns were not predicted by HAB. Thus, in contrast to our hypotheses, the HAB did not predict improvements in detained juveniles' stress and self-esteem. These findings underline the need for more research into the often-presumed role of HAB within prison-based dog training programs.

The effects of school-based interventions on physiological stress in adolescents: A meta-analysis.

Chronic stress is associated with dysregulations in the physiological stress system, resulting in diverse negative developmental outcomes. Since adolescence is a period characterized by increased stress-sensitivity, and schools are an important environment for the developing adolescent, school-based interventions promoting psychosocial functioning are of particular interest to prevent adverse outcomes. The present study therefore aimed to investigate the effectiveness of such interventions on hypothalamic pituitary adrenal-axis (i.e., cortisol) and cardiovascular (i.e., blood pressure [BP] and heart rate [HR]/heart rate variability [HRV]) parameters of stress in adolescents, and examined moderators of effectiveness. The search resulted in the inclusion of k = 9 studies for cortisol, k = 16 studies for BP, and k = 20 studies for HR/HRV. The results indicated a significant small overall effect on reducing BP, but no significant effect for HR/HRV. For cortisol, large methodological variation in the few primary studies did not allow for quantitative analyses, but a qualitative review demonstrated inconsistent results. For BP and HR/HRV, larger effects were observed for intervention programs with a mindfulness and/or meditation component, for interventions without a cognitive-behavioural component and for interventions with a higher intensity. Providing adolescents with techniques to improve indicators of physiological stress may prevent emerging mental health problems.

Heart-wired to be cold? Exploring cardiac markers of callous-unemotional traits in incarcerated offenders.

Elevated callous-unemotional (CU) traits have been repeatedly identified in a subgroup of offenders that displays severe antisocial behavior; establishing physiological markers may help improve early identification and treatment efforts. This study examines to what extent baseline-resting heart rate (HR) and heart rate variability (HRV) can be used as markers of CU in incarcerated juvenile and adult offenders. CU traits were assessed using the Inventory of Callous-Unemotional traits. Results of the multiple hierarchical regression tests indicated that there was a small yet significant positive association between baseline HR and CU and negative association between HRV and CU in juvenile offenders with medium model effect sizes (R2 = 0.115 for HR-CU; R2 = 0.126 for HRV-CU). The cardiac markers were unrelated to CU in adult offenders. These findings are important because they demonstrate that impaired cardiac autonomic activity is related to CU traits in juveniles, suggesting that socioemotional processing difficulties should be considered in understanding these deficits. Future research should be conducted in large samples, under reactive and static conditions, while including cardiac covariates, to get more clarity on the interplay between biological systems and behavioral expression.

Prepandemic Risk Factors of COVID-19-Related Concerns in Adolescents During the COVID-19 Pandemic.

To identify adolescents who may be at risk for adverse outcomes, we examined the extent of COVID-19-related concerns reported by adolescents and investigated which prepandemic risk and protective factors predicted these concerns during the COVID-19 pandemic. Dutch adolescents (N = 188; Mage  = 13.49, SD = .81) were assessed before the pandemic and at eight and ten months into the pandemic. Results demonstrated that adolescents' most frequently reported COVID-19-related concerns were about social activities and getting delayed in school. Adolescents that have specific vulnerabilities before the pandemic (i.e., higher stress, maladaptive coping, or internalizing problems) experience more concerns during the pandemic, stressing the importance of guiding and supporting these adolescents in order to prevent adverse developmental outcomes.

A Quasi-Experimental Study on the Effectiveness of Dutch Cell Dogs in Incarcerated Youth.

This study examined the effectiveness of Dutch Cell Dogs (DCD), a prison-based dog training program that aims to improve socioemotional functioning of incarcerated youth by giving them the opportunity to train a shelter dog. Primary (aggression and institutional infractions) and secondary (wellbeing and therapeutic functioning) outcomes were assessed for the intervention (n = 61) and comparison group (n = 77) before the start of DCD, after 4 weeks, and after 8 weeks at posttest. Overall, DCD participation was not effective. Compared to the comparison group, institutional infractions decreased in DCD participants with an immigrant background and increased in DCD participants with a native Dutch background. In addition, DCD participation reduced the quality of the therapeutic alliance for younger participants and those in secure residential facilities. The current study demonstrated heterogeneity in DTP responsiveness. Future research with robust designs and sufficiently large samples is needed to further identify who benefits from DTPs.

Brief report: The effectiveness of Dutch Cell Dogs: A multiple case experimental study.

Prison-based dog training programs (DTPs) aim to improve successful rehabilitation after detention. However, empirical evidence for their effectiveness is lacking. To evaluate the effectiveness of a DTP-Dutch Cell Dogs (DCD)-on externalizing behavior, stress, self-esteem, empathy, and treatment motivation, a pilot study with a Multiple Case Experimental Design in six adolescents residing in a juvenile justice center (JJC) was conducted. Results did not provide convincing evidence for DCD's effectiveness. Further research is needed to determine whether and for whom DCD could be a useful addition to regular JJC programming.

Can Schools Reduce Adolescent Psychological Stress? A Multilevel Meta-Analysis of the Effectiveness of School-Based Intervention Programs.

Increased levels of psychological stress during adolescence have been associated with a decline in academic performance, school dropout and increased risk of mental health problems. Intervening during this developmental period may prevent these problems. The school environment seems particularly suitable for interventions and over the past decade, various school-based stress reduction programs have been developed. The present study aims to evaluate the results of (quasi-)experimental studies on the effectiveness of school-based intervention programs targeting adolescent psychological stress and to investigate moderators of effectiveness. A three-level random effects meta-analytic model was conducted. The search resulted in the inclusion of k = 54 studies, reporting on analyses in 61 independent samples, yielding 123 effect sizes (N = 16,475 individuals). The results indicated a moderate overall effect on psychological stress. Yet, significant effects were only found in selected student samples. School-based intervention programs targeting selected adolescents have the potential to reduce psychological stress. Recommendations for practice, policy and future research are discussed.

The effectiveness of school-based skills-training programs promoting mental health in adolescents: a study protocol for a randomized controlled study.

BACKGROUND: Adolescence is a period of elevated stress sensitivity, which places adolescents at increased risk of developing mental health problems such as burnout, depression, anxiety, and externalizing problems. Early intervention of psychological needs and low-threshold care addressing such needs may prevent this dysfunctional development. Schools may provide an important environment to identify and address psychological needs. The aim of this protocol is to describe the design of a study aiming to evaluate the effectiveness of low-threshold school-based skills-training programs promoting the mental health of adolescents and to examine moderators of the effectiveness. METHODS: A Randomized Controlled Trial will be conducted to examine the effectiveness of two school-based skills-training programs aiming to promote mental health by improving either skills to deal with performance anxiety or social skills. A multi-informant (i.e., students, parents, and trainers) and multi-method (i.e., questionnaires and physiological measurements) approach will be used to assess program targets (skills to deal with performance anxiety or social skills), direct program outcomes (performance or social anxiety) and mental health outcomes (i.e., stress, internalizing and externalizing problems, self-esteem and well-being), as well as specific moderators (i.e., student, parent and program characteristics, social support, perfectionism, stressful life events, perceived parental pressure, positive parenting behavior, treatment alliance and program integrity). DISCUSSION: The current study will provide information on the effectiveness of school-based skills-training programs. It is of crucial importance that the school environment can provide students with effective, low-threshold intervention programs to promote adolescents' daily functioning and well-being and prevent the emergence of mental health problems that negatively affect school performance. TRIAL REGISTRATION: Dutch Trial Register number NL7438 . Registered 12 December 2018.

A Randomized Controlled Trial on the Effectiveness of Family Group Conferencing in Child Welfare: Effectiveness, Moderators, and Level of FGC Completion.

The present study examined the effectiveness of Family Group Conferencing (FGC) in child welfare. Effects were operationalized in terms of child safety (child maltreatment, supervision order, and out-of-home placement), number of professional services used, parental empowerment, and social support in a 1-, 3-, 6-, and 12-month follow-up. Furthermore, the influence of family characteristics and the level of FGC completion were examined. A total of 328 families were included, randomly assigned to an experimental group ( n = 229) and a care as usual (CAU) group ( n = 99). FGC was equally effective as CAU in improving child safety but resulted in more out-of-home placements. Furthermore, FGC resulted in a longer duration of child welfare involvement, a marginally higher number of professional services used, and increased parental empowerment and social support. Family characteristics did not moderate the results. Level of FGC completion was in general low. Higher levels of completion were related to a larger social network, a higher number of professional services used, and, marginally, less parental empowerment. In conclusion, although some beneficial results marginally support the use of FGC, it is the question whether these effects outweigh FGC costs, a longer duration of child welfare involvement and a higher number of professional services used.