6-Week student wellness program improves psychological wellbeing of students.

Objective: Employing a waitlist control design, the current study examined the effectiveness of a shortened version of a newly developed wellness program. Participants/Methods: Twenty-four students were randomly assigned to an experimental wellness (EW) group or a waitlist control (WLC) group. The 6-week wellness program focused on specific wellness topics (i.e., relaxation and mindfulness, yoga, gratitude and self-compassion, emotion regulation, goal setting and time management, and nutrition and movement). Both mental health and wellbeing outcomes were examined pre-post group. Results/Conclusions: Findings revealed that the EW group reported significantly improved overall psychological wellbeing, optimism, self-compassion, and satisfaction with life following the program relative to baseline, but the WLC group did not.

Student wellness: Interest and program ideas & pilot of a student wellness program.

Objective: To increase our knowledge related to student wellness programs, the current studies examined interest in wellness and wellness programs among university students and piloted a newly developed wellness program targeting students in higher education. Participants/Methods: In Study 1, 93 undergraduate students answered questions related to their wellness and mental health (e.g. psychological wellbeing, satisfaction with life, optimism, and stress) and to wellness programs (e.g. interest, barriers, duration, and topics). In Study 2, 13 undergraduate and graduate students participated in a 9-week pilot wellness program focused on specific wellness topics (e.g. relaxation, yoga, gratitude and self-compassion, and emotion regulation). Results/Conclusions: Study 1 results support a strong interest in wellness and wellness programs among undergraduate students. Study 2 results suggest that students who participated in an on-campus wellness program reported higher levels of overall psychological wellbeing and optimism and lower levels of mental health issues relative to baseline.

Parental ADHD Knowledge in Latinx Families: Gender Differences and Treatment Effects.

OBJECTIVE: The current study aimed to extend findings of a study comparing two psychosocial treatments for ADHD in Latinx youth by examining if parental ADHD knowledge improves following treatment and if parental gender differences in ADHD knowledge exist. METHOD: Following a comprehensive ADHD assessment, 58 Latinx families of school-aged children (mean age of 8 years) were randomly assigned to either culturally-adapted treatment (CAT) or standard evidence-based treatment (EBT). Parents completed an ADHD Knowledge measure both pre- and post-treatment. RESULTS/CONCLUSION: Latinx mothers demonstrated greater knowledge of ADHD symptomatology than fathers at pre-treatment. CAT resulted in improvements in parental knowledge of ADHD for both mothers and fathers, whereas standard EBT resulted in no change in maternal knowledge and reduced paternal knowledge of ADHD symptomatology. Clinical implications will be discussed.

Family Functioning in Latinx Families of Children with ADHD: The Role of Parental Gender and Acculturation.

OBJECTIVES: It has been well-established that parents of children with ADHD report significantly higher levels of parenting stress and home chaos, and lower levels of parental efficacy than parents of children without ADHD. Unfortunately, most of the extant ADHD literature has focused on European American children and families, resulting in a paucity of research focusing on ethnic minority families of children with ADHD. The current study aimed to expand what is known about Latinx parents of children with ADHD by exploring contextual and cultural factors, such as parental gender and acculturation, which may account for variations in parenting experiences within this population. METHODS: The present study utilized secondary data analysis to analyze ratings of parenting stress, home chaos, and parental efficacy among a sample of Latinx mothers and fathers of children with ADHD (n = 46 dyads). RESULTS: Results indicated that Latinx mothers of children with ADHD reported higher levels of parenting stress than Latinx fathers of children with ADHD; however, no significant parental gender differences were found in ratings of parental efficacy or home chaos. Additionally, several significant relationships were found between parental acculturation and family functioning variables. CONCLUSIONS: Latinx families of children with ADHD are an understudied and underserved population within the field of clinical psychology. The current study provides critical information on Latinx family functioning within the context of ADHD treatment, specifically pertaining to the complex interplay of parenting and acculturation variables.

Incremental Clinical Utility of ADHD Assessment Measures With Latino Families.

Objective: This study examined the incremental clinical utility of parent and teacher reports of ADHD symptomatology and functional impairment in Latino youth, as well as parent and teacher agreement with the final clinical judgment on a diagnostic structured interview. Method: Participants included 70 Latino youth (47 males, 23 females; M age = 8.13 years, SD = 2.51 years) and their parents and teachers; 60 participants were diagnosed with ADHD. Correlations, percent agreement, kappas, and regressions were utilized. Results: Results demonstrated that teachers agreed with the final clinical judgment more often than did parents. Results additionally demonstrated that functional impairment did not statistically significantly improve diagnostic models already including ADHD symptoms; follow-up analyses were run and are discussed. Finally, results demonstrated that teacher reports statistically significantly improved diagnostic models already including parent reports. Conclusion: The current findings suggest the importance of including both parent and teacher reports of both ADHD symptomatology and functional impairment when assessing ADHD in Latino youth.

Examination of a Parent-Assisted, Friendship-Building Program for Adolescents With ADHD.

OBJECTIVE: Youth with ADHD experience significant impairment in peer functioning. Based on recommendations from the literature, the current pilot study examined the effectiveness of a parent-assisted, friendship-building program at establishing mutual friendships and improving peer relationships in adolescents with ADHD. METHOD: Participants included 20 adolescents with ADHD (ages 11-16 years) and their parent(s). Families completed the Program for the Evaluation and Enrichment of Relational Skills (PEERS). Measures of friendship quality, social knowledge, social self-efficacy, get-togethers, and peer conflict were completed at baseline and post-treatment. At post-treatment, participants also reported on the initiation of a new friendship. RESULTS: Baseline to post-treatment differences were examined using paired-samples t tests. The majority of participants reported the initiation of a new friendship at post-treatment. Adolescents also demonstrated significantly improved social knowledge and increased get-togethers. Effect sizes were large. CONCLUSION: Following participation in PEERS, adolescents improved in several peer functioning domains and many initiated new friendships.

Maternal Functioning Differences Based on ADHD Subtype.

OBJECTIVE: Maternal functioning differences in parenting stress, parental efficacy, and parenting behaviors were examined for mothers of children with ADHD. METHOD: Participants included 29 mothers of children with ADHD, Predominantly Inattentive Type (ADHD-I) and 38 mothers of children with ADHD, Predominantly Hyperactive-Impulsive or Combined Type (ADHD-HI/C). RESULTS: Findings suggest that mothers of children with ADHD-HI/C reported significantly greater parenting stress and engaged in more negative parenting behaviors than mothers of children with ADHD-I. CONCLUSION: This study suggests that tailoring behavioral parent training based on ADHD subtype may be particularly helpful for parents of children with ADHD-HI/C.

Culturally Appropriate Assessment of Functional Impairment in Diverse Children: Validation of the ADHD-FX Scale With an At-Risk Community Sample.

OBJECTIVE: In an effort to reduce disparities in ADHD diagnoses and treatment across cultures, the current study sought to establish initial psychometric and cultural properties of the ADHD-FX: a culturally sensitive assessment measure of functional impairment related to ADHD for diverse families. METHOD: Fifty-four Latino parents (44 mothers and 10 fathers) of school-aged children completed the ADHD-FX, as well as several other measures assessing child behavior and parent acculturation. RESULTS: The ADHD-FX demonstrated adequate reliability (as demonstrated by internal consistency and test-retest reliability), psychometric construct validity (as demonstrated by associations with theoretically related measures), and cultural validity (as demonstrated by or lack of associations with acculturation measures). CONCLUSION: Initial psychometric and cultural properties suggest that the ADHD-FX is a reliable, valid, and culturally appropriate measure to assess functional impairment related to ADHD (i.e., difficulties with academic achievement, social competence, and familial relationships) in an at-risk, school-aged population.

Latino Family Participation in Youth Mental Health Services: Treatment Retention, Engagement, and Response.

Although researchers have identified a multitude of factors that contribute to family participation in mental health services, few studies have examined them specifically for Latino youth and their families in the U.S., a population that continues to experience significant disparities related to the availability, accessibility, and quality of mental health services. Latino youth and their families are at greater risk of dropping out of treatment prematurely and demonstrating poor treatment engagement, both of which have subsequent negative effects on treatment response outcomes. In order to help to guide efforts to improve the accessibility and quality of mental health services for Latino youth and their families, the current paper integrates modern conceptualization of family participation in youth mental health services and provides a summary of contextual factors within an ecological framework (Bronfenbrenner in The ecology of human development: experiments by nature and design, Harvard University Press, Cambridge, 1979). The current review aims to integrate empirical research on the impact of various contextual factors across multiple levels (i.e., culture, community, mental health system, family, parent/caregiver, and child/adolescent) on Latino family participation in youth mental health services, including treatment retention, engagement, and response. Clinical implications will be discussed, and an integrated, conceptual model will be presented. Not only does this model help to demonstrate the way in which existing literature is conceptually linked, but it also helps to highlight factors and underlying processes that health care providers, administrators, and policy makers must consider in working to improve mental health services for Latino youth and their families living in the U.S.

Rates, Associations, and Predictors of Psychopathology in a Convenience Sample of School-Aged Latino Youth: Identifying Areas for Mental Health Outreach.

The Latino youth population is rapidly growing and expected to comprise nearly 40% of the total youth population by 2060. Unfortunate disparities exist in the United States (U.S.), such that young Latinos are less likely than non-Hispanic Whites to receive and benefit from mental health services. In order to identify and prioritize specific areas of mental health outreach, the current study examined preliminary rates, associations, and predictors of child psychopathology in a convenience sample of Latino youth. 123 Spanish and English speaking Latino parents of school-aged children completed a series of questionnaires regarding child and family functioning. Latino youth in the current sample demonstrated comparable rates of psychopathology to non-referred, normative samples. Parental acculturation (particularly Separated parental acculturation status: high orientation to Latino culture and low orientation to U.S. mainstream culture) was associated with an increased prevalence of clinically significant psychopathology across several domains, and socioeconomic status was associated with an increased prevalence of thought problems. Additionally, Separated parental acculturation status significantly predicted the prevalence of clinically significant anxious/depressed problems, such that youth of parents displaying Separated acculturation status were significantly more represented in the clinically-elevated groups than the functional groups. These preliminary results suggest that prioritizing outreach to Latino youth of parents maintaining orientation to Latino culture but not U.S. mainstream culture may be necessary in order to begin addressing existing mental health disparities in the U.S.

Understanding and Measuring Functional Impairment in Diverse Children With ADHD: Development of the ADHD-FX Scale With an At-Risk, Community Sample.

OBJECTIVE: The current study sought to develop a culturally appropriate measure of functional impairment related to ADHD for diverse families, as research suggests that functional impairment may be a more culturally universal construct than symptomatology. METHOD: Seventy-four low-acculturated Latino parents (49 mothers and 25 fathers) of school-aged children provided quantitative and qualitative responses about problem recognition after viewing a language-free video of a child displaying symptoms and behaviors consistent with ADHD. RESULTS: Thirty-two items were developed for the ADHD-FX scale based on most common responses given from participants. The scale is available in Spanish and English and instructs parents to consider how much each item affects their child in his or her everyday life (from 0 = not at all to 3 = a lot). CONCLUSIONS: The scale can provide an overall impairment score, as well as subscale scores in the theoretically derived domains of academic, peer, and familial impairment. (J. of Att. Dis. 2016; 20(6) 487-500).

Understanding parental locus of control in Latino parents: Examination of cultural influences and help-seeking intentions for childhood ADHD.

OBJECTIVE: To address the disparities that exist in utilization of mental health services for ADHD among Latino families and to further our understanding of factors that influence parents' decisions to seek treatment for ADHD, the goal of the current study was to examine parental locus of control (PLOC) in a community sample of Latino parents. Specifically, the current study investigated cultural influences on PLOC, as well as the influence of PLOC on help-seeking. METHOD: Seventy-four primarily Spanish-speaking, Latino parents of school-age children completed measures to assess their help-seeking intentions, PLOC, and cultural orientation. RESULTS: Results indicated that U.S. mainstream orientation was associated with increased feelings of parental control and decreased beliefs in fate/chance and several Latino cultural values were associated with increased beliefs in fate/chance, and decreased feelings of parental efficacy and parental control. In addition, 2 PLOC domains (e.g., parental efficacy and fate/chance) were associated with beliefs that the behaviors of a child with ADHD would go away on their own. CONCLUSIONS: Results highlight the need for interventions aimed at modifying parenting behavior to take parents' cultural beliefs and values into account in order to accommodate and engage Latino families more effectively.

A Review of Peer Relationships and Friendships in Youth With ADHD.

OBJECTIVE: The purpose of this essay is to examine peer relationships in youth with ADHD and to review current peer functioning interventions. METHOD: The studies included in this review were identified using the following search terms: "attention-deficit/hyperactivity disorder," "ADHD," "peer relationships," "friendships," "social skills," "intervention," and "treatment." Other than a few seminal studies published prior to 2000, studies included were published between 2000 and 2012. RESULTS/DISCUSSION: Background information regarding peer relationship difficulties and specific social skills deficits of youth with ADHD is reviewed and current social skills and friendship intervention programs are examined. Future directions also are provided.

Acculturation and Latino adolescent mental health: integration of individual, environmental, and family influences.

In order to address the mental health disparities that exist for Latino adolescents in the United States, psychologists must understand specific factors that contribute to the high risk of mental health problems in Latino youth. Given the significant percentage of Latino youth who are immigrants or the children of immigrants, acculturation is a key factor in understanding mental health among this population. However, limitations in the conceptualization and measurement of acculturation have led to conflicting findings in the literature. Thus, the goal of the current review is to examine and critique research linking acculturation and mental health outcomes for Latino youth, as well as to integrate individual, environmental, and family influences of this relationship. An integrated theoretical model is presented and implications for clinical practice and future directions are discussed.

Latino parental help seeking for childhood ADHD.

To better understand the help seeking process that occurs within Latino families when a child is exhibiting behaviors consistent with attention-deficit/hyperactivity disorder (ADHD), qualitative and quantitative data from 73 Latino parents were examined. Findings suggest that most Latino parents in the current sample recognized ADHD symptoms as concerning and in need of professional help and reported being motivated to seek help. Unfortunately, they also appeared to lack knowledge about the etiology of and effective treatment for ADHD, and many identified barriers to seeking help. Future research must involve community collaborations aimed at increasing awareness and knowledge of ADHD and decreasing barriers to seeking help in targeted Latino communities.

Acculturation, cultural values, and Latino parental beliefs about the etiology of ADHD.

Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent mental health disorders of childhood. Despite the availability of several evidence-based interventions, Latino children are more likely than non-minority children to have an unmet need for services related to ADHD. Given that parental beliefs about the etiology of ADHD likely influence service utilization, research needs to focus on cultural factors that may influence parental beliefs about the etiology of child behavior problems. Thus, the goal of the current study was to investigate the role of acculturation and cultural values of familism, respect, spirituality, and traditional gender roles in explaining parental etiological beliefs about ADHD in a sample of Latino parents. Findings suggest that behavioral acculturation was not significantly correlated with biopsychosocial or sociological/spiritual etiological beliefs; however, the cultural values of familism and traditional gender roles were positively correlated with sociological/spiritual beliefs. Further, exploratory analyses suggested that after controlling for SES, familism and traditional gender roles accounted for 30.5 % of the total variance in sociological/spiritual beliefs about ADHD. Finally, post hoc analyses revealed that cultural values were associated with several individual belief categories within the sociological/spiritual domain, including beliefs about friends, spirituality, and nature disharmony. The current study supports the inclusion of etiological beliefs and cultural factors in research examining help-seeking and access to mental health services among Latino families and suggests that the incorporation of alternative etiological beliefs about child behavior may be an important factor in culturally-appropriate mental health services.

Assessing ADHD in Latino families: evidence for moving beyond symptomatology.

OBJECTIVE: In an effort to combat the mental health disparities that exist among Latinos, the current study aimed to add to our knowledge related to culturally appropriate assessments for Latino children presenting with ADHD. METHOD: As part of a larger study, a community sample of 68 Spanish-speaking, Latino parents completed the Spanish translation of the Disruptive Behavior Disorders Rating Scale (DBD-S), a commonly used, parent-report measure of ADHD. RESULTS: Results suggest that although both the Inattentive and Hyperactive/Impulsive subscales of the DBD-S are psychometrically sound, the Hyperactive/Impulsive subscale may not be culturally appropriate with some Latino families, particularly those who are less acculturated. This was further supported by preliminary evidence suggesting that this subscale also was not diagnostically useful with the current, community sample. CONCLUSION: The potential problems associated with the overemphasis on symptomatology when working with Latino families, the importance of examining functional impairment as part of a culturally appropriate assessment, and the need to replicate the current findings with a clinical sample are discussed.

Peer rejection and friendships in children with Attention-Deficit/Hyperactivity Disorder: contributions to long-term outcomes.

Even after evidence-based treatment, Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with poor long-term outcomes. These outcomes may be partly explained by difficulties in peer functioning, which are common among children with ADHD and which do not respond optimally to standard ADHD treatments. We examined whether peer rejection and lack of dyadic friendships experienced by children with ADHD after treatment contribute to long-term emotional and behavioral problems and global impairment, and whether having a reciprocal friend buffers the negative effects of peer rejection. Children with Combined type ADHD (N = 300) enrolled in the Multimodal Treatment Study of Children with ADHD (MTA) were followed for 8 years. Peer rejection and dyadic friendships were measured with sociometric assessments after the active treatment period (14 or 24 months after baseline; M ages 9.7 and 10.5 years, respectively). Outcomes included delinquency, depression, anxiety, substance use, and general impairment at 6 and 8 years after baseline (Mean ages 14.9 and 16.8 years, respectively). With inclusion of key covariates, including demographics, symptoms of ADHD, ODD, and CD, and level of the outcome variable at 24 months, peer rejection predicted cigarette smoking, delinquency, anxiety, and global impairment at 6 years and global impairment at 8 years after baseline. Having a reciprocal friend was not, however, uniquely predictive of any outcomes and did not reduce the negative effects of peer rejection. Evaluating and addressing peer rejection in treatment planning may be necessary to improve long-term outcomes in children with ADHD.

Parental functioning in families of children with ADHD: evidence for behavioral parent training and importance of clinically meaningful change.

OBJECTIVE/METHOD: Statistically significant and clinically meaningful effects of behavioral parent training on parental functioning were examined for 20 children with ADHD and their parents who had successfully completed a psychosocial treatment for ADHD. RESULTS/CONCLUSION: Findings suggest that behavioral parent training resulted in statistically significant improvements in some domains of parenting behavior for both mothers and fathers and in reductions in most domains of parenting stress for mothers. Importantly, clinically meaningful change also was noted for these parental functioning areas, as well as for other domains of parental functioning that did not result in statistically significant findings. Clinical implications are discussed.

Functional impairment in Latino children with ADHD: implications for culturally appropriate conceptualization and measurement.

Conceptualizing and measuring functional impairment related to childhood ADHD, particularly within the rapidly growing, yet underserved, Latino population, is an important area of research that is in its infancy in the field of psychology. The functional impairments related to academic achievement, social competence, and familial relations experienced by children with ADHD lead to long-lasting and debilitating difficulties that adversely affect the individuals themselves, their families, and society. In addition, limited available research suggests that Latino children are at a great or greater risk for developing ADHD, although they are much less likely to be identified by their parents as displaying problematic behavior and subsequently are less likely to receive proper assessment and treatment due to several practical and cultural factors. Fortunately, initial evidence suggests that the construct of functional impairment may be a more universal notion than the potentially culturally biased measurement of symptomatology. Therefore, in order to provide the best possible outcomes for all children with ADHD, research needs to be expanded to include examination of functional impairment related to ADHD, particularly when working with Latino children and their families. Thus, the primary aim of the current review is to examine and critique how the field of psychology has understood and measured functional impairment in school-aged Latino children with ADHD to date. Based on information reviewed, suggestions for moving toward a culturally modified assessment of functional impairment related to ADHD in Latino children will be proposed. This work is a necessary step toward providing culturally appropriate services for a currently underserved, yet rapidly growing, Latino population in our country.