Examining the Effectiveness of an Intensive Telemental Health Treatment for Pediatric Anxiety and OCD During the COVID-19 Pandemic and Pediatric Mental Health Crisis.

Despite research supporting the efficacy of weekly outpatient videoconferencing-based cognitive behavioral therapy (VCBT), limited evidence exists about the benefits of leveraging VCBT for brief intensive formats. We examined the effectiveness of an intensive outpatient VCBT targeting pediatric anxiety and OCD. Quasi-experimental design was used to compare outcomes of intensive, in-person, group-based cognitive-behavioral therapy with medication management and caregiver guidance pre-pandemic, to a similar VCBT peri-pandemic (n = 130). Pretreatment and posttreatment assessments included patient- and caregiver-report of anxiety and functional impairment. Analyses of covariance were conducted, examining changes in anxiety and impairment between treatment groups, controlling for admission levels. No significant differences in posttreatment anxiety or impairment were observed between conditions. This study illustrates that intensive, group-based treatment for pediatric anxiety and OCD using VCBT is associated with comparable reductions in anxiety and impairment. It marks a crucial step toward providing broader access to quality care for youth in need.

Depressive Symptoms Moderate Dating Violence Prevention Outcomes Among Adolescent Girls.

Purpose: Few dating violence prevention programs assess how variations in initial violence risk affects responsiveness. This study examines the efficacy of Date SMART, a dating violence and sexual risk prevention program designed to target high-risk adolescent girls, in preventing dating violence in the context of varying initial levels of depressive symptoms. Method: A diverse sample of N = 109 female adolescents with a history of physical dating violence participated in a randomized controlled trial of the Date SMART program and a knowledge only (KO) comparison. Results: Using baseline depression level as a primary risk factor, a series of multilevel models revealed significant main effects of baseline depression such that higher baseline depression was associated with greater physical dating violence perpetration and victimization. Results also showed a three-way interaction for assessment point, depressive symptoms, and condition for physical dating violence perpetration. Specifically, those with higher baseline depression in Date SMART showed significantly less physical dating violence perpetration at follow-ups compared with those with higher baseline depression in the KO group. This difference in violence reduction between conditions was not observed for those with lower baseline depression. Discussion: Date SMART appears to effectively reduce physical dating violence perpetration in those with higher levels of initial risk. Current findings support that adolescents with different risk profiles respond differently to violence prevention programs.

Perpetration of Electronic Intrusiveness Among Adolescent Females: Associations With In-Person Dating Violence.

Electronic intrusiveness is a form of cyber dating abuse that includes monitoring a partners' location, whom a partner is talking to, and other private information via technology and social networking sites. The aim of this study was to further explore the prevalence of electronic intrusiveness, as well as to assess how electronic intrusiveness relates to in-person dating violence while controlling for known risk factors for in-person dating violence, namely, depression, emotion regulation, and acceptance of couple violence. Data for this study were drawn from the baseline assessment of a larger clinical trial. A sample of high-risk adolescent females between the ages of 14 and 17 with a lifetime history of prior dating violence victimization or perpetration was used. Participants completed self-report measures for all study variables. Findings demonstrate that perpetration of electronic intrusiveness within the past 3 months is common among a sample of high-risk adolescent females, with rates across various modes of technology ranging from 30% to 57%. Results also revealed electronic intrusiveness is associated with in-person dating violence perpetration after accounting for known risk factors. This study highlights the need to increase awareness of electronic intrusiveness and to better incorporate electronic intrusiveness into theoretical and empirical models of dating violence.

Using Composite Scores to Summarize Adolescent Sexual Risk Behavior: Current State of the Science and Recommendations.

Composite scores offer the advantage of summarizing across multiple sexual risk behaviors to both simplify results and better capture the influence of core contextual, interpersonal, and intrapersonal dynamics that affect multiple sexual risk behaviors. There is inconsistency in how researchers utilize composite scores with minimal guidance on the advantages and disadvantages of frequently used approaches. Strengths and weaknesses of each approach are discussed in the context of assessing adolescent sexual risk behavior. A latent variable model and three commonly used composites were applied to data combined across four clinical trials (n = 1322; 50% female). Findings suggested that the latent variable approach was limited due to minimal correlations among sexual risk behaviors, that choice of composite had minimal impact on cross-sectional results so long as there is sufficient variability in risk behavior in the sample, but composite choice could impact results from clinical trials particularly for subgroup analyses. There are unique challenges to creating composites of adolescent risk behavior, including the fluidity and infrequency of adolescent sexual relationships that result in many participants reporting no sexual behavior at any given assessment and a low correlation between the number of partners and condomless sex acts. These challenges impede application of data-driven approaches to defining sexual risk composites. Recommendations to improve consistency in reporting include: (1) reporting each type of risk behavior separately prior to forming a composite, (2) aggregating across assessments to increase the chance of observing sexual risk behaviors, and (3) continued work toward a unified definition of adolescent sexual risk behavior that can guide the development of appropriate measurement models.

The Association Between Exposure to Violent Pornography and Teen Dating Violence in Grade 10 High School Students.

Exposure to pornography in general has been linked with adolescent dating violence and sexual aggression, but less is known about exposure to violent pornography specifically. The current study examined the association of violent pornography exposure with different forms of teen dating violence (TDV) using baseline survey data from a sample of Grade 10 high school students who reported being in a dating relationship in the past year (n = 1694). Gender-stratified logistic regression models generated odds ratios adjusted for demographics, substance use, history of suspension/expulsion, gender equitable attitudes, and tolerance of rape myths to identify significant associations between violent pornography exposure and self-reported physical, sexual, and threatening TDV perpetration and victimization. Violent pornography exposure was associated with all types of TDV, though patterns differed by gender. Boys exposed to violent pornography were 2-3 times more likely to report sexual TDV perpetration and victimization and physical TDV victimization, while girls exposed to violent pornography were over 1.5 times more likely to be perpetrate threatening TDV compared to their non-exposed counterparts. Comprehensive prevention strategies for TDV may consider the potential risks associated with exposure to violent pornography, particularly for boys, and provide an alternative source of education about healthy sexual behavior and relationships.

Brief report: A network analysis of self-cutting risk among late adolescent girls exposed to dating violence.

Adolescent self-directed violence (SDV) is a major public health concern. Adolescent girls exposed to dating violence (DV) are a particularly vulnerable group. Numerous studies have examined the number and type of SDV risk factors, but few examined global patterns of relationships among them. Exploring global patterns of risk is crucial to developing targeted prevention efforts. In this study we applied a network model to identify risk patterns for a common form of SDV, self-cutting, among American adolescent girls (N = 109) with history of DV. Risk factor networks were compared among girls who did/did not endorse lifetime self-cutting. Girls with a history of self-cutting (19%) had a risk factor network characterized by a higher number of associations than girls who did not (test statistic = 0.142; 95% CI = 02-.03). For these girls, the experience of one risk factor is more likely to co-occur with multiple others, thereby potentially compounding effects and unwanted consequences.