Journal of Emotional and Behavioral Disorders

Meta-analyses were conducted to examine findings on the association between parenting stress and ADHD. Predictors comprising child, parent, and contextual factors, and methodological and demographic moderators of the relationship between parenting stress and ADHD, were examined. Findings from 22 published and 22 unpublished studies were included. Results confirmed that parents of children with ADHD experience more parenting stress than parents of nonclinical controls and that severity of ADHD symptoms was associated with parenting stress. Child co-occurring conduct problems and parental depressive symptomatology predicted parenting stress. Parents of children with ADHD experienced no more parenting stress than parents of other clinically referred children. Little difference in parenting stress was found between mothers and fathers, but child gender was a significant moderator of parenting stress, with lower stress levels in samples with higher proportions of girls.

The goal of this study was to document comorbidity profiles of psychiatric disorder and perceived need for treatment among urban adolescents with unmet behavioral health needs. Participants were 303 community-referred adolescents and their primary caregivers. Adolescents included both boys (54%) and girls and were primarily Hispanic (58%), African American (23%), and multiracial (13%). Home-based interviews with both adolescents and caregivers were used to assess Diagnostic and Statistical Manual of Mental Disorders–Fourth Edition (DSM-IV) diagnoses and perceived treatment needs. Most adolescents (80%) were diagnosed with multiple disorders and most families (66%) reported a need to treat more than one disorder. Latent class analysis of endorsed DSM-IV disorders identified five distinct diagnostic profiles: Parental Concern, Adolescent Distress, Basic Externalizers, Severely Distressed, and Comorbid Externalizers. Diagnostic profiles were compared on perceived treatment need and related psychosocial risk characteristics. Implications for behavioral health care policy and practice for youth with unmet treatment needs are discussed.

This study examined the potential utility of adding items that assessed youths’ emotional and behavioral disorders to a commonly used surveillance survey. The goal was to evaluate whether the added items could enhance understanding of youths’ involvement in high-risk behaviors. A sample of 3,331 adolescents in Grades 8, 10, and 12 from four California school districts were coadministered a mental health screener and a youth surveillance survey. Items from both tools assessing chronic sadness and elevated mental health risk were significantly associated with increased risk of suicide ideation, cigarette use, alcohol use, binge drinking, marijuana use, physical fighting, being threatened or injured with a weapon, and skipping school. However, the addition of mental health content to the surveillance survey increased precision of understanding which youths were at the greatest odds of engaging in risk behaviors. Implications for practice and policy are discussed.

This article examines definitions state education agencies use to describe the federal education disability called “emotional disturbance.” State definitions were collected so that various aspects of them could be analyzed and compared with results of similar studies completed in the 1970s and 1980s. Among results are that state definitions have changed substantially over the decades and definitions have become increasingly similar to the federal definition. Discussion elaborated key findings about components of the state definitions, changes in terminology, and features of the federal definition shared by state definitions. Several recommendations are offered for research and policy consideration, as suggested by the findings.

Treatment participation was examined among youth enrolled in an evaluation of cognitive behavioral therapy (CBT) for trauma following the 9/11 World Trade Center disaster. Staff at nine agencies serving a predominantly low-income, ethnically diverse population were trained to deliver CBT and structured engagement strategies. A total of 445 youth ages 5 to 19 were eligible for CBT, and 417 (94%) received at least one treatment session. Pretreatment and treatment show rates and overall dose were examined. Treatment participation rates were higher than those typically reported in community studies of children’s mental health services. Regression analyses indicated variability across sites in treatment show rates with the highest rates at sites where services were delivered in schools. However, sites, demographic factors, and trauma symptoms accounted for a small amount of variance in treatment participation overall. The study suggests that structured engagement strategies, linked to evidence-based treatments, may improve treatment participation for youth.

This article reports on the effectiveness of First Step to Success, a secondary-level intervention appropriate for students in early elementary school who experience moderate to severe behavior problems and are at risk for academic failure. The authors demonstrate the intervention’s short-term effects on multiple behavioral and academic outcomes as delivered off-the-shelf in a variety of classrooms and schools across the country—effects that were mitigated by fidelity of implementation. Furthermore, the authors assess the body of evidence on First Step to Success against the standards for effectiveness and widespread dissemination promulgated by the Society for Prevention Research, thereby suggesting directions for further research.