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Navigating academic demands in middle and high school may be particularly challenging for youth experiencing emotional and behavioral difficulties, and screening practices are a necessary first step in identifying youth in need of services. The goal of this study was to inform efficient universal screening practices in secondary schools by comparing 3 common methods of screening, including self-and teacher report on the Strengths and Difficulties Questionnaire, and grade point average (GPA) to indicate moderate and high levels of risk. Participants were 2,350 secondary students (47% female; 94% non-Hispanic White) and their teachers in 1 socioeconomically diverse school district. Using the moderate-risk criteria, there was low agreement among methods, and almost half the sample (46%) was identified as at risk by at least 1 of the 3 methods, indicating that responding to the needs of students who cross this liberal cutoff may not be feasible given school resources. Using the high-risk criteria reduced the agreement among screening measures. Self-report identified the most students as high risk and was more sensitive to teacher-rated concerns than the converse. If students were uniquely identified by teacher report, teachers rated them at high levels of risk, and predominant concerns were related to conduct problems. GPA captured few students with self-or teacher-rated internalizing or externalizing difficulties. Implications for universal screening within secondary schools are discussed. Impact and ImplicationsWe found grade point average had little utility for capturing secondary students at risk of emotional and behavioral difficulties, and student-report appeared to capture students with both teacher-and student-reported emotional and behavioral difficulties. Our results demonstrate reliance on teacher report and extant academic data in universal screening practices in secondary schools might allow adolescents experiencing internalizing and externalizing difficulties to fall through the cracks. Integrating self-report within universal screening practices in secondary schools is therefore an important and efficient practice in identifying at-risk youth.

Teachers play an important role in improving the emotional and behavioral problems of students. Intervention characteristics (e.g., frequency of student intervention) and teacher characteristics (e.g., mental health literacy) may influence teacher preferences for an intervention and impact service uptake. Conjoint analysis, a trade-off technique borrowed from marketing research, can authentically assess preferences by quantifying the compromises respondents make when selecting a product or a service and has been used to measure service preferences in the mental health field. A conjoint analysis technique called a "discrete choice experiment" was used to systematically arrange intervention components and subcomponents to assess teachers' preferences for the intensity of three common intervention attributes (i.e., frequency of student intervention, frequency of teacher consultation, and level of parental involvement). The sample consisted of 229 elementary school teachers recruited from Amazon's Mechanical Turk. Simulation analyses estimated teachers' preferences for a low-intensity intervention, medium-intensity intervention, high-intensity intervention or none of these. Differences in teacher characteristics (i.e., beliefs, mental health literacy, stress) were examined between teachers preferring each type of intensity. Results indicated that preferences for intervention intensity varied, with more teachers preferring a medium-intensity intervention than any other intervention. Mental health literacy was significantly greater among teachers preferring a medium-intensity intervention than teachers preferring no intervention. Interventions consisting of weekly options for teacher consultation and parental involvement may appeal to teachers with strong mental health literacy.

Objective: Both qualitative and quantitative analyses were used to (a) describe the romantic and sexual relationships of adolescents with ADHD and (b) examine how ADHD-related impairments (e.g., social skill deficits and emotion dysregulation [ED]) are associated with romantic relationship outcomes in this group. Method: Adolescents with ADHD ( N = 171; 80% male; 70% White) responded to questions about their romantic and sexual relationship experiences and ED. Parents provided ratings of ADHD symptoms, ED, and social skills. Results: Adolescents with ADHD reported high rates of romantic relationship turnover and low rates of physical intimacy. More severe self-reported ED was associated with increased likelihood of engaging in romantic relationships, having more romantic relationship partners, increased likelihood of engaging in sexual intercourse, and increased likelihood of engaging in unprotected sex. Conclusion: Early intervention programs that alter the developmental trajectory of romantic relationships among individuals with ADHD may benefit from targeting ED among these youth.

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