The goal of this study was to examine the ability of friendship to moderate the association between behavioral risk and peer victimization for girls with attention-deficit/hyperactivity disorder (ADHD; n = 140) and comparison girls (n = 88) in a 5-week naturalistic summer camp setting. Participants were an ethnically and socioeconomically diverse group of girls ages 6-12. Parents and teachers reported on pre-summer internalizing behavior, externalizing behavior, and social competence. Participants reported on friendships and peer victimization through a peer report measure at the summer camps; friendship was scored via mutual nominations. Pre-summer externalizing behavior, internalizing behavior, and low social competence predicted peer victimization at the summer camps. Friendship moderated the association between behavioral risk and victimization for the entire sample, such that the presence of at least one friend reduced the risk of victimization. Additional analyses suggested that girls with ADHD were no more or less protected by the presence of a friendship than were comparison girls. Finally, preliminary analyses suggested that girls having only friends with ADHD were not significantly less protected than girls with at least one comparison friend. Future directions and implications for intervention are discussed.
Introduction Intact neurocognition and early cognitive recovery during abstinence are important for substance use treatment outcome. Yet, little is known about them in the largest group of treatment seekers today, individuals with polysubstance use disorders (PSU). This study primarily contrasted PSU and individuals with an alcohol use disorder (AUD) on neurocognitive and inhibitory control measures and, secondarily, measured changes during abstinence in PSU. Method At one month of abstinence from all substances except tobacco, 36 PSU and 69 AUD completed neurocognitive assessments of executive function, general intelligence, auditory-verbal learning/memory, visuospatial learning/memory/skills, processing speed, working memory, fine motor skills, and cognitive efficiency. The groups were also assessed on inhibitory control measures of self-reported impulsivity, risk-taking, and decision-making. Seventeen PSU repeated the assessments after approximately four months of abstinence. All cross-sectional and longitudinal analyses included smoking status as a possible confound. Results At baseline, PSU performed significantly worse than AUD on auditory-verbal memory and on an inhibitory control measure of impulsivity. Polysubstance users showed trends to worse performance than AUD on general intelligence, auditory-verbal learning, and a decision-making task. Between one and four months of abstinence, PSU showed significant improvements on several neurocognitive and inhibitory control measures. Conclusions Polysubstance users exhibit distinct differences in neurocognition and inhibitory control compared to AUD. Between one and four months of abstinence, neurocognition and inhibitory control improve in PSU. This neurocognitive recovery in some domains of abstinent PSU is influenced by smoking status. These results underscore the clinical value of select methods to augment neurocognitive recovery in PSU through appropriate interventions.
a b s t r a c tThere has been strong interest, spanning several disciplines, in understanding adolescence as a developmental period of increased risk-taking behavior. Our goals focus on one line of investigation within this larger developmental risk framework. Specifically, we examined levels of pubertal hormones in girls in relation to their willingness to take greater financial risks to gain social status. To this end, we tested the hypothesis that higher levels of testosterone during the ages of pubertal maturation are associated with a greater willingness to sacrifice money for social admiration. Sixty-three girls ages 10-14 (M age = 12.74) participated in laboratory measures and completed at-home saliva sample collection. The Pubertal Development Scale (PDS) and basal hormone levels (testosterone, estradiol, DHEA) measured pubertal maturation. We made use of a developmentally appropriate version of an Auction Task in which adolescents could take financial risks in order to gain socially motivated outcomes (social status). PDS and testosterone were each associated with overall levels of financial risk taking over the course of the Auction Task. In hierarchical models, PDS and testosterone were predictors of the slope of overbidding over the course of the task. Results provide evidence for the role of testosterone and pubertal maturation in girls' motivations to engage in costly decision making in order to gain social status. Findings contribute to our understanding of the developmental underpinnings of some interesting aspects of adolescent risk behavior.
We examined decision-making in young adulthood in a follow-up study of females diagnosed with attention-deficit/hyperactivity disorder (ADHD) between 6 and 12 years. Participants with childhood ADHD (n=114) and matched comparison females (n=77), followed prospectively for 10 years, performed the Iowa Gambling Task (IGT) at ages 17–25 years. This task assesses preference for high-reward/high-risk chances that result in lower overall gains (disadvantageous decks of cards) compared to low-reward/low-risk chances that result in higher overall gains (advantageous decks of cards). Relative to comparison participants, young adult females with a history of ADHD did not increase their preference for advantageous decks across time blocks, suggesting difficulties in learning to change behavior over the course of the IGT. Overall, childhood diagnoses of ADHD were associated with disadvantageous decision-making in young adulthood. These results extend findings on decision-making in males with ADHD by demonstrating comparable levels of impairment in an all-female sample.
This research examined deviant talk during summer residential treatment using peer nominations and extensive field observations. Participants were 239 youth (M (age) = 12.62, SD = 2.60; 67% male), nested in 26 treatment groups. Deviant talk was present in this setting, showed individual differences, and increased over time, especially for younger boys. As expected, its relationship to treatment response was moderated by peer behavior. Initial levels of individual deviant talk were related to clinical improvement, but primarily when peer deviant talk was low. Initial levels of peer deviant talk were related to higher than expected end of treatment aggression, especially for youth who were high in deviant talk. Deviant talk effects were observed for staff impressions of change and observations of aggression and adjustment. Initial antisocial behavior affected whether individual or peer levels of deviant talk more heavily influenced treatment response. Implications for clinical assessment and treatment monitoring are discussed.
Objective Our goal was to examine the role of adolescent perceived deviant peer affiliation in mediating or moderating the association between adolescent attention-deficit/hyperactivity disorder (ADHD) symptoms and young adult driving risk in females with and without ADHD. Method The overall sample included 228 ethnically and socioeconomically diverse girls with or without a diagnosis of ADHD in childhood (Wave 1; 6–12 years) followed through adolescence (Wave 2; 11–18 years) and into young adulthood (Wave 3; 17–24 years). A subsample of 103 girls with a driving license by Wave 3 and with full data for all study variables was utilized in this investigation. In adolescence, mothers and teachers reported on ADHD symptoms (inattention and hyperactivity/impulsivity), and participants reported on perceived deviant peer affiliation. In young adulthood, participants reported on driving behavior and outcomes, including number of accidents, number of moving vehicle citations, and ever having driven illegally. Covariates included age and adolescent conduct disorder/oppositional defiant disorder. Results Inattention directly predicted citations. Perceived deviant peer affiliation mediated the association between inattention and (a) accidents and (b) citations. Additionally, perceived deviant peer affiliation moderated the association between hyperactivity/impulsivity and accidents, with hyperactivity/impulsivity predicting accidents only for those with low perceived deviant peer affiliation. Conclusions Perceived deviant peer affiliation appears to play an important role in the association between ADHD symptoms and driving outcomes. Our findings provide preliminary evidence that both ADHD symptoms and peer processes should be targeted in interventions that aim to prevent negative driving outcomes in young women with and without ADHD.
This research examined the independent and interactional contributions of peer experiences and group aggression to youth behavioral adjustment in short-term residential treatment. Participants were 219 youth (M age = 12.70, SD = 2.76; 71 % male) nested in 28 same-age, same-sex treatment groups. Sociometric interviews assessed social preference and victimization. Daily behavioral observations by staff assessed overall levels of treatment group aggression, as well as aggressive, withdrawn, and prosocial responses to specific social events. End-of-summer behavioral responses (to all events; to peers; to adults) were predicted, controlling for initial levels of these responses. Social preference predicted higher end-of-summer prosocial responses, and victimization predicted lower prosocial and higher withdrawn responses. Each interacted with group aggression in some analyses, with more positive peer experiences only predicting more favorable responses in groups that were low or average in aggression. Interactant-specific analyses revealed that some of these associations were broad, whereas others applied only to adults. For example, group aggression moderated the association between social preference and aggressive responses to adults but not peers. Gender differences were also interactant-specific. Results highlight the importance of peer experiences in group treatment and underscore the value of both aggregation and disaggregation over interactants in analyses of behavioral adjustment.
Background Many individuals with posttraumatic stress disorder (PTSD) first present to primary care rather than specialty mental health care. Primary care providers often lack the training required to assess and treat patients with PTSD. Virtual trainings have emerged as a convenient and effective way of training primary care providers in PTSD assessment and communication methods (ie, motivational interviewing [MI]). Objective The aim of this study was to conduct a pilot randomized controlled trial of a synchronous Virtual Worlds (VW; a virtual world where learners were immersed as avatars) training versus an asynchronous web-based training on PTSD and MI, comparing the feasibility, acceptability, usability, and preliminary efficacy of 2 different training platforms among primary care providers. Methods Participating primary care providers were randomized to a VW and a web-based PTSD training. Outcomes were collected at baseline, posttraining, and 90-days follow-up. Standardized patient interviews measured participants’ communication skills in assessing and managing patients with PTSD symptoms. Results Compared to the web-based training, the VW training platform achieved larger learning gains in MI (ie, partnership and empathy) and in discussing pharmacotherapy and psychotherapy for PTSD. Both VW and web-based trainings led to increases in PTSD knowledge and primary care providers’ self-confidence. Conclusions The asynchronous web-based PTSD training improved PTSD-related knowledge and self-confidence but was not as effective as the VW immersive experience in teaching MI or clinical management. Because VW training is synchronous and new for many learners, it required more time, facilitation, and technical support. As computer technology improves, VW educational interventions may become more feasible, particularly in teaching clinical skills. Trial Registration ClinicalTrials.gov NCT03898271; https://tinyurl.com/mu479es5
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