Introduction to the Special Issue: Toward Implementing Physiological Measures in Clinical Child and Adolescent Assessments

Abstract

The National Institute of Mental Health recently launched the Research Domain Criteria (RDoC). The RDoC is an initiative to improve classification of mental health concerns by promoting research on the brain mechanisms underlying these concerns, with the ultimate goal of developing interventions that target these brain mechanisms. A key focus of RDoC involves opening new lines of research examining patients' responses on biological measures. The RDoC presents unique challenges to mental health professionals who work with children and adolescents. Indeed, mental health professionals rarely integrate biological measures into clinical assessments. Thus, RDoC's ability to improve patient care rests, in part, on the development of strategies for implementing biological measures within mental health assessments. Further, mental health professionals already carry out comprehensive assessments that frequently yield inconsistent findings. These inconsistencies have historically posed challenges to interpreting research findings as well as assessment outcomes in practice settings. In this introductory article, we review key issues that informed the development of a special issue of articles demonstrating methods for implementing low-cost measures of physiological functioning in clinical child and adolescent assessments. We also outline a conceptual framework, informed by theoretical work on using and interpreting multiple informants' clinical reports (De Los Reyes, Thomas, Goodman, & Kundey, 2013 ), to guide hypothesis testing when using physiological measures within clinical child and adolescent assessments. This special issue and the conceptual model described in this article may open up new lines of research testing paradigms for implementing clinically feasible physiological measures in clinical child and adolescent assessments.

The validity of the multi-informant approach to assessing child and adolescent mental health.

“…However, other modalities may prove as useful, if not more useful, than behavioral observations. For instance, rather than take behavioral ratings of patients' performance within clinically relevant tasks, one could assess patients' physiology using wireless, ambulatory devices (e.g., heart rate monitors; for a review, see De Los Reyes & Aldao, 2015). The principles underlying this approach would function quite similarly to that of previous examples.…”

“…Direct assessments of physiological arousal may distinguish social anxiety patients' experiences within and across these contexts (e.g., arousal during public speaking vs. arousal in anticipation of public speaking; De Los Reyes, Augenstein et al, 2015). These assessments have great potential as validity indicators to interpret informants' reports (De Los Reyes & Aldao, 2015). This is because technology now allows mental health professionals to assess arousal using wireless, ambulatory devices (e.g., heart rate monitors), and implement them in vivo within the laboratory as well as routine clinic settings (see also Thomas, Aldao, & De Los Reyes, 2012).…”

Subjective – Objective Sleep Comparisons and Discrepancies Among Clinically-Anxious and Healthy Children

“…Despite advantages of low cost and ease of administration, reports of the same phenomena by different informants are often discrepant both from each other as well as objective measures (De Los Reyes and Aldao 2015;De Los Reyes et al 2012De Los Reyes and Kazdin 2005;De Los Reyes et al 2013b). In community-based samples, parents typically estimate greater total sleep duration and fewer sleep problems relative to both children's self-reports and actigraphy (Gregory et al 2006;Robinson and Richdale 2004;Short et al 2013).…”

Introduction to the Special Issue: Discrepancies in Adolescent–Parent Perceptions of the Family and Adolescent Adjustment

“…Using this approach, researchers gather reports from those involved in family interactions (e.g., parents and adolescents). Multiple informants' reports may also be augmented by data from other sources, such as independent observers' ratings of family interactions (e.g., level of warmth or hostility displayed within a laboratory-based family discussion task; De Los Reyes et al 2015b), or direct assessments of physiological processes as they manifest within relevant contexts (e.g., elevations in arousal or decreased physiological flexibility displayed during computer-based tasks, unstructured home observations, periods of social stress, or a resting period; Aldao and De Los Reyes 2015;De Los Reyes et al 2015a;De Los Reyes and Aldao 2015;Cohen et al 2015;Franklin et al 2015;Leitzke et al 2015;McLaughlin et al 2015;Youngstrom and De Los Reyes 2015). Further, a key focus of this approach involves collecting assessments of psychosocial outcomes commonly linked to family functioning, such as adolescent psychosocial functioning, which may also leverage multi-informant, multi-method measurement approaches (e.g., reports of adolescents' mental health from adolescents, parents, teachers, clinicians, and independent observers).…”