Adolescent, parent, and provider attitudes toward a machine learning based clinical decision support system for selecting treatment for youth depression.

Background: Machine learning based clinical decision support systems (CDSSs) have been proposed as a means of advancing personalized treatment planning for disorders, such as depression, that have a multifaceted etiology, course, and symptom profile. However, machine learning based models for treatment selection are rare in the field of psychiatry. They have also not yet been translated for use in clinical practice.

Adolescent, parent, and provider attitudes toward a machine-learning based clinical decision support system for selecting treatment for youth depression.

Background: Machine-learning based clinical decision support systems (CDSSs) have been proposed as a means of advancing personalized treatment planning for disorders, such as depression, that have a multifaceted etiology, course, and symptom profile. However, machine-learning based models for treatment selection are rare in the field of psychiatry. They have also not yet been translated for use in clinical practice.

Parent and Child Risk Profiles as Predictors of Response to a Conduct Problem Preventive Intervention.

Current evidence-based prevention programming targeting child externalizing problems demonstrates modest overall effect sizes and is largely ineffective for a sizable proportion of youth who participate. However, our understanding of the youth and family characteristics associated with response to specific programming is quite limited. The current study used child and family risk profiles as predictors of response trajectories to the Early Risers conduct problem preventive intervention.

Bidirectional Relations Between Parenting Practices and Child Externalizing Behaviors in Formerly Homeless Families: A Random-Intercept Cross-Lagged Panel Analysis.

Objective: This study examined the bidirectional relation between effective parenting practices and externalizing problems in children in homeless families.

Design: The sample comprised 223 children ( = 8.12 years) in 137 families living in temporary supportive housing, who participated in the Early Risers conduct problems prevention program lasting 2 years.

Self-Regulatory Profiles and Conduct Problems in Youth Referred to Juvenile Diversion.

The current study utilized a person-centered approach to explore how self-regulatory profiles relate to conduct problems in an ethnically diverse sample of 197 adolescents referred to juvenile diversion programming. Utilizing a multidomain, multimethod battery of self-regulation indicators, three common profiles emerged in a latent profile analysis. The profiles represented an Adaptive group, a Cognitively Inflexible group, and an Emotionally Dysregulated group.

Moving Toward a Precision-Based, Personalized Framework for Prevention Science: Introduction to the Special Issue.

The goal of this Special Issue is to introduce prevention scientists to an emerging form of healthcare, called precision medicine. This approach integrates investigation of the mechanisms of disease and health-compromising behaviors with prevention, treatment, and cure resolved at the level of the individual. Precision Medicine and its derivative personalized prevention represents a promising paradigm for prevention science as it accounts for response heterogeneity and guides development of targeted interventions that may enhance program effect sizes.

Adaptive Recruitment and Parenting Interventions for Immigrant Latino Families with Adolescents.

Parenting programs are an effective strategy to prevent multiple risky outcomes during adolescence. However, these programs usually enroll one caregiver and have low attendance. This study evaluated the preliminary results, cost, and satisfaction of adaptive recruitment and parenting interventions for immigrant Latino families.

Getting "SMART" about implementing multi-tiered systems of support to promote school mental health.

With the growing adoption and implementation of multi-tiered systems of support (MTSS) in school settings, there is increasing need for rigorous evaluations of adaptive-sequential interventions. That is, MTSS specify universal, selected, and indicated interventions to be delivered at each tier of support, yet few investigations have empirically examined the continuum of supports that are provided to students both within and across tiers. This need is compounded by a variety of prevention approaches that have been developed with distinct theoretical foundations (e.

Do Parent Preferences for Child Conduct Problem Interventions Impact Parenting Outcomes? A Pilot Study in Community Children's Mental Health Settings.

A pilot, doubly randomized preference trial was conducted to investigate the impact of providing parents preferences on parenting outcomes. Families with children having conduct problems were randomly assigned to a choice group in which they received their preferred treatment among the four intervention options or a no-choice group in which they were randomized assigned to one of the four options. Results of mixed-effects models showed that parents in the choice group who selected Parent Management Training-Oregon Model (PMTO) had better parenting outcomes over time compared to parents in the choice group who selected child therapy.

A Pilot Study of Stress System Activation in Children Enrolled in a Targeted Prevention Program: Implications for Personalization.

Unlabelled: Empirically validated interventions addressing childhood psychological problems are now readily available, but success likely depends in part on accurately identifying which children will benefit from which intervention. This pilot study examined the stress activation and response system, first as a way to differentiate high versus low-risk children, and second to explore indicators of the stress system associated with favorable intervention response.

Method: Participants ( = 43, 58% male) were school-aged children who qualified for inclusion in the Early Risers "Skills for Success" Prevention Program based on their elevated levels of aggressive and/or socially withdrawn behavior and a normally developing comparison group.

Does Giving Parents Their Choice of Interventions for Child Behavior Problems Improve Child Outcomes?

Empowering consumers to be active decision-makers in their own care is a core tenet of personalized, or precision medicine. Nonetheless, there is a dearth of research on intervention preferences in families seeking interventions for a child with behavior problems. Specifically, the evidence is inconclusive as to whether providing parents with choice of intervention improves child/youth outcomes (i.

Stressful life events and perceived parental control in formerly homeless families: Impact on child-internalizing symptoms.

Research has neglected the potential role of perceived parental control as a moderator between stressful life events (SLEs) and child-internalizing symptoms. Using secondary data from the Early Risers "Skills for Success" Program (August, Realmuto, Hektner, & Bloomquist, 2001), this study examined the impact of perceived parental control on the association between SLEs and child internalizing symptoms in formerly homeless families. The sample consisted of 137 families with 223 children between 4 and 12 years of age (M = 8.

Application of environmental sensitivity theories in personalized prevention for youth substance abuse: a transdisciplinary translational perspective.

Preventive interventions that target high-risk youth, via one-size-fits-all approaches, have demonstrated modest effects in reducing rates of substance use. Recently, substance use researchers have recommended personalized intervention strategies. Central to these approaches is matching preventatives to characteristics of an individual that have been shown to predict outcomes.

A randomized preference trial to inform personalization of a parent training program implemented in community mental health clinics.

Incorporating participant preferences into intervention decision-making may optimize health outcomes by improving participant engagement. We describe the rationale for a preference-based approach to the personalization of community-based interventions. Compensating for the limitations of traditional randomized controlled trials (RCTs) and partially randomized preference trials (PRPTs), we employed a doubly randomized preference trial in the present study.

Two-year outcomes of the Early Risers prevention trial with formerly homeless families residing in supportive housing.

This article reports 2-year outcomes from a cluster randomized, controlled trial of the Early Risers (ER) program implemented as a selective preventive intervention in supportive housing settings for homeless families. Based on the goals of this comprehensive prevention program, we predicted that intervention participants receiving ER services would show improvement in parenting and child outcomes relative to families in treatment-as-usual sites. The sample included 270 children in 161 families, residing in 15 supportive housing sites; multimethod, multi-informant assessments conducted at baseline and yearly thereafter included parent and teacher report of child adjustment, parent report of parenting self-efficacy, and parent-child observations that yielded scores of effective parenting practices.

The Association Between Attention-Deficit Hyperactivity Disorder and Nicotine Use Among Adolescents and Young Adults.

Previous research indicates that youth with ADHD are more susceptible to nicotine use compared to those without ADHD and one explanation for this association is the self-medication theory. The present study examines nicotine use in a prospective sample derived from a community sampling procedure rather than a clinical setting. Nicotine use was measured through young adulthood (mean ages: 18, 20 and 22) and three groups were compared based on childhood status: ADHD-only, ADHD-extemalizers and control groups.

Being "SMART" About Adolescent Conduct Problems Prevention: Executing a SMART Pilot Study in a Juvenile Diversion Agency.

The development of adaptive treatment strategies (ATS) represents the next step in innovating conduct problems prevention programs within a juvenile diversion context. Toward this goal, we present the theoretical rationale, associated methods, and anticipated challenges for a feasibility pilot study in preparation for implementing a full-scale SMART (i.e.

Moderating effects of parental well-being on parenting efficacy outcomes by intervention delivery model of the early risers conduct problems prevention program.

Parent-focused preventive interventions for youth conduct problems are efficacious when offered in different models of delivery (e.g., individual in-home, group center-based).

A longitudinal study of childhood ADHD and substance dependence disorders in early adulthood.

Attention deficit hyperactivity disorder (ADHD) is a childhood disorder that is associated with many behavioral and social problems. These problems may continue when an individual continues to meet criteria for ADHD as an adult. In this study, we describe the outcome patterns for three different groups: individuals who had ADHD as children, but no longer meet criteria as adults (Childhood-Limited ADHD, n = 71); individuals who met ADHD criteria as children and continue to meet criteria as young adults (Persistent ADHD n = 79); and a control group of individuals who did not meet ADHD diagnostic criteria in childhood or adulthood (n = 69).

A 10-year randomized controlled trial of the Early Risers conduct problems preventive intervention: effects on externalizing and internalizing in late high school.

Objective: The purpose of this study was to examine the long-term effects of the Early Risers "Skills for Success" Conduct Problems Prevention Program (ER; August, Bloomquist, Realmuto, & Hektner, 2007), a multifaceted program targeting social, emotional, behavioral, and academic risk and protective factors to promote adaptive psychological development.

Method: Based on the random assignment of their school, 245 kindergartners (mean age = 6.6 years, SD = 0.

Executive functioning as a mediator of conduct problems prevention in children of homeless families residing in temporary supportive housing: a parallel process latent growth modeling approach.

A culturally diverse sample of formerly homeless youth (ages 6-12) and their families (n = 223) participated in a cluster randomized controlled trial of the Early Risers conduct problems prevention program in a supportive housing setting. Parents provided 4 annual behaviorally-based ratings of executive functioning (EF) and conduct problems, including at baseline, over 2 years of intervention programming, and at a 1-year follow-up assessment. Using intent-to-treat analyses, a multilevel latent growth model revealed that the intervention group demonstrated reduced growth in conduct problems over the 4 assessment points.

Going-to-scale with the Early Risers conduct problems prevention program: use of a comprehensive implementation support (CIS) system to optimize fidelity, participation and child outcomes.

The present study is a descriptive report of a comprehensive implementation support (CIS) service that was used to promote high levels of program fidelity in a going-to-scale intervention trial of the Early Risers conduct problems prevention program. The program was delivered across 27 geographically dispersed, elementary school sites over a two-year period. In this study we examined the level of fidelity achieved by program implementers across intervention components, the rate of child and parent participation across intervention components, and proximal child outcomes targeted by the intervention across two years of programming.

A Prospective Examination of the Association of Stimulant Medication History and Drug Use Outcomes among Community Samples of ADHD Youths.

A continuing debate in the child psychopathology literature is the extent to which pharmacotherapy for children with attention-deficit/hyperactivity disorder (ADHD), in particular stimulant treatment, confers a risk of subsequent drug abuse. If stimulant treatment for ADHD contributes to drug abuse, then the risk versus therapeutic benefits of such treatment is greatly affected. We have prospectively followed an ADHD sample (N = 149; 81% males) for approximately 15 years, beginning at childhood (ages 8 to 10 years) and continuing until the sample has reached young adulthood (ages 22 to 24 years).

Identifying unmet mental health needs in children of formerly homeless mothers living in a supportive housing community sector of care.

This study reports psychosocial characteristics of a sample of 111 children (K to 2nd grade) and their mothers who were living in urban supportive housings. The aim of this study was to document the various types and degree of risk endemic to this population. First, we describe the psychosocial characteristics of this homeless sample.

Drug Use and Psychosocial Functioning of a Community Derived Sample of Adolescents with Childhood ADHD.

We describe the late adolescent psychosocial outcomes from a relatively large, community-identified sample of children with ADHD who have been assessed longitudinally from childhood through late adolescence. A range of outcomes were compared between ADHD (n=119) and normal control (n=93) groups, as well as ADHD subgroups that varied as a function of the course of externalizing, predominantly ODD, problems (persisters, desisters, escalators, and resisters). ADHD youth that did not show externalizing problems during childhood (ADHD-resisters) were associated with drug use outcomes generally comparable to the normal non-affected controls.