Early indicators of response to transdiagnostic treatment of pediatric anxiety and depression / Michelle ROZENMAN ; Araceli GONZALEZ ; David A. BRENT ; Giovanna PORTA ; Frances L. LYNCH ; John F. DICKERSON ; V. Robin WEERSING in Journal of Child Psychology and Psychiatry, 64-12 (December 2023)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 64-12 (December 2023) . - p.1689-1698 Titre : Early indicators of response to transdiagnostic treatment of pediatric anxiety and depression Type de document : texte imprimé Auteurs : Michelle ROZENMAN, Auteur ; Araceli GONZALEZ, Auteur ; David A. BRENT, Auteur ; Giovanna PORTA, Auteur ; Frances L. LYNCH, Auteur ; John F. DICKERSON, Auteur ; V. Robin WEERSING, Auteur Article en page(s) : p.1689-1698 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : Background Pediatric anxiety and depression are prevalent, impairing, and highly comorbid. Available evidence-based treatments have an average response rate of 60%. One path to increasing response may be to identify likely non-responders midway through treatment to adjust course prior to completing an episode of care. The aims of this study, thus, were to identify predictors of post-intervention response assessing (a) mid-treatment symptom severity, (b) session-by-session treatment process factors, and (c) a model optimizing the combination of these. Method Data were drawn from the treatment arm (N=95, ages 8-16) of a randomized transdiagnostic intervention trial (Msessions=11.2). Mid-point measures of youth- and parent-reported anxiety and depression were collected, and therapists rated homework completion, youth and parent engagement, and youth therapeutic alliance at each session. Logistic regression was used to predict response on the Clinical Global Impression Improvement Scale (CGI-I 2) rated by independent evaluators masked to treatment condition. Results Mid-point symptom measures were significant predictors of treatment response, as were therapist-ratings of youth and parent engagement, therapeutic alliance, and homework completion. Therapist ratings were significant when tested as mean ratings summing across the first eight sessions of treatment (all ps<.004) and at individual session points (all ps?<0.05). A combined prediction model included youth-reported anxiety, parent-reported depression, youth engagement at Session 2, and parent engagement at Session 8. This model correctly classified 76.5% of youth as non-responders and 91.3% as responders at post-treatment (Nagelkerke R2=.59, 2 (4, 80)=46.54, p<.001). Conclusion This study provides initial evidence that response to transdiagnostic intervention for pediatric anxiety and depression may be reliably predicted by mid-point. These data may serve as foundational evidence to develop adaptive treatment strategies to personalize intervention, correct treatment course, and optimize outcomes for youth with anxiety and depression. En ligne : https://doi.org/10.1111/jcpp.13881 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=517 [article] Early indicators of response to transdiagnostic treatment of pediatric anxiety and depression [texte imprimé] / Michelle ROZENMAN, Auteur ; Araceli GONZALEZ, Auteur ; David A. BRENT, Auteur ; Giovanna PORTA, Auteur ; Frances L. LYNCH, Auteur ; John F. DICKERSON, Auteur ; V. Robin WEERSING, Auteur . - p.1689-1698. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 64-12 (December 2023) . - p.1689-1698 Index. décimale : PER Périodiques Résumé : Background Pediatric anxiety and depression are prevalent, impairing, and highly comorbid. Available evidence-based treatments have an average response rate of 60%. One path to increasing response may be to identify likely non-responders midway through treatment to adjust course prior to completing an episode of care. The aims of this study, thus, were to identify predictors of post-intervention response assessing (a) mid-treatment symptom severity, (b) session-by-session treatment process factors, and (c) a model optimizing the combination of these. Method Data were drawn from the treatment arm (N=95, ages 8-16) of a randomized transdiagnostic intervention trial (Msessions=11.2). Mid-point measures of youth- and parent-reported anxiety and depression were collected, and therapists rated homework completion, youth and parent engagement, and youth therapeutic alliance at each session. Logistic regression was used to predict response on the Clinical Global Impression Improvement Scale (CGI-I 2) rated by independent evaluators masked to treatment condition. Results Mid-point symptom measures were significant predictors of treatment response, as were therapist-ratings of youth and parent engagement, therapeutic alliance, and homework completion. Therapist ratings were significant when tested as mean ratings summing across the first eight sessions of treatment (all ps<.004) and at individual session points (all ps?<0.05). A combined prediction model included youth-reported anxiety, parent-reported depression, youth engagement at Session 2, and parent engagement at Session 8. This model correctly classified 76.5% of youth as non-responders and 91.3% as responders at post-treatment (Nagelkerke R2=.59, 2 (4, 80)=46.54, p<.001). Conclusion This study provides initial evidence that response to transdiagnostic intervention for pediatric anxiety and depression may be reliably predicted by mid-point. These data may serve as foundational evidence to develop adaptive treatment strategies to personalize intervention, correct treatment course, and optimize outcomes for youth with anxiety and depression. En ligne : https://doi.org/10.1111/jcpp.13881 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=517

The impact of autism spectrum disorder on parent employment: Results from the r-Kids study / Frances L. LYNCH in Autism Research, 16-3 (March 2023)  

Public ISBD [article]  inAutism Research > 16-3 (March 2023) . - p.642-652 Titre : The impact of autism spectrum disorder on parent employment: Results from the r-Kids study Type de document : texte imprimé Auteurs : Frances L. LYNCH, Auteur ; Joanna E. BULKLEY, Auteur ; Alexandra VARGA, Auteur ; Phillip M. CRAWFORD, Auteur ; Lisa A. CROEN, Auteur ; Yihe G. DAIDA, Auteur ; Eric FOMBONNE, Auteur ; Brigit HATCH, Auteur ; Maria MASSOLO, Auteur ; John F. DICKERSON, Auteur Article en page(s) : p.642-652 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : Abstract Parents of children with autism spectrum disorder (ASD) and other chronic health conditions often face exceptional caregiving demands that can lead to challenges related to maintaining and succeeding in employment. Detailed information on the specific ways in which these health conditions impact parent employment could aid in designing equitable, effective policies to support families. The r-Kids study used electronic health records to identify three groups of children: those with ASD, asthma, or neither condition (control), from several health care systems. We oversampled racial and ethnic minorities and matched the asthma and control groups to the age and sex distribution of the ASD group. Parents completed three online surveys over the course of a year to measure annual employment outcomes. Surveys included the Family Economic Impact Inventory (measuring employment impacts) and measures of quality of life and symptom severity. All materials were provided in English and Spanish. The study enrolled 1461 families (564 ASD, 468 asthma, 429 control). Youth were 3-16.5 years old and predominantly male (79%). The sample was diverse (43% non-Hispanic White; 35% non-Hispanic Asian, Black, Native Hawaiian, or Other; and 21% Hispanic ethnicity). Parents of children with ASD were significantly less likely to be employed than parents of youth with asthma and control combined (OR: 14.2, p < 0.001), and were more likely to have other difficulties with employment and productivity while at work. Public and employer policies to help mitigate these impacts could aid families in managing care for youth with ASD. En ligne : https://doi.org/10.1002/aur.2882 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=498 [article] The impact of autism spectrum disorder on parent employment: Results from the r-Kids study [texte imprimé] / Frances L. LYNCH, Auteur ; Joanna E. BULKLEY, Auteur ; Alexandra VARGA, Auteur ; Phillip M. CRAWFORD, Auteur ; Lisa A. CROEN, Auteur ; Yihe G. DAIDA, Auteur ; Eric FOMBONNE, Auteur ; Brigit HATCH, Auteur ; Maria MASSOLO, Auteur ; John F. DICKERSON, Auteur . - p.642-652. Langues : Anglais (eng) in Autism Research > 16-3 (March 2023) . - p.642-652 Index. décimale : PER Périodiques Résumé : Abstract Parents of children with autism spectrum disorder (ASD) and other chronic health conditions often face exceptional caregiving demands that can lead to challenges related to maintaining and succeeding in employment. Detailed information on the specific ways in which these health conditions impact parent employment could aid in designing equitable, effective policies to support families. The r-Kids study used electronic health records to identify three groups of children: those with ASD, asthma, or neither condition (control), from several health care systems. We oversampled racial and ethnic minorities and matched the asthma and control groups to the age and sex distribution of the ASD group. Parents completed three online surveys over the course of a year to measure annual employment outcomes. Surveys included the Family Economic Impact Inventory (measuring employment impacts) and measures of quality of life and symptom severity. All materials were provided in English and Spanish. The study enrolled 1461 families (564 ASD, 468 asthma, 429 control). Youth were 3-16.5 years old and predominantly male (79%). The sample was diverse (43% non-Hispanic White; 35% non-Hispanic Asian, Black, Native Hawaiian, or Other; and 21% Hispanic ethnicity). Parents of children with ASD were significantly less likely to be employed than parents of youth with asthma and control combined (OR: 14.2, p < 0.001), and were more likely to have other difficulties with employment and productivity while at work. Public and employer policies to help mitigate these impacts could aid families in managing care for youth with ASD. En ligne : https://doi.org/10.1002/aur.2882 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=498

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