The Role of Community-Based Supportive Services in Remediating Juvenile Adjudicative Competence.

This study aimed to determine the impact of teen depression on peer, family, school, and physical functioning and the burden on parents. Patients participated in a longitudinal study of teens with and without probable depression, drawn from 11 primary care offices in Los Angeles, California, and Washington, DC. A total of 4856 teens completed full screening assessments; 4713 were eligible for the study, and 187 (4.0%) met the criteria for probable depression and were invited to participate, as were teens who were not depressed. A total of 184 baseline assessments for teens with probable depression and 184 for nondepressed teens were completed, as were 339 (90%) parent interviews. Follow-up interviews were conducted with 328 teens (89%) and 302 parents (82%). Measures included teen reports of peer and parent support, 2 measures of school functioning, grades, physical health, and days of impairment. Parent reports included peer, school, and family functioning and subjective and objective burdens on parents. Teens with depression and their parents reported more impairment in all areas, compared with teens without depression at baseline, and reported more coexisting emotional and behavioral problems. Both depression and coexisting problems were related to impairment. There was a lasting impact of depressive symptoms on most measures of peer, family, and school functioning 6 months later, but controlling for coexisting baseline emotional and behavioral problems attenuated this relationship for some measures. Improvements in teen depression might have benefits that extend beyond clinical symptoms, improving peer, family, and school functioning over time.

Previous cross-sectional data showed that children and adolescents with attention-deficit hyperactivity disorder (ADHD) are at increased risk of comorbid conduct, mood, and anxiety disorders as well as impairments in cognitive, social, family, and school functioning. However, longitudinal data were needed to confirm these initial impressions. Using DSM-III-R structured diagnostic interviews and raters blinded as to diagnosis, we reexamined psychiatric diagnoses at 1- and 4-year follow-ups in children with ADHD and controls. In addition, subjects were evaluated for cognitive, achievement, social, school and family functioning. Analyses of follow-up findings revealed significant differences between children with ADHD and controls in rates of behavioral, mood, and anxiety disorders, with these disorders increasing markedly from baseline to follow-up assessments. In addition, children with ADHD had significantly more impaired cognitive, family, school, and psychosocial functioning than did controls. Baseline diagnosis of conduct disorder predicted major depression and bipolar disorder at follow-up, and anxiety disorders at baseline predicted anxiety disorders at follow-up. These results confirm and extend previous retrospective results indicating that children with ADHD are at high risk of developing a wide range of impairments affecting multiple domains of psychopathology such as cognition, interpersonal, school, and family functioning. These findings provide further support for the value of considering psychiatric comorbidity in both clinical assessment and research protocols involving children with ADHD.

To describe stability and change in functional ability among non-institutionalized old people in relation to sex, age, and household composition during two subsequent four-year observation periods. The study describes stability and change in total functional ability as well as in specific daily activities. The study population included a random sample of non-institutionalized 70+-year-olds studied in 1986 with follow-up in 1990 and 1995. The number of participants in the three surveys were 1,231 (participation rate 67%), 911 (90% of 1,008 survivors), and 542 (77% of 706 survivors). Functional ability was measured at all three surveys. There is a considerable health selection from survey 1 to 2 to 3 because of a high mortality among participants with poor health. The proportions with unchanged, improved, and deteriorated functional ability were 51%, 13%, and 37% during the first four years and 50%, 9%, and 42% during the following four years. These changes were not related to age and sex. Major variations were seen with regard to change in individual daily activities with most deterioration in mobility and the more outgoing IADL activities (Instrumental Activities of Daily Living). Relatively large proportions of elderly people demonstrated at the same time improvements in some functions and deterioration in others. A notable minority of the population improved in functional ability and a large proportion was stable over time. These observations suggest a potential for health promotion among elderly persons, which up to now has been more or less neglected in health policy.

The measurement of change in functional ability: Dealing with attrition and the floor/ceiling effect

Prediction of changes in functional ability of inpatients with schizophrenia using logarithmic and linear regression modelling

In a previous cross-sectional study of twins, the authors found evidence of a substantial genetic influence on functional abilities among elderly women. It has been suggested that rate of change in functional abilities over time could underlie such findings and that rate-of-change phenotypes may have an even larger genetic component than "level" phenotypes (e.g., functional abilities per se). If so, rate-of-change phenotypes could be more powerful than level phenotypes in studies aimed at identifying specific polymorphisms of importance for aging. In 1995, the authors assessed a population-based sample of 2,401 Danish twins aged 75 years or more. The survivors were recontacted after 2 years and again after 4 years. Consistent mean-level declines, high within-person correlations over time, and substantial heritability in the female sample were observed for functional abilities. Nonetheless, structural-equation analyses revealed only a very modest and nonsignificant heritability for rate of change in functional abilities: 16% (95% confidence interval: 0, 35) for women and 9% (95% confidence interval: 0, 44) for men. This study had a large initial sample size, high participation rates, and a valid and reliable measure of rate of change in a phenotype that had previously shown substantial heritability in cross-sectional analyses in the same twin population. Still, the present study revealed only a modest and nonsignificant genetic influence on rate of change, which suggests that detection of polymorphisms influencing rate of change in functional abilities among the elderly may prove to be difficult.

Mobile phone addiction and school performance among Chinese adolescents from low-income families: A moderated mediation model

It is essential to measure an individual patient's baseline and follow-up abilities to demonstrate changes in clinical outcomes over time. Inherent in this strategy is interpreting whether the measured change is clinically significant and beyond measurement error. Conditional minimal detectable change (cMDC) values are widely used in many disciplines but have rarely been established for outcome measures in otolaryngology or hearing research, and never in cochlear implantation. To determine cMDC values for the Cochlear Implant Quality of Life-35 (CIQOL-35) Profile instrument to enhance our understanding of the initial and ongoing changes in functional abilities from cochlear implants (CIs). Item response theory analyses of responses from a multi-institutional cohort of 705 CI users at a tertiary CI center were used to derive standard error (SE) values for each possible CIQOL-35 domain score. Using an iterative approach, these SE values were used to calculate cMDC values for every possible pre-CI and post-CI domain score combination. We then compared pre-CI to 12-month post-CI CIQOL-35 domains scores in an independent cohort of 65 adult CI users to determine whether the measured change exceeded error to be clinically significant. The analysis took place on December 14, 2022. The CIQOL-35 Profile instrument and cochlear implantation. The cMDC values were smaller for the communication domain, and global measure and cMDC values for all domains were larger at the extremes of the measurement scale. Overall, 60 CI users (92.3%) demonstrated improvement beyond cMDC at 12 months post-CI for at least 1 CIQOL-35 domain, and no patients' scores declined beyond cMDC for any domain. The percentage of CI users demonstrating improvement beyond cMDC varied by domain, with communication (53 [81.5%]) showing the largest number of CI users improving, followed by global (42 [64.6%]) and entertainment (40 [60.9%]). In general, CI users who demonstrated improvement in CIQOL-35 domains had greater improvement in speech recognition scores than patients who did not, but the strength and significance of these associations greatly varied by domain and speech material. This multistep cohort study found that cMDC values for the CIQOL-35 Profile provided personalized thresholds for detecting real changes in patient self-reported functional abilities over time across multiple domains, which may inform clinical decision-making. Moreover, these longitudinal results reveal the domains with more or less improvement, which may aid in patient counseling.

Adverse consequences such as institutionalization and death are associated with compromised activities of daily living in aging, yet there is little known about risk factors for the development and progression of functional disability. Using generalized linear models, the authors examined the association between the ability to benefit from repetition and rate of change in functional ability in 160 nondemented elders participating in the Religious Orders Study. Three single-word repetition priming tasks were administered that varied in the degree to which visual-perceptual or conceptual processing was invoked. Decline in functional ability was less rapid, during follow-up of up to 10 years, in persons with better baseline priming performance on a task known to draw on both visual-perceptual and conceptual processing (word-stem completion). By contrast, change in functional ability was not associated with priming on tasks that are known to draw primarily on either visual-perceptual (threshold word-identification) or conceptual (category exemplar production) processing. The results are discussed in terms of a common biological substrate in the inferotemporal neocortex, supporting efficient processing of meaningful visual-perceptual experience and proficient performance of activities of daily living.

Introduction There is a need for validated and responsive measurement tools to demonstrate changes in functional ability. Existing outcome measurement tools have significant limitations for children and young people with acquired brain injury (ABI). Aim This study examines the potential of the UK Functional Independence Measure + Functional Assessment Measure (UK FIM + FAM) to detect clinical change in older children and young people with ABI. Method This is a secondary retrospective pretest–post test analysis of 72 children and young people age 8–17 years. Internal responsiveness was examined using Wilcoxon signed-rank tests and effect sizes indices; external responsiveness was examined in relation to the Neurological Impairment Scale (NIS) using Spearman’s correlation coefficient. Results Highly significant changes were detected from admission to discharge on motor, cognitive and total UK FIM + FAM scores ( p < 0.001). Medium to large effect sizes were found on the total scale indicating good internal responsiveness. There was a significant, negative correlation between UK FIM + FAM change scores and NIS change scores ( p < 0.01) indicating good external responsiveness. Conclusion The UK FIM + FAM was able to detect clinically meaningful change in functional ability in children and young people with ABI over 8 years. Further validity and reliability must be established before recommending its use in this client group.

Practice Parameter for the Assessment and Treatment of Children and Adolescents With Substance Use Disorders

Atypical antipsychotics for disruptive behaviour disorders in children and youths.

The present study was designed to examine the extent to which (a) family and school functioning and (b) personal and ethnic identity is associated with conduct problems, drug use, and sexual risk taking in a sample of 227 high-risk Hispanic adolescents. Adolescents participated in the study with their primary parents, who were mostly mothers. Adolescents completed measures of family and school functioning, personal and ethnic identity, conduct problems, and drug use. Parents completed measures of family functioning and adolescent conduct problems. Results indicated that school functioning and personal identity confusion were related to alcohol use, illicit drug use, and sexual risk taking indirectly through adolescent reports of conduct problems. Adolescent reports of family functioning were related to alcohol use, illicit drug use, and sexual risk taking through school functioning and conduct problems. Results are discussed in terms of the problem behavior syndrome and in terms of the finding of relative independence of contextual and identity variables vis-à-vis conduct problems, substance use, and sexual risk taking.

Family-focused therapy (FFT) is associated with reduced rates of mood episodes among youth at high risk for bipolar disorder (BD). In a randomized trial of FFT compared to a psychoeducation-only treatment (enhanced care, EC), we sought to determine if changes in psychosocial functioning mediate mood improvements among high-risk youth. 119 youths with active mood symptoms and a family history of BD were randomized to either 4 months of FFT or EC. Participants were rated on mood symptom severity and provided self-ratings of psychosocial functioning across domains of family, social-emotional, and school functioning. Repeated measures mixed modeling and bootstrapped mediational analyses evaluated the effects of treatment conditions and psychosocial functioning on mood improvements immediately posttreatment and over 2 years of follow-up. Youths in FFT reported greater improvements in family functioning over 24 months compared to those in EC, F(5, 76.8) = 3.1, p < .05. Improvements in family functioning partially mediated participants' improvements in depressive symptoms, B = -0.22, p < .01; 95% CI [-0.55, -0.02]. The effects of FFT versus EC on family functioning were stronger among youth with comorbid anxiety and externalizing disorders than among youth without these comorbid disorders. The findings suggest a temporal link between changes in youths' perceptions of family functioning and improvements in depressive symptoms among high-risk youth in FFT. Family conflict and cohesion are important treatment targets for youth who present with early signs of BD. Future studies should examine whether changes in observational measures of family interaction precede improvements in mood among high-risk youth. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The purpose of this article is (a) to describe changes in functional ability from the age of 70 to 75 years, (b) to examine whether a new functional ability measure is a good predictor of dependency, and (c) to examine whether sociodemographic factors are associated with transitions. The investigation is part of the longitudinal study of the 1914 population in Glostrup, Denmark, and comprised 576 men and women who were interviewed in their homes about functional ability, social situation, and so forth when they were 70 and 75 years old. Tiredness in mobility and daily activities measured by two functional ability scales at age 70 were independent predictors of need for help in mobility and daily activities at age 75. Among the sociodemographic variables, education among women and income among men were found to be independent predictors of dependency at age 75.