Effective Interventions For Adolescents Research Articles

Do single-case experimental designs lead to randomised controlled trials of cognitive behavioural therapy interventions for adolescent anxiety and related disorders recommended in the National Institute of Clinical Excellence guidelines? A systematic review.

Although Cognitive Behavioural Therapy (CBT) is effective for 60% of adolescents with anxiety disorders, only 36% are in remission post-intervention. This indicates that more effective treatments are needed which should be reflected in the NICE guidelines. We hypothesised that Single-case experimental designs (SCEDs) may provide a framework for accelerating the development of novel interventions. The primary purpose of this review was to investigate whether SCEDs are currently followed by randomised controlled trials (RCTs) of CBT intervention for adolescent anxiety disorders named in the NICE guidelines. The secondary objective was to investigate whether using SCEDs prior to RCTs could be a helpful approach. For the primary search of SCEDs five databases were used (PsycINFO, PubMed, PsycArticles, Web of Science and ProQuest). Nineteen articles met eligibility criteria including a total of 107 participants. For the secondary search of RCTs named in the NICE guidelines for adolescent anxiety disorders 53 articles met inclusion criteria and were included in the systematic review. The 19 SCED studies included in the review were conducted with participants with a diverse range of anxiety disorders and across a range of CBT formats. Two of the SCEDs were followed by RCTs, but neither of these were named in the NICE guidelines for anxiety disorders. All of the SCEDs identified were rated as low quality with none meeting the criteria for the highest or second highest quality rating. From the secondary searches, none of the RCTs named in the NICE guide were preceded by SCEDs. It was concluded that currently SCEDs were not followed by RCTs of CBT interventions named in the NICE guidelines for adolescent anxiety disorders. However, it was suggested that SCEDs may provide an important framework for the development of more effective interventions for adolescents with anxiety.

Changing adolescent activity patterns and the correlation of self-esteem and externalizing mental health symptoms across time: results from the USA from 1991 through 2020.

Common adolescent psychiatric symptoms cluster into two dominant domains: internalizing and externalizing. Both domains are linked to self-esteem, which serves as a protective factor against a wide range of internalizing and externalizing problems. This study examined trends in US adolescents' self-esteem and externalizing symptoms, and their correlation, by sex and patterns of time use. Using Monitoring the Future data (N = 338 896 adolescents, grades:8/10/12, years:1991-2020), we generated six patterns of time use using latent profile analysis with 17 behavior items (e.g. sports participation, parties, paid work). Groups were differentiated by high/low engagement in sports and either paid work or high/low peer socialization. Within each group, we mapped annual, sex-stratified means of (and correlation between) self-esteem and externalizing factors. We also examined past-decade rates of change for factor means using linear regression and mapped proportions with top-quartile levels of poor self-esteem, externalizing symptoms, or both. We found consistent increases in poor self-esteem, decreases in externalizing symptoms, and a positive correlation between the two across nearly all activity groups. We also identified a relatively constant proportion of those with high levels of both in every group. Increases in poor self-esteem were most pronounced for female adolescents with low levels of socializing, among whom externalizing symptoms also increased. Rising trends in poor self-esteem are consistent across time use groups, as is the existence of a group facing poor self-esteem and externalizing symptoms. Effective interventions for adolescents' poor self-esteem/co-occurring symptoms are needed broadly, but especially among female adolescents with low peer socialization.

Exploring Lived Experiences of Adolescents Presenting with Self-Harm and Their Views about Suicide Prevention Strategies: A Qualitative Approach.

Suicide is a serious global public health problem and the third leading cause of death in those 15–35 years old. Self-harm is the major predictor of future suicide attempts and completed suicide yet remains poorly understood. There is limited evidence on effective interventions for adolescents who present with self-harm. To identify and develop acceptable preventive and therapeutic interventions it is essential to understand the factors that contribute to self-harm and suicide in young people, in the context of their emotions, interpersonal difficulties, available support and prevention strategies. This qualitative study aimed at exploring the lived experiences of adolescents presenting with self-harm and their views about potential prevention strategies. Semi-structured interviews with 16 adolescents (12–18 years) presenting with a self-harm episode in a public hospital in Pakistan. A topic guide was developed to facilitate the interviews. The following themes emerged using the framework analysis; predisposing factors (interpersonal conflicts, emotional crisis etc.), regret and realization that self-harm is not the only option, perceived impact of self-harm, and suggestions for suicide prevention strategies (sharing, distraction techniques, involvement of family). This study may help in refining a contextual and culturally based explanatory model of self-harm in adolescents and in informing development of culturally acceptable interventions.

Effectiveness of Mindfulness-Based Intervention on Risky Behaviors, Resilience, and Distress Tolerance in Adolescents

Background: The adolescent faces rapid physical growth that is emotionally immature, in terms of limited experience, and fragile and vulnerable in cultural terms. The rate of change in this period is high that can cause various behavioral problems during this period. Objectives: The aim of this research was to explore the effectiveness of Mindfulness-Based Intervention on risky behaviors, resilience and distress tolerance among adolescents in juvenile correction and rehabilitation center. Patients and Methods: This research was a quasi-experimental study with pretest-posttest and control group. A random sampling method was used to select 30 people in the experimental and control groups at Tehran’s Juvenile Correction and Rehabilitation Center in 2019. The control group did not receive any training and just were taken pre-test and post-test. The Iranian Adolescents Risk-Taking Scale, Distress Tolerance Scale and Connor-Davidson Resilience Scale were used in this research. Multivariate analysis of variance, multivariate covariance test were performed to analyze data by SPSS V. 22 software. Results: The results showed that intervention in adolescents at the juvenile correction and rehabilitation center has an important impact on risky behavior, resilience, and distress tolerance. Conclusions: Mindfulness can be used as an effective interventions for adolescents with risky behaviors.

Self-injury: Treatment, Assessment, Recovery (STAR): online intervention for adolescent non-suicidal self-injury - study protocol for a randomized controlled trial

BackgroundNon-suicidal self-injury (NSSI) is a clinically significant behavior affecting approximately 18% of adolescents and young adults worldwide. The importance of NSSI is supported by its association with a broad spectrum of mental disorders. Despite its high relevance, evidence-based, specific, time-, and cost-effective treatment approaches are scarce. Cognitive behavioral therapy (CBT) seems effective in reducing the frequency of NSSI in adolescents and young adults. However, young people are often reluctant to seek professional help and effective interventions adressing NSSI are not sufficiently available across all regions of Germany. Research indicates that the majority of youth with risk behavior (including NSSI) prefer technology-based interventions. To date, effective interventions for adolescents and young adults with NSSI that are deliverd online are not available.MethodsThe present project aims to develop and evaluate an online intervention for adolescents and young adults with NSSI based on the content of a recently evaluated face-to-face short-term program that includes elements of CBT and dialectical behavior therapy (DBT): “The Cutting Down Programme” (CDP). The efficacy of the new online CDP intervention will be tested in a randomized controlled trial (RCT) in which n = 700 youths engaging in repetitive NSSI will participate in either an online psychoeducation (n = 350) or online CDP (n = 350). Within a postline assessment four months after baseline (end of treatment; T1), and follow-up evaluations 12 and 18 months after baseline (follow-ups; T2 and T3), NSSI and comorbid symptoms as well as quality of life will be assessed. It is hypothesized that participants receiving online CDP report a greater reduction in the frequency of NSSI within the last three months at T2 (primary endpoint) compared to those receiving online psychoeducation. Exploratory analyses will focus on predictors of treatment outcome.DiscussionWe report on the development and evaluation of an online intervention for adolescents and young adults engaging in NSSI based on the CDP. If supported by empirical evidence, an online-based intervention for NSSI might help to overcome the limited availability of adequate interventions for youth.Trial registrationGerman Clinical Trials Register, DRKS00014623. Registered on 22 May 2018.

Preventing Suicide in Young People: Systematic Review

Risk of suicide attempt, suicidal ideation and deliberate self-harm is high among young people, yet limited evidence exists regarding effective interventions, particularly from randomized controlled trials. The aim of this study was to conduct a systematic review and meta-analysis of all randomized controlled trials testing interventions for adolescents and young adults who have presented to a clinical setting with any of these behaviours. The Cochrane Central Register of Controlled Trials, Medline, EMBASE and PsycINFO were searched for articles published from 1980 to June 2010. The following keywords formed the basis of the search strategy: 'self-injurious behaviour', 'attempted suicide', 'suicide', 'suicidal behaviour', 'self-inflicted wounds', 'self-mutilation', 'self-harm'. We also hand searched conference abstracts from two major suicide prevention conferences and the reference lists of all retrieved articles and previous reviews. There were 15 trials included in the review, with six ongoing trials also identified. In general, the reporting of the conduct of trials was poor, making it difficult to assess the risk of bias. The reporting of outcome data was inconsistent. No differences were found between treatment and control groups except in one study that found a difference between individual cognitive behavioural therapy and treatment as usual. The evidence regarding effective interventions for adolescents and young adults with suicide attempt, deliberate self-harm or suicidal ideation is extremely limited. Many more methodologically rigorous trials are required. However, in the meantime CBT shows some promise, but further investigation is required in order to determine its ability to reduce suicide risk among young people presenting to clinical services.

Psychosocial treatment of adolescents with ADHD

Attention-deficit/hyperactivity disorder (ADHD) is a disruptive behavior disorder that is associated with social, family, and academic impairment. These areas of impairment are predictive of negative outcomes for adolescents, such as peer rejection, low or failing grades, and family conflict. This article reviews impairment associated with adolescents with ADHD and treatment approaches for these youth, with an emphasis on recent findings. There is a need for more research targeted at developing effective interventions for adolescents with ADHD, establishing reliable and valid assessment instruments, and identifying effective dissemination procedures.

New and emerging treatment options for adolescent bulimia nervosa

While bulimia nervosa (BN) was first described more than 25 years ago, and a substantial body of literature has been accumulated describing both psychosocial and pharmacological treatments for adults with this disorder, little is known about effective interventions for adolescents with BN. The scope of this article is to review recent developments in the treatment of adolescent BN. We highlight our current knowledge of the epidemiology of this disorder among adolescents, emphasize the importance of early recognition of this disorder, and summarize the existing treatment literature for adolescent BN. The gaps in our knowledge regarding adolescents are accentuated by referring, in contrast, to the efficacious treatment for adults with BN. We conclude by underscoring the need to conduct large-scale randomized trials testing efficacious treatments for adolescent BN by borrowing from what is known in the treatment of adults with BN, as well as adolescents with anorexia nervosa.

I Wanna Hold Your Hand: The Progression of Social, Romantic and Sexual Events in Adolescent Relationships

Despite the vast amount of existing research on adolescent sexual behavior, little is known about the trajectory of social, romantic and sexual events within an adolescent's relationship. A subsample of participants in Wave 2 of the National Longitudinal Study of Adolescent Health (8,438 respondents aged 12-21) provided data on the sequence of 15 social, romantic and sexual events that occurred in a recent romantic relationship. Proportions reporting each event and average relative rankings were assessed for all respondents, for different racial and ethnic groups, and for respondents who belonged to the same racial or ethnic group as their partner. Logistic regression was used to compare proportions; ordinary least square regression was used to analyze the mean sequential ranking of each event. Social and romantic events, such as spending time with one's partner in a group and holding hands, were far more common than sexual events, such as touching one's partner without clothing, and typically preceded sexual events in the trajectory of relationship events. Romantic events were the most common across three of the four major U.S. racial and ethnic groups. Asian and Hispanic respondents tended to have low proportions reporting sexual events compared with white respondents. Black adolescents were the only group for whom talking about prevention of pregnancy and STDs preceded sexual events. Reports from male and female adolescents were similar. Recognition of the diversity of relationship experiences may prompt the development of more effective interventions for adolescents who engage in risky sexual behavior.

Effective interventions for adolescents with anorexia nervosa

Background: Anorexia Nervosa (AN) is a serious psychiatric illness with both psychological and medical sequelae that usually onsets during adolescence. The illness presents formidable challenges to clinicians. Despite these facts, there are few treatments studies for the adolescent age group.Aims: This report provides a critical review of the most common treatments and the empirical support for them for adolescent AN.Method: Clinical and research literature was reviewed to identify empirically supported treatments with an emphasis on identifying pertinent randomized controlled trials. However, relevant clinically oriented reports and consensus clinical guidelines were also included when other systematic research was unavailable in order to provide a more comprehensive view of current treatment strategies for adolescents with AN.Results: There are only five randomized clinical trials specifically addressing treatment for adolescent AN. Only 207 subjects were enrolled in these studies with an average cell size of about 20 subjects. Data from these trials suggest that family therapy wherein parents re-feed their adolescent offspring is effective for AN in this age group. However, other treatment approaches (e.g. individual therapy, group therapy, hospitalization, medication) have not been sufficiently or systematically studied.Conclusions: Family therapy based on parental re-feeding is an effective approach for adolescent AN. However, the superiority of family therapy over other types of interventions has not been sufficiently demonstrated. There is an urgent need to conduct treatment research in this area to guide clinical care for this vulnerable population.Declaration of interest: Dr Lock is supported by NIH Grant R01MH070621-01.

Effective HIV Prevention Interventionsfor Adolescents and Young Adults

Abstract The increase in HIV infection among young people has raised serious questions about the effectiveness of HIV prevention interventions for this population group. Empirical research has demonstrated that a theoretical base can enhance the effectiveness of prevention programs for adolescents and young adults. This paper has two main objectives: (1) to identify selected theoretical constructs and principles that have been found to be helpful in developing effective HIV prevention interventions; and (2) to relate critical constructs and principles to effective interventions for adolescents and young adults. This kind of information will help to plan, develop, and implement more effective prevention strategies and interventions for these high-risk target groups.