Long-term Outcomes Of Youth Research Articles

Transdiagnostic Sleep and Circadian Intervention in Youth: Long-term Follow-up of a Randomized Controlled Trial

This preregistered study compared the effects of the Transdiagnostic Sleep and Circadian Intervention (TranS-C) with psychoeducation (PE) about sleep, health, yoga, meditation, and outdoor appreciation activities on sleep and circadian functioning, health risk, and sleep health behaviors at long-term follow-up (LTFU), an average of 8 years following treatment. We also examined if more sleep health behaviors at LTFU were associated with better sleep and circadian functioning at LTFU and if better sleep and circadian functioning were associated with lower health risk at LTFU. At baseline, we randomly assigned adolescents with an eveningness chronotype to TranS-C (n= 89) or PE (n= 87). Of this sample, we assessed 106 young adults (mean age at follow-up= 22.5 years; n= 55 from TranS-C; n= 51 from PE) an average of 8 years following treatment. Despite TranS-C (vs PE) sustaining improvement in circadian functioning through 12-month follow-up, at LTFU, there were no significant differences between the conditions on any outcome, including sleep and circadian functioning, risks in 5 health domains indexed by self-report and ecological momentary assessment, sleep health behaviors, and physical measurements. Across both conditions, measures indicating poorer sleep and circadian functioning were associated with higher health risk across multiple domains, and more sleep health behaviors were associated with lower levels of eveningness at LTFU. These results provide an important window into the influence of development on long-term outcomes for youth and raise the possibility that interventions for youth could be enhanced with a focus on habit formation. Maintaining Behavior Change: A 6-Year Follow-up of Adolescent 'Night-owls'; https://www. gov/; NCT05098782. Long-term Follow-up of Young Adults Who Received TranS-C to Modify Eveningness Chronotype in Adolescence; https://osf.io/; d5a4g. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. We worked to ensure sex and gender balance in the recruitment of human participants. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. One or more of the authors of this paper self-identifies as living with a disability. One or more of the authors of this paper received support from a program designed to increase minority representation in science.

Pragmatic language and associations with externalizing behaviors in autistic individuals and those who have lost the autism diagnosis

BackgroundPragmatic language weaknesses, a core feature of autism spectrum disorder (ASD), are implicated in externalizing behavior disorders (Gremillion & Martel, 2014). Particularly in a clinical setting, these co-occurring externalizing disorders are very common in autism; rates of Attentional Deficit-Hyperactive Disorder (ADHD) and Oppositional Defiant Disorder (ODD) are as high as 83% (ADHD) and 73% (ODD; Joshi et al., 2010). It is possible that pragmatic language weaknesses impact the ability to effectively communicate one’s needs, which may lead autistic children to utilize externalizing behaviors in order to achieve a desired outcome (Ketelaars et al., 2010; Rodas et al., 2017). MethodsThe aim of the current study is to investigate the relationship between pragmatic language, assessed via multiple modalities, and externalizing behaviors, assessed by parent interview, in youth with autistic (n = 33) or neurotypical (NT; n = 34) developmental histories, along with youth diagnosed with autism, who lost the diagnosis (LAD) by adolescence (n = 31). ResultsThe autism group had significantly more pragmatic language difficulties, and more externalizing behaviors and disorders; ADHD symptoms were particularly more prevalent, while LAD and NT groups did not differ. Challenges in pragmatic language abilities were associated with more externalizing symptoms when controlling for other facts that typically influence such symptoms, including nonverbal cognition, structural language, executive functioning, and autistic characteristics, but did not remain when age was included in the model. ConclusionsWe discuss the mechanisms underlying difficult-to-manage externalizing behaviors and implications for interventions and long-term outcomes for youth with and without a history of autism.

Psychotic Vulnerability and its Associations with Clinical Characteristics in Adolescents with Obsessive-Compulsive Disorder.

Compared to peers, children and adolescents with obsessive-compulsive disorder (OCD) are at increased risk of developing psychotic disorders. Yet very few studies have examined early indicators of psychosis in pediatric OCD. In the present study, 52 youth with a primary diagnosis of OCD (Mage = 15.66 [SD = 2.33], 59.6% girls) were interviewed using the Schizophrenia Proneness Instrument Child and Adolescent version (SPI-CY), which is a comprehensive clinical interview assessing both Cognitive-Perceptual basic symptoms (COPER) and high-risk criterion Cognitive Disturbances (COGDIS). Associations between COPER/COGDIS symptoms and demographic and clinical characteristics were examined. Findings showed that COPER or COGDIS symptoms were present in 44% of participants, with no significant difference between girls and boys. Psychotic vulnerability was associated with an earlier age of OCD onset, greater OCD severity, poorer insight, and more contamination/cleaning symptoms. Psychotic vulnerability was also strongly associated with worse psychosocial functioning. Findings suggest that early indicators of psychosis are frequent in pediatric OCD and associated with more severe OCD and poorer functioning. Research examining how psychotic vulnerability is associated with short- and long-term outcomes for youth with OCD is needed.

Using Partnerships to Create a Medical Specialty Camp for Youth with Diabetes

Complications associated with a complex chronic illness, specifically, type 1 diabetes, negatively impact youth as they struggle to maintain healthy lifestyles. Type 1 diabetes is the second most common chronic illness affecting youth as well as one of the most psychologically and behaviorally demanding illnesses. Fortunately, organized camps have been shown to positively influence long-term outcomes for youth. Family Diabetes Camp, the only family medical program in the state where this study occurred, was created in collaboration with a local university, a diabetes center at a hospital, and a chapter of the Lions Club. This collaborative camp program aimed to test the effect of active participation in a Family Diabetes Camp upon youth outcomes for campers with type 1 diabetes. Specifically, the purpose was to evaluate the impact of a collaborative medical camp on campers’ resilience and youth developmental outcomes (e.g., independence). Family Diabetes Camp was designed using Outcome-Focused Programming (OFP) to promote positive youth development. The Family Diabetes Camp included 50 campers for the pre-test and post-test (n= 19 males and n= 31 females). While there were no statistically significant differences from pretest (M=4.97, SD= .53) to post-test scores (M=5.01, SD= .46), with t(50) = -.56, p= .57) researchers found a slight increase in resilience from pre to post-test. Using a retrospective measure, campers showed gains in the seven critical youth development outcomes identified by the American Camp Association. Finally, campers learned new knowledge about site injection, carbohydrate counting, and the use of exercise to help manage their diabetes. The impact associated with adapting activities and an environment to encourage, analyze, and challenge resilient behaviors is essential in encouraging independence, shared experiences, and effective disease management for youth living with type 1 diabetes. The camp, solely staffed by volunteers, included physicians, diabetes educators, certified therapeutic recreation specialists, dietitians, nurses, pump specialists, recreation professionals and students, and Lions Club Members. The camp program is unique not only in how it fills a void for youth with type 1 diabetes but how three large organizations work in concert to meet the needs of entire families. These types of data can be instrumental in establishing more camps and other out of school time programming that positively impacts quality of life, health care cost, and mortality among youth with type 1 diabetes.

Moody kids years later: Long-term outcomes of youth from the Omega-3 and therapy (OATS) studies

BackgroundThis naturalistic follow-up study examines outcomes for youth with depression (n = 25) or subsyndromal bipolar disorder (n = 13) 2–5 years after participation in randomized clinical trials (RCTs) of omega-3 fatty acids (Ω3), individual family psychoeducational psychotherapy (IF-PEP), and their combination MethodsForty percent (38/95) of RCT families completed a follow-up assessment ResultsRelapse rates and conversion to bipolar disorder were consistent with published literature. Original treatment assignment did not impact current functioning. Overall, participants’ mood severity, executive functioning, and global functioning continued to be better than at RCT baseline. Depressive symptoms increased significantly from end of RCT. Manic symptom severity, executive functioning, and global functioning remained comparable to end of RCT. The majority of parents and youth reported improved youth emotion regulation skills and family communication. They considered study participation beneficial, with increased understanding of mood disorders being the top reason. Half of youth commenced or continued Ω3 and 58% commenced or continued psychotherapy post-RCT, suggesting some degree of consumer satisfaction; these youth had lower depression severity than other participants. LimitationsOnly 40% returned to this naturalistic follow-up; they were less likely to have an African-American parent, were of higher income, and youth were more symptomatic at end of RCT than those who did not return ConclusionsImprovement from RCT baseline continued although depressive symptom severity increased from end of RCT to follow-up. Meaningful improvements in youth and family functioning persisted 2–5 years later. Interventions that prevent relapse or conversion to BPSD are still needed for these vulnerable populations.

Long-Term Outcomes for Transition-Age Youth With Mental Health Conditions Who Receive Postsecondary Education Support

This article examines the relationship between receiving support for postsecondary education (college or vocational training) from state vocational rehabilitation (VR) agencies and long-term outcomes for youth with mental health conditions (MHCs). We use longitudinal data to follow three cohorts of youth VR applicants for 9 years after they applied for VR services. The results show a strong relationship between receipt of postsecondary education support and long-term employment, earnings, and federal disability benefit receipt. For some outcomes, such as being employed in the 9 years after VR application, the number of years employed, and benefit receipt in the 9 years after VR application for those who did not receive benefits at the time of application, the association is larger for youth with MHCs than for those with other disabilities. These findings provide valuable descriptive estimates of the benefits of providing postsecondary education support for VR youth with MHCs and how these benefits compare with youth with other types of disabilities.

Long-term outcomes of youth who manifested the CBCL-Pediatric Bipolar Disorder phenotype during childhood and/or adolescence

Objective Recent studies have identified a Child Behavior Checklist (CBCL) profile that characterizes children with severe aggression, inattention, and mood instability. This profile has been coined the CBCL-Pediatric Bipolar Disorder (PBD) phenotype, because it is commonly seen among children with bipolar disorder. However, mounting evidence suggests that the CBCL-PBD may be a better tool for identifying children with severe functional impairment and broad-ranging psychiatric comorbidities rather than bipolar disorder itself. No studies have followed individuals with the CBCL-PBD profile through adulthood, so its long-term implications remain unclear. The present authors examined diagnostic and functional trajectories of individuals with the CBCL-PBD profile from early childhood through young adulthood using data from a longitudinal high-risk study. Method Participants ( n = 101) are part of a 23-year study of youth at risk for major mood disorder who have completed diagnostic and functional assessments at regular intervals. Results Across development, participants with the CBCL-PBD phenotype exhibited marked psychosocial impairment, increased rates of suicidal thoughts and behaviors and heightened risk for comorbid anxiety, bipolar disorder, cluster B personality disorders and ADHD in young adulthood, compared to participants without this presentation. However, diagnostic accuracy for any one particular disorder was found to be low. Conclusions Children with the CBCL-PBD profile are at risk for ongoing, severe, psychiatric symptomatology including behavior and emotional comorbidities in general, and bipolar disorder, anxiety, ADHD, cluster B personality disorders in particular. However, the value of this profile may be in predicting ongoing comorbidity and impairment, rather than any one specific DSM-IV diagnosis.