What five decades of research tells us about the effects of youth psychological therapy: A multilevel meta-analysis and implications for science and practice

Across 5 decades, hundreds of randomized trials have tested psychological therapies for youth internalizing (anxiety, depression) and externalizing (misconduct, attention deficit and hyperactivity disorder) disorders and problems. Since the last broad-based youth metaanalysis in 1995, the number of trials has almost tripled and data-analytic methods have been refined. We applied these methods to the expanded study pool (447 studies; 30,431 youths), synthesizing 50 years of findings and identifying implications for research and practice. We assessed overall effect size (ES) and moderator effects using multilevel modeling to address ES dependency that is common, but typically not modeled, in meta-analyses. Mean posttreatment ES was 0.46; the probability that a youth in the treatment condition would fare better than a youth in the control condition was 63%. Effects varied according to multiple moderators, including the problem targeted in treatment: Mean ES at posttreatment was strongest for anxiety (0.61), weakest for depression (0.29), and nonsignificant for multiprob lem treatment (0.15). ESs differed across control conditions, with "usual care" emerging as a potent comparison condition, and across informants, highlighting the need to obtain and integrate multiple perspectives on outcome. Effects of therapy type varied by informant; only youth-focused behavioral therapies (including cognitive-behavioral therapy) showed similar and robust effects across youth, parent, and teacher reports. Effects did not differ for Caucasian versus minority samples, but more diverse samples are needed. The findings underscore the benefits of psychological treatments as well as the need for improved therapies and more representative, informative, and rigorous intervention science

Are Psychotherapies for Young People Growing Stronger? Tracking Trends Over Time for Youth Anxiety, Depression, Attention-Deficit/Hyperactivity Disorder, and Conduct Problems

With the development of empirically supported treatments over the decades, have youth psychotherapies grown stronger? To investigate, we examined changes over time in treatment effects for four frequently treated youth mental-health problems: anxiety, depression, attention-deficit hyperactivity disorder (ADHD), and conduct disorders. We used PubMed and PsycINFO to search for randomized controlled trials (RCTs) that were published between January 1960 and May 2017 involving youths between the ages of 4 and 18 years. We also searched reviews and meta-analyses of youth psychotherapy research, followed reference trails in the reports we identified, and obtained additional studies identified by therapy researchers whom we contacted. We identified 453 RCTs (31,933 participants) spanning 53 years (1963-2016). Effect sizes for the problem-relevant outcome measures were synthesized via multilevel meta-analysis. We tracked temporal trends for each problem domain and then examined multiple study characteristics that might moderate those trends. Mean effect size increased nonsignificantly for anxiety, decreased nonsignificantly for ADHD, and decreased significantly for depression and conduct problems. Moderator analyses involving multiple study subgroups showed only a few exceptions to these surprising patterns. The findings suggest that new approaches to treatment design and intervention science may be needed, especially for depression and conduct problems. We suggest intensifying the search for mechanisms of change, making treatments more transdiagnostic and personalizable, embedding treatments within youth ecosystems, adapting treatments to the social and technological changes that alter youth dysfunction and treatment needs, and resisting old habits that can make treatments unduly skeuomorphic.status: Published onlin

Os(VI)O₂/K Metal–Organic Frameworks: Infinite Chain, Grid, and Porous Networks

The design of multianionic chelating ligands as new organic linker for producing metal–organic frameworks (MOFs) is discussed. Three potentially polyanionic pro-ligands, 3,5-di-<i>tert</i>-butyl-2-hydroxy-<i>N</i>-(2-hydroxyethyl)­benzamide (¹LH₃), bis­(2-aminoethyl)-5-(<i>tert</i>-butyl)-2-hydroxyisophthalate (^2aLH₃), and 5-(<i>tert</i>-butyl)-2-hydroxy-<i>N</i>1,<i>N</i>3-bis­(1-hydroxy-2-methylpropan-2-yl)­isophthalamide (^2bLH₃), were synthesized and found to coordinate the osmyl ion in trianionic NO₂ fashion through the N-amidate, O-phenolate, and O-alcoholate donor atoms. The X-ray crystal structures of three dioxo-Os­(VI) complexes: [Os₂O₄(¹L)₂(OH)­K₂(H₂O)­(C₃H₆O)] (<b>Os</b>^<b>1</b>), [OsO₂(^2aL^3–)­(MeOH)₄(MeO)­K₂] (<b>Os</b>^<b>2a</b>), and [OsO₂(^2bL)­(H₂O)­(C₃H₆O)­K] (<b>Os</b>^<b>2b</b>) reveal that the osmyl moiety and the ligand establish distinctive interactions with the potassium ions, yielding unprecedented infinite network from stepladder chain (in <b>Os</b>^<b>2b</b>) and 2D-grid (in <b>Os</b>^<b>1</b>) to 3D-porous H-bonding network (in <b>Os</b>^<b>2a</b>)

Os(VI)O₂/K Metal–Organic Frameworks: Infinite Chain, Grid, and Porous Networks

The design of multianionic chelating ligands as new organic linker for producing metal–organic frameworks (MOFs) is discussed. Three potentially polyanionic pro-ligands, 3,5-di-<i>tert</i>-butyl-2-hydroxy-<i>N</i>-(2-hydroxyethyl)­benzamide (¹LH₃), bis­(2-aminoethyl)-5-(<i>tert</i>-butyl)-2-hydroxyisophthalate (^2aLH₃), and 5-(<i>tert</i>-butyl)-2-hydroxy-<i>N</i>1,<i>N</i>3-bis­(1-hydroxy-2-methylpropan-2-yl)­isophthalamide (^2bLH₃), were synthesized and found to coordinate the osmyl ion in trianionic NO₂ fashion through the N-amidate, O-phenolate, and O-alcoholate donor atoms. The X-ray crystal structures of three dioxo-Os­(VI) complexes: [Os₂O₄(¹L)₂(OH)­K₂(H₂O)­(C₃H₆O)] (<b>Os</b>^<b>1</b>), [OsO₂(^2aL^3–)­(MeOH)₄(MeO)­K₂] (<b>Os</b>^<b>2a</b>), and [OsO₂(^2bL)­(H₂O)­(C₃H₆O)­K] (<b>Os</b>^<b>2b</b>) reveal that the osmyl moiety and the ligand establish distinctive interactions with the potassium ions, yielding unprecedented infinite network from stepladder chain (in <b>Os</b>^<b>2b</b>) and 2D-grid (in <b>Os</b>^<b>1</b>) to 3D-porous H-bonding network (in <b>Os</b>^<b>2a</b>)