Observational Measurement of Attachment in Toddlers with Disruptive Behavior Using the Strange Situation Procedure and Attachment Q-Set

Child-caregiver attachment is an important factor in healthy child development and is often targeted by early intervention programs. To assess the efficacy of these interventions, attachment must be accurately measured across the toddler years in populations referred for treatment of externalizing behavior problems. The Strange Situation Procedure (SSP; Ainsworth et al., 1978) and Attachment Q-Set (AQS; Waters, 1987) are empirically-validated measures of child-caregiver attachment, each with unique strengths and weaknesses. Previous research has reached mixed conclusions on relations between the observer-report AQS and SSP, depending on sample and study characteristics, and a review of the literature did not produce any published investigations on concurrent relations between the two measures across clinically-referred, mental health populations. Using a clinical sample of 69 Australian mother-toddler dyads referred for disruptive behavior problems, this study examined associations among behavior problems, SSP classifications, AQS Security scores, and child age. In line with hypotheses, data revealed a significant small to medium correlation between AQS Security and externalizing behavior. Unexpectedly, no significant association was found between SSP classifications and externalizing behavior. Although AQS and SSP Security scores were not significantly correlated for the sample as a whole, there was a moderate correlation among the two measures for children ages 19-25 months. Implications of these results on future research measuring attachment in this population, with particular relevance for early intervention outcome studies and clinical work, are discussed

Emotion Regulation and Attrition in Parent-Child Interaction Therapy

As evidence of the importance of emotion regulation (ER) continues to mount, little is known about how families dealing with child behavior problems can better develop this important ability. This study explored the relations among a caregiver training program for children with severe problem behaviors (i.e., Parent-Child Interaction Therapy; PCIT), child ER, caregiver ER, parent-ing stress, and attrition. This study was part of a larger investigation evaluating the impact of in-centives on treatment outcomes. Measures of caregiver and child ER, child behavior problems, and parenting stress were completed by caregivers referred for PCIT from a predominantly low-income community sample of 66 caregiver-child dyads. Caregiver-child interactions were coded for caregiver verbalizations during three play situations. ANCOVA, t-test, and logistic regression analyses were conducted to examine changes in ER across treatment and compare those who completed treatment with those who dropped out of treatment early. Results suggested that care-giver ER and child ER lability/negativity improved significantly across both phases of PCIT. Child adaptive ER improved significantly from pre- to post-treatment and during the PDI phase of treatment for those children in the non-incentives group only. Baseline levels of child and caregiver ER were not significant predictors of attrition; however, two models composed of base-line (e.g., caregiver-child interactions) and demographic variables significantly predicted attrition. The findings are discussed with respect to the importance of both caregiver and child ER in the provision of PCIT and other behavioral parent training programs

A Host Index to the North American Species of the Genus Cercospora

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Observations on Thyronectria denigrata

Thyrornectria denigrata (Wint.) Seaver,* a Hypocreaceous fungus, occurring on branches and fallen trunks of Gleditschia triacanthos L. in the eastern and central United States, consists of an internal mycelium producing subimmersed or erumpent-superficial, pulvinate, orange-brown stromata. On or near the surfaces of such stromata are formed dense cespitose, carnose-melnbranaceous, subglobose, ostiolate, reddish-brown to black perithecia. The cylindrical, short stipitate asci contain eight hyaline or slightly yellowish short elliptical ascospores which are three to five septate, muriform, more or less constricted at the septa and 10--16 × 7--10μ. This study is based on numerous collections made intermittently in the flood-plain areas around Lincoln, Nebraska, since 1930. Early collections were the source of eighteen monascospore cultures. Slides were made from naturally developed infections and from inoculated materials. The best slides were obtained with materials fixed in formal-acetic-alcohol, cleared in cedar oil, sectioned at three to six microns, stained with Haidenhain\u27s haematoxylin and counter-stained with Orange G. Agar film growth was stained with methyl blue in lactophenol. Zeiss apochromatic lenses have been used in the major part of the microscopic study; sketches have been made with the camera lucida. *Seaver, F. J. (Mycologia 1 : 203--206. 1909) regards Pleonectria Sacc. (Nuov. Giorn. Bot. Ital. 8 : 178. 1876) as synonymous with Thyronectria Sacc. (Grevillea 4; 21, 1875)

Parent–Child Interaction Therapy: current perspectives

Corey C Lieneman, Laurel A Brabson, April Highlander, Nancy M Wallace, Cheryl B McNeil Department of Psychology, West Virginia University, Morgantown, WV, USA Abstract: Parent–Child Interaction Therapy (PCIT) is an empirically supported intervention originally developed to treat disruptive behavior problems in children between the ages of 2 and 7 years. Since its creation over 40 years ago, PCIT has been studied internationally with various populations and has been found to be an effective intervention for numerous behavioral and emotional issues. This article summarizes progress in the PCIT literature over the past decade (2006–2017) and outlines future directions for this important work. Recent PCIT research related to treatment effectiveness, treatment components, adaptations for specific populations (age groups, cultural groups, military families, individuals diagnosed with specific disorders, trauma survivors, and the hearing-impaired), format changes (group and home-based), teacher–child interaction training (TCIT), intensive PCIT (I-PCIT), treatment as prevention (for externalizing problems, child maltreatment, and developmental delays), and implementation are discussed. Keywords: PCIT, adaptations, implementation, effectivenes

Reconceptualizing attrition in Parent–Child Interaction Therapy: “dropouts” demonstrate impressive improvements

Purpose: Behavior disorders in early childhood are linked to a variety of negative outcomes for both children and families. Parent–Child Interaction Therapy (PCIT), an evidence-based parent-training program, demonstrates large effect sizes in reducing child problem behavior for dyads who complete treatment; however, a high number of families seeking treatment in community-based settings terminate from PCIT prior to meeting the protocol’s strict graduation criteria. The purpose of this study was to examine the impact of PCIT on child behavior problems for families who received at least a small dose of PCIT but not enough to meet the strict mastery criteria required for graduation.Patients and methods: This study employed one of the largest community research samples conducted with PCIT (2,787 children and their families across the state of Oregon, 1,318 with usable data) to determine how PCIT impacts both graduates and early terminators.Results: While families who graduated from PCIT (17.7% of the sample) demonstrated a very large effect size in problem behavior intensity improvements (d=1.65), families who terminated treatment early, but after attending at least four treatment sessions (51.7% of the sample), still showed significant improvements in behavior problems with a medium-to-large effect size (d=0.70). In contrast, very early terminators (those attending fewer than four treatment sessions, 0.3% of the sample), demonstrated little improvement at the time of dropout from services (d=0.12).Conclusion: Though early terminators in PCIT have previously been identified as treatment failures, the present study discusses the reconceptualization of “dropouts” in relation to some positive evidence of treatment outcomes, the implications for community-based service delivery, and possible future directions

Case report: Co-occurring autism spectrum disorder (Level One) and obsessive-compulsive disorder in a gender-diverse adolescent

This fictionalized case report captures the common themes and considerations during the diagnostic assessment and behavioral treatment of adolescents demonstrating symptoms of autism spectrum disorder (ASD), obsessive-compulsive disorder (OCD), and attention-deficit/hyperactivity disorder (ADHD), as well as gender-diversity concerns. Our patient was a white, non-Hispanic 17-year-old individual who identified as gender-neutral but had been assigned female at birth. Symptoms presented were social withdrawal, rigid rule-following behavior, unusual repetitive behavior, impairments in social communication skills, sensory sensitivity, body dissatisfaction, self-injury, and anxiety related to contamination, perfectionism, and social interactions. These symptoms contributed to functional impairment with school attendance, school achievement, family relationships, and the activities of daily living. This case report summarizes instruments employed for differential diagnosis concerning cognitive functioning, ASD, OCD, ADHD, depression, anxiety, and commonly co-occurring repetitive behavior. This patient was ultimately diagnosed with ASD, level one for both social communication and restricted, repetitive behaviors, without accompanying intellectual or language impairment; OCD with panic attacks; gender dysphoria; major depressive disorder (single episode and moderate); and ADHD. The subsequent 40-session course of cognitive-behavioral therapy with exposure and response prevention (CBT/ERP) to treat OCD tailored to an individual with ASD and gender diversity concerns is described in detail. Components of family involvement are highlighted. As a result, significant improvements in school attendance, OCD symptoms, depression, social relationships, and adaptive functioning were measured. Lastly, recommendations for clinicians are summarized