Papers by Andrea Chronis-Tuscano
Parental future orientation and parenting outcomes: Development and validation of an adapted measure of parental decision making
Personality and Individual Differences
Journal of Attention Disorders, Feb 14, 2019
Objective: Separate literatures have examined the associations between maternal ADHD symptoms and... more Objective: Separate literatures have examined the associations between maternal ADHD symptoms and parenting and maternal emotion regulation (ER) and parenting. This study examined the effects of both maternal ADHD symptoms and ER on parenting. Method: This cross-sectional study used a multi-method evaluation of parenting behavior to examine the independent and interactive effects of maternal ADHD symptoms and ER on self-reported and observed parenting among 79 demographically diverse families of 5-to 10-year-old children. Results: There were significant main effects of maternal ER difficulties on negative parenting and of maternal ADHD symptoms on harsh responses to children's negative emotions. Maternal ADHD symptoms and ER were not significantly associated with positive parenting behavior. No interaction effects were observed. Conclusion: Maternal ADHD symptoms and emotion dysregulation may uniquely contribute to parenting difficulties. Maternal ADHD symptoms were associated with difficulties responding to children's negative emotions, whereas maternal ER was associated with difficulties with discipline practices. (J. of Att. Dis. XXXX; XX(X) XX-XX
Transactional patterns of depressive symptoms between mothers and adolescents: The role of emotion regulation
Depression and Anxiety, Nov 11, 2021
Depression is a highly prevalent, debilitating disorder that runs in families. Yet, empirical sup... more Depression is a highly prevalent, debilitating disorder that runs in families. Yet, empirical support for bidirectional mechanisms linking mother–adolescent depression symptoms remains limited. This study examined longitudinal bidirectional relations among emotion regulation (ER) constructs and depressive symptoms among mother–adolescent dyads over time. Pathways for girls and boys were explored separately, given extant research on sex differences in the intergenerational transmission of depression.
Frontiers in Psychology
IntroductionBehavioral inhibition (BI) is a temperamental trait characterized by a bias to respon... more IntroductionBehavioral inhibition (BI) is a temperamental trait characterized by a bias to respond with patterns of fearful or anxious behavior when faced with unfamiliar situations, objects, or people. It has been suggested that children who are inhibited may experience early peer difficulties. However, researchers have yet to systematically compare BI versus typically developing children’s observed asocial and social behavior in familiar, naturalistic settings.MethodWe compared the in-school behaviors of 130 (M = 54 months, 52% female) highly inhibited preschoolers (identified using the parent-reported Behavioral Inhibition Questionnaire) to 145 (M = 53 months, 52% female) typically developing preschoolers. Both samples were observed on at least two different days for approximately 60 min. Observers used the Play Observation Scale to code children’s behavior in 10-s blocks during free play. Teachers completed two measures of children’s behavior in the classroom.ResultsRegression m...
Frontiers in Psychology
IntroductionBehavioral inhibition during early childhood is one of the strongest risk factors for... more IntroductionBehavioral inhibition during early childhood is one of the strongest risk factors for the development of later anxiety disorders. Recently developed in-person interventions that target both young children who are highly inhibited and their parents (e.g., the Turtle Program), have decreased children's anxiety and have increased social participation in the peer group. However, researchers have yet to examine the effects of intervention mode of delivery. In the present study, we compared the pre-to post-intervention changes in child and parenting functioning of families participating in the Turtle Program, delivered in-person and online with those changes made in families allocated to a waiting-list condition; compared session attendance, homework completion and satisfaction with the intervention outcomes of families involved in the Turtle Program, delivered in-person and online; and explored the predictive role of parenting and child factors in session attendance, home...
Examining the Relations Between Children’s Vagal Flexibility Across Social Stressor Tasks and Parent- and Clinician-Rated Anxiety Using Baseline Data from an Early Intervention for Inhibited Preschoolers
Research on Child and Adolescent Psychopathology
Specific Pathways from Parental Distress Reactions to Adolescent Depressive Symptoms: The Mediating Role of Youths’ Reactions to Negative Life Events
Journal of Psychopathology and Behavioral Assessment
Perspectives on Social Withdrawal in Childhood: Past, Present, and Prospects
Child Development Perspectives
In this article, we provide definitional clarity for the construct of social withdrawal as it was... more In this article, we provide definitional clarity for the construct of social withdrawal as it was originally construed, and review the original theoretical and conceptual bases that led to the first research program dedicated to the developmental study of social withdrawal (the Waterloo Longitudinal Project). We also describe correlates (e.g., social and social‐cognitive incompetence), precursors (e.g., dispositional characteristics, parenting, insecure attachment), and consequences (e.g., peer rejection and victimization, negative self‐regard, anxiety) of social withdrawal, and discuss how the study of this type of withdrawal led to a novel intervention that targets risk factors that predict social withdrawal and its negative consequences.
Evidence-Based Practice in Child and Adolescent Mental Health, 2021
News of a videogame that received FDA clearance to treat youth with attention-deficit hyperactivi... more News of a videogame that received FDA clearance to treat youth with attention-deficit hyperactivity disorder (ADHD) garnered a great deal of media attention and raised questions about the role of digital cognitive training programs for treatment. In order for clinicians and clients to understand this news for the purposes of making treatment decisions one must have an understanding of what it means for a treatment to be considered evidence-based and an understanding of what is required to obtain FDA clearance. Finally, in order to fully inform decisions about treatment, clinicians and parents must be able to consider the evidence supporting cognitive training programs in relation to other treatments available for children with ADHD. A review of these standards and the evidence supporting cognitive training in general, and the new videogame that received recent FDA clearance (EndeavorRX TM ) specifically, revealed an overall lack of support for this approach to treatment. There are multiple psychosocial and pharmacological treatment options with much more evidence supporting their effectiveness than any commercially available cognitive training program. The contrast between receiving FDA clearance without evidence of any observable benefits to the child is explained within a description of the FDA process for clearance and approval. Finally, these conclusions are described in the context of clinicians' decisions regarding services offered and procedures for explaining this to families who may have seen the media attention related to FDA clearance.
Early intervention for inhibited young children: a randomized controlled trial comparing the Turtle Program and Cool Little Kids
Journal of Child Psychology and Psychiatry, 2021
BackgroundChildren classified as behaviorally inhibited (BI) are at risk for social anxiety. Risk... more BackgroundChildren classified as behaviorally inhibited (BI) are at risk for social anxiety. Risk for anxiety is moderated by both parental behavior and social–emotional competence. Grounded in developmental–transactional theory, the Turtle Program involves both parent and child treatment components delivered within the peer context. Our pilot work demonstrated beneficial effects of the Turtle Program (‘Turtle’) over a waitlist control group. Herein, we report results of a rigorous randomized controlled trial (RCT) comparing Turtle to the best available treatment for young children high in BI, Cool Little Kids (CLK).MethodsOne hundred and fifty‐one parents and their 3.5‐ to 5‐year‐old children selected on the basis of BI were randomly assigned to Turtle or CLK, delivered in group format over 8 weeks. Effects on child anxiety, life interference, BI, and observed parenting were examined at post‐treatment and 1‐year follow‐up. ClinicalTrials.gov registration: NCT02308826.ResultsNo sign...
Although the COVID-19 pandemic caused significant stress and anxiety among many, individuals’ exp... more Although the COVID-19 pandemic caused significant stress and anxiety among many, individuals’ experiences varied. We examined if specific forms of anxiety predicted distinct trajectories of anxiety, perceived stress, and COVID-related worries during three early months of the pandemic. In a longitudinal study (N = 291), adolescents’ (n = 194) social and generalized anxiety levels were assessed via parent- and self-reports and clinical diagnostic interviews. In young adulthood (n = 164), anxiety, stress, and COVID-related worries were assessed thrice during the pandemic. Pre-pandemic generalized anxiety predicted higher initial levels and maintenance of anxiety, stress, and COVID-related worries during the pandemic. In contrast, pre-pandemic social anxiety predicted lower initial levels of anxiety, stress, and COVID-related worries, but this initial effect on anxiety and stress was offset over time by social anxiety’s positive effect on the slope. Our results highlight the importance ...
Infant Mental Health Journal, 2020
High and stable behavioral inhibition during early childhood is a risk factor for later anxiety d... more High and stable behavioral inhibition during early childhood is a risk factor for later anxiety disorders. The few available interventions targeted at behavioral inhibition have not yet been implemented in European countries. Evaluating intervention acceptability is essential when introducing interventions in new cultures. This study aimed to explore the perceptions of parents about the acceptability of the multicomponent Turtle Program in Portugal. Participants were 12 parents (from seven families) of children with a positive screening on the Behavioral Inhibition Questionnaire and no diagnoses of developmental disorders/selective mutism. Children's mean age was 55.86 months and most children were female and first-born. Parents and children participated in the eight-sessions Turtle Program. After each session, parents completed weekly satisfaction checklists. Following completion of the full intervention, parents were invited to participate in individual qualitative in-depth interviews. The thematic analysis revealed that both parents perceived the intervention objectives and contents as relevant. Both parents suggested the introduction of follow-up sessions, the discussion of practical experiences, the need to be sensitive to cultural differences in positive language, and the provision of more feedback about children's activities. These findings support prior research on the acceptability and cultural tailoring needed for parenting and child socioemotional learning interventions.
Journal of Attention Disorders, 2020
Objective: Symptoms of ADHD place adolescents at increased risk for depression. The transition fr... more Objective: Symptoms of ADHD place adolescents at increased risk for depression. The transition from middle to high school may magnify depression risk. This study examined whether changes in adolescents’ negative relationship quality with their mothers and best friends from eighth to 12th grades mediated the longitudinal relations between ADHD and depressive symptoms. Method: 368 adolescents (48.5% male) were initially recruited. Results: Boys with elevated ADHD symptoms in the eighth grade reported steeper increases in negative relationship quality with their mothers relative to girls, and that this trajectory mediated the relation between ADHD and depressive symptoms. ADHD symptoms were also associated with increases in negative friendship quality across high school for boys; however, this did not mediate the relation between ADHD and depressive symptoms for either sex. Conclusion: Growth in mother–adolescent negative relationship quality may be one mechanism that explains the deve...
Journal of Attention Disorders, 2019
Objective: ADHD and depression co-occur at higher than chance levels in adolescence, but moderato... more Objective: ADHD and depression co-occur at higher than chance levels in adolescence, but moderators of this association are not well understood. Consistent with a developmental–transactional framework, one such moderator may be maternal emotion regulation (ER) difficulties. Using latent growth curve modeling, the current study examined the independent and interactive effects of adolescent ADHD symptoms and maternal ER difficulties on the trajectory of depressive symptoms across adolescence. Method: This study included a community sample of 247 adolescents ( Mage = 13.06 years) assessed annually over a 6-year period. Results: Findings suggested that youth with greater ADHD symptoms whose mothers evidenced more ER difficulties demonstrated steeper increases in depressive symptoms over time relative to their peers with lower ADHD symptoms or whose mothers reported fewer ER difficulties. Conclusion: This work highlights the importance of maternal ER difficulties in predicting the trajec...
Developmental Cognitive Neuroscience, 2018
Social Reticence (SR) is a temperament construct identified in early childhood that is expressed ... more Social Reticence (SR) is a temperament construct identified in early childhood that is expressed as shy, anxiously avoidant behavior and, particularly when stable, robustly associated with risk for anxiety disorders. Threat circuit function may develop differently for children high on SR than low on SR. We compared brain function and behavior during extinction recall in a sample of 11-to-15-year-old children characterized in early childhood on a continuum of SR. Three weeks after undergoing fear conditioning and extinction, participants completed a functional magnetic resonance imaging extinction recall task assessing memory and threat differentiation for conditioned stimuli. Whereas self-report and psychophysiological measures of differential conditioning, extinction, and extinction recall were largely similar across participants, SR-related differences in brain function emerged during extinction recall. Specifically, childhood SR was associated with a distinct pattern of hemodynamic-autonomic covariation in the brain when recalling extinguished threat and safety cues. SR and attention focus impacted associations between trial-by-trial variation in autonomic responding and in brain activation. These interactions occurred in three main brain areas: the anterior insular cortex (AIC), the anterior subdivision of the medial cingulate cortex (aMCC), and the dorsolateral prefrontal cortex (dlPFC). This pattern of SCR-BOLD coupling may reflect selective difficulty tracking safety in a temperamentally at-risk population.
Evidence-Based Practice in Child and Adolescent Mental Health, 2018
High and stable behavioral inhibition (BI) during early childhood have been associated with an in... more High and stable behavioral inhibition (BI) during early childhood have been associated with an increased risk of later anxiety disorders and peer difficulties. Developing evidence-based early interventions to prevent these unhealthy developmental trajectories has become a major focus of interest. However, these interventions are not yet available in Europe. This study aimed to explore the perceptions of Portuguese psychologists about the acceptability of the child component of the Turtle Program, before its dissemination in Portugal. Eighteen psychologists were distributed into three focus groups. Each group was moderated by a trained psychologist, using a semi-structured interview guide. The thematic analysis revealed that Portuguese psychologists acknowledged that the intervention needs to go beyond social skills training and enhance children's positive self-perceptions. Overall, psychologists perceived the structure, contents, activities, and materials of the intervention to be acceptable. However, participants recommended minor modifications to strengthen the connection with naturalistic contexts, broaden the focus on emotional expressiveness and social interaction, and introduce creative activities and materials. These findings are consistent with previous research with LatinX practitioners, who typically agree with the acceptability of evidence-based child intervention principles and only report the need to introduce minor changes related to the way how interventions are delivered to children.
Journal of Child and Family Studies, 2018
Considerable evidence has accumulated supporting transactional influences between early childhood... more Considerable evidence has accumulated supporting transactional influences between early childhood behavioral inhibition (BI), parent-child and child-peer relationships, and the development of anxiety disorders in adolescence and adulthood. Drawing from this literature, the Turtle Program was designed to treat children high in BI by intervening at the level of both parents and peers. In this pilot study, we sought to determine whether benefits of participating in the Turtle Program extended to children's classrooms in the form of increased positive social interactions with peers. Forty inhibited children (42-60 months) and their parent(s) were randomized to either the Turtle Program (n = 18) or a waitlist control group (WLC; n = 22). The Turtle Program involved 8 weeks of concurrent parent and child treatment. Trained research assistants, blind to
Clinical child and family psychology review, 2015
The present report synthesizes outcomes across meta-analyses of psychosocial (i.e., non-pharmacol... more The present report synthesizes outcomes across meta-analyses of psychosocial (i.e., non-pharmacological) treatments for ADHD. A total of 12 meta-analyses were identified that met search criteria. The meta-analyses were notable in that there was surprisingly little overlap in studies included across them (range of overlap was 2-46 %). Further, there was considerable diversity across the meta-analyses in terms of the inclusion/exclusion criteria, types of psychosocial treatments reviewed, methodological characteristics, and magnitude of reported effect sizes, making it difficult to aggregate findings across meta-analyses or to investigate moderators of outcome. Effect sizes varied across the outcomes assessed, with meta-analyses reporting positive and significant effect sizes for measures of some areas of child impairment (e.g., social impairment) and small and more variable effect sizes for distal and/or untargeted outcomes (e.g., academic achievement). Results are reviewed in light ...
… KE (2004). An Evaluation of the Summer Treatment Program for Children with Attention-Deficit/Hiperactivity Disorder Using a Treatment Withdrawal Desig
Behavior Therapy
Pediatrics, 1999
Objective. 1) To compare standard twice-daily methylphenidate (MPH) dosing with a single morning ... more Objective. 1) To compare standard twice-daily methylphenidate (MPH) dosing with a single morning dose of MPH and of Adderall during a typical school-day time period, and 2) to conduct a dose-response study of the effects of a late-afternoon (3:30 pm) dose of MPH and Adderall on evening behavior and side effects. Design. Within-subject, placebo-controlled, crossover design. Setting. Intensive summer treatment program with a comprehensive behavioral approach. Study Participants. Twenty-one children with attention-deficit/hyperactivity disorder (19 boys and 2 girls), between the ages of 6 and 12 years. Interventions. Children received, in random order with daily crossovers, each of the following conditions: 1) placebo, 2) 0.3 mg/kg of MPH received 3 times, 3) 0.3 mg/kg of MPH received twice (7:30am and 11:30 am) with 0.15 mg/kg received at 3:30 pm, 4) 0.3 mg/kg of MPH received once in the morning only, 5) 0.3 mg/kg of Adderall received at 7:30 am and at 3:30 pm, 6) 0.3 mg/kg of Adderal...
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Papers by Andrea Chronis-Tuscano