Advances in. Clinical Child. Psychology. Volume 16

Advances in Clinical Child Psychology Volume 16

ADVANCES IN CLINICAL CHILD PSYCHOLOGY Advisory Editors ELAINE BLECHMAN, University of Colorado-Boulder SUSAN B. CAMPBELL, University of Pittsburgh JUDITH L. RAPOPORT, National Institute of Mental Health DONALD K. ROUTH, University of Miami MICHAEL RUTTER, University of London JOHN S. WERRY, University of Auckland A Continuation Order Plan is available for this series. A continuation order will bring delivery of each new volume immediately upon publication. Volumes are billed only upon actual shipment. For further information please contact the publisher.

Advances in Clinical Child Psychology Volume 16 Edited by THOMAS H. OLLENDICK Virginia Polytechnic Institute and State University Blacksburg, Virginia and RONALD J. PRINZ University of South Carolina Columbia, South Carolina Springer Science+Business Media, LLC

The Library of Congress cataloged the first volume of this title as follows: Advances in clinical child psychology, v. 1- New York, Plenum Press, c1977- v. ill. 24 em. Key title: Advances in clinical child psychology. ISSN 0149-4732 1. Clinical psychology-collected works. 2. Child psychology-collected works. 3. Child psychotherapy-collected works. RJ503.3.A37 618.9'28'9 77-643411 ISBN 978-1-4757-9043-6 ISBN 978-1-4757-9041-2 (ebook) DOI 10.1007/978-1-4757-9041-2 1994 Plenum Press, New York Originally published by Springer Science+Business Media New York in 1994. Softcover reprint of the hardcover 1 st edition 1994 All rights reserved No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher

Contributors Eileen S. Anderson Paula Armbruster Carol Bartels Alisa Dennis Paul J. Frick Hyman Hops Heidi M. Inderbitzen Rick E. Ingram Kate Kavanagh Alan E. Kazdin Center for Research in Health Behavior, Virginia Polytechnic Institute, and State University, Blacksburg, Virginia 24061-0436 Child Study Center, Yale University School of Medicine, New Haven, Connecticut 06510-8009 Department of Psychology, University of Maryland at College Park, College Park, Maryland 20742 Department of Psychology, University of Maryland at College Park, College Park, Maryland 20742 Department of Psychology, University of Alabama, Tuscalossa, Alabama 35487-0348 Oregon Research Institute, 1715 Franklin Boulevard, Eugene, Oregon 97403 Department. of Psychology, University of Nebraska-Lincoln, Lincoln, Nebraska 68588-0308 Department of Psychology, San Diego State University, San Diego, California 92182 Oregon Social Learning Center, 207 East 5th Street, Suite 202, Eugene, Oregon 97401 Department of Psychology, Yale University, New Haven, Connecticut 06520-7447 v

vi Elizabeth Pugzles Lorch Raymond P. Lorion CONTRIBUTORS Department of Psychology, University of Kentucky, Lexington, Kentucky 40506 Department of Psychology, University of Maryland at College Park, College Park, Maryland 20742 Vanessa L. Malcarne Department of Psychology, San Diego State University, San Diego, California 92182 Richard Milich Tracy G. Myers William M. Reynolds Richard A. Winett Department of Psychology, University of Kentucky, Lexington, Kentucky 40506 Department of Psychology, University of Maryland at College Park, College Park, Maryland 20742 Psychoeducational Research and Training Centre, University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada Center for Research in Health Behavior, Virginia Polytechnic Institute, and State University, Blacksburg, Virginia 24061-0436

Preface This volume of Advances in Clinical Child Psychology, which is the second under our editorship and the sixteenth of the series, continues the tradition of including a broad range of timely topics on the study and treatment of children and adolescents. Volume 16 includes contributions pertaining to prevention, adolescents, families, cognitive processes, and methodology. The issue of prevention in child clinical psychology is no longer restricted to a few speculative sentences in the future directions part of a discussion section. Prevention research is actually being undertaken, as reflected in two contributions to the volume. Winett and Anderson provide a promising framework for the development, evaluation, and dissemination of programs aimed at the prevention of HIV among youth. Lorion, Myers, Bartels, and Dennis address some of the conceptual and methodological issues in preventive intervention research with children. Adolescent development and adjustment is an important area of study in clinical child psychology. Two contributors address key and somewhat related topics, social competence and depression in adolescence. Inderbitzen critically reviews the assessment methods and methodologies for social competence and peer relations in adolescence. Reynolds analyzes contemporary issues and perspectives pertaining to adolescent depression. Methodological and contextual issues play an important part in the growth and refinement of clinical child psychology, as reflected in two contributions. Kavanagh and Hops present novel empirical work on the interaction between gender and development as a contextual influence in understanding and assessing child adjustment. Armbruster and Kazdin analyze the often-ignored phenomenon of attrition in child psychotherapy and offer recommendations on how to better understand and address this problem. Two contributions underscore the importance of cognitive variables in understand child functioning and development. Malcarne and Ingram consider the role of cognitive variables in children's negative affectivity, particularly with regard to depression and anxiety, and consider the theoretical implications of this link. Milich and Lorch present a series of vii

viii PREFACE studies that applied television-viewing methodology to the problem of understanding cognitive processing by attention-deficit hyperactivity disordered (ADHD) children. Finally, the contribution by Frick is in keeping with our interest in including family research in volumes in recognition of the major roles that family variables play in child development and psychopathology. Frick reviews recent findings relating family dysfunction and disruptive behavior disorders and offers some direction for future research efforts. We appreciate the excellent work by the Plenum editorial staff and applaud the fine chapters by all of the contributing authors. THOMAS H. OLLENDICK RONALD J. PRINZ

Contents Chapter 1. HIV Prevention in Youth: A Framework for Research and Action 1 Richard A. Winett and Eileen S. Anderson 1. Background and Objectives... 1 1.1. Emergence of Adolescents as a Risk Group... 1 1.2. Objectives and Overview... 2 2. Epidemiology... 3 2.1. HIV and the AIDS Epidemic........................ 3 2.2. Prevalence of HIV Infection in Youth... 3 2.3. Incidence and Prevalence of Risk Behavior in Youth... 5 3. Framework for HIV Prevention Programs for Youth... 5 3.1. Developmental/Ecological Considerations... 6 3.2. Competency Perspective............................ 9 3.3. Timing, Level, and Targeting... 12 3.4. Behavior Change Strategies... 21 3.5. Conclusions... 23 4. HIV Prevention Programs with Youth-The First Wave... 25 4.1. Conclusion... 26 5. Family/Media AIDS Prevention Project.................... 26 5.1. Efficacy Studies.................................... 26 5.2. Program Development and the Framework... 27 6. Implications of the Program and Efficacy Studies in Light of the Framework... 33 6.1. Strengths and Weaknesses.......................... 33 6.2. Diffusion....... 37 7. Conclusions... 38 8. References... 40 Chapter 2. Good Girls? Bad Boys? Gender and Development as Contexts for Diagnosis and Treatment 45 Kate Kavanagh and Hyman Hops 1. Introduction... 45 1.1. A Social Interactional Perspective.................... 47 ix

x CONTENTS 1.2. Developmental Issues... 47 1.3. Goals of This Chapter.............................. 48 2. The Study of Gender Differences... 48 2.1. Timing and Incidence of Problem Behavior........... 50 2.2. The Social Context... 51 3. Studies of Context, Gender, and Problem Identification..... 53 3.1. Study 1... 54 3.2. Study 2... 59 3.3. Summary of Data from Study 1 and Study 2... 64 4. Review of Treatments for Internalizing and Externalizing Problems... 66 4.1. Externalizing Disorders............................. 67 4.2. Internalizing Problems........... 68 5. Conclusions... 70 6. References... 73 Chapter 3. Attrition in Child Psychotherapy 81 Paula Armbruster and Alan E. Kazdin 1. Introduction... 81 2. Overview of Major Findings...................... 83........ 3. Limitations and Interpretations... 88 3.1. Definitional Issues... 88 3.2. Difficulties in Comparing Studies... 93 4. Critical Issues and Future Directions... 95 4.1. Conceptualization of Attrition... 95 4.2. Attrition: A Perspective... 96 4.3. Improving Research................................ 98 4.4. Specificity of Focus... 100 4.5. Testing Assumptions about Outcome... 102 4.6. Reducing Attrition... 102 5. Conclusion... 103 6. References....... 105 Chapter 4. Preventive Intervention Research: Pathways for Extending Knowledge of Child/Adolescent Health and Pathology 109 Raymond P. Lorion, Tracy G. Myers, Carol Bartels, and Alisa Dennis 1. Introduction... 109 2. The Emergence of Prevention... 111

CONTENTS xi 3. Classifying Preventive Interventions... 114 3.1. Public Health Categories... 114 3.2. Gordon's Operational Categories.................... 116 3.3. Protection and Promotion Alternatives............... 118 3.4. Multidimensional Preventive Interventions........... 120 4. Targeting Preventive Interventions... 121 4.1. The Concept of Disorder... 122 4.2. A Transactional Concept of Causes and Effects... 124 5. The Scientific Bases of Preventive Interventions... 125 5.1. Knowledge Bases for Program Development... 125 5.2. Evaluating the Achievement of Preventive Goals... 127 6. The Ethics of Preventive Interventions with Youth... 128 6.1. Attention to Iatrogenic Consequences... 128 6.2. The Meaning of Informed Consent... 128 6.3. Procedures for Obtaining Consent... 129 7. Final Comments... ".................................. 131 8. References... 133 Chapter 5. Cognition and Negative Affectivity 141 Vanessa L. Malcarne and Rick E. Ingram 1. Introduction... 141 2. Cognitive Clinical Psychology... 142 2.1. History and Current Status... 142 2.2. The Information-Processing Paradigm... 143 2.3. Information Processing and Psychopathology... 144 3. Negative Affectivity... 146 3.1. Depression, Anxiety, Negative Affectivity, and Cognition..................................... 147 4. Negative Affectivity in Children... 151 4.1. Depression and Anxiety as Diagnostic Categories for Children....................................... 152 4.2. Assessment of Depression and Anxiety... 154 4.3. Treatment Studies... 157 4.4. Conclusions... 158 5. Cognitive Factors in Childhood Negative Affectivity........ 159 5.1. Cognitive Processes of Depressed Children... 159 5.2. Cognitive Processes of Anxious Children... 162 5.3. Cognitive Processes of Depressed versus Anxious Children... 164 5.4. Cognitive Processes and Negative Affectivity......... 165

xii CONTENTS 6. Summary and Conclusions............................... 166 6.1. Cognition and Negative Affectivity... 167 7. References... 170 Chapter 6. Television Viewing Methodology to Understand Cognitive Processing of ADHD Children 177 Richard Milich and Elizabeth Pugzles Lorch 1. Attentional Problems of ADHD Children.................. 177 2. Limitations of Laboratory Measures of Attention... 179 3. The Television Viewing Methodology... 179 4. Television Viewing Studies among Nonreferred Populations... 180 5. Television Viewing Studies among ADHD Populations... 182 5.1. Study 1... 183 5.2. Study 2... 185 5.3. Study 3... 187 5.4. Study 4... 189 6. Implications... 191 7. Future Directions........................................ 195 8. Summary... 197 9. References....... 198 Chapter 7. Family Dysfunction and the Disruptive Disorders: A Review of Recent Empirical Findings 203 Paul J. Frick 1. Introduction 1.1. Organization of Review.... 2. Parental Adjustment.... 2.1. Parental Antisocial Behavior and Child Conduct Problems.... 2.2. Parental Adjustment and ADHD.... 3. Marital Conflict/Divorce.... 3.1. Multivariate Models.... 4. Parental Socialization.... 4.1. Parenting Behavior and Child Conduct Problems.... 4.2. Parenting Behavior and ADHD.... 4.3. Multivariate Models.... 203 204 205 205 209 209 210 213 213 214 215

CONTENTS xiii 5. The Developmental Trends Study......................... 217 5.1. Family Correlates: ADHD and CD................... 217 5.2. Family Correlates: CD and ODD... 219 5.3. Multivariate Models................................ 220 6. Summary and Conclusions............................... 221 7. References....... 222 Chapter 8. Adolescent Peer Social Competence: A Critical Review of Assessment Methodologies and Instruments 227 Heidi M. Inderbitzen 1. Introduction... 227 2. Direct Observation Methodology... 230 2.1. Identification and Classification... 231 2.2. Selection of Treatment Targets... 232 2.3. Evaluation of Treatment Outcome................... 233 2.4. Summary of Direct Observation..................... 235 3. Ratings by Others....................................... 238 3.1. Peer Evaluations... 238 3.2. Teacher Ratings.................................... 241 4. Self-Report... 245 4.1. Utility of Self-Report Measures...................... 248 4.2. Summary of Self-Report... 249 5. Sociometric Measures.................................... 250 5.1. Utility of Sociometric Measures... 251 5.2. Summary of Sociometric Measures... 253 6. Conclusions and Future Directions........................ 253 7. References... 254 Chapter 9. Depression in Adolescents: Contemporary Issues and Perspectives 261 William M. Reynolds 1. Introduction....... 261 1.1. Purpose of Chapter... 262 1.2. The Scope of the Problem... 263 1.3. An Underidentified Disorder... 267 1.4. Problems in Evaluation and Synthesis of Existing Research................................ 270

xiv CONTENTS 2. Diagnostic Issues................................... 270... 3. Comorbidity..... 274 4. Depression and Problems in Adolescence................. 276 4.1. Depression and Educational Outcomes............. 277 4.2. Families Factors and Depression in Adolescents...... 277 4.3. Depression and Suicide in Adolescents......... 278 4.4. Depression and Substance Use...................... 279 5. Treatment of Depression in Adolescents................... 280 5.1. Pharmacotherapy and Other Somatic Treatments..... 280 5.2. Pharmacotherapy for Depression in Adolescents...... 283 5.3. Summary of Pharmacological Interventions.......... 288 5.4. Psychological Interventions for Depression in Adolescents............................ 289......... 6. Summary................................ 298 7. References................................ 299 Index.................................................... 317