John R. Weisz

Harvard University, Cambridge, Massachusetts, United States

Are you John R. Weisz?

Claim your profile

Publications (213)910.01 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: To investigate the association between protocol design and therapist satisfaction in the Child STEPs Randomized Effectiveness Trial (Weisz et al., 2012). Therapist report was obtained at the close of 145 cases seen by 77 therapists, each of whom was randomized to a Standard evidence-based treatment (EBT), modular EBT, or usual care (UC) condition. Analysis of satisfaction items revealed 2 correlated factors representing perceived effectiveness and perceived responsiveness of the treatments. Therapist total satisfaction scores were significantly higher for cases in the modular condition than for those in the standard EBT or UC conditions. With regard to specific dimensions, the modular and UC cases were rated significantly higher than standard EBT cases on the Responsiveness scale, whereas modular and standard EBT cases were rated significantly higher than UC on the Effectiveness scale. Finally, increases in Effectiveness scores from first to second case were significantly larger for Modular cases than for cases in both other study conditions, and increases from first to second case in Total Satisfaction scores were significantly larger for modular cases than for UC cases. Therapist satisfaction with a treatment approach has independent dimensions, which can vary as a function of the protocol design. By virtue of being perceived as more effective than UC and more responsive than standard EBTs, the modular protocol design was also viewed as more overall satisfying than both, and secondary analysis suggested that these results were not due to mere first impressions of the protocols. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
    Journal of Consulting and Clinical Psychology 05/2015; DOI:10.1037/a0039301 · 4.85 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Efforts to identify empirically supported treatments (ESTs) for youth's mental health problems are valuable, but the descriptor empirically supported does not guarantee that a treatment will work well in everyday clinical use. The voltage drop often seen when ESTs move from efficacy studies to clinical practice contexts may reflect limited exposure to real-world conditions during development and testing. One result may be interventions that are focused more narrowly and are more linear than the clinical practice they are designed to enhance. In this article, we suggest three strategies for building and refining ESTs that are robust for real-world application: (a) designing interventions to fit the contexts of youth treatment, (b) structuring interventions that can be tailored to fit individual youth characteristics, and (c) building programs for nontraditional intervention contexts. In addition, we describe how to develop interventions that are ready for practical implementation: the deployment-focused model.
    Child Development Perspectives 04/2015; DOI:10.1111/cdep.12118 · 1.56 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Most youth psychotherapy research involves conditions quite unlike the clinical practice it is designed to strengthen. Most studies have not tested interventions with clinically referred youths and practicing clinicians in clinical care settings, nor have they tested whether new treatments produce better outcomes than usual practice. Limited exposure to real-world conditions and questions may partially explain why empirically supported treatments show such modest effects when tested under more representative conditions, against usual care. Our deployment-focused model calls for intervention development and testing with the kinds of participants (e.g., clients and clinicians) and in the contexts (e.g., clinics) for which the interventions are ultimately intended, and for randomized comparisons to usual clinical care. Research with the Child STEPs (system and treatment enhancement projects) treatment approach illustrates the methods and potential benefits of the deployment-focused model. Findings supporting Child STEPs are but one part of a rich research matrix needed to shrink the gap between intervention research and clinical practice.
    Annual Review of Clinical Psychology 03/2015; 11:139-163. DOI:10.1146/annurev-clinpsy-032814-112820 · 12.92 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Crohn's disease (CD) is associated with depression. It is unclear if psychosocial interventions offer benefit for depressive symptoms during active CD. In this secondary analysis of a larger study of treating depression in pediatric inflammatory bowel disease, we assessed whether cognitive behavioral therapy (CBT) would differentiate from supportive nondirective therapy in treating depression and disease activity in youth with CD. We also explored whether somatic depressive symptoms showed a different pattern of response in the overall sample and the subset with active inflammatory bowel disease. Youth with depression and CD (n = 161) were randomized to 3 months of CBT (teaching coping skills) or supportive nondirective therapy (supportive listening). Depressive severity was measured using the Children's Depression Rating Scale-Revised (CDRS-R) with the somatic depressive subtype consisting of those CDRS-R items, which significantly correlated with CD activity. Disease activity was measured by the Pediatric Crohn's disease Activity Index. Given the potential confound of higher dose steroids, subanalyses excluded subjects on >20 mg/d prednisone equivalent (n = 34). Total CDRS-R scores in the overall sample significantly decreased over time after both treatments (P < 0.0001). Treatment with CBT was associated with a significantly greater improvement in the Pediatric Crohn's disease Activity Index (P = 0.05) and somatic depressive subtype (P = 0.03) in those with active inflammatory bowel disease (n = 95) compared with supportive nondirective therapy. After excluding those on steroids (n = 34), there was a significant improvement in total CDRS-R (P = 0.03) and in Pediatric Crohn's disease Activity Index (P = 0.03) after CBT. Psychotherapy may be a useful adjunct to treat depression in the context of CD-related inflammation in youth who are not concurrently on higher dose steroids.
    Inflammatory Bowel Diseases 03/2015; 21(6). DOI:10.1097/MIB.0000000000000358 · 5.48 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: Research has examined the effects of parental psychopathology, family functioning, and caregiver strain on treatment response in anxious youths. Although these variables have shown individual links to youth treatment response, theoretical models for their combined effects remain unexplored. This study tested the hypothesis that improvements in family functioning and reductions in caregiver strain explained the effects of parental psychopathology on youth treatment outcome in an anxiety treatment trial. Method: A multiple mediation technique was used to test the proposed model across independent evaluator (IE), parent, and youth informants in 488 youths, aged 7-17 years (50% female; mean age = 10.7) meeting Diagnostic and Statistical Manual of Mental Disorders criteria for social phobia, separation anxiety, and/or generalized anxiety disorder. Youths were randomized to receive 12 weeks of cognitive-behavioral treatment (Coping Cat), medication (sertraline), their combination, or a pill placebo. At pre- and posttreatment, parents completed self-report measures of global psychopathology symptoms, family functioning, and caregiver strain; parents, youths, and IEs rated youths' anxiety symptom severity. Results: Changes in family functioning and caregiver strain jointly explained relations between parental psychopathology and reductions in youth anxiety. Specifically, across IE and parent informants, families with higher pretreatment parental psychopathology showed more improvement in family functioning and caregiver strain, which in turn predicted greater youth anxiety reductions. Further, higher pretreatment parental psychopathology predicted greater caregiver strain reductions and, in turn, greater youth anxiety reductions, based on youths' reports of their own anxiety. Conclusions: Findings suggest that improvements in family functioning and reductions in caregiver strain can influence treatment outcomes for anxious youths, especially among youths with more distressed parents. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
    Journal of Consulting and Clinical Psychology 02/2015; 83(1):213-224. DOI:10.1037/a0037935 · 4.85 Impact Factor
  • Source
    Jessica L. Schleider, John R. Weisz
    [Show abstract] [Hide abstract]
    ABSTRACT: Extensive evidence links youth mental health to family functioning, highlighting the need to document causal pathways. This will require longitudinal studies, but traditional methods for longitudinal clinical research have several limitations, including high cost and resource demands, underrepresentation of fathers, and attrition bias. We tested whether an online alternative might address limitations of—and thus provide a useful complement to—traditional methods. We used the Mechanical Turk (MTurk) survey program to obtain reports from parents (N=177) on family functioning, the parents’ own symptoms, their children’s behavioral and emotional problems, and parenting stress, with assessments in three consecutive months. Parents provided largely high-quality data (e.g., passed consistency checks); measures showed acceptable psychometrics at each time-point; and correlations among study measures paralleled those observed in prior research. Compared to prior studies using traditional longitudinal methods, the MTurk method was (a) much lower in cost and resource requirements, (b) successful in enrolling fathers, (c) comparable in participant attrition, and (c) similar in attrition bias, participant race/ethnicity, and enrollment of single parents. Overall, findings suggest that MTurk is a viable tool with its own set of strengths and limitations, and a potentially useful complement to traditional longitudinal methods. In particular, MTurk might be a cost-effective first step in generating causal hypotheses about family processes and youth mental health, for later testing via more traditional methods.
    Journal of Child and Family Studies 01/2015; in press. DOI:10.1007/s10826-015-0126-6 · 1.42 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This study expands upon the Chorpita et al. (J Consult Clin Psychol 81:999-1009, 2013) findings by examining the impact of treatment protocol on youths' service utilization up to 2 years after starting an episode of: standard manualized treatment (Standard); modular treatment (Modular); or usual care (UC). Results showed that youths who received Modular accessed fewer service settings at their one-year follow-up relative to youths who received Standard or UC. Findings suggest that modular treatment may offer an advantage over standardized treatment manuals and UC in terms of sustained clinical benefits, and highlight the importance of treatment design considerations for service systems.
    Administration and Policy in Mental Health and Mental Health Services Research 01/2015; DOI:10.1007/s10488-015-0625-1 · 3.44 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This study tested whether family income and stress in the parent-youth relationship might mediate links between parent symptoms and youth problems, and whether the process might differ for youth externalizing versus internalizing problems. We used a multiple mediation technique to test pathways by which family income and stress in the parent-child relationship might relate to parent-youth symptom associations in a sample of clinically-referred 7-13 year-olds (32 % female; M age = 10.16 years). Family income and stress jointly mediated the relation between parent symptoms and youth externalizing problems but not between parent symptoms and youth internalizing problems. Future longitudinal research should investigate whether low income and parent-youth stress may deplete the parental resources needed to manage youth externalizing behavior. This study extends existing literature by suggesting a specific pattern by which two identified risk factors for youth problems may operate jointly, and by showing specificity to externalizing problems.
    Child Psychiatry and Human Development 01/2015; DOI:10.1007/s10578-014-0446-6 · 1.93 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective Youth in war-affected regions are at risk for poor psychological, social, and educational outcomes. Effective interventions are needed to improve mental health, social behavior, and school functioning. This randomized controlled trial tested the effectiveness of a 10-session cognitive-behavioral therapy (CBT)-based group mental health intervention for multisymptomatic war-affected youth (aged 15-24) in Sierra Leone. Method War-affected youth identified by elevated distress and impairment via community screening were randomized (stratified by sex and age) to the Youth Readiness Intervention (YRI) (n=222) or a control condition (n=214). After treatment, youth were again randomized and offered an education subsidy immediately (n=220) or waitlisted (n=216). Emotion regulation, psychological distress, prosocial attitudes/behaviors, social support, functional impairment, and posttraumatic stress disorder (PTSD) symptoms were assessed at pre- and post-intervention and at six-month follow-up. For youth in school, enrollment, attendance, and classroom performance were assessed after eight months. Linear mixed-effects regressions evaluated outcomes. Results The YRI showed significant post-intervention effects on emotion regulation, prosocial attitudes/behaviors, social support, and reduced functional impairment, and significant follow-up effects on school enrollment, school attendance, and classroom behavior. In contrast, education subsidy was associated with better attendance but had no effect on mental health or functioning, school retention, or classroom behavior. Interactions between education subsidy and YRI were not significant. Conclusion YRI produced acute improvements in mental health and functioning as well as longer-term effects on school engagement and behavior, suggesting efficacy in preparing war-affected youth for educational and vocational opportunities.
    Journal of the American Academy of Child & Adolescent Psychiatry 12/2014; 53(12). DOI:10.1016/j.jaac.2014.09.011 · 6.35 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Compared to youths who believe personal traits are malleable, those who believe personal traits are fixed experience more academic and self-regulatory distress. Recently, studies have begun to explore relations between beliefs about the malleability of personal traits, or implicit theories, and youth mental health problems. We synthesized this emerging body of research in youths (ages 4-19) across 45 effect sizes from 17 research reports. Studies were included if they assessed youth mental health and implicit theories and did not manipulate implicit theory or affective/behavioral states prior to measuring these variables. Our random-effects meta-analysis using clustered data analysis techniques (i.e., effect sizes nested within samples) revealed that youths holding entity theories—the belief that personal traits are fixed—showed more pronounced mental health problems. This association between entity theories and mental health problems was evident across methodological factors and problem types (internalizing versus externalizing; psychopathology versus general distress). Limitations include the small number of eligible studies, insufficient data to test further demographic moderators, and few longitudinal studies on this topic. Overall, findings support the value of parsing the implicit theory-mental health link in youths. Implicit theories may prove to be promising targets for treatment and prevention of youth mental health problems.
    Clinical Psychology Review 11/2014; in press. DOI:10.1016/j.cpr.2014.11.001 · 7.18 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Observational measures to assess implementation integrity (the extent to which components of an evidence-based treatment are delivered as intended) are needed. The authors evaluated the reliability of the scores and the validity of the score interpretations for the Therapy Process Observational Coding System for Child Psychotherapy-Revised Strategies scale (TPOCS-RS; McLeod, 2010) and assessed the potential of the TPOCS-RS to assess treatment differentiation, a component of implementation integrity. The TPOCS-RS includes 5 theory-based subscales (Cognitive, Behavioral, Psychodynamic, Client-Centered, and Family). Using the TPOCS-RS, coders independently rated 954 sessions conducted with 89 children (M age = 10.56, SD = 2.00; age 7-15 years; 65.20% White) diagnosed with a primary anxiety disorder who received different treatments (manual-based vs. nonmanualized) across settings (research vs. practice). Coders produced reliable ratings at the item level (M intraclass correlation coefficient = .76, SD = .18). Analyses support the construct validity of the Cognitive and Behavioral subscale scores and, to a lesser extent, the Psychodynamic, Family, and Client-Centered subscale scores. Correlations among the TPOCS-RS subscale scores and between the TPOCS-RS subscale scores and observational ratings of the alliance and client involvement were moderate suggesting independence of the subscale scores. Moreover, the TPOCS-RS showed promise for assessing implementation integrity as the TPOCS-RS subscale scores, as hypothesized, discriminated between manual-guided treatment delivered across research and practice settings and nonmanualized usual care. The findings support the potential of the TPOCS-RS Cognitive and Behavioral subscales to assess treatment differentiation in implementation research. Results for the remaining subscales are promising, although further research is needed. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
    Psychological Assessment 10/2014; 27(1). DOI:10.1037/pas0000037 · 2.99 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Identifying factors that promote sustained implementation of evidence-based treatments (EBTs) after therapists receive training is critical for professional psychology. To address the field’s minimal knowledge in this area, we interviewed community-based therapists (N = 23) who had completed intensive training in cognitive behavioral therapy (CBT) for either anxiety or depression as part of a randomized effectiveness trial (Southam-Gerow et al., 2010; Weisz et al., 2009). Therapists were interviewed three to five years after completion of the initial trial, representing one of the longest-term follow-ups of therapist practices after training. Therapists viewed each protocol and their individual CBT strategies as effective and appropriate for the majority of their current anxiety and depression caseloads. However, therapists used parts of each protocol much more frequently than the protocol as a whole (i.e., 78.5% used parts of the Coping Cat, and 7.5% used the whole protocol; 58.6% used parts of the PASCET, and 20% used the whole protocol). Therapists reported using problem-solving the most and exposure exercises the least for current anxious cases; they used cognitive restructuring the most and homework the least for current depression cases. Interventions that were more difficult to implement in usual care settings were less likely to be sustained. Future efforts should evaluate the characteristics and structure of EBTs that are most acceptable to therapists and should investigate which kinds of ongoing learning supports will maintain therapist skills in and continued use of EBTs. Keywords: Therapist training, Dissemination, Implementation
    Professional Psychology Research and Practice 10/2014; 46(1). DOI:10.1037/a0038000 · 1.34 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: Pediatric inflammatory bowel disease (IBD) is associated with high rates of depression. This study compared the efficacy of cognitive behavioral therapy (CBT) to supportive nondirective therapy (SNDT) in treating youth with comorbid IBD and depression. Method: Youth (51% female and 49% male; age 9-17 years, mean age 14.3 years) with depression and Crohn's disease (n = 161) or ulcerative colitis (n = 56) were randomly assigned to a 3-month course of CBT or SNDT. The primary outcome was comparative reduction in depressive symptom severity; secondary outcomes were depression remission, increase in depression response, and improved health-related adjustment and IBD activity. Results: A total of 178 participants (82%) completed the 3-month intervention. Both psychotherapies resulted in significant reductions in total Children's Depression Rating Scale Revised score (37.3% for CBT and 31.9% for SNDT), but the difference between the 2 treatments was not significant (p = .16). There were large pre-post effect sizes for each treatment (d = 1.31 for CBT and d =- 1.30 for SNDT). More than 65% of youth had a complete remission of depression at 3 months, with no difference between CBT and SNDT (67.8% and 63.2%, respectively). Compared to SNDT, CBT was associated with a greater reduction in IBD activity (p = .04) but no greater improvement on the Clinical Global Assessment Scale (p = .06) and health-related quality of life (IMPACT-III scale) (p = .07). Conclusion: This is the first randomized controlled study to suggest improvements in depression severity, global functioning, quality of life, and disease activity in a physically ill pediatric cohort treated with psychotherapy. Clinical trial registration information Reducing Depressive Symptoms in Physically III Youth; http://clinical trials.gov; NCT00534911.
    Journal of the American Academy of Child and Adolescent Psychiatry 07/2014; 53(7):726-35. DOI:10.1016/j.jaac.2014.04.014 · 6.35 Impact Factor
  • John R Weisz
    American Journal of Psychiatry 06/2014; 171(6):600-602. DOI:10.1176/appi.ajp.2014.14030361 · 13.56 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Parent-teacher cross-informant agreement, although usually modest, may provide important clinical information. Using data for 27,962 children from 21 societies, we asked the following: (a) Do parents report more problems than teachers, and does this vary by society, age, gender, or type of problem? (b) Does parent-teacher agreement vary across different problem scales or across societies? (c) How well do parents and teachers in different societies agree on problem item ratings? (d) How much do parent-teacher dyads in different societies vary in within-dyad agreement on problem items? (e) How well do parents and teachers in 21 societies agree on whether the child's problem level exceeds a deviance threshold? We used five methods to test agreement for Child Behavior Checklist (CBCL) and Teacher's Report Form (TRF) ratings. CBCL scores were higher than TRF scores on most scales, but the informant differences varied in magnitude across the societies studied. Cross-informant correlations for problem scale scores varied moderately across societies studied and were significantly higher for Externalizing than Internalizing problems. Parents and teachers tended to rate the same items as low, medium, or high, but within-dyad item agreement varied widely in every society studied. In all societies studied, both parental noncorroboration of teacher-reported deviance and teacher noncorroboration of parent-reported deviance were common. Our findings underscore the importance of obtaining information from parents and teachers when evaluating and treating children, highlight the need to use multiple methods of quantifying cross-informant agreement, and provide comprehensive baselines for patterns of parent-teacher agreement across 21 societies.
    Journal of Clinical Child & Adolescent Psychology 04/2014; 43(4):627-642. DOI:10.1080/15374416.2014.900719 · 1.92 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study examined patterns of evidence-based treatment (EBT) implementation within community settings by evaluating integrity along separate dimensions of practice content (PC; a session included the prescribed procedure) and practice sequencing (a session occurred in the prescribed sequence) within a recent randomized effectiveness trial. We measured whether sessions showed integrity to PC and to flexible or linear practice sequences. Findings revealed that providers tended to incorporate content from the EBT protocol in most treatment sessions, but that the sequencing of the sessions was often modified, suggesting that providers are amenable to evidence-based procedures, but not necessarily their prescribed arrangement.
    Administration and Policy in Mental Health and Mental Health Services Research 03/2014; 42(2). DOI:10.1007/s10488-014-0559-z · 3.44 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Links between parents' psychiatric symptoms and their children's behavioral and emotional problems have been widely documented in previous research, and the search for moderators of this association has begun. However, family structure (single versus dual-parent households) has received little attention as a potential moderator, despite indirect evidence that risk may be elevated in single-parent homes. Two other candidate moderators-youth gender and age-have been tested directly, but with inconsistent findings across studies, perhaps in part because studies have differed in whether they used youth clinical samples and in which informants (parents vs. youths) reported on youth problems. In the present study, we examined these three candidate moderators using a sample of exclusively clinic-referred youths (N = 333, 34 % girls, aged 7-14,) and assessing youth problems through both parent- and youth-reports. Both family structure and youth gender emerged as robust moderators across parent and youth informants. Parent symptoms were associated with youth internalizing and externalizing problems in single-parent but not dual-parent homes; and parent symptoms were associated with youth internalizing problems among boys, but not girls. The moderator findings suggest that the risks associated with parent psychopathology may not be uniform but may depend, in part, on family structure and youth gender.
    Journal of Abnormal Child Psychology 02/2014; 42:195-204. DOI:10.1007/s10802-013-9780-6 · 3.09 Impact Factor
  • John R. Weisz, Mei Yi Ng, Sarah Kate Bearman
    [Show abstract] [Hide abstract]
    ABSTRACT: Decades of clinical psychological science have produced empirically supported treatments that are now undergoing dissemination and implementation (DI) but with little guidance from a science that is just taking shape. Charting a future for DI science (DIS) and DI practice (DIP), and their complex relationship, will be complicated by significant challenges—the implementation cliff (intervention benefit drops when tested practices are scaled up), low relevance of most clinical research to actual practice, and differing timetables and goals for DIP versus DIS. To address the challenges, and prepare the next generation of clinical psychological scientists, we propose the following: making intervention research look more like practice, solving the “too many empirically supported treatments” problem, addressing mismatches between interventions and their users (e.g., clients, therapists), broadening the array of intervention delivery systems, sharpening outcome monitoring and feedback, incentivizing high-risk/high-gain innovations, designing new professional tracks, and synchronizing and linking the often-insular practice and science of DI.
    01/2014; 2(1):58-74. DOI:10.1177/2167702613501307
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: Worldwide, over one billion children and adolescents live in war-affected regions. These youth represent a uniquely vulnerable population at heightened risk of developing mental health problems, interpersonal difficulties and impairments in daily functioning. This study tested the effectiveness of a stabilization and skills-focused mental health intervention for multi-symptomatic, war-affected youth. Methods: A randomized controlled trial was conducted in Freetown, Sierra Leone for youth (N=436, ages 15-24 years old) who exhibited psychological distress and functional impairments who were not enrolled in school. The Youth Readiness Intervention (YRI) is a group-based behavioral treatment targeting co-occurring emotion dysregulation/anger-management difficulties, deficits in interpersonal skills, psychological distress and functional impairments in war-affected youth. Participants were randomly assigned and enrolled in either the YRI (n=222) or a control condition (n=214). YRI participants received the group intervention once per week over a 10 week period and were assessed pre and post-YRI for emotion regulation/anger-management skills, functional impairment, psychological distress, and prosocial attitudes/behavior. Secondary outcomes were social support and post-traumatic stress (PTS) symptoms. Results. Post-intervention, YRI participants reported significant improvements in emotion regulation skills, prosocial attitudes/behaviors, and improvements in day-to-day functioning compared to controls. YRI participants also reported greater perceived social support. The two conditions showed similar levels of improvement in psychological distress and PTS symptoms. Conclusions. The YRI improved emotion regulation, prosocial skills, social supports and daily functioning among war-affected youth. Future research should investigate adding additional components to address PTS and depression symptoms and how to link such interventions to education and employment programs.
    141st APHA Annual Meeting and Exposition 2013; 11/2013
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This study examined the psychometric properties of the DSM-oriented scales of the Child Behavior Checklist (Achenbach, Dumenci, & Rescorla, 2003) using confirmatory factor analysis to compare the six-factor structure of the DSM-oriented scales to competing models consistent with developmental theories of symptom differentiation. We tested these models on both clinic-referred (N = 757) and school-based, nonreferred (N = 713) samples of youths in order to assess the generalizability of the factorial structures. Although previous research has supported the fit of the six-factor DSM-oriented structure in a normative sample of youths ages 7 to 18 (Achenbach & Rescorla, 2001), tripartite model research indicates that anxiety and depressive symptomology are less differentiated among children compared to adolescents (Jacques & Mash, 2004). We thus examined the relative fit of a six- and a five-factor model (collapsing anxiety and depression) with younger (ages 7-10) and older (ages 11-18) youth subsamples. The results revealed that the six-factor model fit the best in all samples except among younger nonclinical children. The results extended the generalizability of the rationally derived six-factor structure of the DSM-oriented scales to clinic-referred youths and provided further support to the notion that younger children in nonclinical samples exhibit less differentiated symptoms of anxiety and depression.
    Development and Psychopathology 11/2013; 25(4pt1):1005-1015. DOI:10.1017/S0954579413000333 · 4.89 Impact Factor

Publication Stats

12k Citations
910.01 Total Impact Points

Institutions

  • 1970–2015
    • Harvard University
      • Department of Psychology
      Cambridge, Massachusetts, United States
  • 2013
    • University of Washington Seattle
      • Department of Psychology
      Seattle, Washington, United States
  • 1991–2013
    • University of California, Los Angeles
      • Department of Psychology
      Los Ángeles, California, United States
  • 2009
    • University of Hawaiʻi at Mānoa
      • Department of Psychology
      Honolulu, HI, United States
    • Cardiff University
      • Department of Psychological Medicine and Neurology
      Cardiff, Wales, United Kingdom
  • 2006
    • Texas A&M University
      • Department of Educational Psychology
      College Station, TX, United States
  • 1989–2006
    • Vanderbilt University
      • Department of Psychology and Human Development
      Nashville, Michigan, United States
  • 2005
    • Virginia Commonwealth University
      • Department of Psychiatry
      Richmond, VA, United States
  • 1998–2000
    • Yale University
      • Department of Psychology
      New Haven, Connecticut, United States
  • 1993
    • University of Vermont
      • Department of Psychiatry
      Burlington, Vermont, United States
  • 1981–1993
    • University of North Carolina at Chapel Hill
      • Department of Psychology
      North Carolina, United States
  • 1992
    • The University of the West Indies at Mona
      Kingston, Kingston, Jamaica
  • 1987
    • University of Florida
      Gainesville, Florida, United States