Eric Youngstrom

University of North Carolina at Chapel Hill | UNC · Department of Psychology

Aim To replicate and extend previous psychometric findings for the Autism Symptom Dimensions Questionnaire (ASDQ). Method Using a cross‐sectional design in two samples, including a total of 3366 children and adolescents (aged 2–17 years; 1399 with autism spectrum disorder) and a small case series, factor structure, measurement invariance, reliabil...

Evidence shows that bipolar disorders often start in youth and are belatedly recognized and treated, causing significant (and partially avoidable) functional impairment and psychological distress. At the same time, growing evidence indicates that adjunctive psychosocial intervention for the treatment and maintenance of pediatric bipolar disorders i...

Social attention is a key aspect of neurodevelopment and is significantly altered in neurodevelopmental genetic syndromes and many individuals with idiopathic autism spectrum disorder (ASD). The primary aim of the present study was to examine the psychometric properties of webcam‐collected social attention measurements, including four new specific...

Aim: To carry out the process of cross-cultural adaptation of the Child Mania Rating Scale - Parent Version (CMRS-P) for the Brazilian context. Method: Statistical procedures were carried out, based on the analysis of the validity of the internal structure of the scale, as well as its relationship with external variables. 224 parents/guardians o...

Background Routine process and outcome monitoring interventions added to psychotherapy are known to improve treatment outcomes, although they vary in format and effectiveness. Objective This study aimed to evaluate whether a therapist-independent, internet-based routine process monitoring and feedback system could significantly reduce psychologica...

Introduction: The Positive and Negative Syndrome Scale (PANSS) is a widely accepted outcome measure for pediatric schizophrenia trials; however, it has notable limitations. Psychometric investigations have shown a multifactorial structure and some items have limited utility assessing symptom severity in children. To address these issues, we develop...

Internet sites are increasingly being used to disseminate clinical resources to mental health clinicians. Wikimedia platforms (e.g., Wikipedia and Wikiversity) are open-source, freely available resources that are among the most visited websites and could be an effective way to disseminate mental health information. An important first step in learni...

In this study, we examined how four components of the therapeutic relationship—working alliance, real relationship, and positive and negative affective reactions of the patient toward their therapist—relate to each other and to the psychotherapy session outcome, from the patient’s point of view. Our simple comprised 700 adult patients in individual...

BACKGROUND Routine process and outcome monitoring interventions added to psychotherapy are known to improve treatment outcomes, although they vary in format and effectiveness. OBJECTIVE This study aimed to evaluate whether a therapist-independent, internet-based routine process monitoring and feedback system could significantly reduce psychologica...

Background There is a growing recognition of the key role of the therapeutic relationship in the outcomes of psychotherapy. However, current understanding of its specific components, their interplay and related patient-therapist dynamics is limited. Objective (a) To validate two self-report measures to assess subjective affective reactions of pati...

Background Psychotherapists need effective tools to monitor changes in the patient’s affective perception of the therapist and the therapeutic relationship during sessions to tailor therapeutic interventions and improve treatment outcomes. This study aims to evaluate the factor structure, reliability, and validity of the in-Session Patient Affectiv...

Background The quality of the therapeutic relationship is pivotal in determining psychotherapy outcomes. However, facilitating patients’ self-awareness, reflection on, and sharing of their affective responses toward their therapist remains underexplored as a potential tool for enhancing this relationship and subsequent treatment outcomes. Objectiv...

Background: While numerous studies have compared symptoms of major depressive episodes (MDEs) associated with bipolar disorder (BD; i.e., bipolar depression) versus major depressive disorder (MDD; i.e., unipolar depression), little is known about this topic in youth. We compared MDE symptoms in youth with BD with youth with suspected BD who have si...

The present study reports on the development and validation of the clinician affective response (CARE) scale. The CARE scale was designed as a self-report measure of therapists’ patterns of thoughts, feelings, and behaviors toward the patient during an individual psychotherapy session. An initial pool of 116 items was generated, and its quality was...

BACKGROUND The quality of the therapeutic relationship is pivotal in determining psychotherapy outcomes. However, facilitating patients' self-awareness and reflection on their affective responses to their therapist remains underexplored as a potential tool for enhancing this relationship and subsequent treatment outcomes. OBJECTIVE The primary obj...

Objective: Sleep is crucial to overall health, playing a complex role in a wide range of mental health concerns in children and adults. Nevertheless, clinicians may not routinely assess sleep problems due to lack of awareness or limitations such as cost or time. Scoring sleep-related items embedded on broader scales may help clinicians get more ou...

Background: Youth with bipolar disorder (BD) are at high risk for suicide and have high rates of self-harm, which includes both suicide attempts and non-suicidal self-injury. Greater risk-taking has been associated with suicide attempts in youth with major depression, although there are no studies examining the relationship between risk-related dec...

Question: Do the shortened Positive and Negative Syndrome Scale (PANSS) [1] versions recently developed from a National Institute of Mental Health (NIMH) pediatric dataset continue to perform well in a third independent randomized double-blind clinical trial of adolescents with schizophrenia? Findings: Secondary analysis of the double-blind, place...

Background: There is a growing recognition of the key role of the therapeutic relationship in the outcomes of psychotherapy. However, current understanding of its specific components, their interplay and related patient-therapist dynamics is limited. Objective: (a) To validate two self-report measures to assess subjective affective reactions of pat...

Objective Severe reactive aggression poses a major mental health challenge for many families. A lack of validated instrumentation for assessing young children may present a barrier to more effective clinical assessment and treatment. This scoping review evaluates tools currently used in clinical research to assess aggressive behavior, and identifie...

This article discusses the development and preliminary validation of a self-report inventory of the patient’s perception of, and affective reaction to, their therapist during a psychotherapy session. First, we wrote a pool of 131 items, reviewed them based on subject matter experts’ review, and then collected validation data from a clinical sample...

With almost a billion Spanish and Portuguese Latin American speakers around the globe, Helping Give Away Psychological Science’s (HGAPS.org) Assessment Center is working to increase the number of open-access psychological scales and resources for the use and benefit of these populations. The present study describes key obstacles faced by the HGAPS...

Objective Impulsive aggression in youth is a significant clinical and public health concern, spanning multiple diagnostic categories and causing significant psychosocial impairment. To advance its assessment and treatment, recent research has focused on developing an empirically derived nosology that can distinguish impulsive aggression from other...

Experiencing erotic feelings towards a patient is a fairly common occurrence, not pathological per se, during phases of psychotherapy. This study aims to analyze associations between, on the one hand, the presence in therapists of romantic attraction (RA), sexual attraction (SA), or flirting behavior (FB) toward patients and, on the other hand, a s...

Background: This study aimed to develop and preliminarily validate a self-report inventory of the patterns of thoughts, feelings, and behaviors of the therapist toward the patient during an individual psychotherapy session using modern psychometric methods. Methods: An initial pool of 116 items was generated and its quality was evaluated by subject...

Objective: An expert consensus approach was used to determine the adequacy of children's psychopharmacology and to examine whether adequacy varied by demographic or clinical characteristics. Methods: Data were from the baseline interview of 601 children, ages 6-12 years, who had visited one of nine outpatient mental health clinics and participat...

The course of childhood-onset attention deficit hyperactivity disorder (ADHD) varies across individuals; some will experience persistent symptoms while others’ symptoms fluctuate or remit. We describe the longitudinal course of ADHD symptoms and associated clinical characteristics in adolescents with childhood-onset ADHD. Participants (aged 6–12 at...

To improve the dissemination and actionability of mental health research, many mental health professionals have developed online informational resources to increase the general public’s awareness of mental health difficulties and available treatments. Yet, limited information exists on the quality and scope of these resources. This study aimed to e...

Despite its potentials benefits, using prediction targets generated based on latent variable (LV) modeling is not a common practice in supervised learning, a dominating framework for developing prediction models. In supervised learning, it is typically assumed that the outcome to be predicted is clear and readily available, and therefore validating...

Experiencing erotic feelings towards a patient is a fairly common occurrence, not pathological per se, during phases of psychotherapy. This study aims to analyze associations between, on the one hand, the presence in therapists of romantic attraction (RA), sexual attraction (SA), or flirting behavior (FB) toward patients and, on the other hand, a s...

Now in its fourth edition, the acclaimed Oxford Textbook of Psychopathology aims for both depth and breadth, with a focus on adult disorders and special attention given to personality disorders. It provides an unparalleled guide for professionals and students alike. Esteemed editors Robert F. Krueger and Paul H. Blaney selected the most eminent res...

Objective: Severe reactive aggression poses a major mental health challenge for many families. A lack of validated instrumentation for assessing young children may present a barrier to more effective clinical assessment and treatment. This scoping review evaluates tools currently used in clinical research to assess aggressive behavior and identifie...

Objectives: This study benchmarks quality of life (QoL) of youth with bipolar disorder (BD) against healthy youth, youth with chronic medical conditions, and youth with other psychiatric disorders. The relative impacts of depressive, (hypo)manic, mixed, and externalizing symptoms on QoL is tested for youth with BD. Method: 657 youth completed the S...

Objectives: This study benchmarks quality of life (QoL) of youth with bipolar disorder (BD) against healthy youth, youth with chronic medical conditions, and youth with other psychiatric disorders. The relative impacts of depressive, (hypo)manic, mixed, and externalizing symptoms on QoL is tested for youth with BD. Method: 657 youth completed th...

Emotion dysregulation is at the heart of our work with families. Learning to recognize and regulate emotions is among the most important developmental tasks. Culturally inappropriate displays of emotion are a major driver of clinical referrals for externalizing problems, but ineffective and maladaptive emotion regulation also contributes to interna...

To improve the dissemination and actionability of mental health research, many mental health professionals have developed online informational resources to increase the general public’s awareness of mental health difficulties and available treatments. Yet, limited information exists on the quality and scope of these resources. This study aimed to e...

Background A key question for any psychopathological diagnosis is whether the condition is continuous or discontinuous with typical variation. The primary objective of this study was to use a multi‐method approach to examine the broad latent categorical versus dimensional structure of autism spectrum disorder (ASD). Method Data were aggregated acr...

ARTICLE FREE TO ACCESS AT: https://doi.org/10.1080/15374416.2022.2158842. In this editorial statement, we briefly delineated a series of observations, guidelines, and directions for future research focused on the most common outcome of multi-informant assessments of youth mental health. Discrepancies commonly occur between estimates of youth mental...

Unlabelled: We aimed to find agreement between diagnoses obtained through standardized (SDI) and non-standardized diagnostic interviews (NSDI) for schizophrenia and Bipolar Affective Disorder (BD). Methods: A systematic review with meta-analysis was conducted. Publications from 2007 to 2020 comparing SDI and NSDI diagnoses in adults without neur...

Aim To describe the development and initial psychometric evaluation of a new, freely available measure, the Autism Symptom Dimensions Questionnaire (ASDQ). Method After development and revision of an initial 33‐item version, informants completed a revised 39‐item version of the ASDQ on 1467 children and adolescents (aged 2–17 years), including 104...

Aggressive behavior is one of the most common reasons for referrals of youth to mental health treatment. While there are multiple publications describing different types of aggression in children, it remains challenging for clinicians to diagnose and treat aggressive youth, especially those with impulsively aggressive behaviors. The reason for this...

Objective: This paper provides initial validation of the Dimensional Assessment of Restricted and Repetitive Behaviors (DARB)-a new parent-report measure designed to capture the full range of key of restricted and repetitive behaviors (RRB) subdomains. Method: Parents of 1892 children and adolescents with autism spectrum disorder (ASD) (M= 10.81...

Objective: The accepted primary outcome measure for evaluating psychotic symptoms is decades old, long, and initially designed for adults. Surprisingly, the psychometric properties of primary outcome measures have never been reported for a pediatric sample using modern methods. The present study's aim is to use a pediatric sample to evaluate the p...

Identifying substance use disorders (SUDs) early and accurately improves case formulation and treatment. Previous studies have investigated validity and reliability of the Child and Adolescent Symptom Inventory (CASI) for anxiety, mood, and behavior problems. The present study's aim was to test if the embedded CASI Substance Use (SU) subscale can d...

The purpose of this article is to narratively review the empirical literature on clinicians’ emotional, cognitive, and behavioral responses (i.e., countertransference) to depressive and other symptoms of patients with mood disorders. Therapist subjective responses (countertransference) can negatively affect both diagnostic and therapeutic processes...

The patient’s perception of and reaction to the therapist (i.e., the transference) is theoretically and empirically associated with the psychotherapy process and outcome, regardless of the therapeutic approach. However, there are very few measures of transference, and the existing ones are observer- or clinician-report. The current project sought t...

Machine learning (ML) is making significant inroads into the field of medicine. It can be used as a preventative measure by predicting a patient’s diagnosis and introducing early treatment to prevent adverse outcomes or lessen their impact. However, despite many demonstrated advantages of machine learning tools in health-care, their performance ass...

Background In the 1970 s, scientific research on psychiatric nosology was summarized in Research Diagnostic Criteria (RDC), based solely on empirical data, an important source for the third revision of the official nomenclature of the American Psychiatric Association in 1980, the Diagnostic and Statistical Manual, Third Edition (DSM-III). The inter...

Sleep is crucial to overall health, and its disruption is both associated with and a diagnostic symptom of multiple mental illnesses. Several broad assessment instruments embed sleep-related items in scales about other constructs. Using these items as their own scale has not yet been validated for differentiating among psychiatric disorders or meas...

OBJECTIVE: To provide a review of journal articles discussing clinical cases or vignettes of psychoanalysis or psychoanalytic psychotherapy of patients affected by bipolar disorder (BD). METHODS: A thorough search of journal articles was performed in five databases to identify studies published from 1990-2021. RESULTS: Twenty-four articles were i...

No systematic review has been conducted to provide an overview of the effectiveness of psychoanalysis for treatment outcomes in bipolar depression and mania. The present study undertakes a scoping review of the effectiveness of psychoanalysis for bipolar disorder (BD), provides a summary of the evidence base, and identifies issues for future resear...

Objectives We aimed to investigate the characteristics of adolescents with Bipolar disorder-I with irritability and agitation (Mania+IA) compared to those without irritability and agitation (Mania-IA) in a multi-center representative sample. Methods Data of 145 patients from three tertiary-care inpatient units between 2016 and 2021 were obtained....

Objective: To describe the theoretical procedures of the cross-cultural adaptation process of the Child Mania Rating Scale - Parent Version (CMRS-P) for Brazil. METHOD: Seven steps were carried out: (1) translations and synthesis; (2) Committee of Judges-I; (3) grammatical review; (4) Committee of Judges-II; (5) Semantic Analysis (Pre-test); (6) B...

The status of irritability as a feature of mood and behavior disorders in children has been a topic of much debate. From a disruptive behavior disorder (DBD) perspective, irritability has emerged as a central feature of Oppositional Defiant Disorder (ODD) and has been uniquely associated with symptoms of depression and anxiety. From the perspective...

Objective Building on prior findings in adults, we investigated regional cerebral blood flow (CBF) in relation to DSM-5 Criterion A symptoms of depression and mania among youth with bipolar disorder (BD). Method We recruited 81 youth with BD and 75 healthy controls (HC) 13-20 years old. CBF was ascertained using pseudocontinuous arterial spin labe...

Aggressive behavior in early childhood characterized by frequent, severe temper outbursts, causes high impairment and distress for families. Emerging evidence suggests that aggression which is impulsive or reactive may define a distinct group of children who experience severe behavior problems outside the context of a mood disorder. Accepted diagno...

We thank Andrew Shaw and colleagues for their recent paper1 in Bipolar Disorders, highlighting that the effective treatment of patients with bipolar disorder requires a good therapeutic alliance, which is related to the clinicians’ countertransference reactions and their management. The authors suggest that the integration of a psychodynamic approa...

There are not enough of us. That was true even before the COVID-19 pandemic, which has only made the need for mental health services more acute.1,2 There are roughly 30,500 practicing psychiatrists in the United States, and 106,000 licensed psychologists, and perhaps a million mental health practitioners worldwide. That translates to roughly one ps...

It is vital to identify substance use disorders (SUDs) in youths and adults early and accurately. Previous studies have investigated the validity and reliability of the Achenbach Child Behavior Checklist (CBCL) and Youth Self Report (YSR) for other related anxiety, mood, and behavior problems. The present study tested if the CBCL and YSR substance...

The present study examined language trajectories and placement outcomes for children with autism spectrum disorder (ASD) receiving early intensive behavioral intervention (EIBI). Language measures were collected at baseline and 6, 12, 18, 24, and 36 months or until exit from EIBI in 131 children with ASD. Growth models estimated overall and subgrou...

Background Numerous studies have found elevated pro-inflammatory markers and reduced brain-derived neurotrophic factor (BDNF) during symptomatic episodes of bipolar disorder (BD) in adults. There is a paucity of research examining these markers in youth with BD, or longitudinally in any BD age group. Methods 79 adolescents, ages 13-19 years, were...

Aim Given ongoing disagreement about the diagnosis of pediatric bipolar disorder, we sought to illuminate key empirical findings regarding the condition in children and adolescents. Methods We conducted a review of extant studies of the diagnosis, course, and treatment bipolar disorder in children and adolescents. Results Bipolar disorder is a li...

Information related to the COVID-19 pandemic ranges from biological to bibliographic, from geographical to genetic and beyond. The structure of the raw data is highly complex, so converting it to meaningful insight requires data curation, integration, extraction and visualization, the global crowdsourcing of which provides both additional challenge...

Objective: Despite being a core diagnostic feature of autism spectrum disorder (ASD), developmental and clinical correlates of restricted and repetitive behaviors and interests (RRB) remain poorly characterized. This study aimed to utilize the largest available RRB data set to date to provide a comprehensive characterization of how distinct RRB do...

Although hopelessness has been linked to depression for centuries, the diagnostic criteria for depression are inconsistent with regard to the status of hopelessness. Most research on hopelessness and depression has focused on adults. The current study examined this relation in children and adolescents. Integrative data analyses with a pooled sample...

Objectives: Irritability and anhedonia are cardinal symptoms of depression for children and adolescents. However, anhedonia may be more strongly associated with illness severity compared with irritability. The present study evaluated the impact of irritability and anhedonia on symptom severity and functional impairment among depressed children and...

For many years, scholars have sought to examine "for whom" psychotherapy is most likely to yield efficacious results. This special issue offers a review of research in several areas of child and adolescent psychopathology, and provides helpful points to guide future research in this area.

Objective: This study evaluated the association between mood and anxiety symptoms and suicidal attempt (SA) and/or non-suicidal self-injury (NSSI) in adolescents seeking mental health services. We also tested predictors of SA and NSSI. Methods: We retrospectively reviewed the medical records of 220 adolescents who completed psychological assessm...

Objective: Aggression with impulsivity and reactivity (AIR) may distinguish a subset of youth from those with