Jonathan Comer

• Ph.D.
• Professor at Florida International University

Objective Sleep problems are frequently reported and associated with externalizing behavior problems in young children, especially those with developmental delay (DD). Parent-child interaction therapy (PCIT) led to improved sleep in young children with DD, but research has not examined the effect of internet-delivered PCIT (iPCIT) on sleep quality...

Introduction Families from racial/ethnic minoritized backgrounds and families of children with developmental delay (DD) often face more obstacles to engaging in psychosocial interventions compared to White families and families of typically developing children. Yet, research on engagement in behavioral parenting interventions has predominantly focu...

This study examined family factors (i.e., parenting style and relationship quality) at the beginning of the pandemic that predicted profiles of family communication about COVID-19 6 months later, as well as communication profile differences in child well-being. Parents (N = 1,025, 66% female, 33.8% male, 0.1% nonbinary) of children aged 5–17 years...

Depressive disorders affect a rising number of youth and are associated with significant comorbidities and adverse psychosocial outcomes. Despite the critical need for effective assessment tools, existing measures for youth depression are often limited by cost, length, and a narrow conceptualization of depressive symptoms. This study adapts the Ove...

Military combat can result in the need for comprehensive care related to both physical and psychological trauma, most commonly chronic pain and post-traumatic stress disorder (PTSD). These conditions tend to co-occur and result in high levels of distress and interference in everyday life. Thus, it is imperative to develop effective, time-efficient...

Objective: This mixed-methods study examined teachers' perceptions of student anxiety in urban elementary schools serving predominantly low-income and ethnically/racially minoritized youth. Method: Most participating teachers were female (87.7%) and from minoritized backgrounds themselves (89.2%), teaching in schools serving predominantly Black/...

Importance Children with developmental delays are at a heightened risk of experiencing mental health challenges, and this risk is exacerbated among racially minoritized children who face disproportionate adversity. Understanding the impact of parenting interventions on biological markers associated with these risks is crucial for mitigating long-te...

Selective mutism (SM) is a highly impairing anxiety disorder, characterized by a persistent inability to speak in unfamiliar settings and significant impairment in social and academic functioning. Although cognitive-behavioral therapy (CBT) is effective in treating childhood SM, traditional outpatient CBT for SM is inaccessible, relative to treatme...

The Adolescent Brain Cognitive Development (ABCD) Study represents a pioneering initiative aimed at unraveling the complexities of behavioral and neural development in youth. In this paper, we address the multifaceted challenges inherent in extracting meaningful insights from the extensive data compiled by the ABCD initiative. Our focus is on advoc...

The COVID-19 pandemic led many in-office therapeutic programs to pivot to virtual programming without empirical data supporting the acceptability and efficacy of the remote-delivered adaptations. These adaptations were essential for continuing care and addressing surging youth psychological problems at the time. To serve adolescents with comorbid p...

Objective: Despite effective treatment options, many families—especially those from marginalized backgrounds—lack access to quality care for their children’s behavioral difficulties. Since the COVID-19 pandemic, telehealth has become a prominent format for the delivery of outpatient services, with potential to increase access to quality care. Altho...

The School Services Sourcebook, third edition is a comprehensive reference guide that provides school social workers, other mental health professionals, and educators essential information on the various approaches to working with students in schools. The book covers a broad range of topics, including mental health services, school safety, trauma i...

Las personas latinas que tuvieron Experiencias Adversas en la Infancia (ACEs, por sus siglas en inglés) podrían tener un riesgo particularmente alto de sufrir un mayor nivel de ansiedad a principios de la edad adulta. Sin embargo, la investigación aún no ha examinado los vínculos entre las ACEs y la ansiedad subsiguiente en personas latinas que asi...

Importance: Child behavior problems have been shown to contribute to caregiver distress and vice versa among youth with developmental delay (DD). However, studies have not examined these associations among children and caregivers from underrepresented ethnic/racial backgrounds. Furthermore, research has not explored how associations function diffe...

Clinical presentations of selective mutism (SM) vary widely across affected youth. Although studies have explored general externalizing problems in youth with SM, research has not specifically examined patterns of irritability. Relatedly, research has not considered how affected families differentially accommodate the anxiety of youth with SM as a...

Despite common use of the Therapy Attitude Inventory (TAI) to measure satisfaction with parenting interventions, psychometric support has only been demonstrated in predominantly White caregivers of typically developing children following clinic-based treatments. Additionally, the reliability and validity of the Spanish version of the TAI have not b...

Obsessive‐compulsive disorder (OCD) is a debilitating psychiatric disorder. Worldwide, its prevalence is ~2% and its etiology is mostly unknown. Identifying biological factors contributing to OCD will elucidate underlying mechanisms and might contribute to improved treatment outcomes. Genomic studies of OCD are beginning to reveal long‐sought risk...

In the aftermath of discrete disasters, how families discuss the event has been linked with child well-being. There is less understanding, however, of how family communication affects adjustment to a protracted and ongoing public health crisis such as the COVID-19 pandemic. The present research leveraged a large longitudinal sample of families (N =...

This study examined whether children exposed to adversity would exhibit lower epigenetic age acceleration in the context of improved parenting. Children with developmental delays and externalizing behavior problems ( N = 62; M age = 36.26 months; 70.97% boys, 29.03% girls; 71% Latinx, 22.6% Black) were drawn from a larger randomized controlled tria...

The unique needs of first-generation immigrants and their families have not been prioritized in mental healthcare. Cultural tailoring of child services requires valid, reliable, and efficient assessments of family cultural identity. The Abbreviated Multidimension Acculturation Scale (AMAS) is a self-report of acculturation and enculturation that ha...

Obsessive-compulsive disorder (OCD) is a debilitating psychiatric disorder. Worldwide, its prevalence is ~2% and its etiology is mostly unknown. Identifying biological factors contributing to OCD will elucidate underlying mechanisms and might contribute to improved treatment outcomes. Genomic studies of OCD are beginning to reveal long-sought risk...

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...

There is tremendous need for brief and supported, non-commercial youth- and caregiver-report questionnaires of youth anxiety. The pediatric and parent proxy short forms of the Patient-Reported Outcome Measurement System (PROMIS) Anxiety scale (8a v2.0) are free, brief, publicly accessible measures of youth- and caregiver-reported anxiety in childre...

Importance: Early behavior problems in children with developmental delay (DD) are prevalent and impairing, but service barriers persist. Controlled studies examining telehealth approaches are limited, particularly for children with DD. Objective: To evaluate the efficacy of a telehealth parenting intervention for behavior problems in young child...

Objective: Emotion dysregulation, understood as a critical transdiagnostic factor in the etiology and maintenance of psychopathology, is among the most common reasons youth are referred for psychiatric care. The present systematic review examines two decades of questionnaires used to assess emotion (dys)regulation in youth. Method: Using "emotio...

The parent-report Affective Reactivity Index (ARI-P) is the most studied brief scale specifically developed to assess irritability, but relatively little is known about its performance in early childhood (i.e., ≤8 years). Support in such populations is particularly important given developmental shifts in what constitutes normative irritability acro...

Objective Treatment protocols for youth-internalizing disorders have been developed, however these protocols have yielded mixed findings in routine care settings. Despite increased recognition of the importance of flexibility when delivering evidence-based treatments (EBTs), little is known about the extent to which protocols offer guidance to prov...

Within pediatric anxiety, accommodation describes ways caregivers modify their behavior in an effort to alleviate distress shown by anxious youth. In schools, accommodation refers to school-based supports (SBS) placed to increase academic success for students with disabilities. The present study, using school documents provided at treatment, examin...

Student anxiety is less frequently identified and treated in school settings relative to other mental health concerns (e.g., externalizing behavior problems). Considering the perspectives of school-based mental health providers is critical for improving supports for students with anxiety in schools. The present study examined patterns and predictor...

Selective mutism (SM) is a relatively rare, but highly interfering, child anxiety disorder characterized by a consistent failure to speak in certain situations, despite demonstrating fluent speech in other contexts. Exposure-based cognitive behavioral therapy and Parent-Child Interaction Therapy adapted for SM can be effective, but the broad availa...

Given the salience of socialization factors on adolescence and their role in vulnerability to disasters and trauma, this study examined whether COVID-19-associated fears and impacted quality of life mediated associations between pandemic-focused family conversations and media exposure and subsequent youth mental health. A primarily Latinx sample of...

Objective Commonly-used youth anxiety measures may not comprehensively capture fears, worries, and experiences related to the pervasive impact of the COVID-19 pandemic. This study described the development of the Fear of Illness and Virus Evaluation (FIVE) scales and validated the caregiver-report version. Method After initial development, feedbac...

Objective Disparities in child mental health service engagement suggest traditional evidence-based practices do not properly consider cultural and contextual factors relevant for marginalized families. We propose a person-centered approach to improve the cultural responsiveness of services. Preliminary research supports broadening standard assessme...

Background: Despite progress in youth anxiety assessment, there is need for a measure that is simultaneously (a) free, (b) brief, (c) focused broadly on anxiety and avoidance severity, frequency, and interference, and (d) concerned with the past week. The adult Overall Anxiety Severity and Impairment Scale (OASIS) was adapted to yield a caregiver-...

The human toll of disasters extends beyond death, injury and loss. Post-traumatic stress (PTS) can be common among directly exposed individuals, and children are particularly vulnerable. Even children far removed from harm’s way report PTS, and media-based exposure may partially account for this phenomenon. In this study, we examine this issue usin...

Objective A lack of universal definitions for response and remission in pediatric obsessive-compulsive disorder (OCD) has hampered the comparability of results across trials. To address this problem, we conducted an individual participant data diagnostic test accuracy meta-analysis to evaluate the discriminative ability of the Children’s Yale-Brown...

Objective: Natural disasters, such as hurricanes, can contribute to the development of posttraumatic stress symptoms (PTSS), anxiety, and depression. Furthermore, mothers and children are especially vulnerable postdisasters. Despite the rise in the frequency of climate-related disasters and also the threat of disasters (e.g., storms that threaten...

Introduction: Research on families of young children with developmental delay and disruptive behavior problems has failed to examine caregiver stress in the context of cultural factors. Methods: Families of 3-year-old children with developmental delay and behavior problems were recruited from Early Intervention sites. All caregivers in the curre...

Whereas family-based CBT has been shown to be effective in controlled settings for an array of youth mental health difficulties, disparities in treatment engagement and outcomes across racial and ethnic groups remain. In practice, cultural minority families are less likely to reap the demonstrated benefits of supported programs. Although there have...

Youth with anxiety often experience significant impairment in the school setting. Despite the relevance and promise of addressing anxiety in schools, traditional treatment approaches to school-based anxiety often do not adequately address generalization to the school setting, or they require removing the student from the classroom to deliver time-...

Background and objectives: New diagnostic criteria for posttraumatic stress disorder (PTSD) were introduced by DSM-5 and ICD-11. It remains unclear how well these new definitions of PTSD capture the posttrauma responses of children, particularly when using parent report. This study compared different conceptual models of PTSD in children following...

Despite recent advances in the treatment of early child social anxiety, the broad accessibility of brick-and-mortar services has been limited by traditional barriers to care, and more recently by new obstacles related to efforts to slow the spread of COVID-19. The present waitlist-controlled trial examined the preliminary efficacy of a family-based...

The field has increasingly used developmental science to systematically inform clinical psychological science, and recent years have witnessed rapid advances in the developmentally informed study and treatment of youth and older adults. The present chapter outlines the basic principles that underlie developmentally informed clinical psychology, and...

Children raised in families with low socioeconomic status (SES) are more likely to exhibit symptoms of psychopathology. However, the strength of this association, the specific indices of SES most strongly associated with childhood psychopathology, and factors moderating the association are strikingly inconsistent across studies. We conducted a meta...

As natural disasters increase in frequency and severity (1,2), mounting evidence reveals that their human toll extends beyond death, injury, and loss. Posttraumatic stress (PTS) can be common among exposed individuals, and children are particularly vulnerable (3,4). Curiously, PTS can even be found among youth far removed from harm's way, and media...

Children with selective mutism (SM) experience significant challenges in a variety of social situations, leading to difficulties with academics, peers, and family functioning. Despite the extensive evidence base for cognitive-behavioral interventions for youth anxiety, the literature has seen relatively limited advancement in specialized treatment...

Although families with children are particularly vulnerable in hurricanes, little is known about factors affecting families’ evacuation decisions. Following Hurricane Irma, we evaluated multiple factors potentially influencing mothers’ evacuation decisions and evacuation intentions for future hurricanes. Mothers of children under 18 years (N=536) c...

Recent efforts to improve access to evidence-based parent training programs using online delivery have largely neglected findings that young children with callous-unemotional (CU)-type conduct problems receive less benefit from parent training than children with conduct problems alone. The current study aimed to examine the moderating effect of chi...

Parental accommodation plays a key role in the maintenance of child anxiety, yet much of the research to date has been correlational, making it difficult to draw conclusions about underlying mechanisms. Given preliminary evidence that parental beliefs play a role in parental accommodation, the present study sought to experimentally reduce accommoda...

Intolerance of uncertainty (IU) is a trait characteristic marked by distress in the face of insufficient information. Elevated IU has been implicated in the development and maintenance of anxiety disorders, particularly during adolescence, which is characterized by dramatic neural maturation and the onset of anxiety disorders. Previous task-based w...

Objective: Although research has examined negatively reinforcing patterns of parental accommodation of youth anxiety, limited research considers school staff-led accommodations for students with anxiety. Further, the extent to which patterns of school staff-led accommodations/supports for anxiety align with anxiety expert perspectives remains uncle...

Youth anxiety disorders are highly prevalent and are associated with considerable school impairment. Despite the identification of well-supported strategies for treating youth anxiety, research has yet to evaluate the differential effects of these treatments on anxiety-related school impairment. The present study leveraged data from the Child/Adole...

Sequential, multiple-assignment, randomized trials (SMARTs) have emerged as a preferred design strategy with which to inform dynamic mental-health treatment decisions and adaptive interventions, yet their potential to improve patient outcomes is only as strong as the extent to which selected tailoring variables (i.e., interim response factors that...

Distress Intolerance (DI), defined as the perceived inability to tolerate negative mood states and experiential discomfort, has been posited as a vulnerability factor for several anxiety and emotional disorders. There is a relative paucity of research on DI in youth samples, in large part due to the absence of a psychometrically sound measure of DI...

Objective: Very few controlled trials have evaluated targeted treatment methods for childhood selective mutism (SM); the availability of evidence-based services remains limited. This study is the first controlled trial to evaluate an intensive group behavioral treatment (IGBT) for children with SM. Method: Twenty-nine children with SM (5–9 years; 7...

Terrorism directly impacts an enormous number of children and adolescents each year, and by definition, the explicit goals of terrorism extend beyond causing death, injury, and the destruction of property. An increasing body of research finds that direct and indirect terrorism exposure can be associated with a very heavy mental health toll in a siz...

NOCD is a mobile application that was developed as an adjunct to evidence-based treatment for individuals diagnosed with OCD. NOCD is not a stand-alone treatment, but rather a resource for patients to access supported strategies outside of treatment sessions. NOCD allows users to assess OCD symptom severity, create exposure and response prevention...

Objective Parents and children are vulnerable populations following hurricanes, and evacuation is an important safety strategy. Yet, little is known about “before the storm” stressors, particularly the surrounding evacuation, affecting families. Thus, following Hurricane Irma, we evaluated both stressful and positive aspects of the evacuation proce...

The controlled evaluation of treatments for early childhood anxiety and related problems has been a relatively recent area of investigation, and accordingly, trials examining early childhood anxiety treatment have not been well represented in existing systematic reviews of youth anxiety treatments. This Evidence Base Update provides the first syste...

This comprehensive, 51-chapter handbook presents recent advances in the expression, etiology, assessment, and treatment of child and adolescent psychiatric disorders and related problems from a developmental psychopathology perspective. Following a broad conceptual overview of this area of clinical research and practice, assessment and treatment pr...

Although most research with youth exposed to violent manmade disasters has focused on internalizing problems, recent work suggests conduct problems (CPs) may also manifest in exposed youth. However, the extent to which youth postevent CPs present independently, versus co-present in conjunction with PTSD symptoms, remains unclear. The present study...

Studies point to parental experiential avoidance (EA) as a potential correlate of maladaptive parenting behaviors associated with child anxiety. However, research has not examined the relationship between EA and parental accommodation of child anxiety, nor the extent to which parental negative beliefs about child anxiety help explain such a relatio...

Although recent studies have linked pediatric anxiety to irritability, research has yet to examine the mechanisms through which youth anxiety may be associated with irritability. Importantly, sleep related problems (SRPs) have been associated with both child anxiety and irritability, but research has not considered whether the link between youth an...

In this meta-analysis, we review findings on the relationships between parental combat exposure and PTSD/PTSS in military-serving families and (1) parenting problems, (2) family maladjustment, and (3) offspring problems. We systematically searchedfor studies in PsycInfo, PsychArticles, Psychology and Behavior Sciences Collection, Published Internat...

Progress in evidence-based treatments for child anxiety has been hampered by limited accessibility of quality care. This study utilized a multiple baseline design to evaluate the pilot feasibility, acceptability, and preliminary efficacy of real-time, Internet-delivered, family-based cognitive-behavioral therapy for child anxiety delivered to the h...

Children’s mental health problems are highly prevalent and impose enormous burdens at the individual, family, and societal level. Fortunately, the past few decades have witnessed tremendous advances in the development and evaluation of developmentally sensitive cognitive behavioral procedures with demonstrated success in treating a considerable sha...

Objective: Given problems and disparities in the use of community-based mental health services for youth, school personnel have assumed frontline mental health service roles. To date, most research on school-based services has evaluated analog educational contexts with services implemented by highly trained study staff, and little is known about t...

Controlled evaluations comparing medication, cognitive-behavioral therapy (CBT), and their combination in the treatment of youth anxiety have predominantly focused on global ratings by independent evaluators. Such ratings are resource intensive, may be of limited generalizability, and do not directly inform our understanding of treatment responses...

Adolescents with ADHD demonstrate notoriously poor treatment utilization. Barriers to access have been partially addressed through tailored therapy content and therapist delivery style; yet, additional challenges to engaging this population remain. To leverage modern technology in support of this aim, the current study investigates parent-teen ther...

This chapter offers a review of the behavioral model of psychosocial treatment for early-onset conduct problems (CPs). It focuses on three common formats of psychosocial treatment for them: individual family-based treatment, group-based treatment, and school-based treatment. The chapter then highlights a number of promising trends in, and future di...

Anxiety disorders are collectively the most prevalent mental health problems affecting youth. To increase the reach of mental healthcare, recent years have seen increasing enthusiasm surrounding mobile platforms for expanding treatment delivery options. Apps developed in academia and supported in clinical trials are slow to reach the consumer marke...

Intolerance of uncertainty (IU), a dispositional negative orientation toward uncertainty and its consequences, has been studied in adults, but research has only recently examined IU in youth. Despite some advances, little is known about the factor structure of measures of IU in youth. The present study used confirmatory factor analysis to examine t...

Background: Social networking services (SNS) have rapidly become a central platform for adolescents' social interactions and media consumption patterns. The present study examined a representative sample of publicly accessible content related to deliberate self-injurious cutting across three SNS platforms: Twitter, Tumblr, and Instagram. Methods:...

Objective: Remote technologies are increasingly being leveraged to expand the reach of supported care, but applications to early child-behavior problems have been limited. This is the first controlled trial examining video-teleconferencing to remotely deliver behavioral parent training to the home setting with a live therapist. Method: Racially/eth...

This chapter covers the growing literature on the phenomenology, assessment, and recent advances in treatment of obsessive-compulsive problems in very young children, and concludes with a discussion of future directions and areas in need of focused empirical attention. Obsessive-compulsive (OC) symptoms in early childhood tend to onset gradually. C...

Teachers are a primary source of referral to mental health services for children and adolescents. However, studies find that students identified by teachers differ from those identified by standardized screening scales. This suggests possible discrepancies in conceptualizations of student emotional and behavioral challenges. The current article des...

Disruptive behavior disorders (DBD) are highly prevalent, emerge in early childhood, exhibit considerable stability across time, and are associated with profound disability. When DBD co-occur with callous-unemotional (CU) traits (i.e., lack of empathy/guilt), the risk of early-onset, stable, and severe disruptive behavior is even higher, relative t...

Parasympathetic nervous system influences on cardiac functions-commonly indexed via respiratory sinus arrhythmia (RSA)-are central to self-regulation. RSA suppression during challenging emotional and cognitive tasks is often associated with better emotional and behavioral functioning in preschoolers. However, the links between RSA suppression and c...

Recent years have seen an increase in demand for evidence-based practices (EBPs) in mental health care; however there exists a dearth of accessible, low-cost trainings in EBPs. This has led national organizations, such as the Society of Clinical Child and Adolescent Psychology (SCCAP; Division 53 of the American Psychological Association), to under...

Disorders of negative affect include mental health difficulties characterized by depressive mood and/or anxious distress. These diagnoses collectively constitute one of the most prevalent and impairing classes of mental health diagnoses affecting individuals across the life span. The optimal system for classifying disorders of negative affect and t...

SuperBetter is a family of interfaces including a browser-based game, an online forum, and a companion mobile application that collectively seek to “gamify” resilience, wellness, motivation, and mental health. Players register and use “gamified” components and content to address mental and physical health challenges and to pursue identified goals....

Objective: Despite advances in supported treatments for early onset obsessive–compulsive disorder (OCD), progress has been constrained by regionally limited expertise in pediatric OCD. Videoteleconferencing (VTC) methods have proved useful for extending the reach of services for older individuals, but no randomized clinical trials (RCTs) have evalu...

Background: Worry is a common feature across many anxiety disorders. It is important to understand how and when worry presents from childhood to adolescence to prevent long-term negative outcomes. However, most of the existing studies that examine the relationship between worry and anxiety disorders utilize adult samples. Aims: The present study...

Intolerance of Uncertainty (IU), defined as the dispositional interpretation of uncertain or ambiguous events as stressful and problematic, has been linked to excessive worry and other anxiety-related problems in adults and youth. IU has been conceptualized as a vulnerability factor for excessive worry and anxiety, but the historical absence of a s...

After mass crises, trauma-exposed children report increased psychological distress, yet most receive no mental health (MH) services and supports. This study identifies factors associated with teachers’ reports of outreach to school-based MH providers (such as social workers, psychologists, and counselors) as well as provision of informal supports a...

Anxiety disorders are commonly occurring among children and are associated with increased risk for poor educational outcomes. However, little is known about the specific supports and accommodations provided to anxious children in schools. This study examines reports of school functioning and school-based supports and accommodations among a sample o...

The relationship between intolerance of uncertainty (IU) and anxiety has been extensively studied in adults, while research on child IU is nascent. Despite recent advances in the evaluation of IU and clinical correlates in youth, little is known about familial patterns of IU and intergenerational links between parent and child IU. The present study...

Over the past two decades, the field has witnessed tremendous advances in our understanding of terrorism and its impacts on affected youth. It is now well established that a significant proportion of exposed youth show elevated PTSD symptoms in the months following a terrorist attack. In more recent years, research has expanded beyond confirming ou...

Background: The DSM-5 includes a revised definition of the experiences that qualify as potentially traumatic events. This revised definition now offers a clearer and more exclusive definition of what qualifies as a traumatic exposure, but little is known about the revision's applicability to youth populations. The present study evaluated the predi...

Although practitioners and researchers have considered children’s television-based terrorism exposure, Internet-based exposure has not been sufficiently examined. We examined the scope and correlates of children’s Internet-based exposure following the Boston Marathon bombing among Boston-area youth (N=460; 4-19 years), and the potential moderating...