Stephen Basil Scott

• MB BChir
• King's College London

Parenting programs have proven effective in reducing disruptive child behavior. However, not all families benefit equally, and, to date, we have little insight into who benefits more or less and why. One possible solution is to explore how different potential moderators cluster together in individual families and whether such family profiles predic...

Background Despite high rates of adolescent mental health problems, there are few effective school-based interventions to address this. Whole-school interventions offer a feasible and sustainable means of promoting mental health, but few have to date been evaluated. Previously we trialled the Learning Together intervention comprising local needs as...

Background Despite high rates of adolescent mental-health problems, there are few effective whole-school interventions to address this. Whole-school interventions offer a feasible and sustainable means of promoting mental health. We previously evaluated the Learning Together (LT) intervention which was effective in preventing bullying (primary outc...

Introduction Accurate prediction of short-term offending in young people exhibiting antisocial behaviour could support targeted interventions. Here we develop a set of machine learning (ML) models that predict offending status with good accuracy; furthermore, we show interpretable ML analyses can complement models to inform clinical decision-making...

Behavioral parenting programs, such as Incredible Years (IY), reduce conduct problems in children. However, conduct problems encompass many different behaviors, and little is known about the effects of parenting programs on specific aspects of children’s conduct problems, such as children’s relationships with others. The aim of this study was to ex...

Objective: We tested if baseline disruptive child behavior problem severity predicts parental attendance at sessions of a parenting group program. Method: We used a database of randomized trials of the Incredible Years parenting program in Europe and restricted the sample to participants randomized to the intervention arm. Using baseline Eyberg Chi...

Background Conduct disorders (CD) are among the most frequent psychiatric disorders in children and adolescents, with an estimated worldwide prevalence in the community of 2–4%. Evidence-based psychological outpatient treatment leads to significant improvement in about two-thirds of cases. However, there seems to be considerable variation in rates...

Studies report that the microstructural integrity of the uncinate fasciculus (UF; connecting the anterior temporal lobe to the orbitofrontal cortex) is abnormal in adults with psychopathy and children with conduct problems (CP), especially those with high callous-unemotional (CU) traits. However, it is unknown if these abnormalities are ‘fixed’ or...

The current study explored the role of pre-existing and pandemic-time child, family or environmental factors in the presentation of mental health symptoms of autistic youth and their parents during the pandemic. Participants were parents/carers of autistic children (Autism Spectrum Treatment and Resilience Cohort, N = 67, Mage = 9 years) and adoles...

Objectives Criminal offending and re-offending comes at a significant social and economic cost. Offending prevention therefore presents a high priority policy area. Low educational attainment is a known risk factor for offending, but little is understood about how changes in school performance over time might be associated with offending. Methods W...

Parental self-efficacy predicts outcomes for parenting interventions for child behaviour problems, but there is a need for a brief measure that can be repeated over treatment and applies to a wide age range. The present study describes the development of such a measure, the Brief Parental Self-Efficacy Scale (BPSES). The psychometrics of the BPSES...

Background Social and economic costs associated with antisocial behaviour are well-established, but little is known about the potential costs savings/benefits of secure attachment in this high-risk group. We aimed to provide the first test of attachment quality as a distinct predictor of economic costs. Methods 111 adolescents (10–17 years of age,...

Objective Most young autistic children display emotional and behavioral problems (EBPs). There is evidence that behavioral parenting interventions (BPIs) reduce these. The COVID-19 pandemic and associated lockdowns can be seen as a natural experiment to test the longer-term effect of BPIs under conditions of increased uncertainty. Method Opportuni...

Introduction Good quality parenting in early childhood is reliably associated with positive mental and physical health over the lifespan. Objectives The hypothesis that early parenting quality has significant long-term financial benefits has not been previously tested. Methods Design: Longitudinal study with follow-up from 2012 to 2016 ; UK multi...

Objective: The current study examined the mental health symptoms of autistic children and young people and their parents during the COVID-19 pandemic in two pre-existing well-characterised cohorts. We explored whether child, family or environmental factors were associated with child and parental mental health symptoms during the pandemic. Method: P...

Background Looked-after children are at risk of suboptimal attachment patterns and reactive attachment disorder. However, access to interventions varies widely and there are no evidence-based interventions for this disorder. Objectives (1) To adapt an existing video-feedback intervention to meet the specific needs of foster children in the UK with...

Human beings are social animals, and social psychiatry is a key discipline within psychiatry around the world. The impact of social factors on the genesis and perpetuation of mental illnesses and maintenance of well-being of individuals and families is well recognized. Exploring social factors is the key to understanding aetiology and developing th...

In molti contesti professionali, compreso quello del Tribunale per i minorenni, si fa riferimento alla teoria dell'attaccamento e alla relativa ricerca, con fraintendimenti ampiamente diffusi che spesso si traducono in applicazioni scorrette. La finalità di questa dichiarazione di consenso è, pertanto, quella di migliorarne la comprensione, contras...

There is a social gradient to the determinants of health; low socioeconomic status (SES) has been linked to reduced educational attainment and employment prospects, which in turn affect physical and mental wellbeing. One goal of preventive interventions, such as parenting programs, is to reduce these health inequalities by supporting families with...

Background Looked-after children are at risk of suboptimal attachment patterns and reactive attachment disorder (RAD). However, access to interventions varies widely, and there are no evidence-based interventions for RAD. Aims To modify an existing parenting intervention for children with RAD in the UK foster care setting, and test the feasibility...

La théorie et les recherches sur l’attachement sont utilisées dans de nombreux cadres d’application, y compris dans les tribunaux compétents en matière familiale [1], mais les incompréhensions sont fréquentes et sources d’erreurs lorsqu’il s’agit de les mettre en pratique. L’objectif de cet article de consensus est donc d’accroître la compréhension...

Emotional and behavioral problems (EBPs) frequently occur in young autistic children. Discrepancies between parents and other informants are common but can lead to uncertainty in formulation, diagnosis and care planning. This study aimed to explore child and informant characteristics are associated with reported child EBPs across settings. Particip...

The recent death of our colleague and friend Professor Sir Michael Rutter has quite rightly been greeted by an outpouring of gratitude and respect from distinguished commentators across the globe working in diverse fields of the basic, social and clinical sciences as well as from clinicians and policy makers. These have without exception highlighte...

La teoría y la investigación sobre el apego se utilizan en muchos contextos aplicados, incluidos los juzgados de familia, pero hay malentendidos muy extendidos y que a veces dan lugar a aplicaciones erróneas. El objetivo de este documento de consenso es, por lo tanto, mejorar la comprensión, contrarrestar la desinformación y dirigir el uso de la te...

Global access to practitioner training in the clinical engagement of fathers in family-based interventions is limited. The current study evaluated the feasibility of training practitioners in Canada and UK using online training developed in Australia by examining improvements in practitioner confidence and competence in father engagement, training...

Background In the United Kingdom, schools play an increasingly important role in supporting young peoples’ mental health. While there is a growing evidence base to support the effectiveness of school‐based interventions, less is known about how these provisions impact on local Child and Adolescent Mental Health Service (CAMHS) referral rates. There...

Background and objectives Studies suggest that individual student-reported connection to school is associated with better mental health. However, there is less evidence for associations between schools’ overall school climate and the mental health of their students. This may reflect limitations in which mental health outcomes have been examined. We...

Background Good quality parenting in early childhood is reliably associated with positive mental and physical health over the lifespan. The hypothesis that early parenting quality has significant long‐term financial benefits has not been previously tested. Methods Design: Longitudinal study with follow‐up from 2012 to 2016. Setting: UK multicentre...

Objective: To examine the feasibility and preliminary efficacy of a group behavioral parenting intervention for emotional and behavioral problems (EBPs) in young autistic children. Method: This was a feasibility pilot randomized controlled trial comparing a 12-week group behavioral parenting intervention (Predictive Parenting) to an attention co...

Background: Behaviour problems emerge early in childhood and place children at risk for later psychopathology. Objectives: To evaluate the clinical effectiveness and cost-effectiveness of a parenting intervention to prevent enduring behaviour problems in young children. Design: A pragmatic, assessor-blinded, multisite, two-arm, parallel-group...

Importance Behavior problems are one of the most common mental health disorders in childhood and can undermine children’s health, education, and employment outcomes into adulthood. There are few effective interventions for early childhood. Objective To test the clinical effectiveness of a brief parenting intervention, the Video-feedback Interventi...

Attachment theory and research are drawn upon in many applied settings, including family courts, but misunderstandings are widespread and sometimes result in misapplications. The aim of this consensus statement is, therefore, to enhance understanding, counter misinformation, and steer family-court utilisation of attachment theory in a supportive, e...

Co-occurring emotional and behavioral problems (EBPs) frequently exist in young autistic children. There is evidence based on parental report that parenting interventions reduce child EBPs. More objective measures of child EBPs should supplement parent reported outcomes in trials. We describe the development of a new measure of child and parenting...

Background Parenting programmes aim to alleviate behavioural problems in children, including conduct disorder. This study was part of a multi-phase mixed-methods project seeking to extend the reach of parenting programmes for the treatment of conduct problems through developing an evidence base to inform a personalised approach. It explored the nar...

Background Multisystemic therapy is a manualised treatment programme for young people aged 11–17 years who exhibit antisocial behaviour. To our knowledge, the Systemic Therapy for At Risk Teens (START) trial is the first large-scale randomised controlled trial of multisystemic therapy in the UK. Previous findings reported to 18 months after baselin...

Background The Systemic Therapy for At Risk Teens (START) trial is a randomised controlled trial of multisystemic therapy (MST) compared with management as usual (MAU). The present study reports on long-term follow-up of the trial (to 60 months). Objectives The primary objective was to compare MST and MAU for the proportion of young people in each...

Parent-mediated interventions can reduce behavioral and emotional problems in children with ASD. This report discusses the development of the first group parent intervention targeting behaviors and anxiety in children with ASD, across the spectrum of cognitive and language ability. ‘Predictive Parenting’ was developed from the clinical observation...

Background The children of parents with severe personality difficulties have greater risk of significant mental health problems. Existing care is poorly co-ordinated, with limited effectiveness. A specialised parenting intervention may improve child and parenting outcomes, reduce family morbidity and lower the service costs. Objectives To develop...

Oppositional defiant and conduct disorders are the most common mental health problems in childhood. They have a poor prognosis if left untreated, with increased crime, violence, drug misuse, academic failure, dependence on state welfare, psychosis, and early death. A number of children additionally have callous-unemotional traits, and they are at r...

Background Specialist parenting intervention could improve coexistent parenting and child mental health difficulties of parents affected by severe personality difficulties. Objective Conduct a feasibility trial of Helping Families Programme-Modified (HFP-M), a specialist parenting intervention. Design Pragmatic, mixed-methods trial, 1:1 random al...

Objective: There is concern whether established parenting programs for children's conduct problems meet the needs of families with severe and complex mental health problems. For example, many children with conduct problems show comorbid ADHD or emotional problems, or have parents who are depressed, but families with such complex mental health prob...

This chapter reviews landmark studies in the history of child psychotherapy. Studies were chosen based on innovation, impact, and methodological rigour. They include Mary Cover Jones’ first use of observational methods to overcome fear in young children; Ivan Lovaas’ work with autism in children; the Oregon Social Learning Center’s conceptualizatio...

Background Bullying, aggression and violence among children and young people are some of the most consequential public mental health problems. Objectives The INCLUSIVE (initiating change locally in bullying and aggression through the school environment) trial evaluated the Learning Together intervention, which involved students in efforts to modif...

Background Knowing that your parent or caregiver will be there for you in times of emotional need and distress is a core aspect of the human experience of feeling loved and being securely attached. In contrast, an insecure attachment pattern is found in many antisocial youth and is related to less sensitive caregiving. Such youth are often distrust...

Children vary in the extent to which they benefit from parenting programs for conduct problems. How does parental mental health change if children benefit less or more? We assessed whether changes in conduct problems and maternal depressive symptoms co-occur following participation in the Incredible Years parenting program. We integrated individual...

Objective: Recent research suggests that comorbidity in child and adolescent psychiatric symptoms can be summarized by a single latent dimension known as the p factor and more specific factors summarizing clusters of symptoms. This study investigated within- and between-person changes in general and specific psychopathology factors over a psychoso...

Introduction The majority of young autistic children display impairing emotional and behavioural difficulties that contribute to family stress. There is some evidence that behavioural parenting interventions are effective for reducing behavioural difficulties in autistic children, with less evidence assessing change in emotional difficulties. Previ...

Background: Childhood conduct problems are a costly public health problem and are five times more common in socially disadvantaged groups than they are in advantaged groups. Untreated, conduct problems have a poor prognosis, with increasing gaps between socioeconomic groups, and high rates of subsequent criminality. Incredible Years is a high qual...

There is growing interest in the development of behavioral parent interventions targeting emotional and behavioral problems in children with autism spectrum disorders. Such interventions have potential to improve a number of child and parental well-being outcomes beyond disruptive child behavior. This systematic review and meta-analysis assesses ev...

Background Bullying, aggression, and violence among children and young people are some of the most consequential public mental health problems. We tested the Learning Together intervention, which involved students in efforts to modify their school environment using restorative practice and by developing social and emotional skills. Methods We did...

Strong arguments have been made for early intervention for child problems, stating that early is more effective than later, as the brain is more malleable, and costs are lower. However, there is scant evidence from trials to support this hypothesis, which we therefore tested in two well-powered, state-of-the-art meta-analyses with complementary str...

Background A growing research base demonstrates that adolescents' construction of secure attachment relationships may underlie successful social and personal relationships and healthy behavioral adjustment. Little is known about the early caregiving origins of adolescent attachment security; this study provides some of the first data on this topic....

Background: Adolescent antisocial behaviour is a major health and social problem. Studies in the USA have shown that multisystemic therapy reduces such behaviour and the number of criminal offences committed by this group. However, findings outside the USA are equivocal. We aimed to assess the effectiveness and cost-effectiveness of multisystemic...

Background Child disruptive behavioural problems are a large and costly public health problem. The Incredible Years ® (IY) parenting programme has been disseminated across the UK to prevent this problem and shown to be effective in several trials. It is vital for policy to know for which families IY is most effective, to be sure that it helps reduc...

Background Behavioural problems are common in early childhood, and can result in enduring costs to the individual and society, including an increased risk of mental and physical illness, criminality, educational failure and drug and alcohol misuse. Most previous research has examined the impact of interventions targeting older children when difficu...

Background: Youth offending and antisocial behavior (ASB) are associated with low quality mental health and relationships and usually lead to poor adult functioning; they are very costly for society. Family interventions are effective in children but there are few reliably effective and inexpensive interventions for adolescents. Functional Family...

The Helping Families Programme is a psychoeducational parenting intervention that aims to improve outcomes and engagement for parents affected by clinically significant personality difficulties. This is achieved by working collaboratively with parents to explore ways in which their emotional and relational difficulties impact on parenting and child...

Background Bullying and cyberbullying are common phenomena in schools. These negative behaviours can have a significant impact on the health and particularly mental health of those involved in such behaviours, both as victims and as bullies. This UK study aims to investigate student-level and school-level characteristics of those who become involve...

Background: Parenting programs aim to reduce children's conduct problems through improvement of family dynamics. To date, research on the precise benefits and possible harms of parenting programs on family well-being has been unsystematic and likely to be subject to selective outcome reporting and publication bias. Better understanding of program...

Background: Parenting programs aim to reduce children’s conduct problems through improvement of family dynamics. To date, research on the precise benefits and possible harms of parenting programs on family well-being has been unsystematic and likely to be subject to selective outcome reporting and publication bias. Better understanding of program b...

Background Systematic reviews suggest that multi-component interventions are effective in reducing bullying victimisation and perpetration. We are undertaking a phase III randomised trial of the INCLUSIVE multi-component intervention. This trial aims to assess the effectiveness and cost-effectiveness of the INCLUSIVE intervention in reducing aggres...

The link with depression, anxiety and other emotional problems is clear, although smaller than that found for disruptive outcomes. There is also a connection between parenting and quality of a child's peer relationships, mediated by social cognitions and behavioural strategies learned from interacting with parents. Programmes based on social learni...

Multi-dimensional Treatment Foster Care (MTFC), recently renamed Treatment Foster Care Oregon for Adolescents (TFCO-A) is an internationally recognised intervention for troubled young people in public care. This paper seeks to explain conflicting results with MTFC by testing the hypotheses that it benefits antisocial young people more than others a...

Background: The biological basis of severe antisocial behaviour in adolescents is poorly understood. We recently reported that adolescents with conduct disorder (CD) have significantly increased fractional anisotropy (FA) of the uncinate fasciculus (a white matter (WM) tract that connects the amygdala to the frontal lobe) compared to their non-CD...

(SAV)

Children and adolescents with callous-unemotional (CU) traits have been distinguished as a subset of individuals with disruptive behavioral disorders who may be less sensitive to parenting influence; we test this hypothesis using multiple methods and assessment paradigms. Two hundred seventy-one adolescents (mean age = 12.6 years) from 3 samples at...

Background Bullying and cyberbullying are common phenomena in schools and can have a significant impact on the health and mental health of those involved in such behaviours, both as victims and as bullies. This study aims to investigate student-level and school-level characteristics of those who become involved in bullying and cyberbullying behavio...

The article by Ng and Weisz () on how to build a science of personalized intervention for youth mental health is ambitious and wide-ranging, being packed with penetrating analyses and imaginative proposals that set the agenda for psychotherapeutic research for years to come. It is driven by the desire to make therapy more effective, and underpinned...

Oppositional defiant and conduct disorders refer to persistent antisocial and aggressive behavior that is outside socially acceptable norms. Considerable advances have been made in recent years in understanding different subtypes and their trajectories over the lifespan. The early onset persistent group do particularly poorly and are characterised...

Children who cannot be looked after by their parents or close relatives often end up being cared for by state-run organizations. In many parts of the world, orphaned young infants are put into institutions that lack good quality intimate social relationships and cognitive stimulation. The effects on physical, neurobiological, cognitive and social d...

The prevalence, harms and costs of aggressive behaviours, such as bullying and violence, among young people make addressing them a public health priority.(1-4) The World Health Organization considers bullying to be a major adolescent health problem, defining it as the intentional and repetitive use of physical or psychological force against another...

There are many theories as to what form good-quality parenting should take. Attachment theory emphasises providing a secure base through sensitive responding at times of emotional need. Social learning theory outlines the need for firm limits in addition to the promotion of positive interchanges. These theories are supported by numerous quantitativ...

Parenting programs are the most widely proven intervention for children's behavior and attachment problems. They are based on an ever-increasing understanding of how different styles of parenting affect children with different characteristics. The degree of skill with which therapists deliver programs has a substantial impact on effectiveness, so t...

The review by Klahr and Burt (this issue) is very welcome as it covers a condition that is the commonest in child and adolescent mental health, but one that is usually met with woefully inadequate availability of interventions despite an excellent evidence base of effective treatments. Antisocial behaviour in childhood is much researched in terms o...

Systematic reviews suggest that interventions that address school organisation are effective in reducing victimisation and bullying. We successfully piloted a school environment intervention modified from international studies to incorporate 'restorative justice' approaches. This trial aims to establish the effectiveness and cost-effectiveness of t...

Systematic reviews suggest that interventions that address school organisation are effective in reducing victimisation and bullying. We successfully piloted a school environment intervention modified from international studies to incorporate 'restorative justice' approaches. This trial aims to establish the effectiveness and cost-effectiveness of t...

Group care for children and adolescents is widely used as a rearing environment and sometimes used as a setting in which intensive services can be provided. This consensus statement on group care affirms that children and adolescents have the need and right to grow up in a family with at least 1 committed, stable, and loving adult caregiver. In pri...

Objective: Antisocial personality is a common adult problem that imposes a major public health burden, but for which there is no effective treatment. Affected individuals exhibit persistent antisocial behavior and pervasive antisocial character traits, such as irritability, manipulativeness, and lack of remorse. Prevention of antisocial personalit...

Children in care often have poor outcomes. There is a lack of evaluative research into intervention options. To examine the efficacy of Multidimensional Treatment Foster Care for Adolescents (MTFC-A) compared with usual care for young people at risk in foster care in England. A two-arm single (assessor) blinded randomised controlled trial (RCT) emb...

Conceptually and methodologically distinct models exist for assessing quality of parent-child relationships, but few studies contrast competing models or assess their overlap in predicting developmental outcomes. Using observational methodology, the current study examined the distinctiveness of attachment theory-based and social learning theory-bas...

Children who were maltreated and enter foster care are at risk for maladjustment and relationship disturbances with foster carers. A popular hypothesis is that prior attachment relationships with abusive birth parents are internalized and carried forward to impair the child's subsequent attachment relationships. However, the empirical base for this...

We previously hypothesised that the early development of psychopathy is associated with a failure to attend to the eyes of attachment figures, and we have presented preliminary data from a parent-child 'love' scenario in support of this. Here, we confirm the association in a larger sample and test mechanisms of impaired eye contact during expressio...