Zoe R Smith

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• PhD
• Assistant Professor at Loyola University Chicago

In this article, the authors highlight their experience in navigating outdated, inequitable policies at institutions and in advocating for changes that support health equity research with a focus on participant compensation. As two new assistant professors establishing their programs of health equity research, they call on colleagues to examine the...

Objective (1) Evaluate current knowledge and identify key directions in the study of sluggish cognitive tempo (SCT) and (2) arrive at a consensus change in terminology for the construct that reflects the current science and may be more acceptable to researchers, clinicians, caregivers, and patients. Method Convened an international Work Group that...

Sluggish cognitive tempo (SCT) is characterized by behavioral symptoms reflecting slowness and lethargy (e.g., sluggishness, appearing sleepy) and inconsistent alertness/mental confusion (e.g., daydreaming, fogginess). SCT is substantially correlated with the inattentive symptoms of attention-deficit/hyperactivity disorder (ADHD) and may be part of...

Preeminent theories of attention-deficit/hyperactivity disorder (ADHD) suggest that motivation deficits are core underlying features of the disorder. However, it is currently unclear whether empirical evidence supports the assertion that significant group (ADHD v. comparison) differences in motivation exist or that problems with motivation contribu...

Youth with spina bifida (SB) are at increased risk for inattention and executive dysfunction challenges. This study aimed to characterize the development of inattention and executive dysfunction in SB and examine the relationship between condition severity (i.e. lesion level, shunt status, and shunt revisions) and inattention and executive dysfunct...

Objective: Very few studies have investigated intervention approaches that may be efficacious for youth with ADHD and co-occurring cognitive disengagement syndrome (CDS) symptoms. This study examined the feasibility, acceptability, and preliminary efficacy of a mindfulness-based intervention for adolescents with ADHD and co-occurring CDS symptoms....

Objective Benefit-finding and growth is an important process across a range of medical populations. However, it has been understudied in the context of lifelong chronic conditions, such as spina bifida (SB). This study aimed to develop a new measure of benefit-finding and growth for youth with SB, confirm its factor structure, and examine its psych...

Purpose This study examined preliminary psychometrics of the Adolescent/Young Adult Self‐Management and Independence Self‐Report Scale (AMIS II SR). Methods Adolescents and adults ( N = 159; 13–38 years old) with spina bifida from two clinics and one community sample completed the AMIS II SR. The majority (83%) had myelomeningocele, and about half...

Objective This study aims to characterize the growth in condition-related knowledge in youth with spina bifida (SB), identify neurocognitive predictors of growth, and examine associations between growth in knowledge and subsequent levels of medical self-management skills. Methods Participants were recruited from a larger longitudinal study involvi...

Fasting and negative urgency (the disposition to act rashly when distressed) are risk factors for binge eating. It may be that each influences the other over time to predict binge eating. Objective: This study tested whether (1) fasting predicts binge eating through negative urgency, and (2) negative urgency predicts binge eating through fasting. M...

Cognitive disengagement syndrome (CDS), previously referred to as sluggish cognitive tempo, is a set of symptoms characterized by excessive daydreaming, mental fogginess, and slowed behavior/thinking. Studies examining the association between CDS and academic functioning have reported mixed findings and have relied upon limited measures of CDS, bro...

A growing body of research demonstrates that school climate is associated with adolescent mental health. Much of the extant literature have focused on identifying risk factors for adverse mental health outcomes, whereas much less work has been done examining factors that are important to foster adolescents’ strengths and thereby increase the likeli...

Objective: Cognitive disengagement syndrome (CDS; formally known as sluggish cognitive tempo), difficulties with social engagement, and lower levels of autonomy have been identified as maladaptive comorbidities in youth with spina bifida (SB). This study compared growth curves of CDS for youth with and without SB and examined whether these traject...

Background This longitudinal study examined growth trajectories of academic motivation in youth with and without attention‐deficit/hyperactivity disorder (ADHD) across the important developmental transition from middle school to high school, and associations with academic success. Consistent with self‐determination theory (SDT) of motivation, traje...

The current study seeks to understand the potential benefits of culturally matched cross-age peer mentoring for Black and Latinx adolescent mentors residing in low-income, urban communities. Data for the study were derived from a 4-year longitudinal project examining the effectiveness of community-based cross-age mentoring. Data from the current sa...

Objective This study examined marital satisfaction among parents of youth with spina bifida (SB) over an 8-year period and investigated the usefulness of the double ABCX model for understanding factors that predict change in marital satisfaction across child age. Methods Data from five time points of a longitudinal investigation of psychosocial ou...

This study explored the experiences of Head Start parents becoming involved in their pre-school age children’s individualized education program (IEP) process. Seven participants from the rural Midwest engaged in focus group ( N = 2) or interview ( N = 1) format discussions regarding barriers to involvement in the IEP process and recommendations to...

As sluggish cognitive tempo (SCT) shows similar inattention and neuropsychological dysfunction as youth with spina bifida (SB), it is important to examine whether neuropsychological functioning may affect the development of SCT in this population. Participants were 140 youth with SB and their parents who participated in five waves of a longitudinal...

Objective: This study examined the transition to adult health care for individuals with spina bifida (SB) and explored demographic and relational associations with transition status. Method: Young adults with SB (18-30; n = 326) were recruited to complete an anonymous, online survey. Frequencies of reported experiences, behaviors, and satisfacti...

Objective This study examined bidirectional associations between mother- and father-reported medical responsibility and medical skill mastery in youth with spina bifida (SB). Methods Participants were 140 youth with SB and their parents who participated in three waves of a longitudinal study across four years (ages 8–15 years at Time 1). Mother- a...

Background Suicide is one of the leading mental health crises and takes one life every 40 seconds. Four out of every five suicides occur in low- and middle-income countries. Despite religion being a protective factor against suicide, the estimated number of suicides is rapidly increasing in Pakistan. Aims Our review focuses on the trends of suicid...

Objective: The primary goal of this study was to examine the factor structure of a spina bifida (SB) medical responsibilities measure and a medical regimen skills scale across time in families of youth with SB. Method: One-hundred and forty youth with SB and their parents were assessed in both childhood/adolescence and adolescence/young adulthoo...

Objective To examine the predictive role of social skills in youth with spina bifida (SB) on growth in medical responsibility across development. Methods As part of a larger, longitudinal study, 140 youth with SB were assessed across four time points (ages 8–22 across time points). Mixed-effects models were investigated for change with: (a) no p...

Adolescents with attention-deficit/hyperactivity disorder (ADHD) are at high risk for tobacco use, but tobacco use prevention strategies are not regularly incorporated into evidence-based ADHD interventions. We conducted a pilot randomized-controlled trial to determine the feasibility of integrating tobacco use prevention skills into a behavioral t...

Objective: Examine individual factors associated with peer victimization (PV) in adolescents with attention-deficit/hyperactivity disorder (ADHD) and to examine the association between PV and educational outcomes. Method: Participants were 121 adolescents (Mage = 13.62, SD = 1.03; 89% boys) with diagnosed ADHD. Using path analysis, we tested whethe...

A growing number of studies support the internal and external validity of youth self-reported sluggish cognitive tempo (SCT) symptoms. However, no study has examined SCT in adolescents without ADHD, examined whether adolescent self-reported SCT is distinct from adolescent self-reported ADHD inattention (ADHD-IN), or evaluated whether links between...

The present study evaluates differences in self-reported intrinsic and extrinsic academic motivation and amotivation between eighth-grade adolescents with (n = 162) and without (n = 140) ADHD. This study also examines associations between motivation and academic functioning with objective (i.e., grade point average, standardized reading and math sc...

Background: Sluggish cognitive tempo (SCT) is a construct that includes symptoms of slowness, excessive daydreaming, and drowsiness. SCT is often comorbid with attention-deficit/hyperactivity disorder (ADHD), and SCT symptoms are associated with significant academic impairment above the influence of ADHD. Despite the overlap between ADHD and SCT a...

Background Prior studies examining the sleep of adolescents with and without attention‐deficit/hyperactivity disorder (ADHD) have relied on mean values such as average sleep duration, which masks intraindividual variability (IIV). The objective was to investigate whether adolescents with ADHD have greater IIV of sleep/wake patterns than adolescents...

Objectives: This study used a multi-informant approach to examine differences in types and rates of technology used by adolescents with and without attention-deficit/hyperactivity disorder (ADHD), associations between technology use and sleep/daytime sleepiness, and whether technology use was differentially related to sleep/daytime sleepiness in a...

The goal of the present study was to evaluate the relative importance of adolescent and parent skills acquired during participation in the Homework, Organization, and Planning Skills (HOPS) intervention in predicting intervention response. A sample of 111 middle school students with attention-deficit/hyperactivity disorder (66% male; Mage = 11.99,...

Sluggish cognitive tempo (SCT) consists of symptoms of slowness, sluggishness, daydreaming, and low motivation. SCT has been linked to attention-deficit/hyperactivity disorder (ADHD), internalizing symptoms, and daytime sleepiness. Although there is clear evidence that SCT and ADHD symptoms are distinct constructs, the distinction between SCT, anxi...

In the present study, we sought to examine response trajectories to brief (11-week) school-based homework interventions and factors that may help schools predict responses. Participants included 222 middle-school students (72% boys; M _age = 12.00 years, SD = 1.02) who had been diagnosed with attention-deficit/hyperactivity disorder (ADHD...

Deficits in organization, time management, and planning (OTMP) abilities are common in adolescents with attention-deficit/hyperactivity disorder (ADHD) and contribute to impairment. Assessment of these skills is vital, but few measures have been validated for youth with ADHD. The Rey-Osterrieth Complex Figure (ROCF) task is frequently used in resea...

Objective: To evaluate the importance of therapeutic processes in two brief school-based psychosocial treatments targeting homework problems in adolescents with attention-deficit/hyperactivity disorder (ADHD) as delivered by school mental health professionals. Method: A sample of 222 middle school students (72% male; Mage = 12.00 years, SD = 1.02)...

Objective: This study evaluated which Sluggish Cognitive Tempo (SCT) factors (i.e., Slow, Sleepy, Daydreamer) are most strongly associated with homework motivation, and whether homework motivation mediates the path between SCT and academic impairment. Method: Participants were 285 middle school students (boys 209) in Grades 6 to 8 (ages 10-15 years...

Parenting stress is common in families with an adolescent with attention-deficit/hyperactivity disorder (ADHD). The Stress Index for Parents of Adolescents (SIPA) was developed to assess parenting stress but has not been validated outside of the original development work. This study examined the factor structure and sources of convergent validity o...

Objective: To evaluate the effectiveness of 2 brief school-based interventions targeting the homework problems of adolescents with attention-deficit/hyperactivity disorder (ADHD)-the Homework, Organization, and Planning Skills (HOPS) intervention and the Completing Homework by Improving Efficiency and Focus (CHIEF) intervention, as implemented by...

Adolescents with Sluggish Cognitive Tempo (SCT) exhibit symptoms of slowness, mental confusion, excessive daydreaming, low motivation, and drowsiness/sleepiness. Although many symptoms of SCT reflect internalizing states, no study has evaluated the clinical utility of self-report of SCT in an attention-deficit/hyperactivity disorder (ADHD) sample....

Many students with attention-deficit/hyperactivity disorder (ADHD) exhibit deficits in motivation to pursue long-term goals. Students with ADHD have particular difficulty with motivation to complete homework-related tasks and often fail to complete assignments. Although these problems are common and may impact academic performance, no homework-moti...

Children and adolescents with ADHD often have difficulties with organization, time management, and planning skills, and these skills are a common target of intervention. A limited array of tools for measuring these abilities in youth is available, and one of the most prominent measures is the Children’s Organizational Skills Scale (COSS). Although...

The primary goals of this study were to evaluate the dimensionality of the Penny et al. Sluggish Cognitive Tempo Scale and to compare model fits for parent- and youth self-report versions. Participants were 262 young adolescents (ages 10-15) comprehensively diagnosed with attention-deficit/hyperactivity disorder. Both confirmatory factor analysis (...

The primary goal of this study was to longitudinally evaluate the homework assignment completion patterns of middle school age adolescents with ADHD, their associations with academic performance, and malleable predictors of homework assignment completion. Analyses were conducted on a sample of 104 middle school students comprehensively diagnosed wi...

Objective: The primary aim of this study was to evaluate longitudinal pathways to impairment as outlined in the cognitive-behavioral model of ADHD in a sample of 59 college students diagnosed with ADHD. Method: Serial mediation models were used to test whether underachievement, defined as prior year GPA, would longitudinally predict self-reported i...

Sleep restriction (SR) impairs adolescents' attention, which could contribute to high rates of driving crashes. Here, we examine the impact of experimental SR on adolescent drivers, considering whether that impact is moderated by the nature of the drive (urban/suburban vs. rural) or how vulnerable each adolescent is to attentional decline after SR....