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Background: Screen media activity (SMA) can negatively affect youth behavioral health. Sleep may mediate this association but has not been previously explored. We examined whether sleep mediated the association between SMA and youth behavioral health among a community sample. Method: Parents completed questions about their child (N = 564) ages 3–17 at Wave 1, Wave 2 (4–8 months later), and Wave 3 (12 months later). Path analyses were conducted to examine links between Wave 1 SMA and Wave 3 behavioral health problems (i.e., internalizing, externalizing, attention, peer problems) through Wave 2 sleep disturbance and duration. Results: SMA was significantly associated with greater sleep disturbance, β =.11, 95% CI [.01,.21] and shorter sleep duration, β = −.16 [−.25, −.06], and greater sleep disturbance was associated with worse youth behavioral health across internalizing, β =.14 [.04,.24], externalizing, B =.23 [.12,.33], attention, β =.24 [.15,.34], and peer problems, β =.25 [.15,.35]. Longer sleep duration was associated with more externalizing, β =.13 [.04,.21], and attention problems, β =.12 [.02,.22], and fewer peer problems, β = −.09 [−.17, −.01], but not with internalizing problems. Lastly, there was a direct effect of SMA on peer problems, β = −.15 [−.23, −.06] such that higher SMA that does not impact sleep may have a positive impact on reducing peer problems. Conclusions: Sleep (i.e., disturbances and shorter duration) may partially account for the small associations observed between SMA and worse behavioral health in youth. To continue expanding our understanding, future research should utilize more diverse representative samples, use objective measures of SMA and sleep, and examine other relevant aspects of SMA, including content, device type, and timing of use. [ABSTRACT FROM AUTHOR]

Exposure to early life adversity (ELA) is associated with increased externalizing symptoms (e.g., aggression and oppositionality), internalizing symptoms (e.g., withdrawal and anxiety), and biological indicators of accelerated aging (e.g., telomere length) in childhood. However, little is known about how distinct dimensions of ELA, such as threat and deprivation, impact youth psychobiological outcomes. The present study includes data from the Future of Families and Child Wellbeing Study (FFCWS), a large population-based, birth cohort study of majority (approximately 75%) racial and ethnic minority youth born between 1998 and 2000 across 20 large cities in the United States. The present study includes a subset of the original sample (N = 2,483, 51.6% male) who provided genetic data at age 9. First, confirmatory factor analyses were conducted, which revealed four distinct dimensions of ELA (home threat, community threat, neglect, and lack of stimulation) when children were age 3. Second, latent profile analyses identified an eight-profile solution based on unique patterns of the four ELA dimensions. Lastly, latent profiles were used to predict associations with child psychological and biological outcomes at age 9. Results suggest that exposure to specific combinations of ELA is differentially associated with internalizing and externalizing behaviors in childhood, but not with telomere length. Findings have implications for personalized early intervention and prevention efforts aimed at reducing ELA exposure to protect against downstream negative mental health outcomes for diverse youth. [ABSTRACT FROM AUTHOR]

This study examined the cost-effectiveness of standard parent–child interaction therapy (PCIT) and three adaptations: intensive-PCIT (I-PCIT), small group PCIT, and large group PCIT. This study used cost-effectiveness analyses to calculate average cost-effectiveness ratios, which represents the average cost for one family to change one standard deviation on each outcome measure: externalizing behavior problems, positive parenting skills, negative parenting skills, child compliance, and parenting stress. While it had the lowest initial set up cost, results indicated that standard PCIT was the least cost-effective option in reducing child disruptive behaviors and in increasing child compliance. Large group PCIT was the most cost-effective in increasing positive parenting skills and child compliance and in reducing negative parenting skills and parenting stress. I-PCIT was the most cost-effective in reducing child disruptive behaviors and the second most cost-effective option in increasing positive parenting skills and child compliance and in decreasing negative parenting. As large group and I-PCIT were the most cost-effective in different domains, both could be recommended to parents as treatment options. Future research should confirm our cost-effective results within community settings. [ABSTRACT FROM AUTHOR]

Objective: The current study examined the comparative efficacy of a more intensive version of Parent-Child Interaction Therapy (I-PCIT; 5 days/week over 2 weeks) versus a time-limited weekly PCIT format (1 day/week over 10 weeks) in treating early childhood externalizing behavior problems. Method: Using a randomized trial design, 60 young children (mean age [Mage] = 4.33 years; 65% male; 85% Latinx) with clinically elevated levels of externalizing behavior problems and their parents were assigned to either I-PCIT (n = 30) or time-limited PCIT (n = 30). Families completed pre-, post-, and follow-up assessments 6–9 months following treatment completion. Parents completed measures of child behavior, discipline practices, and parenting stress. Observational data on child behavior and parenting were also collected. Results: Noninferiority and multivariate repeated-measures analyses indicated comparable improvements across 6 out of 7 observed and parent-reported outcomes, including parenting skills, discipline practices, and child externalizing behavior problems at posttreatment. Comparable treatment gains remained at follow-up, with the caveat that parents in time-limited PCIT reported lower externalizing behavior problems compared with I-PCIT, although both groups were still significantly better compared with pretreatment. Lastly, moderation analyses indicated that parents experiencing high levels of stress benefited more from I-PCIT in terms of decreasing child externalizing behavior compared with time-limited PCIT. Conclusions: I-PCIT appears to be a viable treatment option for families, especially those experiencing high levels of stress, in terms of targeting early externalizing behavior problems within a short period of time. What is the public health significance of this article?: This study provides evidence that a well-established early intervention program like Parent-Child Interaction Therapy (PCIT) can be delivered in a briefer, more intensive package (I-PCIT) with comparable benefits to time-limited PCIT. Parents with high levels of stress may particularly benefit from I-PCIT. [ABSTRACT FROM AUTHOR]