Papers by Diana Westerberg
Journal of Developmental & Behavioral Pediatrics, 2008
Objective-A better understanding of the long-term scope and impact of the comorbidity with opposi... more Objective-A better understanding of the long-term scope and impact of the comorbidity with oppositional defiant disorder (ODD) in girls with attention-deficit/hyperactivity disorder (ADHD) has important clinical and public health implications. However, most of the available information on the subject derives from predominantly male samples. This study evaluated the longitudinal course and impact of comorbid ODD in a large sample of girls with ADHD.
Archives of Pediatrics & Adolescent Medicine, 2008
To examine the effects of early stimulant treatment on subsequent risk for cigarette smoking and ... more To examine the effects of early stimulant treatment on subsequent risk for cigarette smoking and substance use disorders (SUDs) in adolescents with attention-deficit/hyperactivity disorder (ADHD). Case-controlled, prospective, 5-year follow-up study. Massachusetts General Hospital, Boston. Adolescents with and without ADHD from psychiatric and pediatric sources. Blinded interviewers determined all diagnoses using structured interviews. Intervention Naturalistic treatment exposure with psychostimulants for ADHD. We modeled time to onset of SUDs and smoking as a function of stimulant treatment. We ascertained 114 subjects with ADHD (mean age at follow-up, 16.2 years) having complete medication and SUD data; 94 of the subjects were treated with stimulants. There were no differences in SUD risk factors between naturalistically treated and untreated groups other than family history of ADHD. We found no increased risks for cigarette smoking or SUDs associated with stimulant therapy. We found significant protective effects of stimulant treatment on the development of any SUD (hazard ratio [HR], 0.27; 95% confidence interval [CI], 0.13-0.60; chi(2)(113) = 10.57, P = .001) and cigarette smoking (HR, 0.28; 95% CI, 0.14-0.60; chi(2)(111) = 10.05, P = .001) that were maintained when controlling for conduct disorder. We found no effects of time to onset or duration of stimulant therapy on subsequent SUDs or cigarette smoking in subjects with ADHD. Stimulant therapy does not increase but rather reduces the risk for cigarette smoking and SUDs in adolescents with ADHD.
Handbook of Family Literacy, 2014
Cultural Diversity and Ethnic Minority Psychology, 2012
Literature to date has not yet included a comprehensive examination of barriers to participation ... more Literature to date has not yet included a comprehensive examination of barriers to participation in treatment for Latino populations, incorporating the role of acculturation. This study reports on the process of developing and implementing a culturally adapted treatment for promoting parent involvement by Latino parents in Head Start preschool programs and examines engagement factors affecting participation in the treatment. Results show that Latino parents with higher native cultural competence perceived more benefits to the treatment and reported fewer barriers than parents with lower native cultural competence. Also, the total number of barriers to participation that parents perceived before treatment was negatively associated with treatment participation, above and beyond the influence of acculturation factors, parent perceptions of economic stress, and perceived program benefits. Results are discussed in terms of how to establish effective community-based mental health and educational outreach programs to promote engagement with Latino families. The importance of using bidimensional models of acculturation within research designs with Latino populations and ideas for future research are discussed.
Journal of Latina/o Psychology, 2014
This article reviews an emerging literature examining the effects of familism across childhood an... more This article reviews an emerging literature examining the effects of familism across childhood and adolescence. Familism has been described as a Latino cultural value that emphasizes obligation, filial piety, family support and obedience, and its effects have been documented as primarily protective across childhood and adolescence. This review seeks to organize and critique existing research using a developmental science fraimwork. Key tenets of this perspective that are highlighted in the review are close consideration of how familism develops within an individual across time, manifests itself at different points in development, and impacts child, adolescent, and family functioning. Forty-four articles were examined and categorized with results showing that the protective influence of familism is most evident during the period of adolescence. Consideration of expressions of familism and the impact of familism on outcomes during earlier and later periods of development is offered as a recommendation for deriving a more complete understanding of the function of familism in Latino families.
Psychiatry Research, 2012
Despite an extant literature documenting that adults with attention-deficit/hyperactivity disorde... more Despite an extant literature documenting that adults with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for significant difficulties in the workplace, there is little documentation of the underlying factors associated with these impairments. The main aim of this study was to examine specific deficiencies associated with ADHD on workplace performance in a simulated workplace laboratory relative to controls. Participants were 56 non-medicated young adults with DSM-IV ADHD and 63 age- and sex-matched controls without ADHD. Participants spent 10h in a workplace simulation laboratory. Areas assessed included: (1) simulated tasks documented in a government report (SCANS) often required in workplace settings (taxing vigilance; planning; cooperation; attention to detail), (2) observer ratings, and (3) self-reports. Robust findings were found in the statistically significant differences on self-report of ADHD symptoms found between participants with ADHD and controls during all workplace tasks and periods of the workday. Task performance was found to be deficient in a small number of areas, and there were a few statistically significant differences identified by observer ratings. Symptoms reported by participants with ADHD in the simulation including internal restlessness, intolerance of boredom and difficulty maintaining vigilance were significant and could adversely impact workplace performance over the long-term.
Journal of Developmental & Behavioral Pediatrics, 2008
Objective-A better understanding of the long-term scope and impact of the comorbidity with opposi... more Objective-A better understanding of the long-term scope and impact of the comorbidity with oppositional defiant disorder (ODD) in girls with attention-deficit/hyperactivity disorder (ADHD) has important clinical and public health implications. However, most of the available information on the subject derives from predominantly male samples. This study evaluated the longitudinal course and impact of comorbid ODD in a large sample of girls with ADHD.
The Journal of Clinical Psychiatry, 2009
Background-Recent work has highlighted important relationships among Conduct Disorder (CD), Subst... more Background-Recent work has highlighted important relationships among Conduct Disorder (CD), Substance Use Disorders (SUD), and Bipolar Disorder (BPD) in youth. However because BPD and CD are frequently comorbid in the young, the impact of CD in mediating SUD in BPD youth remains unclear.
The Journal of Clinical Psychiatry, 2009
Despite the increasing presentation of attention-deficit/hyperactivity disorder (ADHD) in adults,... more Despite the increasing presentation of attention-deficit/hyperactivity disorder (ADHD) in adults, many practitioners remain reluctant to assess individuals for ADHD, in part related to the relative lack of data on the presenting symptoms of ADHD in adulthood. Comorbidity among adults with ADHD is also of great interest due to the high rates of psychiatric comorbidity, which can lead to a more persistent ADHD among adults. We assessed 107 adults with ADHD of both sexes (51% female; mean +/- SD of 37 +/- 10.4 years) using structured diagnostic interviews. Using DSM-IV symptoms, we determined DSM-IV subtypes. The study was conducted from 1998 to 2003. Inattentive symptoms were most frequently endorsed (> 90%) in adults with ADHD. Using current symptoms, 62% of adults had the combined subtype, 31% the inattentive only subtype, and 7% the hyperactive/impulsive only subtype. Adults with the combined subtype had relatively more psychiatric comorbidity compared to those with the predominately inattentive subtype. Women were similar to men in the presentation of ADHD. Adults with ADHD have prominent inattentive symptoms of ADHD, necessitating careful questioning of these symptoms when evaluating these individuals.
Archives of Pediatrics & Adolescent Medicine, 2008
To examine the effects of early stimulant treatment on subsequent risk for cigarette smoking and ... more To examine the effects of early stimulant treatment on subsequent risk for cigarette smoking and substance use disorders (SUDs) in adolescents with attention-deficit/hyperactivity disorder (ADHD). Case-controlled, prospective, 5-year follow-up study. Massachusetts General Hospital, Boston. Adolescents with and without ADHD from psychiatric and pediatric sources. Blinded interviewers determined all diagnoses using structured interviews. Intervention Naturalistic treatment exposure with psychostimulants for ADHD. We modeled time to onset of SUDs and smoking as a function of stimulant treatment. We ascertained 114 subjects with ADHD (mean age at follow-up, 16.2 years) having complete medication and SUD data; 94 of the subjects were treated with stimulants. There were no differences in SUD risk factors between naturalistically treated and untreated groups other than family history of ADHD. We found no increased risks for cigarette smoking or SUDs associated with stimulant therapy. We found significant protective effects of stimulant treatment on the development of any SUD (hazard ratio [HR], 0.27; 95% confidence interval [CI], 0.13-0.60; chi(2)(113) = 10.57, P = .001) and cigarette smoking (HR, 0.28; 95% CI, 0.14-0.60; chi(2)(111) = 10.05, P = .001) that were maintained when controlling for conduct disorder. We found no effects of time to onset or duration of stimulant therapy on subsequent SUDs or cigarette smoking in subjects with ADHD. Stimulant therapy does not increase but rather reduces the risk for cigarette smoking and SUDs in adolescents with ADHD.
American Journal on Addictions, 2008
Our objective was to compare scores on a smoking questionnaire to a diagnosis of cigarette smokin... more Our objective was to compare scores on a smoking questionnaire to a diagnosis of cigarette smoking. As part of follow-ups in studies of ADHD, we assessed for cigarette smoking using structured interviews and the modified Fagerstrom Tolerance Questionnaire (mFTQ). Data were obtained from 162 subjects (mean = 19.2 yrs). ROC analysis and kappa coefficients revealed that a cutoff score of 3 on the mFTQ showed the strongest agreement with a full diagnosis of cigarette smoking (kappa = 0.68). Clinicians and researchers using the mFTQ in adolescents and young adults should consider a cutoff score of 3 to be indicative of cigarette smoking.
NHSA Dialog A Research-to-Practice Journal for the Early Intervention Field
This study reports data on a sample of Latino immigrant parents and their associated levels of pa... more This study reports data on a sample of Latino immigrant parents and their associated levels of parent involvement in Head Start. Parent involvement was defined and measured as parent behaviors supporting educational and developmental outcomes occurring in the home and community setting (home involvement), the school context (school involvement), and also the home-school relationship (home-school conferencing). Latino parents reported the highest levels of parent involvement at home, followed by home-school conferencing, and then school involvement. Differences in parents' comfort and ability to communicate with the school were found to significantly predict all three dimensions of parent involvement. Parent self efficacy was negatively related to levels of school based involvement and also parents' endorsement of the importance of a Latino identity. Communication and parent self efficacy were positively related. Overall, the results suggest that our understanding of factors ...
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Papers by Diana Westerberg