Cognitive Behavioural Therapy (CBT) is an underutilized evidence-based treatment for Anxiety Disorders. Increasing effective knowledge translation and implementation of CBT has significant public health implications. This study sought to increase the use of CBT by providing a 20-week-group-supervision program to Northern Ontario. Therapist measures of CBT knowledge competence were collected pre and post training, and treatment outcome measures were obtained by child and parent report. Clients in Northern Ontario were older (M=11.6years, Toronto M=10.0 years), were more likely on medication, and more likely to have a comorbid diagnosis than clients from an existing data-set in Toronto, Ontario. The training program was successful in increasing CBT knowledge competence and decreasing client anxiety in both locations, with greater improvements in self-reported anxiety in the Northern Ontario group. Therapist CBT knowledge competence was predictive of client symptom change as reported by parent but not child. Two therapist variables were found to be moderators.

Cognitive Behavioural Therapy (CBT) is an underutilized evidence-based treatment for Anxiety Disorders. Increasing effective knowledge translation and implementation of CBT has significant public health implications. This study sought to increase the use of CBT by providing a 20-week-group-supervision program to Northern Ontario. Therapist measures of CBT knowledge competence were collected pre and post training, and treatment outcome measures were obtained by child and parent report. Clients in Northern Ontario were older (M=11.6years, Toronto M=10.0 years), were more likely on medication, and more likely to have a comorbid diagnosis than clients from an existing data-set in Toronto, Ontario. The training program was successful in increasing CBT knowledge competence and decreasing client anxiety in both locations, with greater improvements in self-reported anxiety in the Northern Ontario group. Therapist CBT knowledge competence was predictive of client symptom change as reported by parent but not child. Two therapist variables were found to be moderators.

This study investigated the relationships among attachment styles, affect regulation, and outcome in a clinical sample receiving treatment for depression. Sixty-six clients completed questionnaire measures of adult attachment, dysfunctional attitudes, interpersonal problems, self-esteem, and depression. Clients’ levels of affect regulation were assessed with an observer-rated measure of affect regulation. The study’s purpose was to extend previous research by examining the relationship between adult attachment and affect regulation within a clinical context. Results indicated significant and positive associations between clients’ attachment security and their levels of affect regulation at early and late stages of psychotherapy. Late modulation of expression and arousal were found to mediate the relationship between pre-treatment attachment insecurity and outcome. Pre-treatment attachment avoidance, characterized by high discomfort with closeness, had a direct relationship with depressive symptoms not mediated by the cognitive-affective processes of affect regulation. Implications of present findings for the treatment of depression are discussed.

The present study involved an extension and evaluation of a mindfulness-based training program for families of adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD). MYmind: Mindfulness training for Youth with ADHD and their parents (Bogels et al., 2008) is an eight-week manualized treatment incorporating elements of mindfulness meditation, ADHD psychoeducation and cognitive behavioural therapy. MYmind focuses on helping families cultivate mindfulness through training in formal meditation practices and integrating this skill into the context of everyday life as a means of managing ADHD symptoms, stress, family relations and difficult emotions. A North American sample of 13 parents and 9 adolescents (ages 13-18) participated in MYmind; during the intervention, parents and adolescents attended separate groups that ran simultaneously. Using a time-series multiple baseline design, constructs of stress, distress from family conflict, ADHD symptomatology and meditation practice were measured via short questionnaires emailed daily to both parents and adolescents throughout baseline, treatment and six months of follow-up. For multiple baseline purposes, intervention was introduced in a time-lagged fashion. Results from parent and adolescent reports indicated reductions in parent and adolescent stress, parent and adolescent distress due to family conflict, and increased frequency and duration of meditation practice. Parent reports suggested a decrease in their adolescents’ inattention, hyperactivity and impulsivity symptoms after participating in MYmind, a reduction that was not confirmed by adolescent reports. Most treatment gains were maintained up to six-months following treatment completion. Meditation practice was significantly correlated with reduced stress levels for both groups. Both parents and adolescents reported high satisfaction with the MYmind program overall. Mindfulness training appears to hold considerable potential for improving the multiple difficulties experienced by adolescents with ADHD and their parents.

The gender normative hypothesis of relational aggression and psychopathology states that relational aggression is more detrimental to boys than it is to girls because relational aggression is more normative in girls. In the present study, this hypothesis was tested in a large sample of 6-to-18-year-old children and this hypothesis was also extended to the domain of age norms. Specifically, it was tested whether relational aggression would also be most detrimental outside of the age in which it is most normative. The results showed some evidence supporting the gender normative hypothesis. Specifically, it was found that relationally aggressive boys suffered more internalizing and externalizing problems than non-relationally aggressive boys did. Relationally aggressive girls, however, suffered only more externalizing problems than non-relationally aggressive girls did. Results did not support the age normative hypothesis. Implications of these findings and future directions are discussed.

The gender normative hypothesis of relational aggression and psychopathology states that relational aggression is more detrimental to boys than it is to girls because relational aggression is more normative in girls. In the present study, this hypothesis was tested in a large sample of 6-to-18-year-old children and this hypothesis was also extended to the domain of age norms. Specifically, it was tested whether relational aggression would also be most detrimental outside of the age in which it is most normative. The results showed some evidence supporting the gender normative hypothesis. Specifically, it was found that relationally aggressive boys suffered more internalizing and externalizing problems than non-relationally aggressive boys did. Relationally aggressive girls, however, suffered only more externalizing problems than non-relationally aggressive girls did. Results did not support the age normative hypothesis. Implications of these findings and future directions are discussed.

Personality, motives, and self-efficacy have all been recognized as factors contributing to relapse, and the interaction among these factors has been outlined in Witkiewitz and Marlatt’s contemporary relapse model. However, there is limited empirical research examining the mechanisms involved in this theory. This study aimed to better understand the relationship between personality risk, drinking motives, and confidence to resist drinking during high-risk situations among adults who have changed their drinking. Results indicate that prior to participants’ change in drinking, introversion/hopelessness was associated with coping motives and confidence in situations involving unpleasant emotions, anxiety sensitivity was associated with coping motives, and impulsivity was associated with conformity motives. Following participants’ change, two specific motives (i.e., coping and conformity) were found to moderate the association between two of the personality profiles (i.e., introversion/hopelessness and anxiety sensitivity) and confidence to resist drinking during specific high-risk situations (i.e., negative emotional and social pressure to use).

Semi-structured interviews with 29 probation officers were conducted about their experiences addressing youths’ criminogenic needs in accordance with the Risk-Need-Responsivity framework. Probation officers discussed barriers they face at the individual, organizational, and systemic level (‘environmental’ issues that transcend – but impact on – the individual youth). Results revealed that challenges probation officers faced included ambiguity with respect to their role addressing certain risk-need domains, waitlist for services, having to prioritize certain noncriminogenic needs, involving parents, and the prevalence of mental illness (particularly concurrent diagnoses). Probation officers also discussed systemic barriers that they felt were out of their control but significantly impacted youths’ risk. Results are discussed in terms of implications for theory, research, policy, and practice.

The overarching goal of this dissertation was to examine the self-perceptions of adolescents with ADHD with regard to their core ADHD symptoms and associated problem behaviors. Self-perceptions were examined in relation to awareness of problem behaviors (i.e., presence of a “positive illusory bias” or PIB), attributions, and stigma. Study 1 examined the PIB in relation to the ignorance of incompetence hypothesis in 74 13-to-18 year old adolescents [40 ADHD; 34 Typically-Developing Comparison (TD)]. Compared to TD adolescents, adolescents with ADHD underestimated their ADHD symptoms and associated oppositional, academic, and social problems relative to parent raters, indicating that they have a PIB. Nevertheless, they were cognizant of their patterns of academic achievement and social problems. The only area in which adolescents with ADHD demonstrated limited awareness of their difficulties was for oppositional behaviors. Within the ADHD sample, adolescents with external locus of causality attributions had a higher PIB for oppositional behaviors than adolescents with ADHD with internal locus of causality attributions. Using a cross-sectional design, Study 2 examined the PIB, attributions, and stigma perceptions in 66 14-to-18 year old adolescents (31 ADHD, 35 TD) and 107 9-to-12 year old children (65 ADHD, 42 TD); cognitive immaturity as a mechanism for the PIB and developmental differences in attribution patterns and stigmatization were the focus. Although both children and adolescents with ADHD demonstrated a PIB for their ADHD symptoms, the magnitude of the PIB was reduced in adolescence (particularly for hyperactivity-impulsivity). Both adolescents with and without ADHD showed a reduction in the PIB for inattentive symptoms relative to children. Participants with ADHD viewed their problem behaviors as more pervasive, uncontrollable, and stigmatizing than participants without ADHD, and adolescents viewed their behaviors as more pervasive, uncontrollable, and stigmatizing than children. The findings offered theoretical support to the cognitive immaturity mechanism for the PIB and to Harters(2012) model of normative development of self-representations. Associations were found between the PIB and attributions. Minimal support was obtained for the ignorance of incompetence hypothesis in most domains. Future research directions and clinical implications are discussed.

Personality, motives, and self-efficacy have all been recognized as factors contributing to relapse, and the interaction among these factors has been outlined in Witkiewitz and Marlatt’s contemporary relapse model. However, there is limited empirical research examining the mechanisms involved in this theory. This study aimed to better understand the relationship between personality risk, drinking motives, and confidence to resist drinking during high-risk situations among adults who have changed their drinking. Results indicate that prior to participants’ change in drinking, introversion/hopelessness was associated with coping motives and confidence in situations involving unpleasant emotions, anxiety sensitivity was associated with coping motives, and impulsivity was associated with conformity motives. Following participants’ change, two specific motives (i.e., coping and conformity) were found to moderate the association between two of the personality profiles (i.e., introversion/hopelessness and anxiety sensitivity) and confidence to resist drinking during specific high-risk situations (i.e., negative emotional and social pressure to use).