Department of Psychology
Permanent URI for this collection
Browse
Recent Submissions
Item Embargo Executive functions and behavioral economic demand for cannabis among young adults: Indirect associations with cannabis consumption and cannabis use disorder(American Psychological Association, 2024) Coelho, Sophie; Hendershot, Christian; Ashton, Elizabeth; Ruocco, Anthony; Quilty, Lena C.; Tyndale, Rachel; Wardell, JeffreyBehavioral economic demand for cannabis is robustly associated with cannabis consumption and cannabis use disorder (CUD). However, few studies have examined the processes underlying individual differences in the relative valuation of cannabis (i.e., demand). This study examined associations between executive functions and cannabis demand among young adults who use cannabis. We also examined indirect associations of executive functions with cannabis consumption and CUD symptoms through cannabis demand. Young adults (N = 113; 58.4% female; mean age 22 years) completed a Marijuana Purchase Task. Participants also completed cognitive tasks assessing executive functions (set shifting, inhibitory control, working memory) and semistructured interviews assessing past 90-day cannabis consumption (number of grams used) and number of CUD symptoms. Poorer inhibitory control was significantly associated with greater Omax (peak expenditure on cannabis) and greater intensity (cannabis consumption at zero cost). Poorer working memory was significantly associated with lower elasticity (sensitivity of consumption to escalating cost). Lower inhibitory control was indirectly associated with greater cannabis consumption and CUD symptoms through greater Omax and intensity, and poorer working memory was indirectly associated with greater cannabis consumption and CUD symptoms through reduced elasticity. This study provides novel evidence that executive functions are associated with individual differences in cannabis demand. Moreover, these results suggest that cannabis demand could be a mechanism linking poorer executive functioning with heavier cannabis use and CUD, which should be confirmed in future longitudinal studies. Impact Statement This study found that young adults who performed more poorly on cognitive tasks assessing working memory and inhibitory control had higher behavioral economic demand for cannabis. Further, poorer cognitive performance was indirectly associated with increased cannabis consumption and symptoms of cannabis use disorder through greater cannabis demand. Results suggest that cannabis demand may be an important mechanism linking certain cognitive deficits with cannabis use among young adults.Item Restricted Screening for cannabis use disorder among young adults: Sensitivity, specificity, and item-level performance of the Cannabis Use Disorders Identification Test – Revised(Elsevier Ltd., 2023-09-15) Coelho, Sophie; Hendershot, Christian; Quilty, Lena C.; Wardell, JeffreyThe Cannabis Use Disorders Identification Test Revised (CUDIT-R) is a widely used screening tool. However, its utility in screening for cannabis use disorder (CUD) among young adults requires further investigation. The current study evaluated the accuracy of the CUDIT-R in distinguishing between young adults with and without CUD. We also examined the individual item properties of the CUDIT-R in this sample. A community sample of young adults (N = 153, ages 19–26 years) who reported at least one lifetime period of regular cannabis use (i.e., twice or more per month for at least six months) completed the CUDIT-R and the Structured Clinical Interview for DSM-5 (SCID-5) Substance Use Module. The CUDIT-R showed good accuracy in distinguishing between young adults with and without CUD as determined by the SCID-5 (area under the receiver operating characteristic curve = 0.84). A cut-point of nine yielded 87.80 % sensitivity and 70.42 % specificity, with positive and negative predictive values of 77.42 % and 83.33 %, respectively. Item response theory analyses revealed that CUDIT-R items assessing impaired control, failure to meet expectations, time devoted to use, and memory and concentration problems displayed high discrimination and were relatively difficult, whereas items assessing frequency of use and attempts to reduce use showed moderate discrimination and relatively low difficulty. Items assessing hours high and use with potential for physical hazard displayed poor discrimination. The CUDIT-R appears to validly distinguish between young adults with and without CUD and may be useful in screening for CUD in this high-risk population. Further research considering individual item properties is needed to refine the CUDIT-R for use among young adults.Item Restricted Demographic, Mental Health, and Substance Use Correlates of Self-Described Medicinal Use, Recreational Use, and Non-Use of Hallucinogenic Drugs(2024-09-17) Coelho, Sophie; Kim, Hyoun; Keough, Matthew; Dawson, Samantha J.; Tabri, Nassim; Hodgins, David; Shead, N. Will; Wardell, JeffreyThere is growing public interest in the use of hallucinogens to manage mental health symptoms (i.e., medicinal hallucinogen use). Yet, limited research has examined the correlates of hallucinogen use for self-described medicinal purposes––an important gap given that self-medication may confer increased risk for harm. Accordingly, this study examined the demographic, mental health, and substance use correlates of medicinal hallucinogen use relative to no hallucinogen use and to exclusively recreational hallucinogen use. Adults reporting no hallucinogen use (n=4837), medicinal hallucinogen use (n=110), and exclusively recreational hallucinogen use (n=240) were recruited from within Canada via Prolific and from six Canadian universities. Participants completed an online questionnaire assessing demographic characteristics, mental health, hallucinogen use, and other substance use. Logistic regression analyses showed that greater depression severity; more frequent use of alcohol, cannabis, and nicotine; and using several illegal and prescription drugs were associated with an increased likelihood of medicinal hallucinogen use relative to no hallucinogen use. Greater depression severity was also associated with an increased likelihood of medicinal hallucinogen use relative to exclusively recreational hallucinogen use. Further, participants who used hallucinogens for medicinal reasons reported more frequent hallucinogen use relative to those who used hallucinogens for exclusively recreational reasons. Results suggest that poorer mental health and greater use of other substances differentiate people who use hallucinogens for medicinal reasons from people who do not use hallucinogens or who use hallucinogens for exclusively recreational reasons. Further, medicinal hallucinogen use, relative to exclusively recreational hallucinogen use, is associated with using hallucinogens more frequently. Findings may inform targeted prevention and harm reduction interventions for hallucinogen use.Item Restricted Descriptive norms for simultaneous cannabis and alcohol use predict simultaneous use patterns assessed via daily surveys(American Psychological Association, 2025-05) Coelho, Sophie; Hendershot, Christian; O'Connor, Roisin; Cunningham, John Alastair; Wardell, JeffreyObjective: Simultaneous cannabis and alcohol use is common, but few studies have examined normative perceptions of simultaneous use. This study examined unique associations of baseline descriptive norms for simultaneous use (i.e., perceptions about others’ simultaneous use) with simultaneous use behaviors assessed via daily surveys. Method: Young adults reporting frequent simultaneous use (N = 150) completed baseline measures of descriptive norms for the frequency of simultaneous use and the amounts of cannabis and alcohol consumed during typical simultaneous use occasions. Further, participants completed measures of descriptive norms for the frequency and quantity of cannabis and alcohol use in general (not limited to simultaneous use). Norms were assessed referencing both peer and friend groups. Following this assessment, participants completed 21 daily smartphone surveys assessing cannabis and alcohol use each day. Simultaneous use was operationalized as same-day use of cannabis and alcohol. Results: Multilevel models revealed that, controlling for descriptive norms for cannabis and alcohol use in general, perceiving more frequent simultaneous use among friends (but not peers) was significantly associated with a greater tendency to engage in simultaneous use relative to cannabis-only use across days. Further, perceiving heavier cannabis and alcohol consumption during simultaneous use occasions among friends (but not peers) was significantly associated with greater quantities of cannabis and alcohol consumed, respectively, across simultaneous use days. Conclusions: Descriptive norms for simultaneous use contribute uniquely to simultaneous use behavior, over and above norms for cannabis use and alcohol use in general. Findings may inform norms-based interventions for young adults who engage in simultaneous use. Impact Statement This study found that perceptions of others’ simultaneous alcohol and cannabis use behaviors predicted one’s own simultaneous use behaviors over and above perceptions of others’ broader alcohol and cannabis use behavior (i.e., not limited to simultaneous use). Specifically, perceptions of friends’ (but not peers’) frequency of simultaneous use and quantities of alcohol and cannabis consumed during simultaneous use occasions predicted one’s own frequency of simultaneous use and quantities of each substance consumed simultaneously, respectively. Results suggest that normative perceptions that are specific to simultaneous use contribute uniquely to simultaneous use patterns and should be examined in future research as potential targets of harm reduction interventions for simultaneous use among young adults.Item Open Access Knowledge of Cannabinoid Content Among People Living With HIV Who Use Cannabis: A Daily Diary Study(2023-10-04) Coelho, Sophie G.; Rueda, Sergio; Costiniuk, Cecilia T.; Jenabian, Mohammad-Ali; Margolese, Shari; Madarino, Enrico; Shuper, Paul A.; Hendershot, Christian; Cunningham, John A.; Arbess, Gordon; Singer, Joel; Wardell, Jeffrey D.Background: Many people living with HIV (PLWH) use cannabis for medicinal reasons. Patients’ knowledge of the tetrahydrocannabinol (THC) and cannabidiol (CBD) concentrations of the cannabis products they use may be important in helping patients achieve symptom relief while guarding against potential risks of cannabis use. However, no studies have examined cannabinoid concentration knowledge among PLWH. Methods: PLWH (N=29; 76% men, mean age 47 years) reporting cannabis use for both medicinal and nonmedicinal reasons completed daily surveys over 14 days assessing cannabis products used, knowledge of cannabinoid concentrations of cannabis products used, cannabis use motives (medicinal, nonmedicinal, both), and positive and negative cannabis-related consequences. Across the 361 cannabis use days captured on the daily surveys, at least some knowledge of cannabinoid concentrations was reported on an average of 43.1% (for THC) and 26.6% (for CBD) of the days. Results: Generalized linear mixed models revealed that participants were more likely to report knowing THC and CBD concentrations on days when they used non-flower forms of cannabis relative to days when they used cannabis flower only. Participants who used cannabis for medicinal reasons on a greater proportion of days had greater knowledge of cannabinoid concentration overall across days. Further, greater overall knowledge of cannabinoid concentrations was associated with fewer reported negative cannabis-related consequences. Conclusions: Findings suggest that PLWH’s knowledge of cannabinoid concentrations may be higher when using non-flower cannabis products and higher among those reporting primarily medicinal cannabis use. Moreover, knowledge of cannabinoid concentration may protect against negative cannabis-related consequences in this population.Item Open Access Altered white matter structure in auditory tracts following early monocular enucleation(Elsevier Inc., 2019-09-16) Wong, Nikita; Rafique, Sara; Moro, Stefania S.; Kelly, Krista; Steeves, Jennifer Kate EvelynPurpose: Similar to early blindness, monocular enucleation (the removal of one eye) early in life results in crossmodal behavioral and morphological adaptations. Previously it has been shown that partial visual deprivation from early monocular enucleation results in structural white matter changes throughout the visual system (Wong et al., 2018). The current study investigated structural white matter of the auditory system in adults who have undergone early monocular enucleation compared to binocular control participants. Methods: We reconstructed four auditory and audiovisual tracts of interest using probabilistic tractography and compared microstructural properties of these tracts to binocularly intact controls using standard diffusion indices. Results: Although both groups demonstrated asymmetries in indices in intrahemispheric tracts, monocular enucleation participants showed asymmetries opposite to control participants in the auditory and A1-V1 tracts. Monocular enucleation participants also demonstrated significantly lower fractional anisotropy in the audiovisual projections contralateral to the enucleated eye relative to control participants. Conclusions: Partial vision loss from early monocular enucleation results in altered structural connectivity that extends into the auditory system, beyond tracts primarily dedicated to vision.Item Open Access Overtone focusing in biphonic tuvan throat singing(eLife Sciences Publications, Ltd, 2020-02-17)Khoomei is a unique singing style originating from the republic of Tuva in central Asia. Singers produce two pitches simultaneously: a booming low-frequency rumble alongside a hovering high-pitched whistle-like tone. The biomechanics of this biphonation are not well-understood. Here, we use sound analysis, dynamic magnetic resonance imaging, and vocal tract modeling to demonstrate how biphonation is achieved by modulating vocal tract morphology. Tuvan singers show remarkable control in shaping their vocal tract to narrowly focus the harmonics (or overtones) emanating from their vocal cords. The biphonic sound is a combination of the fundamental pitch and a focused filter state, which is at the higher pitch (1–2 kHz) and formed by merging two formants, thereby greatly enhancing sound-production in a very narrow frequency range. Most importantly, we demonstrate that this biphonation is a phenomenon arising from linear filtering rather than from a nonlinear source.Item Open Access Brain Activation for Audiovisual Information in People With One Eye Compared to Binocular and Eye-Patched Viewing Controls(Frontiers Media S.A., 2020-05-21) Moro, Stefania S.; Gorbet, Diana; Steeves, Jennifer Kate EvelynBlindness caused by early vision loss results in complete visual deprivation and subsequent changes in the use of the remaining intact senses. We have also observed adaptive plasticity in the case of partial visual deprivation. The removal of one eye, through unilateral eye enucleation, results in partial visual deprivation and is a unique model for examining the consequences of the loss of binocularity. Partial deprivation of the visual system from the loss of one eye early in life results in behavioral and structural changes in the remaining senses, namely auditory and audiovisual systems. In the current study we use functional neuroimaging data to relate function and behavior of the audiovisual system in this rare patient group compared to controls viewing binocularly or with one eye patched. In Experiment 1, a whole brain analysis compared common regions of cortical activation between groups, for auditory, visual and audiovisual stimuli. People with one eye demonstrated a trend for increased activation for low-level audiovisual stimuli compared to patched viewing controls but did not differ from binocular viewing controls. In Experiment 2, a region of interest (ROI) analysis for auditory, visual, audiovisual and illusory McGurk stimuli revealed that people with one eye had an increased trend for left hemisphere audiovisual activation for McGurk stimuli compared to binocular viewing controls. This aligns with current behavioral analysis and previous research showing reduced McGurk Effect in people with one eye. Furthermore, there is no evidence of a correlation between behavioral performance on the McGurk Effect task and functional activation. Together with previous behavioral work, these functional data contribute to the broader understanding of cross-sensory effects of early sensory deprivation from eye enucleation. Overall, these results contribute to a better understanding of the sensory deficits experienced by people with one eye, as well as, the relationship between behavior, structure and function in order to better predict the outcome of early partial visual deafferentation.Item Open Access Assessing differential effects of single and accelerated low-frequency rTMS to the visual cortex on GABA and glutamate concentrations(Wiley Periodicals, LLC., 2020-09-29) Rafique, Sara; Steeves, Jennifer Kate EvelynBackground: The application of repetitive transcranial magnetic stimulation (rTMS) for therapeutic use in visual-related disorders and its underlying mechanisms in the visual cortex is under-investigated. Additionally, there is little examination of rTMS adverse effects particularly with regards to visual and cognitive function. Neural plasticity is key in rehabilitation and recovery of function; thus, effective therapeutic strategies must be capable of modulating plasticity. Glutamate and γ-aminobutyric acid (GABA)-mediated changes in the balance between excitation and inhibition are prominent features in visual cortical plasticity. Objectives and method: We investigated the effects of low-frequency (1 Hz) rTMS to the visual cortex on levels of neurotransmitters GABA and glutamate to determine the therapeutic potential of 1 Hz rTMS for visual-related disorders. Two rTMS regimes commonly used in clinical applications were investigated: participants received rTMS to the visual cortex either in a single 20-min session or five accelerated 20-min sessions (not previously investigated at the visual cortex). Proton (1H) magnetic resonance spectroscopy for in vivo quantification of GABA (assessed via GABA+) and glutamate (assessed via Glx) concentrations was performed pre- and post-rTMS. Results: GABA+ and Glx concentrations were unaltered following a single session of rTMS to the visual cortex. One day of accelerated rTMS significantly reduced GABA+ concentration for up to 24 hr, with levels returning to baseline by 1-week post-rTMS. Basic visual and cognitive function remained largely unchanged. Conclusion: Accelerated 1 Hz rTMS to the visual cortex has greater potential for approaches targeting plasticity or in cases with altered GABAergic responses in visual disorders. Notably, these results provide preliminary insight into a critical window of plasticity with accelerated rTMS (e.g., 24 hr) in which adjunct therapies may offer better functional outcome. We describe detailed procedures to enable further exploration of these protocols.Item Open Access Lack of affective priming indicates attitude-behaviour discrepancy for COVID-19 affiliated words(2021-11-09) Moro, Stefania S.; Steeves, Jennifer Kate EvelynThe ongoing novel coronavirus (COVID-19) pandemic has resulted in the enforcement of national public health safety measures including precautionary behaviours such as border closures, movement restrictions, total or partial lockdowns, social distancing, and face mask mandates in order to reduce the spread of this disease. The current study uses affective priming, an indirect behavioural measure of implicit attitude, to evaluate COVID-19 attitudes. Explicitly, participants rated their overall risk perception associated with contracting COVID-19 significantly lower compared to their perception of necessary precautions and overall adherence to public health measures. During baseline trials, participants explicitly rated COVID-19 affiliated words as unpleasant, similar to traditional unpleasant word stimuli. Despite rating the COVID-19 affiliated words as unpleasant, affective priming was not observed for congruent prime-target COVID-19 affiliated word pairs when compared to congruent prime-target pleasant and unpleasant words. Overall, these results provide quantitative evidence that COVID-19 affiliated words do not invoke the same implicit attitude response as traditional pleasant and unpleasant word stimuli, despite conscious explicit rating of the COVID-19 words as unpleasant. This reduction in unpleasant attitude towards COVID-19 related words may contribute towards decreased fear-related behaviours and increased incidences of risky-behaviour facilitating the movement of the virus.Item Open Access Continuous and intermittent theta burst stimulation to the visual cortex do not alter GABA and glutamate concentrations measured by magnetic resonance spectroscopy(Wiley Periodicals, LLC., 2022-01-14) Stoby, Karlene; Rafique, Sara; Oeltzschner, Georg; Steeves, Jennifer Kate EvelynBackground: Theta burst stimulation (TBS), a form of repetitive transcranial magnetic stimulation (rTMS), uses repeated high-frequency bursts to non-invasively modulate neural processes in the brain. An intermittent TBS (iTBS) protocol is generally considered “excitatory,”while continuous TBS (cTBS) is considered “inhibitory.” However, the majority of work that has led to these effects being associated with the respective protocols has been done in the motor cortex, and it is well established that TMS can have variable effects across the brain. Objectives and method:We investigated the effects of iTBS and cTBS to the primary visual cortex (V1) on composite levels of gamma-aminobutyric acid+co-editedmacromolecules (GABA+) and glutamate + glutamine (Glx) since these are key inhibitory and excitatory neurotransmitters, respectively. Participants received a single session of cTBS, iTBS, or sham TBS to V1. GABA+ and Glx were quantified in vivo at the stimulation site using spectral-edited proton magnetic resonance spectroscopy (1H-MRS) at 3T. Baseline pre-TBS GABA+ and Glx levels were compared to immediate post-TBS and 1 h post-TBS levels. Results: There were no significant changes in GABA+ or Glx following either of the TBS conditions. Visual cortical excitability, measured using phosphene thresholds, remained unchanged following both cTBS and iTBS conditions. There was no relationship between excitability thresholds and GABA+ or Glx levels. However, TBS did alter the relationship between GABA+ and Glx for up to 1 h following stimulation. Conclusions: These findings demonstrate that a single session of TBS to the visual cortex can be used without significant effects on the tonic levels of these key neurotransmitters; and add to our understanding that TBS has differential effects at visual, motor, and frontal cortices.Item Open Access Modulating intrinsic functional connectivity with visual cortex using low-frequency repetitive transcranial magnetic stimulation(Wiley Periodicals, LLC., 2022-01-20) Rafique, Sara; Steeves, Jennifer Kate EvelynIntroduction: Intrinsic network connectivity becomes altered in pathophysiology. Noninvasive brain stimulation can modulate pathological functional networks in an attempt to restore the inherent response. To determine its usefulness for visual-related disorders, we developed procedures investigating repetitive transcranial magnetic stimulation (rTMS) protocols targeting the visual cortex on modulating connectivity associated with the visual network and default mode network (DMN). Methods: We compared two low-frequency (1 Hz) rTMS protocols to the visual cortex (V1)—a single 20 min session and five successive 20 min sessions (accelerated/within-session rTMS)—using multi-echo resting-state functional magnetic resonance whole-brain imaging and resting-state functional connectivity (rsFC). We also explored the relationship between rsFC and rTMS-induced changes in key inhibitory and excitatory neurotransmitters, γ-aminobutyric acid (GABA) and glutamate. GABA (GABA+) and glutamate (Glx) concentrations were measured in vivo using magnetic resonance spectroscopy. Results: Acute disruption with a single rTMS session caused widespread connectivity reconfiguration with nodes of interest. Changes were not evident immediately post-rTMS but were observed at 1 h post-rTMS. Accelerated sessions resulted in weak alterations in connectivity, producing a relatively homeostatic response. Changes in GABA+ and Glx concentrations with network connectivity were dependent on the rTMS protocol. Conclusions: This proof-of-concept study offers new perspectives to assess stimulation-induced neural processes involved in intrinsic functional connectivity and the potential for rTMS to modulate nodes interconnected with the visual cortex. The differential effects of single-session and accelerated rTMS on physiological markers are crucial for furthering the advancement of treatment modalities in visual cortex related disorders.Item Open Access Continuous and intermittent theta burst stimulation of primary visual cortex do not modulate resting state functional connectivity: A sham-controlled multi-echo fMRI study(Wiley Periodicals, LLC, 2023-04-16) Cohan, Remy; Rafique, Sara; Stoby, Karlene; Gorbet, Diana; Steeves, Jennifer Kate EvelynIntroduction: Theta burst stimulation (TBS) is a type of rTMS protocol which has the advantage of a shorter delivery time over traditional rTMS. When applied to motor cortex, intermittent TBS (iTBS) has been shown to yield excitatory aftereffects, whereas continuous TBS (cTBS) may lead to inhibitory aftereffects, both lasting from minutes to hours. The majority of TBS research has targeted motor, frontal, and parietal regions, and to date very few studies have examined its efficacy at visual areas. We designed a sham-controlled study to investigate the immediate poststimulation and short-term (1 h post-stimulation) effects of iTBS and cTBS to V1. Methods: Using multiecho functional magnetic resonance imaging, we measured the direct and indirect effects of TBS by comparing resting state functional connectivity (FC) before and after stimulation in whole brain networks, and seeds from V1 (stimulation site) and neighboring occipital and parietal visual networks. In addition, we also measured pre- and post-TBS phosphene thresholds (PTs) to examine the modulatory effects of TBS on cortical excitability. Results: We found no changes in FC for iTBS, cTBS or sham stimulation conditions from baseline to poststimulation timepoints. Additionally, cTBS and iTBS had no effect on visual cortical excitability. Conclusions: Our results indicate that unlike our previous low frequency rTMS to V1 study, which resulted in widespread FC changes up to at least 1 h after stimulation, TBS to V1 does not affect FC. Contrary to the studies showing comparable TBS and rTMS aftereffects in motor and frontal regions, our findings suggest that a single session of cTBS or iTBS to V1 at 80% PT using a standard protocol of 600 pulses may not be effective in targeting FC, especially in clinical settings where therapy for pathological networks is the goal.Item Open Access Coherence of Parental Representations Following Therapy for Autistic Children(Springer Nature, 2024-01-28) Vashi, Nisha; Ibrahim, Alaa; Pouyandeh, Ava; Weiss, Jonathan AAutistic children experience high rates of mental health challenges, and links have been found between child mental health and the parent-child relationship. As parents of autistic children are often actively involved in their child’s treatment, it is important to consider aspects of the parent-child relationship within this context. The present study investigated changes in a component of the parent-child relationship, the coherence of parental representations, following participation in a 10-week cognitive behavioural therapy intervention designed to address autistic children’s mental health challenges. Relationships were examined between coherence and child characteristics (i.e., autism symptoms, mental health), and associations with child treatment outcomes (i.e., mental health). Participants included 81 children (89% boys) aged 8 to 13 years and their parents (85% mothers) aged 35 to 54 years. Baseline levels of coherence were related to children’s mental health symptoms but not autism symptoms. Although there were no significant changes in overall coherence across therapy, subscale-level improvements (i.e., concern, acceptance) emerged. Changes in coherence across therapy were linked with children’s post-intervention behavioural symptoms and were approaching significance for internalizing problems, but were not associated with externalizing problems. It is critical to investigate factors that shape the coherence of parents’ representations of their children, as this may provide insight into potential targets for intervention. Ascertaining whether participation in therapy improves parental coherence, and consequently child treatment outcomes, can advocate for parent-involved therapy, which will ultimately benefit the well-being of autistic children.Item Open Access Transdiagnostic Symptoms in Children with Neurodevelopmental Disabilities and Perceived Parent-Child Relationship Quality: A Pilot Study(Springer Nature, 2023-04-27) Vashi, Nisha; Bohr, Yvonne; Weiss, Jonathan AThis pilot study examined associations between transdiagnostic symptoms and parent-perceived parent-child relationship quality in treatment-seeking families of children with neurodevelopmental disabilities, and interactions among clinical symptoms and cognitive functioning. Sixty-three children between 8 to 13 years of age and their caregivers were assessed at baseline while seeking cognitive behaviour therapy for emotion regulation and mental health difficulties. Diagnoses included autism, ADHD, cerebral palsy, and learning disability, with 52% of children having multiple diagnoses. Parent-perceived parent-child relationship quality was assessed by the Positive Affect Index, autism symptoms (e.g., social communication, repetitive behaviours) by the Social Responsiveness Scale, Second Edition, mental health (i.e., internalizing problems, externalizing problems, behavioural symptoms) by the Behaviour Assessment Scale for Children, Third Edition, and IQ by the Weschler Abbreviated Scale of Intelligence, Second Edition. Results revealed that higher IQ scores and greater social communication challenges, externalizing problems, and behavioural symptoms, were associated with lower parent-child relationship quality. Interaction effects were found between IQ and social communication challenges, reflecting significantly stronger relationships between social communication challenges and lower parent-child relationship quality in the context of higher IQ. Understanding the interactions between cognitive functioning and social communication challenges can help to inform individualized supports, and advocate for a transdiagnostic approach to intervention.Item Open Access Clinician Knowledge, Confidence, and Treatment Practices in Their Provision of Psychotherapy to Autistic Youth and Youth with ADHD(Springer Nature, 2022-09-09) Gallant, Caitlyn; Roudbarani, Flora; Ibrahim, Alaa; Maddox, Brenna B; Weiss, Jonathan AAutistic youth have an increased risk of mental health problems. Despite the efficacy of various psychotherapeutic approaches for autistic youth, they often do not receive these interventions. Research is needed to identify patterns of effective treatment for autistic youth and whether they differ from those used for youth with other neurodevelopmental conditions (e.g., attention-deficit hyperactivity disorder; ADHD). We compared clinicians’ (N = 557) knowledge, confidence and practices when treating autistic youth and youth with ADHD. Although ratings were moderately high overall and similar interventions were used for both groups, clinicians were significantly less knowledgeable and confident when supporting autistic clients compared to clients with ADHD. Thus, improving clinician perspectives may help facilitate treatment for autistic youth with mental health problems.Item Open Access Parent Involvement in Mental Health Treatment for Autistic Children: A Grounded Theory-Informed Qualitative Analysis(Springer Nature, 2023-10-17) Chan, Victoria; Albaum, Carly S; Khanlou, Nazilla; Westra, Henny; Weiss, Jonathan ACognitive behavior therapy (CBT) is an effective treatment for many autistic children experiencing mental health problems, and parents are particularly involved in their psychotherapy. This study presents a conceptual framework of successful parent involvement in CBT for autistic children. Seventeen therapists (94% female) and 11 mothers were interviewed about their involvement in a CBT program for autistic children ages 8–13 years. The conceptual framework depicts how parent involvement varies depending on child, parent, and environmental factors. Parents’ contributions to therapy were grouped into five main roles. Parents’ beliefs and attitudes toward therapy also influenced their involvement. This is the first study to empirically investigate how parents of autistic children contribute to the therapeutic process in CBT.Item Open Access Treatment Engagement as a Predictor of Therapy Outcome Following Cognitive Behaviour Therapy for Autistic Children(Springer Nature, 2023-08-29) Albaum, Carly S; Sellitto, Teresa; Vashi, Nisha; Bohr, Yvonne; Weiss, Jonathan APurpose: Active engagement in one’s therapy is a key contributor to successful outcomes. Research on child engagement in cognitive behaviour therapy (CBT) has largely focused on youth without autism. This longitudinal study examined multiple indicators of child engagement in relation to outcomes for autistic children who took part in CBT for emotion regulation. Method: Data were collected from 60 autistic children who were between 8 and 13 years of age (86.7% male; Mage = 9.58 years, SD = 1.44 years; 75% White). Indicators of child engagement included independent observer ratings of in-session involvement, as measured by the Child Involvement Rating Scale, and therapist ratings of the therapeutic relationship and homework completion using single-item measures. Indicators of engagement were measured at early (i.e., first third), middle (i.e., mid third), and late (i.e., final third) stages of treatment. Parent-reported emotion regulation was the primary treatment outcome, as measured by the Emotion Regulation Checklist. Results: After controlling for pre-treatment scores, in-session involvement significantly predicted some aspects of post-treatment emotion regulation, whereas therapeutic relationship and homework completion did not. Conclusions: Child in-session involvement throughout therapy may be particularly relevant for treatment change. Addressing issues related to in-session involvement early in treatment may help to promote therapeutic success for autistic children.Item Open Access A Systematic Review of Therapeutic Process Factors in Mental Health Treatment for Autistic Youth(Springer Nature, 2022-08-24) Albaum, Carly S; Vashi, Nisha; Bohr, Yvonne; Weiss, Jonathan AUnderstanding the role of therapeutic process factors in treatment change may prove useful for discerning why some autistic youth benefit from psychosocial interventions that target emotional and psychological aspects of mental health, while others do not. The aim of the current study was to synthesize what is currently known about therapeutic process factors in mental health treatment of emotional and psychological challenges for autistic youth, regarding how process factors have been measured in past research, and the relation between process factors and treatment outcome. A systematic review of the literature was conducted to narratively synthesize all articles published up until June 2021. Methodological quality of included studies was appraised. Twenty-five studies met inclusion criteria. Process factors assessed across studies included relational factors; treatment expectations, readiness, and satisfaction; and treatment engagement from youth and their parents. Process-outcome associations were reported for a limited number of constructs. There is a limited, albeit growing, body of high-quality research evaluating the role of process factors in the treatment of mental health issues for autistic youth. Future research should continue to examine process factors in relation to treatment outcome, and validate measures to accurately capture process-related constructs in mental health treatment for this population. Greater understanding of therapy processes can lead to developing evidence-informed strategies that clinicians can implement to promote positive expectations, relationships, and engagement.Item Open Access Clinician factors related to the delivery of psychotherapy for autistic youth and youth with attention-deficit hyperactivity disorder(SAGE Publications, 2022-07-02) Roudbarani, Flora; Modica, Paula Tablon; Maddox, Brenna B; Bohr, Yvonne; Weiss, Jonathan AAutistic children and adolescents are more likely than non-autistic youth to experience mental health problems, such as anxiety or depression, but less likely to receive psychotherapy to address these concerns. Recent research indicates that clinician factors, such as knowledge, attitudes, confidence and beliefs, can impact their decisions to provide care, though this work has primarily focused on adults or within the context of one kind of treatment (cognitive behaviour therapy). The current study examined psychological predictors (e.g. attitudes and confidence) of clinicians’ intention to deliver psychotherapy to autistic youth and those with attention-deficit hyperactivity disorder. Participants included 611 clinicians across publicly funded agencies in Ontario, Canada. Multiple mediation analyses revealed that clinician knowledge on mental health-related topics (e.g. core symptoms, developing treatment plans and identifying progress towards treatment goals) was associated with intention to treat autistic clients or clients with attention-deficit hyperactivity disorder, and normative pressures and attitudes partially mediated this association. Clinicians felt less likely to treat autistic clients than clients with attention-deficit hyperactivity disorder, partly because of differences in attitudes, normative pressures and knowledge. This research suggests that targeted training around autism and mental health care may be a useful initiative for agency staff. Lay abstract: Autistic children and youth often experience mental health problems, such as anxiety, depression and behavioural challenges. Although there are therapy programmes that have been found helpful in reducing these issues, such as cognitive behaviour therapy, autistic children often struggle to receive adequate mental health care. Clinicians’ knowledge, attitudes, confidence and beliefs about treating mental health problems in autistic people may be related to their choices in providing psychotherapy. Across Ontario, Canada, 611 mental health clinicians, working in publicly funded agencies, completed an online survey about their experiences and opinions on delivering therapy for autistic clients compared to those with attention-deficit hyperactivity disorder. Clinician knowledge was associated with their intention to treat autistic clients or clients with attention-deficit hyperactivity disorder, partly because of their attitudes and the social pressures or values they felt. Clinicians reported feeling less intent on providing therapy to autistic youth compared to youth with attention-deficit hyperactivity disorder because of differences in their attitudes, social pressures and knowledge. This research can inform the training and educational initiatives for mental health practitioners.