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Johnsen DB, Lomholt JJ, Heyne D, Jensen MB, Jeppesen P, Silverman WK, Thastum M. The Effectiveness of Modular Transdiagnostic Cognitive Behavioral Therapy Versus Treatment as Usual for Youths Displaying School Attendance Problems: A Randomized Controlled Trial. Res Child Adolesc Psychopathol 2024:10.1007/s10802-024-01196-8. [PMID: 38739306 DOI: 10.1007/s10802-024-01196-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2024] [Indexed: 05/14/2024]
Abstract
School attendance problems (SAPs) are associated with negative short- and long-term outcomes. Despite high prevalence of SAPs, there is a shortage of evidence-based interventions. Existing approaches often target either school refusal or truancy, leaving a gap in effective interventions addressing both types of SAPs. This randomized controlled trial (RCT) assessed the effectiveness of Back2School (B2S), a modular transdiagnostic cognitive behavioral therapy (CBT) for SAPs, compared to treatment as usual (TAU). Outcomes included youths' school attendance and mental health. A group (B2S, TAU) × time (Pre, Post, 3-Month Follow-Up) design involving 152 youths (B2S; n = 74, TAU; n = 78) with SAPs (i.e., ≥ 10% absence in the past three months), aged 6-16 years (M = 12.2, SD = 2.2, males = 60%) were used. B2S comprised three months of CBT with youths, parents, and school involvement, while TAU comprised public and/or private intervention services. On average, youths in B2S received 15.0, (SD = 3.9) hours of intervention, while those in TAU received 13.4, (SD = 21.6). Intervention effects were investigated using mixed linear models. Both B2S and TAU exhibited significant within-group improvements in school attendance, with no significant differences between them. However, the B2S group significantly outperformed TAU in reducing youths' emotional problems, conduct problems, problems with peers, the overall impact of problems, and increasing youths self-efficacy for attending school and parent self-efficacy for dealing with a SAP. This RCT represents the first evaluation of a modular transdiagnostic CBT for youths displaying SAPs, showing significant mental health and self-efficacy benefits. (Clinical trial registration: ClinicalTrials.gov: NCT03459677).
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Affiliation(s)
- Daniel B Johnsen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Johanne J Lomholt
- Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark
- TrygFonden's Centre for Child Research, Aarhus University, Aarhus, Denmark
| | - David Heyne
- School of Psychology, Deakin University, Melbourne, Australia
| | - Morten B Jensen
- Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
| | - Pia Jeppesen
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Roskilde, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Roskilde, Denmark
| | - Wendy K Silverman
- Child Study Center, Yale University School of Medicine, New Haven, USA
| | - Mikael Thastum
- Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark.
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2
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Li B, Heyne D, Scheeren A, Blijd-Hoogewys E, Rieffe C. School participation of autistic youths: The influence of youth, family and school factors. Autism 2024:13623613231225490. [PMID: 38311864 DOI: 10.1177/13623613231225490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
LAY ABSTRACT School-aged youths have a basic human right to participate in educational and recreational activities at school. Yet, autistic youths are at high risk of being excluded from school and from school-based activities. It is important to understand how this occurs, to ensure that all autistic youths have opportunities to participate in school activities that are equal to the opportunities of their non-autistic peers. The present study investigated multiple influences on the school participation of autistic youths, including youth factors (age and autistic traits), family factors (parent education level and parental self-efficacy for supporting their child's schoolwork) and school factors (the impact of problems autistic youths experienced with the physical and social environments of school). Using an online survey, we gathered the views and experiences of the parents of 200 autistic youths aged between 4 and 16 years, in the Netherlands. We found that among the factors, only the impact of problems that autistic youths experienced with the physical environment of school was associated with their school participation. In particular, autistic youths who experienced greater difficulties with the physical environment of school had lower levels of school participation. Our findings highlight the pressing need to modify school environments to better accommodate the needs of autistic youths so that they can participate easily and comfortably.
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Affiliation(s)
- Boya Li
- Leiden University, The Netherlands
- Delft University of Technology, The Netherlands
| | | | | | | | - Carolien Rieffe
- Leiden University, The Netherlands
- University of Twente, The Netherlands
- University College London, UK
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3
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Totsika V, Kouroupa A, Timmerman A, Allard A, Gray KM, Hastings RP, Heyne D, Melvin GA, Tonge B. School Attendance Problems Among Children with Neurodevelopmental Conditions One year Following the Start of the COVID-19 Pandemic. J Autism Dev Disord 2023:10.1007/s10803-023-06025-3. [PMID: 37480438 DOI: 10.1007/s10803-023-06025-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2023] [Indexed: 07/24/2023]
Abstract
PURPOSE The present study investigated school absence among 1,076 5-15 year-old children with neurodevelopmental conditions (intellectual disability and/or autism) approximately one year following the start of COVID-19 in the UK. METHODS Parents completed an online survey indicating whether their child was absent from school during May 2021 and the reason for each absence. Multi-variable regression models investigated child, family and school variables associated with absenteeism and types of absenteeism. Qualitative data were collected on barriers and facilitators of school attendance. RESULTS During May 2021, 32% of children presented with persistent absence (missing ≥ 10% of school). School refusal and absence due to ill-health were the most frequent types of absence, accounting for 37% and 22% of days missed, respectively. COVID-19 related absence accounted for just 11% of days missed. Child anxiety was associated with overall absenteeism and with days missed because of school refusal. Parent pandemic anxiety and child conduct problems were not associated with school absenteeism. Hyperactivity was associated with lower levels of absenteeism and school refusal but higher levels of school exclusion. A positive parent-teacher relationship was associated with lower levels of absenteeism, school refusal and exclusion. Child unmet need in school was the most frequently reported barrier to attendance while COVID-19 was one of the least frequently reported barriers. CONCLUSION COVID-19 had a limited impact on school attendance problems during this period. Findings highlighted the role of child mental health in different types of absence and the likely protective role of a positive parent-teacher relationship.
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Affiliation(s)
- Vasiliki Totsika
- Division of Psychiatry, University College London, 149 Tottenham Court Road, Maple House 6th Floor, London, W1T 7NF, UK.
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, UK.
- Tavistock & Portman NHS Foundation Trust, London, UK.
| | - Athanasia Kouroupa
- Division of Psychiatry, University College London, 149 Tottenham Court Road, Maple House 6th Floor, London, W1T 7NF, UK
| | - Amanda Timmerman
- Division of Psychiatry, University College London, 149 Tottenham Court Road, Maple House 6th Floor, London, W1T 7NF, UK
| | - Amanda Allard
- Council for Disabled Children, National Children's Bureau, London, UK
| | - Kylie M Gray
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, UK
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, Monash University, Melbourne, Australia
| | - Richard P Hastings
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, UK
| | - David Heyne
- Developmental and Educational Psychology Unit, Institute of Psychology, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, The Netherlands
| | - Glenn A Melvin
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, UK
- School of Psychology, Faculty of Health, Deakin University, Melbourne, Australia
| | - Bruce Tonge
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, UK
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, Monash University, Melbourne, Australia
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4
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Melvin GA, Freeman M, Ashford LJ, Hastings RP, Heyne D, Tonge BJ, Bailey T, Totsika V, Gray KM. Types and correlates of school absenteeism among students with intellectual disability. J Intellect Disabil Res 2023; 67:375-386. [PMID: 36744441 DOI: 10.1111/jir.13011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/24/2022] [Accepted: 01/05/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND It appears that students with intellectual disability (ID) are more frequently absent from school compared with students without ID. The objective of the current study was to estimate the frequency of absence among students with ID and the reasons for absence. Potential reasons included the attendance problems referred to as school refusal, where absence is related to emotional distress; truancy, where absence is concealed from parents; school exclusion, where absence is instigated by the school; and school withdrawal, where absence is initiated by parents. METHODS Study participants were 629 parents (84.6% mothers) of Australian school students (Mage = 11.18 years; 1.8% Aboriginal and/or Torres Strait Islander) with an ID. Participants completed a questionnaire battery that included the School Non-Attendance ChecKlist via which parents indicated the reason their child was absent for each day or half-day absence their child had over the past 20 school days. The absence data presented to parents had been retrieved from school records. RESULTS Across all students, absence occurred on 7.9% of the past 20 school days. In terms of school attendance problems as defined in existing literature, school withdrawal accounted for 11.1% of absences and school refusal for 5.3% of absences. Students were also absent for other reasons, most commonly illness (32.0%) and appointments (24.2%). Of students with more than one absence (n = 217; 34.5%), about half were absent for more than one reason. Students attending mainstream schools had lower attendance than those attending special schools. CONCLUSIONS Students with ID were absent for a range of reasons and often for multiple reasons. There were elevated rates of school withdrawal and school refusal. Understanding the reasons for absenteeism can inform targeted prevention and intervention supports.
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Affiliation(s)
- G A Melvin
- School of Psychology, Deakin University, Burwood, Australia
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
| | - M Freeman
- Centre for Developmental Psychiatry & Psychology, Monash University, Clayton, Australia
| | - L J Ashford
- Centre for Forensic Behavioural Science, Swinburne University of Technology, Hawthorn, Australia
| | - R P Hastings
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
- Centre for Developmental Psychiatry & Psychology, Monash University, Clayton, Australia
| | - D Heyne
- Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - B J Tonge
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
- Centre for Developmental Psychiatry & Psychology, Monash University, Clayton, Australia
| | - T Bailey
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
| | - V Totsika
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
- Centre for Developmental Psychiatry & Psychology, Monash University, Clayton, Australia
- Division of Psychiatry, University College London, London, UK
| | - K M Gray
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
- Centre for Developmental Psychiatry & Psychology, Monash University, Clayton, Australia
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5
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Kouroupa A, Allard A, Gray K, Hastings RP, Heyne D, Melvin GA, Tonge B, Totsika V. The association between home learning during COVID-19 lockdowns and subsequent school attendance among children with neurodevelopmental conditions. Child Care Health Dev 2023. [PMID: 36898964 DOI: 10.1111/cch.13113] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 01/23/2023] [Accepted: 03/03/2023] [Indexed: 03/12/2023]
Abstract
BACKGROUND Children with neurodevelopmental conditions have high levels of school absence. During the COVID-19 pandemic, schools closed for many students. The relationship between home learning during school closures and subsequent school attendance requires attention to better understand the impact of pandemic education policy decisions on this population. This study aims to investigate the association between home learning, hybrid learning and school learning during school closures (in January-March 2021) with subsequent school attendance (in May 2021) in children with neurodevelopmental conditions. METHODS An online survey was completed by 809 parents/carers of 5- to 15-year-old autistic children and/or children with intellectual disability. Regression models examined the association of learning location during school closures with subsequent school absence (i.e., total days missed, persistent absence and school refusal). RESULTS Children who were learning from home during school closures later missed 4.6 days of a possible 19. Children in hybrid and school learning missed 2.4 and 1.6 school days, respectively. The rates of school absence and persistent absence were significantly higher in the home learning group even after adjusting for confounders. Learning location was not associated with subsequent school refusal. CONCLUSIONS Policies for school closures and learning from home during public health emergencies may exacerbate school attendance problems in this group of vulnerable children.
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Affiliation(s)
| | - Amanda Allard
- Council for Disabled Children, National Children's Bureau, London, UK
| | - Kylie Gray
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, UK.,Department of Psychiatry, Monash University, Clayton, Victoria, Australia
| | - Richard P Hastings
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, UK.,Department of Psychiatry, Monash University, Clayton, Victoria, Australia
| | - David Heyne
- Developmental and Educational Psychology Unit, Institute of Psychology, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, The Netherlands
| | - Glenn A Melvin
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, UK.,School of Psychology, Faculty of Health, Deakin University, Melbourne, Victoria, Australia
| | - Bruce Tonge
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, UK.,Department of Psychiatry, Monash University, Clayton, Victoria, Australia
| | - Vasiliki Totsika
- Division of Psychiatry, University College London, London, UK.,Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, UK.,Tavistock and Portman NHS Foundation Trust, London, UK
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Heyne D. Practitioner Review: Signposts for Enhancing Cognitive-Behavioral Therapy for School Refusal in Adolescence. Z Kinder Jugendpsychiatr Psychother 2023; 51:61-76. [PMID: 36111580 DOI: 10.1024/1422-4917/a000899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Factors associated with adolescent development influence the occurrence and presentation of school refusal (SR). Cognitive-behavioral therapy (CBT) manuals for the treatment of SR account for these developmental issues to varying degrees. Some multimodal treatments aim to address the complexity of adolescent SR by incorporating interventions alongside CBT, such as medication, inpatient treatment, and educational support in a special setting. However, CBT manuals and multimodal treatments appear to fail to help approximately one-third to two-thirds of adolescents, with respect to achieving regular school attendance. This paper provides an overview of suggestions in the literature for improving treatment for SR, with a focus on adolescent SR. Seven signposts emerge from the literature, namely, increased number or frequency of sessions, greater attention to social anxiety disorder and social functioning, greater attention to depression, greater attention to emotion regulation, careful consideration of the role of parents, greater attention to parent-adolescent communication and problem-solving, and the use of alternative educational settings. Professionals may find these signposts helpful when planning and delivering treatment for SR in adolescents. Research is needed to determine the benefit of including one or more of these adaptations alongside an existing SR treatment.
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Affiliation(s)
- David Heyne
- Institute of Psychology, Leiden University, The Netherlands
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7
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Paulauskaite L, Timmerman A, Kouroupa A, Allard A, Gray KM, Hastings RP, Heyne D, Melvin GA, Tonge B, Totsika V. Elective home education of children with neurodevelopmental conditions before and after the COVID-19 pandemic started. Front Psychol 2022; 13:995217. [PMID: 36438394 PMCID: PMC9687365 DOI: 10.3389/fpsyg.2022.995217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 10/05/2022] [Indexed: 01/27/2024] Open
Abstract
COVID-19 brought disruptions to children's education and mental health, and accelerated school de-registration rates. We investigated Elective Home Education (EHE) in families of children with a neurodevelopmental condition. A total of 158 parents of 5-15 year-old children with neurodevelopmental conditions (80% autistic) provided information on reasons for de-registration, their experience of EHE, and children's mental health. Few differences were found between children participating in EHE before and after the pandemic started. Low satisfaction with school for not meeting children's additional needs was the main reason for de-registering in both groups. COVID-19 had a more limited role in parents' decision to de-register. The main advantage of EHE reported in both groups was the provision of personalised education and one-to-one support. Levels of anxiety, internalising and externalising problems were similar between children participating in EHE before and after the pandemic started, and also similar between all children in EHE and school-registered children (N = 1,079).
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Affiliation(s)
- Laura Paulauskaite
- Social Research Institute, University College London, London, United Kingdom
| | - Amanda Timmerman
- Division of Psychiatry, University College London, London, United Kingdom
| | - Athanasia Kouroupa
- Division of Psychiatry, University College London, London, United Kingdom
| | - Amanda Allard
- Council for Disabled Children, National Children’s Bureau, London, United Kingdom
| | - Kylie M. Gray
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, United Kingdom
- Department of Psychiatry, Monash University, Melbourne, VIC, Australia
| | - Richard P. Hastings
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, United Kingdom
- Department of Psychiatry, Monash University, Melbourne, VIC, Australia
| | - David Heyne
- Developmental and Educational Psychology Unit, Faculty of Social and Behavioural Sciences, Institute of Psychology, Leiden University, Leiden, Netherlands
| | - Glenn A. Melvin
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, United Kingdom
- School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Bruce Tonge
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, United Kingdom
- Department of Psychiatry, Monash University, Melbourne, VIC, Australia
| | - Vasiliki Totsika
- Division of Psychiatry, University College London, London, United Kingdom
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, United Kingdom
- Department of Psychiatry, Monash University, Melbourne, VIC, Australia
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Heyne D. Developmental Issues Associated with Adolescent School Refusal and Cognitive-Behavioral Therapy Manuals. Z Kinder Jugendpsychiatr Psychother 2022; 50:471-494. [PMID: 35762908 DOI: 10.1024/1422-4917/a000881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
It is important to consider developmental issues when addressing school refusal (SR) in adolescence. Referral rates appear to be higher among adolescents relative to children, and treatment appears to be less effective among adolescents. This paper provides an in-depth review of developmental issues associated with adolescent SR and treatment via cognitive-behavioral therapy (CBT). It begins by considering the reasons for the higher referral and poorer treatment outcomes, including the higher level of absenteeism in adolescence, higher rates of concurrent social anxiety disorder and depressive disorder, and the developmental challenges inherent to adolescence. Such challenges include increased academic and social demands in the secondary-school environment, and increasing autonomy which may contribute to family conflict. These developmental issues may potentiate and exacerbate an adolescent's difficulty attending school, make it difficult for families to cope, and complicate practitioners' efforts to provide effective treatment for SR. Further, the review describes CBT manuals for SR and the extent to which they are developmentally sensitive. There are five CBT manuals, which vary in their sensitivity to developmental issues. Various multimodal treatments employ interventions in addition to CBT, such as medication or inpatient treatment, to address the complexity of SR in adolescence. Nevertheless, nonresponse to treatment for adolescent SR ranges from one-third to two-thirds of youths. Attention thus needs to be given to ways of improving treatment outcomes.
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Affiliation(s)
- David Heyne
- Institute of Psychology, Leiden University, The Netherlands
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9
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Johnsen DB, Lomholt JJ, Heyne D, Jeppesen P, Jensen MB, Silverman WK, Thastum M. Sociodemographic and clinical characteristics of youths and parents seeking psychological treatment for school attendance problems. PLoS One 2022; 17:e0261449. [PMID: 35081106 PMCID: PMC8791456 DOI: 10.1371/journal.pone.0261449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 11/20/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Knowledge of school attendance problems (SAPs) is needed to inform treatments targeting SAPs and protecting youths from negative outcomes associated with SAPs. OBJECTIVES This study examined the school absence, absence categories (i.e., absence due to illness, excused, non-excused), sociodemographic characteristics, and mental health problems among youths seeking psychological treatment for SAPs. METHODS The study used a cross-sectional design. Sociodemographic and clinical characteristics of 152 help-seeking youths with SAPs (i.e., >10% absenteeism) and their parents were examined. The data were derived from the baseline assessment conducted before treatment start. RESULTS Older youths, youths with mental health problems, and youths whose parents had mental health problems exhibited higher levels of absence. Lower levels of non-excused absence were found among youths with highly educated fathers, and youths living with both parents. Many youths had clinical levels of anxiety, depression, or 'emotional and behavioral difficulties'. CONCLUSION The study highlights the need for early intervention, addressing a broad range of mental health problems. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov: NCT03459677.
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Affiliation(s)
- Daniel B. Johnsen
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Johanne J. Lomholt
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
- TrygFonden’s Centre for Child Research, Aarhus University, Aarhus, Denmark
| | - David Heyne
- Institute of Psychology, Leiden University, Leiden, Netherlands
| | - Pia Jeppesen
- Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Child and Adolescent Mental Health Center, Mental Health Services—Capital Region of Denmark, Copenhagen, Denmark
| | - Morten B. Jensen
- Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
| | - Wendy K. Silverman
- Yale University Child Study Center, New Haven, Connecticut, United States of America
| | - Mikael Thastum
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
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10
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Kearney CA, Heyne D, Gonzálvez C. Editorial: School Attendance and Problematic School Absenteeism in Youth. Front Psychol 2020; 11:602242. [PMID: 33240186 PMCID: PMC7681236 DOI: 10.3389/fpsyg.2020.602242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 10/19/2020] [Indexed: 11/25/2022] Open
Affiliation(s)
- Christopher A. Kearney
- Department of Psychology, University of Nevada, Las Vegas, NV, United States
- *Correspondence: Christopher A. Kearney
| | - David Heyne
- Institute of Psychology, Leiden University, Leiden, Netherlands
| | - Carolina Gonzálvez
- Department of Developmental Psychology and Didactics, Universidad de Alicante, San Vincente del Raspeig, Alicante, Spain
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11
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Heyne D, Strömbeck J, Alanko K, Bergström M, Ulriksen R. A Scoping Review of Constructs Measured Following Intervention for School Refusal: Are We Measuring Up? Front Psychol 2020; 11:1744. [PMID: 32973595 PMCID: PMC7468385 DOI: 10.3389/fpsyg.2020.01744] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 06/23/2020] [Indexed: 12/17/2022] Open
Abstract
Reviews of the effectiveness of interventions for school refusal (SR) rely upon well-conducted primary studies. Currently there are no guidelines for those conducting primary studies about the measurement of outcome following intervention for SR. Most people would agree that it is important to measure school attendance as an outcome but there has been little discussion about other constructs that warrant measurement. To facilitate this discussion and support the development of guidelines, we conducted a scoping review of constructs measured in studies evaluating intervention for SR. We screened the title and abstract of 3,213 publications found in peer-reviewed journals between 1980 and 2019. After full text review of 271 publications, 50 publications describing 51 studies were included. Results address the frequency with which constructs were measured, along with instruments used, informants, and time-points for measurement. Based on the results, we offer guidelines for choosing constructs to measure following intervention for SR and considerations for how to measure the constructs. Guidelines can increase consistency across primary studies, with benefits for future meta-analyses and international comparisons. They also provide support for practitioners contemplating routine evaluation of their interventions for SR. Ultimately, a core outcome set for SR can be developed.
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Affiliation(s)
- David Heyne
- Institute of Psychology, Leiden University, Leiden, Netherlands
| | - Johan Strömbeck
- Magelungen Utveckling AB, Stockholm, Sweden.,Faculty of Arts, Psychology and Theology, Åbo Akademi University, Turku, Finland
| | - Katarina Alanko
- Faculty of Arts, Psychology and Theology, Åbo Akademi University, Turku, Finland
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12
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Heyne D, Gentle-Genitty C, Gren Landell M, Melvin G, Chu B, Gallé-Tessonneau M, Askeland KG, Gonzálvez C, Havik T, Ingul JM, Johnsen DB, Keppens G, Knollmann M, Lyon AR, Maeda N, Reissner V, Sauter F, Silverman WK, Thastum M, Tonge BJ, Kearney CA. Improving school attendance by enhancing communication among stakeholders: establishment of the International Network for School Attendance (INSA). Eur Child Adolesc Psychiatry 2020; 29:1023-1030. [PMID: 31372748 DOI: 10.1007/s00787-019-01380-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 07/22/2019] [Indexed: 01/05/2023]
Affiliation(s)
- David Heyne
- Leiden University Institute of Psychology, PO Box 9555, 2300 RB, Leiden, The Netherlands.
| | | | | | - Glenn Melvin
- Deakin University School of Psychology, Burwood, Australia
| | - Brian Chu
- Rutgers University, New Brunswick, USA
| | | | | | | | | | - Jo Magne Ingul
- Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Gil Keppens
- Vrije Universiteit Brussel, Brussels, Belgium
| | - Martin Knollmann
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | | | - Naoki Maeda
- Kyushu University of Health and Welfare, Nobeoka, Japan
| | - Volker Reissner
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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Totsika V, Hastings RP, Dutton Y, Worsley A, Melvin G, Gray K, Tonge B, Heyne D. Types and correlates of school non-attendance in students with autism spectrum disorders. Autism 2020; 24:1639-1649. [PMID: 32419486 PMCID: PMC7545649 DOI: 10.1177/1362361320916967] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
School non-attendance in autism spectrum disorders has received very little attention to date. The study aimed to provide a comprehensive description of school non-attendance in students with autism spectrum disorders. Through an online survey, parents of 486 children (mean age: 11 years) reported on school attendance over 1 month and reasons for instances of non-attendance. On average, students missed 5 days of school of a possible 23 days. Persistent non-attendance (absent on 10%+ of available sessions) occurred among 43% of students. School non-attendance was associated with child older age, not living in a two-parent household, parental unemployment and, especially, attending a mainstream school. School refusal accounted for 43% of non-attendance. School exclusion and school withdrawal each accounted for 9% of absences. Truancy was almost non-existent. Non-problematic absenteeism (mostly related to medical appointments and illness) accounted for 32% of absences. Non-problematic absenteeism was more likely among those with intellectual disability, school refusal was more likely among older students and school exclusion was more likely among students from single-parent, unemployed and well-educated households. Findings suggest that school non-attendance in autism spectrum disorders is a significant issue, and that it is important to capture detail about attendance patterns and reasons for school non-attendance.
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Affiliation(s)
- Vasiliki Totsika
- University College London, UK.,University of Warwick, UK.,Monash University, Australia
| | | | | | | | - Glenn Melvin
- University of Warwick, UK.,Deakin University, Australia
| | - Kylie Gray
- University of Warwick, UK.,Monash University, Australia
| | - Bruce Tonge
- University of Warwick, UK.,Monash University, Australia
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Lomholt JJ, Johnsen DB, Silverman WK, Heyne D, Jeppesen P, Thastum M. Feasibility Study of Back2School, a Modular Cognitive Behavioral Intervention for Youth With School Attendance Problems. Front Psychol 2020; 11:586. [PMID: 32328012 PMCID: PMC7153503 DOI: 10.3389/fpsyg.2020.00586] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 03/12/2020] [Indexed: 11/25/2022] Open
Abstract
There is large heterogeneity among youth with school attendance problems (SAPs). For this reason, protocols for the treatment of SAPs need to be flexible. Back2School (B2S) is a new manual-based, modular transdiagnostic cognitive behavioral intervention to increase school attendance among youth with SAPs. It also aims to increase the self-efficacy of these youth and their parents. B2S includes evidence-based modules addressing youth anxiety, depression, and behavior problems, together with modules focused on parent guidance and school consultation. The current study examined the feasibility of evaluating B2S in an randomized controlled trial and acceptability of the B2S program in a non-randomized trial, including both qualitative and quantitative data, in preparation for a randomized controlled trial of its effectiveness. Youth, parents, and teachers completed questionnaires at baseline, post-intervention, and follow-up. School attendance data were collected from school registers. Twenty-four youth with a SAP (defined as more than 10% absenteeism during the last 3 months) were recruited from primary and lower secondary schools in Aarhus Municipality, Denmark. Their parents also participated in B2S. Two of the 24 families withdrew during the intervention, after sessions two and six respectively. Of the remaining 22 families, 19 (86%) completed all 10 sessions. Parents and youth rated their satisfaction with B2S as high, and high levels of satisfaction were maintained 1 year after the intervention. Teacher satisfaction was lower than that of youth and parents, but the majority found the school’s participation in the intervention helpful. Preliminary evaluation of intervention outcomes showed significant increase in school attendance and decrease in psychological symptoms, as well as a significant increase in self-efficacy for both youth and parents. Based on this feasibility data, adaptations were made to the B2S manual and study procedures prior to commencement of a randomized controlled effectiveness trial. The main adaptation to the manual was to increase school consultation. The main procedural adaptation was to broaden recruitment. Furthermore, it was necessary to increase level of staffing by psychologists because treatment delivery was more time consuming than expected.
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Affiliation(s)
- Johanne Jeppesen Lomholt
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark.,TrygFonden's Centre for Child Research, Aarhus University, Aarhus, Denmark
| | - Daniel Bach Johnsen
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | | | - David Heyne
- Institute of Psychology, Leiden University, Leiden, Netherlands
| | - Pia Jeppesen
- Child and Adolescent Mental Health Center, Mental Health Services - Capital Region of Denmark, Gentofte, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mikael Thastum
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
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Affiliation(s)
| | - David Heyne
- Leiden University Institute of Psychology , Leiden, The Netherlands
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16
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Maeda N, Heyne D. Rapid Return for School Refusal: A School-Based Approach Applied With Japanese Adolescents. Front Psychol 2019; 10:2862. [PMID: 31920885 PMCID: PMC6934052 DOI: 10.3389/fpsyg.2019.02862] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 12/03/2019] [Indexed: 11/29/2022] Open
Abstract
Cognitive behavioral therapy (CBT) is often effective in the treatment of school refusal (SR). Its usefulness is limited, however, if youth displaying SR also refuse to attend treatment sessions. In these cases parents and school staff may consider using school-based interventions that do not rely on face-to-face assessment and treatment with the young person. The current study examined the effectiveness of a school-based intervention applied in Japan to achieve rapid return to school among adolescents displaying SR. Between 2009 and 2015, the parents of 62 adolescents displaying SR were invited to implement a school-based rapid return approach. Thirty-nine parents agreed to implement the approach and 23 decided to wait until their child spontaneously attended school. Of the 39 cases in which the approach was implemented, 28 adolescents (72%) resumed attendance at their original school, 2 (5%) transferred to another school, and 9 (23%) did not resume attendance. In contrast, all 23 non-intervention cases continued to refuse to attend school for 3 months or longer, and none of these adolescents returned to regular school attendance within 9 months. This study tentatively suggests that the rapid return approach may be an effective form of intervention for adolescents displaying SR and simultaneously refusing to attend individual therapy. Because this approach is ethically complex, involving forced school attendance in adolescence, it should only be employed under specific circumstances. These circumstances are discussed.
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Affiliation(s)
- Naoki Maeda
- School of Social Welfare, Kyushu University of Health and Welfare, Nobeoka, Japan
| | - David Heyne
- Institute of Psychology, Leiden University, Leiden, Netherlands
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Vien Ng V, Heyne D, Cheng Kueh Y, Husain M. The Malay Self–Efficacy Questionnaire for School Situations: Development, reliability, and validity among early adolescents in primary school. EJEP 2019. [DOI: 10.30552/ejep.v12i1.243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Low perceived self–efficacy (SE) for responding to school–related situations is posited to be associated with school refusal. This study examined the validity and reliability of the Malay version of the Self–Efficacy Questionnaire for School Situations (SEQ–SS) among early adolescents in Kota Bharu. The English version of the 25–item SEQ–SS was translated into Malay. Employing a cross–sectional design, students (10-11 years) from five randomly selected public primary schools were recruited via proportionate cluster sampling. Two hundred and fifteen students, 65% female, mean age of 10.3 years (SD=0.5), completed the Malay SEQ–SS. Validity was examined with exploratory factor analysis (EFA). Cronbach’s alpha was used to determine internal consistency. Means and standard deviations were used to describe the total and subscale scores. EFA analyses retained 19 items which clustered into four factors: ‘SE in socially challenging situations’, ‘SE in personally challenging situations’, ‘SE in separation situations’, and ‘SE in situations of disengagement from school’. Internal consistencies were low, approaching moderate, with Cronbach’s alpha values between 0.64 and 0.69. The four–factor solution of the Malay SEQ–SS appears to permit identification of specific domains of low SE which could inform individualized interventions targeting early adolescents in primary school.
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Brouwer-Borghuis ML, Heyne D, Sauter FM, Scholte RH. The Link: An Alternative Educational Program in the Netherlands to Reengage School-Refusing Adolescents With Schooling. Cognitive and Behavioral Practice 2019. [DOI: 10.1016/j.cbpra.2018.08.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Heyne D. Developments in Classification, Identification, and Intervention for School Refusal and Other Attendance Problems: Introduction to the Special Series. Cognitive and Behavioral Practice 2019. [DOI: 10.1016/j.cbpra.2018.12.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ingul JM, Havik T, Heyne D. Emerging School Refusal: A School-Based Framework for Identifying Early Signs and Risk Factors. Cognitive and Behavioral Practice 2019. [DOI: 10.1016/j.cbpra.2018.03.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Heyne D, Gren-Landell M, Melvin G, Gentle-Genitty C. Differentiation Between School Attendance Problems: Why and How? Cognitive and Behavioral Practice 2019. [DOI: 10.1016/j.cbpra.2018.03.006] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Manassis K, Lee TC, Bennett K, Zhao XY, Mendlowitz S, Duda S, Saini M, Wilansky P, Baer S, Barrett P, Bodden D, Cobham VE, Dadds MR, Flannery-Schroeder E, Ginsburg G, Heyne D, Hudson JL, Kendall PC, Liber J, Masia-Warner C, Nauta MH, Rapee RM, Silverman W, Siqueland L, Spence SH, Utens E, Wood JJ. Types of parental involvement in CBT with anxious youth: A preliminary meta-analysis. J Consult Clin Psychol 2014; 82:1163-72. [DOI: 10.1037/a0036969] [Citation(s) in RCA: 122] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Bennett K, Manassis K, Walter SD, Cheung A, Wilansky-Traynor P, Diaz-Granados N, Duda S, Rice M, Baer S, Barrett P, Bodden D, Cobham VE, Dadds MR, Flannery-Schroeder E, Ginsburg G, Heyne D, Hudson JL, Kendall PC, Liber J, Warner CM, Mendlowitz S, Nauta MH, Rapee RM, Silverman W, Siqueland L, Spence SH, Utens E, Wood JJ. Cognitive behavioral therapy age effects in child and adolescent anxiety: an individual patient data metaanalysis. Depress Anxiety 2013; 30:829-41. [PMID: 23658135 PMCID: PMC4854623 DOI: 10.1002/da.22099] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Revised: 02/22/2013] [Accepted: 02/23/2013] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Investigations of age effects on youth anxiety outcomes in randomized trials (RCTs) of cognitive behavior therapy (CBT) have failed to yield a clear result due to inadequate statistical power and methodologic weaknesses. We conducted an individual patient data metaanalysis to address this gap. QUESTION Does age moderate CBT effect size, measured by a clinically and statistically significant interaction between age and CBT exposure? METHODS All English language RCTs of CBT for anxiety in 6-19 year olds were identified using systematic review methods. Investigators of eligible trials were invited to submit their individual patient data. The anxiety disorder interview schedule (ADIS) primary diagnosis severity score was the primary outcome. Age effects were investigated using multilevel modeling to account for study level data clustering and random effects. RESULTS Data from 17 of 23 eligible trials were obtained (74%); 16 studies and 1,171 (78%) cases were available for the analysis. No interaction between age and CBT exposure was found in a model containing age, sex, ADIS baseline severity score, and comorbid depression diagnosis (power ≥ 80%). Sensitivity analyses, including modeling age as both a categorical and continuous variable, revealed this result was robust. CONCLUSIONS Adolescents who receive CBT in efficacy research studies show benefits comparable to younger children. However, CBT protocol modifications routinely carried out by expert trial therapists may explain these findings. Adolescent CBT protocols are needed to facilitate the transportability of efficacy research effects to usual care settings where therapists may have less opportunity for CBT training and expertise development.
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Affiliation(s)
- Kathryn Bennett
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
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King N, Tonge BJ, Mullen P, Myerson N, Heyne D, Rollings S, Muris P. Posttraumatic Stress Disorder in Sexually Abused Children. Behav change 2012. [DOI: 10.1375/bech.17.1.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractChild sexual abuse is a highly prevalent problem that frequently occasions the onset of posttraumatic stress disorder in the victimised youngster. Given the success of cognitive-behavioral interventions with adult trauma victims, it has been suggested that this treatment approach be applied to sexually abused children. We review the empirical support for the efficacy and acceptability of cognitive-behavioral strategies in the treatment of sexually abused children. Several clinical practice and research issues are also noted.
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King NJ, Heyne D, Gullone E, Molloy GN. Usefulness of emotive imagery in the treatment of childhood phobias: Clinical guidelines, case examples and issues. Counselling Psychology Quarterly 2010. [DOI: 10.1080/09515070126328] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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King N, Tonge BJ, Mullen P, Myerson N, Heyne D, Rollings S, Ollendick TH. Sexually abused children and post-traumatic stress disorder. Counselling Psychology Quarterly 2010. [DOI: 10.1080/09515070110040656] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Gullone E, King NJ, Tonge B, Heyne D, Ollendick TH. The fear survey schedule for children — ii (fssc-ii): Validity data as a treatment outcome measure. Australian Psychologist 2007. [DOI: 10.1080/00050060008257485] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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28
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Melvin GA, Tonge BJ, King NJ, Heyne D, Gordon MS, Klimkeit E. A comparison of cognitive-behavioral therapy, sertraline, and their combination for adolescent depression. J Am Acad Child Adolesc Psychiatry 2006; 45:1151-1161. [PMID: 17003660 DOI: 10.1097/01.chi.0000233157.21925.71] [Citation(s) in RCA: 121] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate cognitive-behavioral therapy, antidepressant medication alone, and combined CBT and antidepressant medication in the treatment of depressive disorders in adolescents. METHOD Seventy-three adolescents (ages 12-18 years) with a primary diagnosis of DSM-IV major depressive disorder, dysthymic disorder, or depressive disorder not otherwise specified were randomly allocated to one of three treatments. Treatment outcome measures were administered before and after acute treatment, and at a 6-month follow-up. Depression diagnosis was the primary outcome measure; secondary measures were self- and other report and clinician rating of global functioning. The trial was conducted at three community-based clinics between July 2000 and December 2002. Data analyses used an intent-to-treat strategy. RESULTS Following acute treatment, all treatment groups demonstrated statistically significant improvement on outcome measures (depressive diagnosis, Reynolds Adolescent Depression Scale, Revised Children's Manifest Anxiety Scale, Suicidal Ideation Questionnaire), and improvement was maintained at follow-up. Combined cognitive-behavioral therapy and antidepressant medication was not found to be superior to either treatment alone. Compared with antidepressant medication alone, participants receiving cognitive-behavioral therapy alone demonstrated a superior acute treatment response (odds ratio = 6.86; 95% confidence interval 1.12-41.82). Although cognitive-behavioral therapy was found to be superior to antidepressant medication alone for the acute treatment of mild to moderate depression among youth, this may have stemmed from the relatively low dose of sertraline used. CONCLUSIONS All treatments led to a reduction in depression, but the advantages of a combined approach were not evident.
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Affiliation(s)
- Glenn A Melvin
- Drs. Melvin, Tonge, Gordon, and Klimkeit are with the Centre for Developmental Psychiatry and Psychology and Dr. King is with the Faculty of Education, Monash University, Australia; and Dr. Heyne is with Developmental and Educational Psychology, Leiden University, The Netherlands.
| | - Bruce J Tonge
- Drs. Melvin, Tonge, Gordon, and Klimkeit are with the Centre for Developmental Psychiatry and Psychology and Dr. King is with the Faculty of Education, Monash University, Australia; and Dr. Heyne is with Developmental and Educational Psychology, Leiden University, The Netherlands
| | - Neville J King
- Drs. Melvin, Tonge, Gordon, and Klimkeit are with the Centre for Developmental Psychiatry and Psychology and Dr. King is with the Faculty of Education, Monash University, Australia; and Dr. Heyne is with Developmental and Educational Psychology, Leiden University, The Netherlands
| | - David Heyne
- Drs. Melvin, Tonge, Gordon, and Klimkeit are with the Centre for Developmental Psychiatry and Psychology and Dr. King is with the Faculty of Education, Monash University, Australia; and Dr. Heyne is with Developmental and Educational Psychology, Leiden University, The Netherlands
| | - Michael S Gordon
- Drs. Melvin, Tonge, Gordon, and Klimkeit are with the Centre for Developmental Psychiatry and Psychology and Dr. King is with the Faculty of Education, Monash University, Australia; and Dr. Heyne is with Developmental and Educational Psychology, Leiden University, The Netherlands
| | - Ester Klimkeit
- Drs. Melvin, Tonge, Gordon, and Klimkeit are with the Centre for Developmental Psychiatry and Psychology and Dr. King is with the Faculty of Education, Monash University, Australia; and Dr. Heyne is with Developmental and Educational Psychology, Leiden University, The Netherlands
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Tonge B, King N, Klimkeit E, Melvin G, Heyne D, Gordon M. The Self-Efficacy Questionnaire for Depression in Adolescents (SEQ-DA). Development and psychometric evaluation. Eur Child Adolesc Psychiatry 2005; 14:357-63. [PMID: 16254764 DOI: 10.1007/s00787-005-0462-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/03/2004] [Indexed: 10/25/2022]
Abstract
The 12-item clinician or self-administered Self-Efficacy Questionnaire for Depression in Adolescents (SEQ-DA) was developed as a measure of perceived ability to cope with depressive symptomatology. This study examined the reliability and validity of the SEQ-DA in a clinical population of 130 adolescents that were receiving treatment for depression. Psychometric evaluation revealed good internal consistency and test-retest reliability. Results indicated that higher SEQ-DA scores were associated with lower self-rated depression scores (Reynolds Adolescent Depression Scale), which is evidence of good construct validity. Further, higher SEQ-DA scores prior to treatment predicted better outcome at the end of the 3 months of treatment and at 6 months post-treatment. Therefore, the SEQ-DA has a potentially useful role in clinical work and research with depressed young people.
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Affiliation(s)
- Bruce Tonge
- Monash University Centre for Developmental Psychiatry and Psychology, Psychiatry and Psychological Medicine, Monash Medical Centre, Clayton,Victoria, Australia
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King NJ, Heyne D, Tonge BJ, Mullen P, Myerson N, Rollings S, Ollendick TH. Sexually Abused Children Suffering From Post-traumatic Stress Disorder: Assessment and Treatment Strategies. Cogn Behav Ther 2003; 32:2-12. [PMID: 16291530 DOI: 10.1080/16506070310003620] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Child sexual abuse is a highly prevalent problem that frequently occasions the onset of post-traumatic stress disorder in the victimized youngster. This selective review addresses recent advances in the assessment and treatment of sexually abused children with post-traumatic stress disorder. Firstly, we outline the diagnostic criteria for post-traumatic stress disorder and significant moderating variables in the development of post-traumatic stress disorder. Secondly, we address the clinical assessment of post-traumatic stress disorder in sexually abused children, recommending a developmentally sensitive, multi-informant approach. Thirdly, we consider a family-wide cognitive-behavioural treatment framework for sexually abused children with post-traumatic stress disorder that involves both child and non-offending caregivers. Fourthly, we examine the results of recent evaluation studies supportive of cognitive-behavioural therapy in the treatment of sexually abused children. Lastly, we consider conclusions for clinical practice and directions for future research.
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Affiliation(s)
- Neville J King
- Faculty of Education, Monash University, Clayton, Victoria, Australia.
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Heyne D, King NJ, Tonge BJ, Rollings S, Young D, Pritchard M, Ollendick TH. Evaluation of child therapy and caregiver training in the treatment of school refusal. J Am Acad Child Adolesc Psychiatry 2002; 41:687-95. [PMID: 12049443 DOI: 10.1097/00004583-200206000-00008] [Citation(s) in RCA: 106] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the relative efficacy of (1) child therapy, (2) parent/teacher training, and (3) the combination of child therapy and parent/teacher training in the treatment of anxiety-based school refusal. METHOD Sixty-one school-refusing children (aged 7-14 years) from throughout Melbourne, Australia, were randomized to a child therapy program, a parent and teacher training program, or a combination of the two. Children were assessed before and after treatment, and at 4.5-month follow-up, by means of attendance records, self-report of emotional distress and self-efficacy, parent and teacher reports of emotional distress, and clinician ratings of overall functioning. RESULTS Statistically and clinically significant pretreatment-posttreatment change occurred for each group. Immediately posttreatment, child therapy appeared to be the least effective in increasing attendance. By follow-up, the attendance and adjustment of those in the child therapy group equalled that of children whose parents and teachers were involved in treatment, whether on their own (parent/teacher training) or together with their children (combined child therapy and parent/teacher training). CONCLUSION Contrary to expectations, combined child therapy and parent/teacher training did not produce better outcomes at posttreatment or follow-up.
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Affiliation(s)
- David Heyne
- Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Victoria, Australia.
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Abstract
School refusal is differentiated from other attendance problems such as truancy and school withdrawal. It is characterised by the child's emotional upset at the prospect of going to school, parental awareness of and antipathy toward the problem, and an absence of significant antisocial behaviour in the child. The child's emotional upset is frequently associated with an anxiety disorder, but it may also be associated with a mood disorder. School refusal affects approximately 1% of school children across the primary and secondary school levels. Severe and prolonged school refusal jeopardises the young person's social, emotional and academic development, and may be associated with mental health problems in adulthood. A first step in management involves efficient identification and the assessment of contributing and maintaining factors. Clinical outcome studies support the efficacy of cognitive behavioural therapy (CBT). The psychosocial approach encompassed in CBT incorporates anxiety management training with the young person, behaviour management training with parents and consultation with school personnel. Pharmacological treatments are commonly employed although empirical support for their use is limited. Tricyclic antidepressants and selective serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibitors are the more commonly used agents, with the latter having fewer associated adverse effects. It is suggested that the first line of treatment should be CBT, with simultaneous or subsequent pharmacological treatment contingent upon the response to CBT.
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Affiliation(s)
- D Heyne
- Victorian Child Psychiatry Training Department, Faculty of Medicine, Dentistry, & Health Sciences, University of Melbourne, Australia.
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King NJ, Heyne D, Tonge B, Gullone E, Ollendick TH. School refusal: categorical diagnoses, functional analysis and treatment planning. Clin Psychol Psychother 2001. [DOI: 10.1002/cpp.313] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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King N, Tonge BJ, Heyne D, Turner S, Pritchard M, Young D, Rollings S, Myerson N, Ollendick TH. Cognitive-Behavioural Treatment of School-Refusing Children: Maintenance of improvement at 3- to 5-year follow-up. ACTA ACUST UNITED AC 2001. [DOI: 10.1080/02845710117011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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King NJ, Tonge BJ, Mullen P, Myerson N, Heyne D, Rollings S, Martin R, Ollendick TH. Treating sexually abused children with posttraumatic stress symptoms: a randomized clinical trial. J Am Acad Child Adolesc Psychiatry 2000; 39:1347-55. [PMID: 11068889 DOI: 10.1097/00004583-200011000-00008] [Citation(s) in RCA: 182] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the efficacy of child and caregiver participation in the cognitive-behavioral treatment of sexually abused children with posttraumatic stress symptoms. METHOD Thirty-six sexually abused children (aged 5-17 years) were randomly assigned to a child-alone cognitive-behavioral treatment condition, a family cognitive-behavioral treatment condition, or a waiting-list control condition. RESULTS Compared with controls, children who received treatment exhibited significant improvements in posttraumatic stress disorder symptoms and self-reports of fear and anxiety. Significant improvements also occurred in relation to parent-completed measures and clinician ratings of global functioning. In general, parental involvement did not improve the efficacy of cognitive-behavioral therapy. Maintenance of improvement was evident at a 12-week follow-up assessment. CONCLUSIONS Cognitive-behavioral treatment was useful, but further research is required on caregiver involvement.
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Affiliation(s)
- N J King
- Faculty of Education, Monash University, Victoria, Australia.
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Abstract
Cognitive-behavior therapy is frequently used in the treatment of school refusal, a challenging problem for mental health professionals and school authorities. We review the clinical and research support for the efficacy of cognitive-behavior therapy using recently published guidelines for determining the level of evidentiary support for psychosocial interventions. Although cognitive-behavior therapy appears to be a useful treatment for school refusal, further research is needed before it can be considered as having "well-established" empirical status. Several other important methodological and theoretical issues are emphasized.
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Affiliation(s)
- N King
- Faculty of Education, Monash University, Clayton, Victoria, Australia.
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King NJ, Heyne D. Promotion of empirically validated psychotherapies in counselling psychology. Counselling Psychology Quarterly 2000. [DOI: 10.1080/09515070050011024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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King NJ, Tonge BJ, Turner S, Heyne D, Pritchard M, Rollings S, Young D, Myerson N, Ollendick TH. Brief cognitive-behavioural treatment for anxiety-disordered children exhibiting school refusal. Clin Psychol Psychother 1999. [DOI: 10.1002/(sici)1099-0879(199902)6:1<39::aid-cpp178>3.0.co;2-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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King NJ, Tonge BJ, Heyne D, Pritchard M, Rollings S, Young D, Myerson N, Ollendick TH. Cognitive-behavioral treatment of school-refusing children: a controlled evaluation. J Am Acad Child Adolesc Psychiatry 1998; 37:395-403. [PMID: 9549960 DOI: 10.1097/00004583-199804000-00017] [Citation(s) in RCA: 199] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate the efficacy of a 4-week cognitive-behavioral treatment program for children who refuse to go to school. METHOD Thirty-four school-refusing children (aged 5 to 15 years) were randomly assigned to a cognitive-behavioral treatment condition or a waiting-list control condition. Treatment consisted of individual child cognitive-behavioral therapy plus parent/teacher training in child behavior management skills. Measures taken before and after treatment included school attendance, child self-report of emotional distress and coping, caregiver reports on emotional and behavioral problems, and clinician ratings of global functioning. RESULTS Relative to waiting-list controls, children who received cognitive-behavioral therapy exhibited a significant improvement in school attendance. These children also improved on self-reports of fear, anxiety, depression, and coping. Significant improvements also occurred in relation to caregiver reports and clinician ratings. Maintenance of therapeutic gains was demonstrated at a 3-month follow-up assessment. CONCLUSIONS Cognitive-behavioral treatment of school refusal was efficacious and acceptable. The relative contributions of child therapy and parent/teacher training require further study.
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Affiliation(s)
- N J King
- Faculty of Education, Monash University, Clayton, Victoria, Australia
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King NJ, Ollendick TH, Tonge BJ, Heyne D, Pritchard M, Rollings S, Young D, Myerson N. Behavioural management of school refusal. ACTA ACUST UNITED AC 1996. [DOI: 10.1080/16506079609456002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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King N, Ollendick T, Heyne D, Tonge B. Treatment of school refusal. Strategies for the family physician. Aust Fam Physician 1995; 24:1250-3. [PMID: 7661779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Although school refusal is not a common problem, it causes extreme turmoil in families and affects psychological and social development of the growing child. Causes for school refusal are diverse. Careful assessment to clarify the function of the school refusal is critical for successful intervention. Effective management strategies have been developed and are described in more detail in a recent book by King, Ollendick, and Tonge.
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Affiliation(s)
- N King
- Faculty of Education, School of Graduate Studies, Monash University
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Tonge BJ, King NJ, Heyne D, Pritchard M. Anxious children and school refusal. Aust Fam Physician 1994; 23:919-20. [PMID: 8037632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- B J Tonge
- Centre for Developmental Psychiatry, Monash Medical Centre, Clayton, Victoria
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De Wals P, Hertoghe L, Borlée-Grimée I, Heyne D, De Maeyer-Cleempoel S, Reginster-Haneuse G, Dachy A, Lechat MF. Meningococcal disease in Belgium. I. Risk of secondary cases among household contacts and evaluation of prophylaxis. Acta Paediatr Belg 1978; 31:73-8. [PMID: 685682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Heyne D. [Diphtheria in Belgium. 1975]. Arch Belg Med Soc 1976; 34:401-25. [PMID: 1027367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Heyne D. [Tetanus in Belgium, 1975]. Arch Belg Med Soc 1976; 34:354-77. [PMID: 1026198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Heyne D. [Rabies in Belgium 1974; summary 1966-1974]. Arch Belg Med Soc 1975; 33:357-95. [PMID: 1231645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Heyne D. [Meningococcal infections in Belgium in 1974]. Arch Belg Med Soc 1975; 33:277-307. [PMID: 817670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Heyne D. [Poliomyelitis in belgium 1973]. Arch Belg Med Soc 1975; 33:213-26. [PMID: 1231641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Sternon J, Van de Weyer R, Butzler JP, Kocheleff P, Heyne D, Paulet P. [Human anthrax in Belgium. Recent cases and epidemiological data]. Acta Clin Belg 1974; 29:405-12. [PMID: 4440401 DOI: 10.1080/17843286.1974.11716962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Heyne D. [Syphilis in Belgium. Year 1967]. Arch Belg Med Soc 1968; 26:632-46. [PMID: 5759732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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