Browsing by Author "Yoder, Rachel"

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    The adverse childhood experiences questionnaire: Two decades of research on childhood trauma as a primary cause of adult mental illness, addiction, and medical diseases
    (Taylor & Francis, 2019-01-01) Zarse, Emily M.; Neff, Mallory R.; Yoder, Rachel; Hulvershorn, Leslie; Chambers, Joanna E.; Chambers, R. Andrew; Psychiatry, School of Medicine
    Objective. In 1998, Felitti and colleagues published the first study of the Adverse Childhood Experiences-Questionnaire (ACE-Q), a 10-item scale used to correlate childhood maltreatment and adverse rearing contexts with adult health outcomes. This paper qualitatively reviews nearly two decades of research utilizing the ACE-Q, highlighting its contribution to our understanding of the causal roots of common, interlinked comorbidities of the brain and body.Methods. An OVID/PubMed search was conducted for English language articles published before 2016, containing the phrase “Adverse Childhood Experiences” in which the ACE-Q was utilized. Source review included a manual search of bibliographies, resulting in 134 articles, including 44 based on the original ACE-Q study population.Results. ACE-Q research has demonstrated that exposures to adverse childhood experiences converge dose-dependently to potently increase the risk for a wide array of causally interlinked mental illnesses, addictions, and multi-organ medical diseases. The intergenerational transmission of this disease burden via disrupted parenting and insecure rearing contexts is apparent throughout this literature. However, the ACE-Q does not tease out genetic or fetal drug exposure components of this transmission.Conclusions. Adverse childhood experiences and rearing may generate a public health burden that could rival or exceed all other root causes. Translating this information to health-care reform will require strengthening brain-behavioral health as core public and preventative health-care missions. Greater integration of mental health and addiction services for parents should be accompanied by more research into brain mechanisms impacted by different forms and interactions between adverse childhood experiences.
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    Family-Based Treatment for Anxiety, Depression, and ADHD for a Parent and Child
    (MDPI, 2024-04-19) Yoder, Rachel; Michaud, Alyssa; Feagans, Amanda; Hinton-Froese, Kendra E.; Meyer, Allison; Powers, Victoria A.; Stalnaker, Leah; Hord, Melissa K.; Psychiatry, School of Medicine
    Children with mental illness commonly live with caregivers who suffer from mental illness. Integrated mental-health-treatment approaches can provide more convenient and comprehensive care for families. This case report describes family-based treatment (FBT) for one parent/child dyad. The parent was a 37-year-old female with a history of anxiety and major depressive disorder and concern for symptoms of attention-deficit/hyperactivity disorder (ADHD). The child was an 8-year-old female with generalized anxiety disorder and concern for ADHD and behavioral problems. The parent received individual cognitive behavioral therapy (CBT) and parent management training. The child received CBT. Both also received medication management. The FBT team met regularly for coordinated treatment planning. Self-reported assessments via the Child Behavior Checklist showed meaningful improvement; anxiety decreased to nonclinical range week 12 and depression decreased to nonclinical range week 8. Clinician assessments showed improvement for both patients. Though more time intensive, FBT can yield significant improvement, particularly for children. Pragmatic approaches to treatment planning are important to minimize barriers to FBT.
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    Racial/Ethnic differences in the prevalence of anxiety using the Vanderbilt ADHD scale in a diverse community outpatient setting
    (Wolters Kluwer, 2016-10) Bauer, Nerissa S.; Yoder, Rachel; Carroll, Aaron E.; Downs, Stephen M.; Pediatrics, School of Medicine
    Objective Pediatric anxiety is prevalent but frequently under-diagnosed compared to other behavioral conditions in primary care practice. Pediatricians routinely screen for attention deficit hyperactivity disorder using the Vanderbilt Rating Scale, which includes a short screen for anxiety. We sought to examine the prevalence of potential anxiety among patients whose parents originally had concerns of disruptive behavior in a diverse setting and examine differences in anxiety across ethnic groups using the Vanderbilt ADHD Diagnostic Rating Scale (VADRS). Methods This was a cross-sectional analysis of medical records data of children between the ages of 5–12 years whose parents had concerns of disruptive behavior and received primary care from May 25, 2010 to January 31, 2014 at 2 pediatric community health clinics in Indianapolis. Results 16% of children whose parents had concerns for disruptive behavior screened positive for anxiety based on the VADRS screen. Hispanic parents were less likely to report symptoms of anxiety (Spanish-speaking: AOR 0.4, 95% CI 0.2 – 0.8; English-speaking: AOR 0.3, 95% CI 0.1 – 0.9) compared to white and black families. Conclusion Anxiety is detected at a lower rate among Hispanic pediatric patients using the VADRS. This may suggest differences in the performance of the VADRS among Spanish speaking families.