Publications by authors named "Kristine Amlund Hagen"

11 Publications

  • Page 1 of 1

Bullying Victimization and Trauma.

Front Psychiatry 2020 14;11:480353. Epub 2021 Jan 14.

Norwegian Center for Child Behavioral Development, Oslo, Norway.

Bullying victimization and trauma research traditions operate quite separately. Hence, it is unclear from the literature whether bullying victimization should be considered as a form of interpersonal trauma. We review studies that connect bullying victimization with symptoms of PTSD, and in doing so, demonstrate that a conceptual understanding of the consequences of childhood bullying needs to be framed within a developmental perspective. We discuss two potential diagnoses that ought to be considered in the context of bullying victimization: (1) developmental trauma disorder, which was suggested but not accepted as a new diagnosis in the DSM-5 and (2) complex post-traumatic stress disorder, which has been included in the ICD-11. Our conclusion is that these frameworks capture the complexity of the symptoms associated with bullying victimization better than PTSD. We encourage practitioners to understand how exposure to bullying interacts with development at different ages when addressing the consequences for targets and when designing interventions that account for the duration, intensity, and sequelae of this type of interpersonal trauma.
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http://dx.doi.org/10.3389/fpsyt.2020.480353DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7841334PMC
January 2021

Common Elements of Practice, Process and Implementation in Out-of-School-Time Academic Interventions for At-risk Children: a Systematic Review.

Prev Sci 2020 05;21(4):545-556

Norwegian Center for Child Behavioral Development, Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway.

Academic achievement is a strong preventive factor against marginalization. Children at risk of academic failure and drop out can benefit from out-of-school-time academic (OSTA) interventions. Wide-scaled implementation and sustainment of effective interventions remain a struggle across education, welfare, and health. The need for approaches to increase implementability, effectiveness, and efficiency of interventions is pressing. Advancements in the field of education and mental health suggest identifying and studying discrete elements that are common across interventions for the purpose of hypothesis generation, intervention optimization, design improvement, and implementation. This review identified OSTA interventions for primary school children at risk of academic failure. Common elements methodology was used to code practice elements (n = 62), process elements (n = 49), and implementation elements (n = 36) in 30 effective and six ineffective OSTA interventions in matrices. Based on frequency counts, common practice, process, and implementation elements across the interventions were identified, and given frequency count values (FV) reflecting how often elements were included in effective studies as opposed to in ineffective studies. The five common practice elements with the highest FVs were homework support, training in positive parental school involvement, positive reinforcement, structured tutoring, and psychoeducation. The most common process element was regular support to intervention receiver, and the most common implementation element was quality monitoring. Common combinations of elements were also identified and given FVs. Results from this review can inform efforts to design or optimize OSTA interventions, and inform education, implementation, and practice to improve academic achievement for children at risk.
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http://dx.doi.org/10.1007/s11121-020-01091-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7162823PMC
May 2020

Evaluating Modular Approach to Therapy for Children with Anxiety, Depression, Trauma and Conduct Problems (MATCH-ADCT) in Norwegian child and adolescent outpatient clinics: Study protocol for a randomized controlled trial.

Trials 2019 Jan 7;20(1):16. Epub 2019 Jan 7.

Department of Psychology, Faculty of Arts and Sciences, Harvard University, 1030 William James Hall, 33 Kirkland Street, Cambridge, MA, 02138, USA.

Background: Norwegian health, care, and welfare services are experiencing increased demands to deliver services that are safe, effective, of high quality, and that ensure user involvement. Yet, evidence-based treatment for common disorders such as depression, anxiety, trauma, and behavioral problems in children are not regularly used in clinical practice in Norway. Possible explanations for this are that many standard, evidence-based treatments may have difficulty addressing the complexity and comorbidity of referred children and the fact that children's treatment needs often shift during treatment. The Modular Approach to Therapy for children with Anxiety, Depression, Trauma and Conduct problems (MATCH-ADTC) was designed to address these challenges and reduce some of the barriers to therapists' use of evidence-based treatment in their practice.

Methods/design: Participants will include 280 children (aged 6-14.5 years at intake) who receive treatment in child and adolescent mental health outpatient clinics in Norway, and their families. Families are randomly assigned to either the experimental group receiving treatment from therapists trained in MATCH, or to the comparison group receiving treatment from therapists delivering treatment as usual (TAU). Data on children's symptomology, child and family functioning, demographics, background information, and mental health outcomes are collected as well as frequent feedback on treatment response, plus video-recordings of treatment sessions and implementation quality scores from each participating clinic. Questionnaires are administered in six waves.

Discussion: MATCH has been tested in the US with promising results, but we do not know whether this treatment approach will produce similar results in Norway. The implications of this study are 1. Possibly better treatment outcomes and/or more efficient improvements for children and families treated in mental health outpatient clinics in Norway 2. Clinicians learning to use more evidence-based practices in their treatment 3. Implementation of standard procedures for obtaining feedback from children and families and sharing the feedback with clinicians 4. Increased understanding, at the end of the trial, of whether introducing MATCH improves outcomes for children and families treated in mental health outpatient clinics TRIAL REGISTRATION: ISRCTN, registration number: ISRCTN24029895 . Registered on 8 August 2016.
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http://dx.doi.org/10.1186/s13063-018-3074-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6322284PMC
January 2019

Knowledge translation in child welfare-improving educational outcomes for children at risk: study protocol for a hybrid randomized controlled pragmatic trial.

Trials 2018 Dec 29;19(1):714. Epub 2018 Dec 29.

The Norwegian Center for Child Behavioral Development (NCCBD), a University of Oslo affiliate, Postboks 7053 Majorstuen, 0306, Oslo, Norway.

Background: In Norway, a disproportionately high number of children receiving Child Welfare Services (CWS) struggle academically and drop out of school. Academic attainment is one of the strongest protective factors against societal marginalization. The present study is part of a knowledge translation project in collaboration with local CWS with the aim to develop, implement, and evaluate Enhanced Academic Support (EAS) for primary school children in CWS.

Methods/design: The study is a mixed-methods hybrid type 2 randomized, controlled pragmatic trial. The participants are approximately 120 children whose families receive support measures from three child welfare agencies in and around Oslo, Norway, and practitioners from these agencies. Families are randomly assigned to either the EAS condition or "business as usual" support. Primary outcomes are math and reading skills, parental involvement in school, and intervention fidelity. Questionnaires and academic tests are administered at baseline, post-intervention (after 6 months), and at follow-up (after 12 months). Implementation drivers are assessed before and after the trial period, and intervention fidelity is monitored during the trial through checklists and structured telephone interviews. Semi-structured interviews and focus groups are conducted after the trial.

Discussion: This hybrid study has two implications. (1) The effects of providing EAS to children in child welfare will be investigated. The study also explores how each core component of the intervention and the use of specific adaptations, implementation drivers, and other important child-level covariates moderate the overall effects. The results can provide valuable knowledge about how to deliver precise and effective academic support to increase academic skills and prevent dropout. In turn, this can promote academic completion and well-being, outcomes that are beneficial for both children and society at large. (2) The study also evaluates the feasibility of applying an Integrated Knowledge Translation model designed to develop, implement, and evaluate research-supported practice in health, care, and welfare services in less time than is usually the case. If deemed successful, this model will provide an efficient collaborative approach to translate the best available evidence into effective evidence-based practice, applicable in effectiveness research and quality improvement efforts.

Trial Registration: ISRCTN, ISRCTN38968073 . Registered on 18 September 2017. https://doi.org/10.1186/ISRCTN38968073 .
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http://dx.doi.org/10.1186/s13063-018-3079-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6311076PMC
December 2018

Health-related quality of life (HRQoL) in children of ill or substance abusing parents: examining factor structure and sub-group differences.

Qual Life Res 2019 Apr 26;28(4):1063-1073. Epub 2018 Nov 26.

Department for Research and Development, Mental Health Services, Akershus University Hospital, Box 1000, 1478, Lørenskog, Norway.

Purpose: Health-related quality of life (HRQoL) may be helpful in identifying children at risk of developing adjustment problems. Few studies have focused on HRQoL among children of ill or substance abusing parents despite their considerable risk status. In the present study, we used the KIDSCREEN-27 to assess self-reported HRQoL in children and adolescents living in families with parental illness, or substance dependence. First, we tested whether the factor structure of the KIDSCREEN-27 was replicated in this population of children. Next, we examined differences in HRQoL according to age, gender, and type of parental illness. Finally, we compared levels of HRQoL in our sample to a normative reference population.

Method: Two hundred and forty-six children and adolescents aged 8-17 years and their ill parents participated. The construct validity of the KIDSCREEN-27 questionnaire was examined by confirmatory factor analysis (CFA). T-tests and ANOVA were used to test differences in HRQoL levels according to age, gender, and parental patient groups, and for comparisons with reference population.

Results: The KIDSCREEN-27 fit the theoretical five-factor model of HRQoL reasonably well. Boys and younger children reported significantly greater well-being on physical well-being, psychological well-being, and peers and social support, compared to girls and older children. Younger children also reported significantly greater well-being at school than did older children. There were no significant differences in HRQoL between groups of children living with different type of parental illness. The children in our sample reported their physical well-being significantly lower than the reference population.

Conclusion: The KIDSCREEN-27 questionnaire appears to work satisfactorily among children of ill or substance abusing parents.
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http://dx.doi.org/10.1007/s11136-018-2067-1DOI Listing
April 2019

Predictors of changes in child behaviour following parent management training: Child, context, and therapy factors.

Int J Psychol 2017 Apr 18;52(2):106-115. Epub 2016 Jul 18.

Norwegian Center for Child Behavioral Development, Oslo, Norway.

This non-randomised study examined a set of predictive factors of changes in child behaviour following parent management training (PMTO). Families of 331 Norwegian girls (26%) and boys with clinic-level conduct problems participated. The children ranged in age from 3 to 12 years (M = 8.69). Retention rate was 72.2% at post-assessment. Child-, parent- and therapy-level variables were entered as predictors of multi-informant reported change in externalising behaviour and social skills. Behavioural improvements following PMTO amounted to 1 standard deviation on parent rated and ½ standard deviation on teacher rated externalising behaviour, while social skills improvements were more modest. Results suggested that children with higher symptom scores and lower social skills score at pre-treatment were more likely to show improvements in these areas. According to both parent- and teacher-ratings, girls tended to show greater improvements in externalising behaviour and social skills following treatment and, according to parents, ADHD symptomology appeared to inhibit improvements in social skills. Finally, observed increases in parental skill encouragement, therapists' satisfaction with treatment and the number of hours spent in therapy by children were also positive and significant predictors of child outcomes.
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http://dx.doi.org/10.1002/ijop.12365DOI Listing
April 2017

Treatment outcomes and mediators of parent management training: a one-year follow-up of children with conduct problems.

J Clin Child Adolesc Psychol 2011 ;40(2):165-78

Norwegian Center for Child Behavioral Development, University of Oslo, Oslo, Norway.

This effectiveness study presents the results of a 1-year follow-up of a randomized controlled trial of Parent Management Training. Families of 112 Norwegian girls and boys with clinic-level conduct problems participated, and 75 (67%) families were retained at follow-up. Children ranged in age from 4 to 12 at intake (M = 8.44). Families randomized to the control group received an active treatment alternative as would be normally offered by participating agencies. Multi-informant, multisetting outcome measures were collected and results from both intention-to-treat and treatment-on-the-treated analyses are presented. In two separate indirect effects models, assignment to Parent Management Training-the Oregon model predicted greater effective discipline and family cohesion at postassessment, which in turn predicted improvements in several child domains at follow-up.
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http://dx.doi.org/10.1080/15374416.2011.546050DOI Listing
July 2011

What works for whom? Gender differences in intake characteristics and treatment outcomes following Multisystemic Therapy.

J Adolesc 2009 Dec 19;32(6):1425-35. Epub 2009 Jul 19.

Norwegian Center for Child Behavioral Development, Unirand, University of Oslo, Majorstuen, 0368 Oslo, Norway.

Aims Of The Study: We investigated whether girls and boys had similar referral symptoms and background characteristics at intake to Multisystemic Therapy (MST) and whether adolescent girls with serious behavior problems benefited as much from MST treatment as did boys. We also examined gender differences in rate of co-morbidity at intake and whether the families of boys and girls referred to MST differed in their evaluation of the treatment received.

Method: Participants were 117 Norwegian adolescent girls (35%) and boys (65%), ranging in age from 12 to 17 (M=14.58), referred to MST treatment in the first and second year of the program operation.

Results: Gender differences appeared for some referral reasons, intake characteristics and treatment changes, but the similarities between girls and boys far outnumbered their differences.

Conclusions: Although girls may present a somewhat different problem profile than do boys and their risk factors for developing conduct problems may be somewhat different, MST seemed flexible and robust enough to be effective for most adolescents in the present sample, regardless of gender.
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http://dx.doi.org/10.1016/j.adolescence.2009.06.006DOI Listing
December 2009

Treatment effectiveness of Parent Management Training in Norway: a randomized controlled trial of children with conduct problems.

J Consult Clin Psychol 2008 Aug;76(4):607-621

Norwegian Center for Child Behavioral Development.

This study was a randomized control trial (RCT) of Parent Management Training--The Oregon Model (PMTO) in Norway. A sample representing all health regions of Norway and consisting of 112 children with conduct problems and their families participated in the study. Families were randomly assigned to either PMTO or a regular services comparison group. PMTO was delivered via existing children's services, and families were recruited using the agencies' regular referral procedures, making this the first effectiveness study of PMTO and the first RCT of PMTO conducted outside of the United States. Using a multiagent-multimethod approach, results showed that PMTO was effective in reducing parent-reported child externalizing problems, improving teacher-reported social competence, and enhancing parental discipline. Age level and gender modified the effects of PMTO treatment on other outcomes. In a path model, participation in PMTO was associated with improved parental discipline, and effective discipline predicted greater child compliance, fewer child-initiated negative chains, and lower levels of child externalizing problems. Findings are presented along with a discussion of the implications for practice and research and the challenges accompanying effectiveness trials.
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http://dx.doi.org/10.1037/0022-006X.76.4.607DOI Listing
August 2008

Multisystemic Treatment of Serious Behaviour Problems in Youth: Sustainability of Effectiveness Two Years after Intake.

Child Adolesc Ment Health 2006 Sep 21;11(3):142-149. Epub 2006 Mar 21.

The Norwegian Centre for Studies of Conduct Problems and Innovative Practice, Unirand, PO Box 1565, Vika, N-0118 Oslo, Norway E-mail:

Background:   Multisystemic Treatment (MST) is an intensive home- and community based intervention for youths with serious behaviour problems. The aim of this study was to examine the effectiveness of MST compared to 'regular services' (RS) two years after intake to treatment. In particular, our goals were to investigate whether MST was successful at preventing placement out of home, and to examine reductions in behaviour problems in multi-informant assessments.

Method:   Participants were 75 adolescents who were randomly assigned to MST or Regular Child Welfare Services (RS) at 3 sites across Norway. Data were gathered from youths, caregivers and teachers.

Results:   MST was more effective than RS in reducing out of home placement and behavioural problems.

Discussion:   The sustainability of treatment effects was evident, supporting the MST approach to the treatment of serious behavioural problems in youth. Site differences and the moderating effects of age and gender are discussed.
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http://dx.doi.org/10.1111/j.1475-3588.2006.00396.xDOI Listing
September 2006

Hope, social support, and behavioral problems in at-risk children.

Am J Orthopsychiatry 2005 Apr;75(2):211-9

Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284-2018, USA.

This study investigated the effects of hope, social support, and stress on behavioral problems in a high-risk group of 65 children of incarcerated mothers. Children with low levels of hope had more externalizing and internalizing problems. Children who perceived less social support had more externalizing problems, and children who had experienced more life stressors reported more internalizing problems. Regression analyses indicated that hope contributed unique variance to both internalizing and externalizing behavioral problems after social support and stress were controlled. These findings suggest that being confident in one's ability to overcome challenges and having a positive outlook function as protective factors, whereas being less hopeful may place a child at risk for developing adjustment problems. Whether it is possible to foster agency and teach pathways to children with lower levels of hope is discussed.
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http://dx.doi.org/10.1037/0002-9432.75.2.211DOI Listing
April 2005