Using Neuroimaging to Understand Children's Mental Health and Treatment Outcomes

This project will implement and evaluate the Child STEPs treatment approach as compared to
"treatment as usual" (known as Usual Care or UC) through a randomized controlled trial (RCT)
at eight K-8 public schools. The STEPs model has two components: (1) a modular protocol that
combines 33 modules—i.e., descriptions of common elements within evidence-based therapies for
anxiety, depression, post-traumatic stress, and conduct problems; and (2) a web-based system
for monitoring student responses to treatment and providing weekly feedback to therapists to
guide their selection and sequencing of the STEPs modules. The project will examine: (a)
whether self-regulation skills at baseline are associated with baseline patterns of mental
health and school problems; (b) whether self-regulation skills at baseline predict degree of
improvement during treatment; (c) whether self-regulation skills improve from pre-to post
treatment, and whether extent of this improvement differs by treatment condition; and (d)
whether self-regulation improvement (from pre-to-post treatment) mediates the long-term
benefit of treatment.

Inclusion Criteria:

1. enrolled in grades 3-7

2. have a primary clinical problem in the areas of anxiety, depression, conduct, or
posttraumatic stress

3. clinically elevated problem levels on the Internalizing, Externalizing,
Anxious-Depressed, Withdrawn-Depressed, Aggressive Behavior, or Rule-Breaking Behavior
scales of the Child Behavior Checklist or Youth Self-Report or on the UCLA
Post-Traumatic Stress Disorder Reaction Index.

Exclusion Criteria:

1. Mental retardation

2. Pervasive developmental disorder

3. Eating disorder

4. children for whom attention problems or hyperactivity are the primary referral concern

5. active psychosis and/or a suicide attempt in the previous year

To participate in the two neuroimaging tasks (Emotion Regulation Task; Emotional Go/No Go
Task), participants must be healthy (no major medical illness), right-handed, fluent in
English, have no history of neurological impairment (including but not limited to history
of loss of consciousness for great than 20 minutes, seizures, stroke, etc.), have normal or
corrected to normal vision, and have no contra-indications or risk factors for MRI research
(such as braces or metal implants).