Hoarding disorder is present in 2-6% of the population and can have an immense impact on the lives of patients and their families. Before its inclusion the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, pathological hoarding was often characterized as a symptom of obsessive-compulsive disorder, and several different diagnostic assessment methods were used to identify and characterize it. Although the age of onset of pathological hoarding is an important epidemiological measure, as clarifying the age of onset of hoarding symptoms may allow for early identification and implementation of evidence-based treatments before symptoms become clinically significant, the typical age of onset of hoarding is still uncertain. To that end, this study is a systematic review and meta-analysis of research published in English between the years 1900 and 2016 containing information on age of onset of hoarding symptoms. Twenty-five studies met inclusion criteria. The mean age of onset of hoarding symptoms across studies was 16.7 years old, with evidence of a bimodal distribution of onset. The authors conclude by discussing practice implications for early identification and treatment.

Few studies have investigated the relationship between comorbid depression and anxiety and cognitive and academic functioning. To understand this relationship, this study used a retrospective chart review from an inpatient facility for 42 adolescents diagnosed with a comorbid anxiety and depressive disorder. Multiple regression was used to determine whether anxiety and depression predicted academic achievement, as well as whether intelligence predicted current levels of anxiety and depression. Results indicated that higher severity of depression was associated with lower reading (β = –0.39) and writing (β = –0.40) achievement, while higher severity of anxiety was associated with higher scores on reading (β = 0.41) and writing (β = 0.36). Full-scale IQ was not significantly predictive of anxiety severity (β = 0.08) or depression severity (β = –0.24). Results are discussed in terms of identifying risk factors and improving outcomes for adolescents with severe comorbid anxiety and depression psychopathology.

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Chapter 5 presents fundamental counseling skills that are easily implemented within a cognitive behavioral therapy framework: psychoeducation, motivational interviewing, relaxation training, and mindfulness. The chapter offers a brief historical note on each technique, an evaluation of its research support, and authentic client–therapist dialog that emphasizes its utility and key elements. Each technique is discussed within the context of cognitive behavioral theory, including its overall effect on intervention outcomes and applicability for different referral problems. This chapter’s appendix material includes practical school-based resources for practitioners seeking to apply these techniques in session (detailed breathing, muscle relaxation, and guided imagery scripts) along with multimedia resources for children and families.