Far from a monolith: a typology of externalizing behavior among African American youth

Foster Care Involvement Among Youth With Intellectual and Developmental Disabilities

Importance

Youth with intellectual and developmental disabilities (I/DD) are more likely to be placed in foster care than other youth. Examining the clinical and sociodemographic characteristics of youth with I/DD in the foster care system is critical for identifying disparities and understanding service needs.

Objective

To produce a population-level analysis of youth with I/DD in foster care that examines differences in rates of foster care involvement based on race, ethnicity, age, and sex.

Design, Setting, and Participants

This cross-sectional study involved all individuals with I/DD 21 years and younger enrolled in Medicaid through foster care in 2016 via data from Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) for all 50 US states and Washington, DC. As a key insurer of I/DD services and foster care, Medicaid claims offer a timely population-level analysis. Youth with I/DD were grouped into diagnostic subgroups: autism spectrum disorder (ASD) only, intellectual disability only, or ASD and ID. The data analysis took place from July 2022 to September 2023.

Exposure

TAF data contain Medicaid enrollment information by month with a binary indicator of foster care involvement, and eligibility files identify race, ethnicity, age, and sex.

Main Outcomes and Measures

The period prevalence of foster care involvement was determined among I/DD youth by diagnostic subgroups using an intersectional approach across race, ethnicity, age, and sex. Logistic regression examined associations between risk for foster care involvement and race, ethnicity, age, and sex.

Results

A total of 39 143 youth with I/DD had foster care involvement in 2016. Black youth (adjusted odds ratio [aOR], 1.37; 95% CI, 1.28-1.47) and females (aOR, 1.18; 95% CI, 1.1-1.27) had increased likelihood for foster care involvement. The likelihood for foster care involvement increased with age in all groups relative to the age group 0 to 5 years old.

Conclusions and Relevance

This study found that among youth with I/DD, Black youth and females faced higher risk for foster care involvement, and the likelihood of foster care involvement increased with age. There is an urgent need for research that focuses on addressing system-level factors that drive increased risk. Understanding the specific health needs of Black and female youth with I/DD is critical to ensure the formation, implementation, and monitoring of equitable delivery of health services.

Does Conduct, Oppositional Defiant, and Panic Disorder Symptoms Associate with Suicidal Ideations Among African American Adolescents?

Previous studies suggest that mental illness symptoms among adolescents, such as conduct disorder, oppositional defiant disorder, and panic disorder symptoms often associate with suicidal ideations. Despite this, few studies have examined whether these mental illness symptoms associate with suicidal ideations among African American adolescents. To address these limitations, the current study examined whether conduct disorder, oppositional defiant disorder, and panic disorder symptoms associated with suicidal ideations (N = 261). Using binominal logistic regression, results suggest that conduct disorder symptoms were associated with a higher likelihood of endorsing suicidal ideations than oppositional defiant disorder symptoms. Finally, panic disorder symptoms and gender differences were not associated with suicidal ideations. Preventive efforts and psychotherapy implications are discussed.

Prevalence and correlates of driving under the influence of stimulants: Evidence from a national sample

BACKGROUND

Several million Americans use illicit stimulants every month and national data suggest stimulant use is increasing. However, little evidence exists that examines the prevalence and correlates of driving under the influence of stimulants (DUIS). The present study aimed to provide new evidence on the prevalence of DUIS in the U.S. adult population.

METHODS

This study examined data from 170,944 adults 18 and older in the 2016-2019 National Survey on Drug Use and Health. Using Stata and R, we estimated the prevalence and key correlates of DUIS among adults in the United States.

RESULTS

The overall prevalence of DUIS was 0.7% among adults in general and 28.3% among past-year stimulant users. Among the full adult sample, the prevalence of DUI cocaine was 0.5% and the prevalence of DUI methamphetamine was 0.3%. More than one in five (21.6%) adults with past year cocaine use reported DUI of cocaine, while nearly one half (47.2%) of adults with past year methamphetamine use reported DUI of methamphetamine. There is also a substantially higher likelihood of driving under the influence of stimulants among individuals reporting early onset of use and among those meeting criteria for cocaine/methamphetamine use disorders. Among adults who used cocaine/methamphetamine, those who reported driving under the influence of stimulants were more than 2 times more likely to experience a depressive episode or psychological distress.

CONCLUSION

Findings suggest that prevention/treatment approaches focused on multiple substances as well as mental health needs may be most appropriate for addressing the challenge of DUIS.