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Curzon MM, Graziano PA, Arcia E, Cox SK, Ayala M, Carnero NA, O'Mara N. Initial promise of child-parent psychotherapy in reducing stress and postpartum depression among mothers experiencing homelessness: a feasibility and pilot study. Arch Womens Ment Health 2025; 28:385-394. [PMID: 39136761 DOI: 10.1007/s00737-024-01492-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 07/01/2024] [Indexed: 04/25/2025]
Abstract
PURPOSE Mothers experiencing homelessness undergo significant stressors in addition to parenting stress, yet the rate and treatment of postpartum depression (PPD) within this population has yet to be explored. We assessed the risk for PPD and examined the changes in PDD and parenting stress following engagement in treatment. METHODS Participants included 182 mothers with infants 7 months of age or younger in a shelter setting. After initial assessment of PPD and parenting stress, families participated in Child-Parent Psychotherapy (CPP). Post assessment was then conducted after 16 weeks. RESULTS CPP was successfully implemented with high levels of procedural and content fidelity (M = 0.99, SD = 0.04; M = 0.95, SD = 0.09, respectively), treatment satisfaction (94%; M = 4.83, SD = 0.52), and relatively moderate levels of intervention completion (53.8%). Following participation in CPP, mothers reported decreases in parenting stress (d = 0.51) and continuous PPD symptom severity (d = 0.43). The proportion of mothers with clinically elevated self-report PPD symptoms also decreased from 15.3 to 6.7% (p = .013). Lastly, improvements in total parenting stress predicted improvements in PPD symptom severity (B = 0.12, p < .001). CONCLUSIONS The findings highlight the relevance of screening for PPD among mothers experiencing homelessness. Most importantly, relationship-based interventions like CPP demonstrate promise in indirectly treating PPD for at-risk populations and within a shelter setting.
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Affiliation(s)
- Madeline M Curzon
- Department of Psychology, Center for Children & Families, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
| | - Paulo A Graziano
- Department of Psychology, Center for Children & Families, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA.
| | - Emily Arcia
- Emily Arcia Consulting Co., Miami Beach, FL, USA
| | - Shana K Cox
- Sundari Foundation Inc., dba Lotus House Women's Shelter, Miami, FL, USA
| | - Muriel Ayala
- Sundari Foundation Inc., dba Lotus House Women's Shelter, Miami, FL, USA
| | - Nicole A Carnero
- Sundari Foundation Inc., dba Lotus House Women's Shelter, Miami, FL, USA
| | - Noelle O'Mara
- Sundari Foundation Inc., dba Lotus House Women's Shelter, Miami, FL, USA
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Kim LH, Lee SJ, Ahn SY. The moderation effect of mental health services use on the relationship between exposures to adverse childhood experiences and mental health outcomes among US adolescents. Child Adolesc Ment Health 2025; 30:13-20. [PMID: 39637915 DOI: 10.1111/camh.12745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/18/2024] [Indexed: 12/07/2024]
Abstract
BACKGROUND The prevailing exposure to Adverse Childhood Experiences (ACEs) among youth is associated with adolescents' mental health. However, few studies have examined whether receiving help from mental health services affects mental health outcomes among adolescents with ACEs. Therefore, this study examines the moderated effects of mental health services use on the relationship between exposures to ACEs and mental health outcomes among US adolescents. METHODS The sample was restricted to adolescents aged 11-17 using data from the National Health Interview Survey (NHIS) from 2019, 2021, and 2022. Multivariate logistic regressions and descriptive analyses were performed to estimate the moderation effect of mental health services use. RESULTS Using mental health services buffered the associations between ACEs and severe anxiety and depressive symptoms. Receiving counseling/therapy moderated the impact of ever living with an individual who had severe anxiety (Adjusted Odds Ratio, AOR: 0.58, p < .05) and depressive symptoms (AOR: 0.38, p < .01) among adolescents. Furthermore, counseling/therapy moderated the effect of ever living with an individual with a history of alcohol or drug abuse on severe depressive symptoms (AOR: 0.49, p < .05) and the effect of being a victim or witness of violence on severe anxiety symptoms (AOR: 0.45, p < .01). In addition, taking prescription medication moderated the effect of the experience of incarcerated family members on severe anxiety symptoms (AOR: 0.41, p < .05). CONCLUSION Our findings suggest that policy and practice need to encourage access to mental health care for vulnerable adolescents with ACEs to reduce the detrimental effect of their experiences on their mental health problems.
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Affiliation(s)
- Lyoung Hee Kim
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - Seung Joo Lee
- Korea Educational Development Institute, Chungcheong Buk-Do, Jincheon-gun, South Korea
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Osborne MC, Reidy DE, Temple JR, DeMello A, Lu Y. Examining the Relation Between Early Violence Exposure and Firearm-Related Experiences in Emerging Adulthood: A Longitudinal Cohort Study. Psychol Rep 2025; 128:78-99. [PMID: 38738909 DOI: 10.1177/00332941241254313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
Firearms are a leading cause of death among adolescents and young adults in the United States. Early exposure to violence, as a victim or witness, is associated with increased risk of firearm-related experiences, including carrying and threatening others with a gun. These experiences, in turn, increase the risk of both fatal and non-fatal firearm injuries. Using an ethnically diverse sample of emerging adults, we build on prior research by examining the link between early violence exposure at multiple contexts of the social-ecological model and multiple firearm-related experiences (i.e., firearm-threatening victimization, firearm-threatening perpetration, and firearm carriage). We analyzed data from a 10-year longitudinal study of 1042 youth in the Southern United States. Experiencing childhood physical abuse was associated with both firearm-threatening victimization and perpetration in emerging adulthood. Additionally, exposure to neighborhood and interparental violence were linked to threatening others with firearms and carrying firearms, respectively. Counter to expectations, bullying victimization did not emerge as a predictor of any firearm-related experiences. Findings highlight the importance of cross-cutting violence prevention efforts to prevent high-risk firearm-related behaviors among emerging adults. Programs for children and adolescents that address these types of violence exposure should highlight coping skills and sources of positive social support to bolster protective factors against firearm-related outcomes.
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Affiliation(s)
- Melissa C Osborne
- Wellstar School of Nursing, Wellstar College of Health and Human Services, Kennesaw State University, Kennesaw, GA, USA
| | - Dennis E Reidy
- School of Public Health, Georgia State University, Atlanta, GA, USA;Center for Research on Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Jeff R Temple
- Center for Violence Prevention, UTHealth, Houston, TX, USA; School of Behavioral Health Sciences, UTHealth, Houston, TX, USA
| | - Annalyn DeMello
- School of Nursing, University of Texas Medical Branch, Galveston, TX, USA
| | - Yu Lu
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA
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Graziano PA, Hernandez ML, Dick AS, Arcia E, Cox SK, Ayala M, Carnero NA, O'Mara NL, Foundation S. Parenting Challenges Among Families Experiencing Homelessness with Children with and without Externalizing Behavior Problems. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024:1-17. [PMID: 39636279 DOI: 10.1080/15374416.2024.2429087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/07/2024]
Abstract
OBJECTIVE To examine differences in parenting factors among caregivers with children with and without externalizing behavior problems (EBP) in a community homeless shelter sample versus a stable housing sample. METHOD Nine hundred and fourteen children (ages = 2.01-7.49 years, SD = 1.45 years, 40.8% female, 54.3% Black, 46.7% Hispanic) were recruited from a service-driven research project in a shelter setting (n = 638) and a longitudinal/clinical study (n = 276). Primary caregivers (97% mothers) completed a parenting stress questionnaire and an observational measure of parent-child interactions. RESULTS Logistic regression indicated that children who were Black and/or of Hispanic background were less likely to be identified as having elevated EBP but only in the homeless shelter sample. Multivariate analyses indicated that the homeless shelter-EBP group reported the highest levels of overall stress compared to the homeless shelter-typically developing (TD), stable housing-EBP and stable housing-TD groups. Mothers from the homeless shelter-EBP group exhibited a higher proportion of negative verbalizations relative to caregivers from all other groups while mothers from the homeless shelter-TD group exhibited a higher proportion of positive verbalizations relative to the caregivers from the homeless shelter-EBP group and the stable housing TD group. Both homeless shelter groups engaged in less total verbalizations relative to both stable housing samples, with the stable housing-EBP group exhibiting the most verbalizations. CONCLUSIONS High levels of parenting stress and negative parent-child interactions within a homeless shelter sample are exacerbated by having a child with EBP. Embedding universal parenting programs in a homeless shelter setting to reduce parenting stress would be valuable to address health disparities in this vulnerable population.
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Affiliation(s)
- Paulo A Graziano
- Department of Psychology, Florida International University - Center for Children and Families
| | - Melissa L Hernandez
- Department of Psychology, Florida International University - Center for Children and Families
| | - Anthony S Dick
- Department of Psychology, Florida International University - Center for Children and Families
| | | | - Shana K Cox
- Sundari Foundation, Inc. dba Lotus House Women's Shelter (Lotus House)
| | - Muriel Ayala
- Sundari Foundation, Inc. dba Lotus House Women's Shelter (Lotus House)
| | - Nicole A Carnero
- Sundari Foundation, Inc. dba Lotus House Women's Shelter (Lotus House)
| | - Noelle L O'Mara
- Sundari Foundation, Inc. dba Lotus House Women's Shelter (Lotus House)
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Ermita KC, Rosenthal DM. Exploring Mental Health Services for Youth Experiencing Homelessness in East Asian Pacific Regions: A Systematic Scoping Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:864. [PMID: 39062313 PMCID: PMC11275148 DOI: 10.3390/children11070864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 06/30/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Youth experiencing homelessness (YEH) in East Asian Pacific (EAP) regions represent one of the most at-risk populations due to cultural and geographical factors. Effective mental health interventions, primarily researched in Western contexts, may not fully apply to YEH in EAP. Their lack of stable shelter, disrupted social networks, and limited access to mental health services elevate their susceptibility to adverse mental health, making urgent interventions essential to address their needs. OBJECTIVE The objective of this study is to explore and systematically search the types of mental health services and interventions available for YEH in EAP and their impact on overall quality of life and wellbeing. METHODS Electronic databases (e.g., Medline, PsycINFO, PubMed, Scopus) were systematically searched (publication dates between 1 January 1990 and 13 May 2023), as well as additional online resources specific to homelessness. Articles were screened, and a critical appraisal assessed the quality of the included studies. RESULTS Eight studies with different interventions were identified in Indonesia (n = 2), Malaysia (n = 1), South Korea (n = 3), and the Philippines (n = 1). These were thematically clustered into six categories: art, cognitive behavioural therapy, life skills education, resilience enhancement, family strengthening, and government interventions/services. CONCLUSIONS This review highlights effective mental health interventions' positive impact on YEH mental health outcomes and quality of life in EAP, stressing the urgent need to implement socio-culturally sensitive services. Future research should address knowledge gaps through comprehensive studies covering diverse EAP regions and populations, prioritising socio-culturally specific psychological measures.
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Affiliation(s)
- Kimberley Cortez Ermita
- UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK;
| | - Diana Margot Rosenthal
- UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK;
- UCL Collaborative Centre for Inclusion Health, University College London, London WC1E 7HB, UK
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, NY 10003, USA
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Hou X, Wan J, Peng L, Sheng J, Long N, Mao P. Application of trauma-focused cognitive behavioral therapy among children and adolescents with childhood household dysfunction. ZHONG NAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF CENTRAL SOUTH UNIVERSITY. MEDICAL SCIENCES 2024; 49:145-152. [PMID: 38615176 PMCID: PMC11017028 DOI: 10.11817/j.issn.1672-7347.2024.230333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Indexed: 04/15/2024]
Abstract
Childhood household dysfunction (CHD) is a common adverse childhood experience, which brings the heavy physical and mental afflictions to children and adolescents. Trauma-focused cognitive behavioral therapy (TF-CBT) is an evidence-based psychotherapy that helps children and adolescents who have experienced childhood trauma with traumatic memories. It aims to enhance the coping abilities of CHD children and adolescents, thereby improving the negative effects caused by trauma and effectively reducing psychological burden. TF-CBT can effectively improve post-traumatic stress disorder, emotional and behavioral problems, and family function in children and adolescents with CHD. It is recommended to conduct high-quality original research in the future, develop targeted TF-CBT intervention plans based on potential predictive factors, adopt a combination of online and offline methods, and construct TF-CBT interventions suitable for the Chinese CHD population to meet the mental health service needs of CHD children and adolescents.
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Affiliation(s)
- Xinyi Hou
- Department of Nursing, Third Xiangya Hospital, Central South University, Changsha 410013.
- Hunan Key Laboratory of Nursing, Changsha 410013.
- Xiangya School of Nursing, Central South University, Changsha 410013.
| | - Jingjing Wan
- Hunan Key Laboratory of Nursing, Changsha 410013
- Department of Outpatient and Emergency Operating Room, Third Xiangya Hospital, Central South University, Changsha 410013
| | - Lianhua Peng
- Clinical Medical Research Center, Affiliated Hospital of Jinggangshan University, Ji'an Jiangxi 343000
| | - Jiangming Sheng
- Department of Outpatient, Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Nannan Long
- Hunan Key Laboratory of Nursing, Changsha 410013
- Xiangya School of Nursing, Central South University, Changsha 410013
| | - Ping Mao
- Department of Nursing, Third Xiangya Hospital, Central South University, Changsha 410013.
- Hunan Key Laboratory of Nursing, Changsha 410013.
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Hare MM, Landis TD, Hernandez M, Graziano PA. Mental health prevention and treatment programs for infants experiencing homelessness: A systematic review. EVIDENCE-BASED PRACTICE IN CHILD AND ADOLESCENT MENTAL HEALTH 2023; 9:162-172. [PMID: 38817740 PMCID: PMC11136483 DOI: 10.1080/23794925.2023.2169971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
Experiencing homelessness in infancy has been linked to negative physical and mental health outcomes. Parental well-being and the parent-infant relationship can also be negatively impacted by experiencing homelessness. While numerous parent-based infant mental health programs have been identified by a recent review, the goal of this study was to further determine the extent to which these existing programs were developed and/or examined with at-risk populations such as families experiencing homelessness. Out of 60 programs identified by Hare et al., in press, only three had been implemented specifically in shelter settings with infants 0-12 months (Parent-Infant Psychotherapy, New Beginnings, and My Baby's First Teacher). Additionally, when examining programs that began in later infancy (after 12 months), only 2 programs were implemented in shelter settings (Incredible Years and Parent-Child Interaction Therapy). Implications for research, policy, and clinicians regarding implementation of evidence-based prevention/treatment programs for parents and their infants experiencing homelessness are discussed.
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Affiliation(s)
- Megan M Hare
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL
| | - Taylor D Landis
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL
- Department of Pediatrics, Baylor College of Medicine, Houston, TX
- Psychology Service, Texas Children's Hospital
| | - Melissa Hernandez
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL
| | - Paulo A Graziano
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL
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