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Jones AA, Strong-Jones S, Bishop RE, Brant K, Owczarzak J, Ngigi KW, Latkin C. The impact of family systems and social networks on substance use initiation and recovery among women with substance use disorders. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2024; 38:850-859. [PMID: 38661657 PMCID: PMC11502511 DOI: 10.1037/adb0001007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
OBJECTIVE While social networks influence individuals with substance use disorders (SUDs), the mechanisms for such influence are under-explored among women who use drugs. This study triangulates the perspectives of criminal justice professionals, SUD treatment professionals, and women with past and current experiences with substance use to explore these dynamics. METHOD We conducted semistructured interviews (N = 42) in 2022 with women with current or past opioid use disorder (n = 20), SUD treatment professionals (n = 12), and criminal justice professionals (n = 10) who work with women with opioid use disorder. Interviews centered around participants' backgrounds, perceived barriers and facilitators to medications for opioid use disorder (MOUD) treatment, and gender-specific issues in MOUD treatment. All interviews were audio-recorded, transcribed, and deidentified. We used a four-step qualitative data analysis process to code transcripts. RESULTS Across these participants' accounts, we identified mechanisms by which women's social networks influenced their opioid use trajectories: intergenerational substance use, family support and strain, intimate partner influence, and peer support and pressure. Overall, the emergent themes in the present study reflect the embedded nature of support within social systems. Women who had access to and engaged with various forms of social support tended to be those who use/used MOUD and self-identified as in recovery. CONCLUSIONS Combining MOUD treatment with psychosocial interventions allows women to heal from trauma, learn effective coping skills, and receive valuable resources to support recovery. Interventions focusing on family resilience and peer recovery support can disrupt the cycle of addiction and promote MOUD treatment success. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Abenaa A Jones
- Department of Human Development and Family Studies, Pennsylvania State University
| | - Sienna Strong-Jones
- Department of Human Development and Family Studies, Pennsylvania State University
| | - Rachael E Bishop
- Department of Communication Arts and Sciences, Pennsylvania State University
| | - Kristina Brant
- Consortium for Substance Use and Addiction, Pennsylvania State University
| | - Jill Owczarzak
- Department of Health, Behavior and Society, Bloomberg School of Public Health, John Hopkins University
| | - Kelly W Ngigi
- Department of Human Development and Family Studies, Pennsylvania State University
| | - Carl Latkin
- Department of Health, Behavior and Society, Bloomberg School of Public Health, John Hopkins University
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Scheer JR, Mereish EH, Gilmore AK, Cascalheira CJ, Helminen EC, Dobani F, Behari K, Pirog S, Jackson SD, Sullivan TP, Batchelder AW. Examining Daily Self-Efficacy, Minority Stressors, and Alcohol and Other Drug Use Among Trauma-Exposed Sexual Minority Women and Transgender and Gender-Diverse People. Ann Behav Med 2024; 58:832-844. [PMID: 39402938 PMCID: PMC11568352 DOI: 10.1093/abm/kaae065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2024] Open
Abstract
BACKGROUND AND PURPOSE This study aimed to develop and test a novel model integrating social-learning and self-medication frameworks by examining the association between self-efficacy to resist alcohol and other drug (AOD) use and daily AOD use and unhealthy drinking risk among trauma-exposed sexual minority women (SMW) and transgender and gender-diverse (TGD) people. We examined whether minority stressors moderated these associations. METHODS Data were from 57 trauma-exposed SMW and TGD people who participated in a 14-day daily diary study. Multilevel binary logistic models and ordinal logistic models were employed to examine associations between self-efficacy to resist AOD use and daily AOD use and unhealthy drinking risk at within- and between-person levels. We assessed same- and cross-level interactions between daily self-efficacy to resist AOD use and minority stressors in predicting AOD use and unhealthy drinking risk within the same 24-hour period (i.e., standardized as 6 pm to 6 pm; hereafter referred to as "same-day"). RESULTS Self-efficacy to resist AOD use was associated with lower AOD use and unhealthy drinking risk. Minority stressors were associated with daily AOD use. Among those who experienced higher (vs. lower) average sexual minority stressors over the 2-week daily diary period, higher-than-usual self-efficacy to resist AOD use was less protective in decreasing risk of same-day unhealthy drinking. CONCLUSIONS Interventions aiming to mitigate AOD use and unhealthy drinking risk by bolstering self-efficacy to resist AOD use should consider the impact of recent cumulative exposure to sexual minority stressors in this population. Further, policy efforts are needed to reduce perpetuation of stigma.
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Affiliation(s)
- Jillian R Scheer
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Ethan H Mereish
- Department of Psychology, Lavender Lab, University of Maryland, College Park, MD, USA
| | - Amanda K Gilmore
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
- National Center for Sexual Violence Prevention, Mark Chaffin Center for Healthy Development, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Cory J Cascalheira
- PTSD Outpatient Clinic, VA Puget Sound Health Care System, Seattle, WA, USA
| | - Emily C Helminen
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
| | - Fatima Dobani
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Kriti Behari
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Sophia Pirog
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Skyler D Jackson
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Tami P Sullivan
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Abigail W Batchelder
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston Medical Center, Boston, MA, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
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Tyler KA, Eisenbraun AR, Synya A, Lloyd M. Familial and Individual Risk Factors, Sexual Assault, and Mental Health: A Comparison of Black, Hispanic, Asian, and White College Students. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241298298. [PMID: 39548816 DOI: 10.1177/08862605241298298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2024]
Abstract
Though sexual assault is prevalent among college campuses, there is a paucity of research on whether risk factors vary for different racial/ethnic groups. As such, this article examines familial and individual risk factors and three sexual assault types (coercive, physically forced, and incapacitated) with depressive symptoms and post-traumatic stress disorder (PTSD) symptoms to see whether such risks vary for Black/African American, White, Asian, and Hispanic groups of college students. Data were gathered in 2019 to 2020 from 783 undergraduate college women and men at a large public university in the Midwestern United States. Results revealed that in terms of family background, Black/African American, Asian, and Hispanic students reported more experiences of child physical abuse and lower levels of warmth and support compared to White students. White college students, however, reported more frequent heavy drinking compared to Asian and Hispanic students. For sexual assault, Asian students reporting experiencing incapacitated sexual assault more so than White students, whereas Black/African American students reported experiences of physically forced sexual assault more so than White students. For mental health, Hispanic students reported more PTSD symptoms compared to White students while Asian students reported more depressive symptoms compared to their White counterparts. It is noteworthy that early experiences of child physical abuse and lower warmth and support continued to significantly impact both PTSD symptoms and depressive symptoms. Our results demonstrate the importance of going beyond the typical dichotomy of White and non-White to gain a more nuanced understanding of how risk factors vary for different racial and ethnic groups, which has implications for intervention and prevention when understanding sexual assault and mental health outcomes.
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Rew L, Kelley M, Preston A. Psychological capital variables as protective factors in indigenous youth experiencing homelessness. Arch Psychiatr Nurs 2024; 51:235-240. [PMID: 39034083 DOI: 10.1016/j.apnu.2024.06.009] [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: 02/01/2023] [Revised: 04/01/2024] [Accepted: 06/09/2024] [Indexed: 07/23/2024]
Abstract
Indigenous youth in the United States are at high-risk for experiencing homelessness related to adverse childhood experiences such as parental substance use and low educational attainment. Such experiences may lead to adverse physical and mental health issues; these youth also have positive attributes of psychological capita (hope, self-efficacy, resilience, optimism) that are related to health outcomes. The purpose of this secondary analysis was to describe demographic attributes and psychological capital in Indigenous youth experiencing homelessness (IYEH) who participated in a longitudinal intervention study related to safe sex behaviors and life satisfaction. From a total of 602, Indigenous participants (n = 111; mean age 21.25 ± 1.82 years) were recruited from drop-in centers in Austin, Texas and Columbus, Ohio. Data were collected immediately after the intervention and at 3- and 6-month intervals. For this analysis, only data collected at the final time-point were used. Valid scales with Cronbach alphas of 0.75-0.92 (Hope, Resilience, Optimism, Self-efficacy for Substance Refusal, Self-efficacy for Safer Sex, Safe Sex Behaviors, Social Connectedness, and Life Satisfaction) were used. The majority of the IYEH reported smoking, drinking, and using drugs. Psychological capital variables of hope, self-efficacy for negotiating safer sex, resilience, and optimism were significantly related to one another, but not to safe sex behaviors or intention to use condoms. Resilience and optimism were significantly related to social connectedness but not to other psychological capital variables. Life satisfaction was significantly associated with hope, resilience, and optimism. Findings have implications for further theory and research development.
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Affiliation(s)
- Lynn Rew
- The University of Texas at Austin School of Nursing, United States of America.
| | - Melessa Kelley
- The University of Texas at Austin School of Nursing, United States of America
| | - Angela Preston
- The University of Texas at Austin School of Nursing, United States of America
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Melkam M, Demilew D, Kassew T, Fanta B, Yitayih S, Alemu K, Muhammed Y, Getnet B, Abetu E, Tarekeg GE, Oumer M, Nenko G. Anxiety disorders among youth with substance use and associated factors in Northwest Ethiopia: A community-based study. PLoS One 2024; 19:e0300927. [PMID: 38512930 PMCID: PMC10956842 DOI: 10.1371/journal.pone.0300927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 03/05/2024] [Indexed: 03/23/2024] Open
Abstract
INTRODUCTION Anxiety disorder is an unpleasant emotional feeling with symptoms related to psychological and autonomic symptoms such as headache, perspiration, palpitations, dizziness, and stomach discomfort. The use of substances become a worldwide problem among youth which brings situation that leads to serious social and health-related problems. Anxiety disorders with substance use have a huge impact on their high prevalence, therapeutic issues, and poor prognosis on clinical effects. Although the prevalence of anxiety disorders is significant among young people who use substances, limited studies were conducted. Therefore, this study revealed the burden of anxiety disorders among youth with substance use and associated factors in Ethiopia. METHOD A community-based multi-stage with a simple random sampling technique was conducted. A total of 372 substance users study participants were recruited for this study. Alcohol, Smoking, and Substance Involvement Screening Tests, Depression Anxiety Stress Scales, and other tools were used to assess anxiety disorders with substance use and associated factors. Data were entered into Epi-data version 4.6, and exported to SPSS version 20 for further analysis. Bi-variables logistic regression analysis was employed to identify variables with a p-value of < 0.2 and associated factors were determined in multi-variables logistic regression analysis with a p-value < 0.05 with AOR and CI. RESULTS From a total of 372 respondents the overall prevalence of anxiety disorders with substance use was 48.1%. Male sex [AOR = 1.99; 95% CI: (1.01-3.93)], low educational status of the father [AOR = 6.38 95%CI: (1.50-7.08)], and the presence of stress [AOR = 2.48; 95% CI: 2.48(2.43-4.40)] were significantly associated factors with anxiety disorders with substances use. CONCLUSIONS AND RECOMMENDATIONS The prevalence of anxiety disorders with substance use was 48.1% therefore; it is recommended that the zonal administration give collaborative work with the health bureau and facilitate awareness creation about the impact of substance abuse. Clinicians are recommended to mitigate anxiety disorders with substance use to get a good prognosis for clients with controlling their stress.
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Affiliation(s)
- Mamaru Melkam
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Demeke Demilew
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Tilahun Kassew
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Biruk Fanta
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Sewbesew Yitayih
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Kassahun Alemu
- Department of Biostatistics & Epidemiology, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Yassin Muhammed
- Department of Psychology, College of Social Science and Humanities, University of Gondar, Gondar, Ethiopia
| | - Berhanie Getnet
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Eden Abetu
- Department of Clinical Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Gebrekidan Ewnetu Tarekeg
- Department of Biostatistics & Epidemiology, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mohammed Oumer
- Department of Human Anatomy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Goshu Nenko
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Pedersen ER, DiGuiseppi G, D'Amico EJ, Rodriguez A, Tran DD, Jose R, Tucker JS. Predictors of Housing Trajectories Among Young Adults Experiencing Homelessness in Los Angeles. J Behav Health Serv Res 2024; 51:31-43. [PMID: 37803216 PMCID: PMC10733216 DOI: 10.1007/s11414-023-09863-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 10/08/2023]
Abstract
Experiencing homelessness during young adulthood is associated with negative health outcomes and understanding housing trajectories of young adults experiencing homelessness may aid in the development of evidence-based public health programs designed to serve this at-risk age group. In the present study, the authors examined baseline predictors of 24-month trajectories of housing stability and unsheltered housing among a sample of 271 young adults aged 18 to 25 recruited from drop-in centers in Los Angeles. In multivariate models, the authors found that identifying as multi-racial/other and better friendship quality at baseline were associated with less steep increases in the likelihood of stable housing over time. Being employed at baseline was associated with a less steep decrease in the probability of being unsheltered over time, while illicit drug use days associated with a steeper decrease in the probability of being unsheltered over time. Continued research is needed to establish important factors determining young adults' long-term housing trajectories in the effort to promote greater access and engagement with housing services.
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Affiliation(s)
- Eric R Pedersen
- Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, University of Southern California, 2250 Alcazar Street, Suite 2200, Los Angeles, CA, 90033, USA.
| | - Graham DiGuiseppi
- School of Social Work, University of Southern California, Los Angeles, CA, 90089, USA
- RAND Corporation, 4570 Fifth Ave #600, Pittsburgh, PA, 15213, USA
| | - Elizabeth J D'Amico
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407, USA
| | | | - Denise D Tran
- Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, University of Southern California, 2250 Alcazar Street, Suite 2200, Los Angeles, CA, 90033, USA
| | - Rupa Jose
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407, USA
| | - Joan S Tucker
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407, USA
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7
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Gajos JM, Cropsey KL, Walters ST, Businelle MS. Relations between Affect, Self-Efficacy, and Alcohol Expectancies in Adults Experiencing Homelessness. ADDICTION RESEARCH & THEORY 2023; 32:440-445. [PMID: 39885873 PMCID: PMC11781608 DOI: 10.1080/16066359.2023.2292583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 02/01/2025]
Abstract
Background Alcohol misuse is higher among adults experiencing homelessness (AEH) compared to housed adults. Greater expectancy that alcohol will improve mood, negative affect, and lower self-efficacy have been linked to alcohol misuse in AEH. However, little is known about the momentary relationships between affect, alcohol expectancies, and self-efficacy to avoid alcohol in AEH. To our knowledge, this is the first study to examine these constructs in a sample of AEH. Methods: AEH (n = 72; M age = 47, 85% Male, 68% Non-White) completed smartphone-based ecological momentary assessments 5x/day for four weeks. Generalized multilevel modeling examined the association between concurrent momentary ratings of (1) expectancy that alcohol would improve mood and negative and positive affect and (2) self-efficacy to do something other than drink to improve mood and negative and positive affect. Results Momentary reports of increased negative affect were associated with greater expectancy that alcohol would improve mood (b = 0.25, p < 0.01), whereas momentary reports of increased positive affect were associated with less expectancy that alcohol would improve mood (b = -0.11, p < 0.01). Increased momentary negative affect was associated with less self-efficacy to improve mood without alcohol (b = -0.09, p = 0.03), but momentary reports of increased positive affect were associated with greater self-efficacy to do something other than drink to improve mood (b = 0.18, p < 0.01). Conclusion It may be important to deliver real-time treatment messages suggesting alternatives to drinking and/or ways to boost self-efficacy during moments when negative affect is high.
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Affiliation(s)
- Jamie M. Gajos
- University of Alabama at Birmingham, Department of Family and Community Medicine, Birmingham, AL, USA
| | - Karen L. Cropsey
- University of Alabama at Birmingham, Department of Psychiatry and Behavioral Neurobiology, Birmingham, AL, USA
| | - Scott T. Walters
- University of North Texas Health Science Center, School of Public Health, Ft. Worth, TX, USA
| | - Michael S. Businelle
- University of Oklahoma Health Sciences Center, TSET Health Promotion Research Center, Stephenson Cancer Center, OK, USA
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Bdier D, Mahamid F. Energy drinks, substance use, and posttraumatic stress symptoms among Palestinian athletes: the mediating role of perceived self-efficacy and resilience. J Ethn Subst Abuse 2023:1-17. [PMID: 37982407 DOI: 10.1080/15332640.2023.2282570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
The current study aimed to test the association between energy drinks, substance use, and posttraumatic stress symptoms, and the mediating role of perceived self-efficacy and resilience among Palestinian athletes. The sample of our study consisted of 480 Palestinian athletes: 160 women and 320 men, all were selected from five Palestinian universities located in the West Bank of Palestine. The findings of our study revealed that energy drinks positively correlated with substance abuse, and posttraumatic stress symptoms. In addition, a negative association was found between perceived self-efficacy, substance use, and posttraumatic stress symptoms. Moreover, a negative association was found between resilience, substance use, and posttraumatic stress symptoms. Results of Structural equation modeling (SEM) revealed that resilience and perceived self-efficacy mediated the association between energy drinks, substance use and posttraumatic stress symptoms. Our findings underline the importance of enhancing resilience and perceived self-efficacy among athletes to prevent initial substance use/misuse, as several traits found in resilient athletes such as high self-esteem, empathy, help-seeking, and self-awareness are important in deterring athletes from engaging in harmful substances like tobacco, marijuana, and alcohol.
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Affiliation(s)
- Dana Bdier
- Psychology and Counseling Department, An-Najah National University, Nablus, Palestine
- Department of Human Sciences & Education "R. Massa", University of Milano-Bicocca, Milan, Italy
| | - Fayez Mahamid
- Psychology and Counseling Department, An-Najah National University, Nablus, Palestine
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Phiri TV, Gloeck N, Musekiwa A. Prevalence of comorbid disease and associated risk factors among homeless people living in temporary shelters during the COVID-19 lockdown in Tshwane, South Africa. S Afr Med J 2023; 113:48-52. [PMID: 37882135 DOI: 10.7196/samj.2023.v113i9.668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND People experiencing homelessness are among the most socially and medically vulnerable populations. OBJECTIVES To assess the prevalence of comorbid disease and associated risk factors among homeless people admitted to temporary shelters in the City of Tshwane during levels 4 and 5 of the COVID-19 national lockdown in South Africa. METHODS A descriptive cross-sectional study design was used. The sample was drawn from secondary data on all individuals placed in temporary shelters constructed by Tshwane during levels 4 and 5 of the COVID-19 lockdown (26 March - 31 May 2020). Descriptive statistics were used to summarise data, and a multivariable logistic regression model was applied to determine factors associated with comorbid disease. RESULTS The overall prevalence of comorbid disease among homeless people in temporary shelters in Tshwane was 28.8% (95% confidence interval (CI) 26.9 - 30.8). There was no significant difference in the prevalence of comorbid disease by illicit substance use (29.9% for users v. 29.5% for non-users; p=0.871). In adjusted analyses, being South African (adjusted odds ratio (aOR) 2.06; 95% CI 1.10 - 3.88; p=0.024), being female (aOR 3.73; 95% CI 1.85 - 7.53; p<0.001), being black (aOR 3.43; 95% CI 1.12 - 10.54; p=0.031) or white (aOR 6.11; 95% CI 1.55 - 24.0; p=0.01), and injecting substances (aOR 1.68; 95% CI 1.19 - 2.37; p=0.003) were significantly associated with having comorbid disease. CONCLUSION The study found a 28.8% prevalence of comorbid disease among homeless people placed in temporary shelters in Tshwane. In adjusted analysis, being South African, being female, black and white race, and injecting substances were associated with having comorbid disease. Strengthening of public health interventions such as needle and syringe exchange programmes, family planning and access to primary care with health education could improve the healthcare of people experiencing homelessness.
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Affiliation(s)
- T V Phiri
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, South Africa.
| | - N Gloeck
- Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, South Africa; Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa.
| | - A Musekiwa
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, South Africa.
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Pedersen ER, D'Amico EJ, Klein DJ, Rodriguez A, Tucker JS. Secondary Outcomes of a Brief Group Alcohol and Risky Sex Intervention for Emerging Adults Experiencing Homelessness. EMERGING ADULTHOOD (PRINT) 2023; 11:704-709. [PMID: 38389804 PMCID: PMC10883596 DOI: 10.1177/21676968231156647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
AWARE is a four-session group-based motivational enhancement intervention designed to reduce substance use and sexual risk behavior among emerging adults experiencing homelessness. Expanding on promising intervention effects on substance use and risky sex outcomes, this study explored intervention effects on changes in secondary outcomes from baseline to 12-month post-intervention: depression, physical health (general health ratings, physical symptoms), social functioning (satisfaction, quality of friendships), and housing stability. Among the 240 participants with baseline and 12-month follow-up data, we found small effect sizes generally favoring the intervention over usual care for all outcomes. Findings show promise that addressing substance use and risky sexual behavior through interventions in drop-in centers could benefit emerging adults experiencing homelessness in additional areas of their lives. More work is needed to understand how interventions could be tailored to more directly address these outcomes and sustain changes in the long-term.
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Affiliation(s)
- Eric R Pedersen
- University of Southern California, Keck School of Medicine, Department of Psychiatry and Behavioral Sciences
| | | | - David J Klein
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407
| | | | - Joan S Tucker
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407
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11
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Moore H, De Pedro K. Lesbian, Gay, and Bisexual Students Experiencing Homelessness and Substance Use in the School Context: A Statewide Study. THE JOURNAL OF SCHOOL HEALTH 2023; 93:107-114. [PMID: 36661077 PMCID: PMC10087241 DOI: 10.1111/josh.13246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 07/22/2022] [Accepted: 08/02/2022] [Indexed: 06/17/2023]
Abstract
PURPOSE This study explored differences between lesbian, gay, and bisexual (LGB)-housed and homeless students regarding substance use patterns on and off school grounds and the unique contribution of homelessness to substance use in school. METHODS Data were from the 2013-2015 California Healthy Kids Survey, a statewide survey of school protective factors and risk behaviors. A representative sample of 9th- and 11th-grade students (N = 20,337) was used. Comparisons between housed (n = 19,456) and homeless (doubled up: n = 715; acute homeless: n = 166) LGB students were conducted. We used chi-square tests to compare rates of lifetime, past-30-day, and in-school substance use and conducted multivariate logistic regression models for each substance use variables. RESULTS Chi-square test results indicated significant differences in rates of substance use among students experiencing homelessness (both categories) and housed LGB students. Lesbian, gay, and bisexual students experiencing homelessness were more likely to report substance use off and on school grounds. Results from logistic regression analyses indicated that LGB students who experience homelessness were significantly more likely to report recent and in-school substance use. For example, students experiencing acute homelessness were about 3 times as likely to report heavy episodic drinking (adjusted odds ratio [AOR] = 3.13; 95% confidence interval [CI] = 2.13, 4.26) and more than 5 times as likely to smoke marijuana in school (AOR = 5.38; 95% CI = 3.46, 8.36), compared to housed LGB students. CONCLUSIONS LGB students who experience homelessness are at higher risk than housed LGB students of substance use on and off school grounds. Findings highlight the need to provide support in the school context for this subpopulation.
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Affiliation(s)
- Hadass Moore
- The Paul Baerwald School of Social Work and Social WelfareHebrew University of JerusalemJerusalemIsrael
| | - Kris De Pedro
- Attallah College of Educational StudiesChapman UniversityOrangeCA
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12
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Burke CW, Firmin ES, Wilens TE. Systematic review: Rates of psychopathology, substance misuse, and neuropsychological dysfunction among transitional age youth experiencing homelessness. Am J Addict 2022; 31:523-534. [PMID: 36036233 DOI: 10.1111/ajad.13340] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 08/10/2022] [Accepted: 08/11/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Transitional age youth experiencing homelessness (TAY-EH) bear a disproportionate burden of morbidity and mortality related to psychopathology, substance use disorders (SUD), and neuropsychological dysfunction. Prior reviews examining these conditions are now nearly a decade old, have focused on younger adolescent populations, or have utilized nonsystematic approaches. To our knowledge, no prior reviews have reported on all three of these domains in an integrated fashion. Here, we provide a contemporary, critical synthesis of the literature on the functioning of TAY-EH in North America within these three domains. METHODS Based upon PRISMA guidelines, a search of PubMed, Medline, and PsycInfo databases was conducted, including literature published between January 2015 and June 2021. RESULTS The initial search yielded 2024 citations; 104 underwent full text review and 32 met inclusion criteria, with a final aggregate sample size of 13,516. Studies revealed elevated rates of mood disorders, PTSD, anxiety disorders, and alcohol misuse. There is insufficient data to draw generalizable conclusions regarding neuropsychological functioning, other SUD, or other psychiatric diagnoses. No studies reported on co-occurrence of disorders among or between the domains of psychopathology, SUD, and neuropsychological dysfunction. Four studies used structured interviews for diagnoses, with the remainder relying upon brief screeners or self-report measures. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE To our knowledge, this is the first systematic review to provide integrated findings on psychopathology, SUD, and neuropsychological dysfunction among TAY-EH. Further research using structured, DSM-based tools is needed to characterize rates of single and co-occurring conditions to inform tailored treatment interventions.
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Affiliation(s)
- Colin W Burke
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Elizabeth S Firmin
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Timothy E Wilens
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
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Chassman S, Barman-Adhikari A, Hsu HT, Ferguson KM, Narendorf SC, Maria DS, Shelton J, Petering R, Bender K. Prevalence and Correlates of Illicit Substance Use Among Young Adults Experiencing Homelessness in Seven Cities Across the United States. JOURNAL OF DRUG ISSUES 2022. [DOI: 10.1177/00220426211049355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Young adults experiencing homelessness (YAEH) engage in substantially higher substance use rates than housed young adults. This current study builds on previous research by investigating the prevalence of and salient correlates of illicit substance use across a seven-city sample. Methods This study used the Homeless Youth Risk and Resiliency Survey (HYRRS) dataset, n=1426 Young adults experiencing homelessness to study patterns and correlates of illicit substance use. Results Multivariate logistic regression analyses were used to assess correlates of substance use. Study site, age, gender identity, sexual orientation, history of suicidal ideation, use of specific substances, and trading sex for drugs were associated with five types of illicit substance use (ecstasy, cocaine, crack, methamphetamine, and injection drug use). Conclusion Findings indicate that substance use interventions for YAEH must be multifaceted, addressing illicit and multiple substance use, along with the myriad factors associated with substance use among this at-risk group.
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Affiliation(s)
| | | | - Hsun-Ta Hsu
- School of Social Work, University of Missouri, Columbia, MO, USA
| | | | - Sarah C. Narendorf
- Graduate College of Social Work, University of Houston, Houston, TX, USA
| | - Diane Santa Maria
- Department of Research, Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Jama Shelton
- Silberman School of Social Work at Hunter College, New York, NY, USA
| | | | - Kimberly Bender
- Graduate School of Social Work, University of Denver, Denver, CO, USA
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Smith-Grant J, Kilmer G, Brener N, Robin L, Underwood JM. Risk Behaviors and Experiences Among Youth Experiencing Homelessness-Youth Risk Behavior Survey, 23 U.S. States and 11 Local School Districts, 2019. J Community Health 2022; 47:324-333. [PMID: 35013979 PMCID: PMC9119052 DOI: 10.1007/s10900-021-01056-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2021] [Indexed: 11/26/2022]
Abstract
Youth experiencing homelessness experience violence victimization, substance use, suicide risk, and sexual risk disproportionately, compared with their stably housed peers. Yet few large-scale assessments of these differences among high school students exist. The youth risk behavior survey (YRBS) is conducted biennially among local, state, and nationally representative samples of U.S. high school students in grades 9-12. In 2019, 23 states and 11 local school districts included a measure for housing status on their YRBS questionnaire. The prevalence of homelessness was assessed among states and local sites, and relationships between housing status and violence victimization, substance use, suicide risk, and sexual risk behaviors were evaluated using logistic regression. Compared with stably housed students, students experiencing homelessness were twice as likely to report misuse of prescription pain medicine, three times as likely to be threatened or injured with a weapon at school, and three times as likely to report attempting suicide. These findings indicate a need for intervention efforts to increase support, resources, and services for homeless youth.
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Affiliation(s)
- Jennifer Smith-Grant
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, Mailstop US 8-1, Atlanta, GA, 30329, USA.
- U.S. Public Health Service Commissioned Corps, Washington, DC, USA.
| | - Greta Kilmer
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, Mailstop US 8-1, Atlanta, GA, 30329, USA
| | - Nancy Brener
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, Mailstop US 8-1, Atlanta, GA, 30329, USA
| | - Leah Robin
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, Mailstop US 8-1, Atlanta, GA, 30329, USA
| | - J Michael Underwood
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, Mailstop US 8-1, Atlanta, GA, 30329, USA
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15
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Shegaw M, Fekadu W, Beka M, Menberu M, Yohannes K, Yimer S, Seid M, Necho M, Moges S, Anbesaw T. Problematic substance use and its associated factors among street youth in Bahir Dar city, Ethiopia. Front Psychiatry 2022; 13:930059. [PMID: 35966470 PMCID: PMC9365990 DOI: 10.3389/fpsyt.2022.930059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 07/05/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Problematic substance use is becoming a common problem in marginalized groups such as street youths. However, there is a dearth of studies on the prevalence and factors associated with problematic substance use among street youth in Ethiopia. OBJECTIVE The objective of this study was to determine the prevalence of problematic substance use and identify its associated factors among street youth. METHODS This community-based cross-sectional study was conducted between June and July 2020. A total of 252 participants were included in this study. Systematic random sampling was used to recruit participants. Cut down, annoyed, guilty feeling, and eye opening-adapted to include drugs (CAGE-AIDs) were used to assess problematic substance use. The data were entered into epidata and exported to SPSS version 25 for analysis. Logistic regression with a 95% confidence interval (CI) was used to show the strength of association. A p-value < 0.5 was statistically significant. RESULTS The prevalence of problematic substance use was 55.8%, 95% CI (49-63%). Peer pressure [adjusted odds ratio (AOR) = 3.01, 95% CI: 1.38, 6.59], family conflict [AOR = 5.05, 95% CI: 1.67, 15.25], physical abuse [AOR = 2.56, 95% CI: 1.11, 5.84], and substance use in the family [AOR = 2.85, 95% CI: 1.29, 6.27] were the factors significantly associated with problematic substance use. CONCLUSION The prevalence of problematic substance use was high. It was also found that peer pressure, family conflict, substance use in the family, and physical abuse were the factors associated with problematic substance use. Therefore, proper screening and intervention for individuals with problematic substance use are needed, and further research should be conducted for marginalized groups.
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Affiliation(s)
- Maregu Shegaw
- Department of Psychiatry, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Wubalem Fekadu
- Department of Psychiatry, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Michael Beka
- Department of Psychiatry, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Melake Menberu
- Department of Psychiatry, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Kalkidan Yohannes
- Department of Psychiatry, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
| | - Solomon Yimer
- Department of Psychiatry, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
| | - Mohammed Seid
- Department of Psychiatry, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Mogesie Necho
- Department of Psychiatry, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Solomon Moges
- Department of Psychiatry, College of Medicine and Health Science, Woldia University, Woldia, Ethiopia
| | - Tamrat Anbesaw
- Department of Psychiatry, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
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Goldbach JT, Schrager SM, Mamey MR, Rhoades H. Confirming the Reliability and Validity of the Sexual Minority Adolescent Stress Inventory in a National Sample of Sexual Minority Adolescents. Front Psychol 2021; 12:720199. [PMID: 34531800 PMCID: PMC8438190 DOI: 10.3389/fpsyg.2021.720199] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 07/21/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: Sexual minority adolescents (SMA) experience numerous behavioral health disparities, including depression, anxiety, substance use, non-suicidal self-injury, and suicidality. The primary framework to understand these disparities is minority stress theory, which frames this disproportionate burden as the result of discrimination, violence, and victimization in a homophobic culture. Empirical examinations of minority stress among SMA have been limited by lack of diverse samples or validated measures. This study engaged a national community sample of SMA to confirm reliability and validity of the Sexual Minority Adolescent Stress Inventory (SMASI). Method: A national sample of 2,310 SMA aged 14-17 was recruited in the United States through a hybrid social media and respondent-driven sampling approach. Item response theory and confirmatory factor analysis established the psychometric properties of the SMASI in this sample; minority stress was modeled as a latent variable in several regression models to verify criterion and divergent validity. Results: In this national sample (M age = 15.9; 64% female and 60% White), the factor structure of the SMASI and its 11 subscales was confirmed and shown to be invariant by demographic characteristics. Minority stress as measured by the SMASI was significantly associated with all mental and behavioral health outcomes. Conclusions: This study provides evidence that SMASI is a reliable, valid, and important tool for better understanding minority stress and subsequent health and mental health consequences among SMA.
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Affiliation(s)
- Jeremy T. Goldbach
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States
| | - Sheree M. Schrager
- Department of Graduate Studies and Research, California State University, Dominguez Hills, Carson, CA, United States
| | - Mary Rose Mamey
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States
| | - Harmony Rhoades
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States
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17
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Pedersen ER, Linnemayr S, Shadel WG, Zutshi R, DeYoreo M, Cabreros I, Tucker JS. Substance Use and Mental Health Outcomes from a Text Messaging-Based Intervention for Smoking Cessation Among Young People Experiencing Homelessness. Nicotine Tob Res 2021; 24:130-134. [PMID: 34375409 DOI: 10.1093/ntr/ntab160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 08/09/2021] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Cigarette smoking and associated high-risk behaviors are prevalent among youth experiencing homelessness (YEH), making appropriately tailored interventions targeting smoking behavior important for this group. We pilot tested a brief text-messaging intervention (TMI) as an adjunct to standard care for YEH who smoke and found promising preliminary effects of the intervention on smoking cessation. The purpose of the present study was to test the TMI's effect on the secondary outcomes of other substance use (including use of other tobacco/nicotine devices) and mental health symptoms. METHODS A total of 77 participants completed the pilot randomized controlled trial, with 40 receiving the TMI (174 automated text messages plus a group smoking counseling session and provision of nicotine patches). They completed an assessment at baseline and another three months later that evaluated use of other tobacco/nicotine devices, alcohol, marijuana, and anxiety and depression symptoms. RESULTS We found that the TMI helped to reduce secondary substance use behaviors and mental health symptoms among the participants; mainly there were medium effects of the intervention on changes in other tobacco/nicotine use, drinking, and anxiety and depression symptoms. The intervention did not have an effect on number of marijuana use days in the past month; however, past 30-day marijuana users who received the intervention benefited by reducing the number of times they used marijuana per day. CONCLUSIONS In addition to helping reduce cigarette smoking, we found that a TMI for YEH was helpful in improving secondary outcomes, suggesting the promise of the TMI on benefiting YEH even beyond targeted smoking behavior. IMPLICATIONS This pilot study demonstrates that by targeting cigarette smoking using a text message-based intervention among youth experiencing homelessness, effects may be seen in other areas of functioning such as other substance use and mental health.
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Affiliation(s)
- Eric R Pedersen
- University of Southern California, Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, Los Angeles, CA
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Heerde JA, Bailey JA, Kelly AB, McMorris BJ, Patton GC, Toumbourou JW. Life-course predictors of homelessness from adolescence into adulthood: A population-based cohort study. J Adolesc 2021; 91:15-24. [PMID: 34271292 PMCID: PMC8423126 DOI: 10.1016/j.adolescence.2021.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 06/20/2021] [Accepted: 06/24/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Internationally, the prevalence of young adult homelessness is concerning. Few data on life-course predictors from longitudinal studies exist, limiting our capacity to inform prevention strategies at the population-level. METHODS Data were drawn from a state representative population-based sample of young adults from Victoria, Australia participating in the International Youth Development Study (IYDS; N = 927, 54% female). Participants were recruited in state-representative secondary school samples at Grade 7 (age 13, 2002), with follow-up in Grades 9 (age 15) and 11 (age 17) and at ages 21, 23 and 25. Using longitudinal path modelling, we conducted a series of analyses testing life-course predictors of young adult homelessness across multiple socializing contexts, and the interrelationships among them. RESULTS The rate of young adult homelessness was 5.5%. Path modelling showed higher levels of family conflict at ages 13 and 15 uniquely predicted homelessness by age 25. This effect remained after accounting for other risk factors in peer-group (e.g., interactions with antisocial peers), school (e.g., low academic performance), and community contexts (e.g., low neighborhood attachment). Peer drug use and interaction with antisocial peers at age 15 mediated the association between family conflict at age 13 and homelessness by age 25. CONCLUSIONS Findings point to the vulnerability of early adolescents to family conflict. This vulnerability heightens risk for young adult homelessness. Findings strengthen the case for both primary prevention programs that build healthy relationships between family members from early on in adolescence and for investment in homelessness prevention at key developmental periods.
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Affiliation(s)
- Jessica A Heerde
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Honorary Research Fellow, The Murdoch Children's Research Institute, Australia.
| | - Jennifer A Bailey
- Social Development Research Group, School of Social Work, University of Washington, USA
| | - Adrian B Kelly
- School of Psychology and Counselling, Queensland University of Technology, Australia
| | | | - George C Patton
- Professorial Fellow in Adolescent Health Research, Department of Paediatrics, The University of Melbourne, Centre for Adolescent Health, Murdoch Children's Research Institute, Australia
| | - John W Toumbourou
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University; and Centre for Adolescent Health, Murdoch Children's Research Institute, Australia
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Terrile VC. Scenes from the Class Struggle in Picture Books: Depictions of Housing and Home in Books for Young Children. CHILDREN'S LITERATURE IN EDUCATION 2021; 53:526-546. [PMID: 35600460 PMCID: PMC8248758 DOI: 10.1007/s10583-021-09458-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/15/2021] [Indexed: 06/15/2023]
Abstract
While there is still much to be done, there have been tremendous strides made in increasing the diversity of children's literature; however one area that is often overlooked in these conversations is social class. From years of providing picture book story time to young children living in homeless shelters, it became obvious that picture books being published in the U.S. privilege the experiences of middle- and upper-class people, especially in their depictions of home and housing. Based on analysis of 185 picture books published in the U.S. between 1999 and 2019, I argue that home as typically represented in children's picture books presents a limited and privileged view that normalizes single-family homes, material possessions, and related middle-class experiences. Further, these books do not reflect the lived experience of the millions of American children in the United States experiencing homelessness and housing instability, as well as those who live in apartments, trailers and other types of homes that contemporary picture books would have us believe do not exist.
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Sulkowski ML, Michael KD. Introduction to the special issue: School and life experiences of highly mobile students: Phenomenology, risk, and resilience. PSYCHOLOGY IN THE SCHOOLS 2020. [DOI: 10.1002/pits.22445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Michael L. Sulkowski
- Department of Disability and Psychoeducational Studies University of Arizona Tucson Arizona USA
| | - Kurt D. Michael
- Department of Psychology Appalachian State University Boone North Carolina USA
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