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Scott BG, Sunchild L, Small C, McCullen JR. Anxiety and Depression in Northern Plains American Indian Youth: Evidence for Resilience and Risk. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2022:1-13. [PMID: 36206519 PMCID: PMC10079783 DOI: 10.1080/15374416.2022.2127101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Developing research collaborations with Indigenous communities to understand the expression and experience of anxiety and depression in American Indian (AI) youth and identifying protective and risk factors may be an important first step toward addressing AI health inequities. We used a community-based participatory research (CBPR) approach to investigate anxiety and depressive disorder symptoms among AI youth living on a Northern Plains reservation. Moreover, we examined whether symptoms were related to two potential protective and risk factors, anxiety control beliefs and rumination. Our tribal research team collected multi-reporter survey data from 71 AI 3rd-6th graders (8-13-years-old; 62.3% female) attending a tribal school, their caregivers, and teachers. Results pointed toward resilience in this sample with 7.3% and 8.7% of AI youth reporting clinical levels of anxiety and depressive disorder symptoms, respectively, and on average experiencing symptoms "Sometimes." There were moderate correlations between youth- and teacher-reported anxiety and depressive disorder symptoms, but no correlation with caregivers. Anxiety control beliefs were lower in older compared to younger AI youth and negatively related to youth-reported anxiety and depressive disorder symptoms, while rumination was positively related to youth-reported anxiety and depressive disorder symptoms and teacher-reported anxiety disorder symptoms. Age moderated relations between anxiety control beliefs and both youth-reported anxiety and depressive disorder symptoms with only significant relations found for older youth. Our findings are consistent with research showing resilience to internalizing problems in AI youth living on a reservation, but replication of their relations to anxiety control beliefs and rumination in other Indigenous peoples is warranted.
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Tolliver-Lynn MN, Marris AM, Sullivan MA, Armans M. The role of the parent-child relationship in fostering resilience in American Indian/Alaskan Native children. JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 49:419-431. [PMID: 33135173 DOI: 10.1002/jcop.22468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 10/04/2020] [Accepted: 10/05/2020] [Indexed: 06/11/2023]
Abstract
Resilience is a key characteristic to study in families, particularly those who have experienced significant systemic risk factors. While much resilience research focuses on ethnic and cultural minorities, little research focuses specifically on American Indian/Alaskan Native (AI/AN) families. The parent-child relationship has been demonstrated to be a key characteristic in families, and this relationship may also serve as a protective factor for AI/AN families. Positive parent-child relationships are consistently linked to positive child outcomes, and parental psychological symptoms are linked with child psychological symptoms in non-Native families. These associations warrant further examination among AI/AN families. We hypothesized that the parent-child relationship would moderate the link between parent distress (i.e., depressive and anxious symptoms) and child internalizing problems in a sample of 57 AI/AN parents of children 3-5 years of age. As expected, the parent-child relationship moderated the associations between parent anxiety symptoms and child internalizing symptoms, and between parent depressive symptoms and child internalizing symptoms. Furthermore, the strength of the parent-child relationship buffered the effects of parent distress on child internalizing symptoms. Results highlight the potentially protective role of strong parent-child relationships in AI/AN families.
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Affiliation(s)
| | - Alvina M Marris
- The Confederated Tribes of The Colville Reservation, Nespelem, Washington, USA
| | - Maureen A Sullivan
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Mira Armans
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
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Walls M, Sittner KJ, Whitbeck LB, Herman K, Gonzalez M, Elm JHL, Hautala D, Dertinger M, Hoyt DR. Prevalence of Mental Disorders from Adolescence through Early Adulthood in American Indian and First Nations Communities. Int J Ment Health Addict 2020; 19:2116-2130. [PMID: 35002580 PMCID: PMC8734560 DOI: 10.1007/s11469-020-00304-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- Melissa Walls
- Johns Hopkins University, Department of International Health; Center for American Indian Health; 1915 South Street, Duluth, MN 55812
| | | | - Les B. Whitbeck
- University of Nebraska, Lincoln, Department of Sociology, Lincoln, NE
| | - Kaley Herman
- Johns Hopkins University, Department of International Health; Center for American Indian Health; 1915 South Street, Duluth, MN 55812
| | - Miigis Gonzalez
- Johns Hopkins University, Department of International Health; Center for American Indian Health; 1915 South Street, Duluth, MN 55812
| | - Jessica H. L. Elm
- Johns Hopkins University, Department of International Health; Center for American Indian Health; 1915 South Street, Duluth, MN 55812
| | - Dane Hautala
- University of Minnesota, Department of Psychiatry, Minneapolis, MN
| | - Melinda Dertinger
- University of Minnesota Medical School, Duluth campus, Department of Family Medicine & Biobehavioral Health
| | - Dan R. Hoyt
- University of Nebraska, Lincoln, Department of Sociology, Lincoln, NE
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Weller BE, Blanford KL, Butler AM. Estimated Prevalence of Psychiatric Comorbidities in U.S. Adolescents With Depression by Race/Ethnicity, 2011-2012. J Adolesc Health 2018; 62:716-721. [PMID: 29784115 DOI: 10.1016/j.jadohealth.2017.12.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 11/08/2017] [Accepted: 12/13/2017] [Indexed: 12/22/2022]
Abstract
PURPOSE Comorbid psychiatric conditions in adolescents with depression are a public health concern. However, little is known about the prevalence of comorbidities in separate racial/ethnic groups. This study estimated the national prevalence of comorbidities for black, Hispanic, and white adolescents separately, and compared the prevalence of comorbidities between adolescents with and without depression. METHODS This secondary analysis used data from the 2011-2012 National Survey of Children's Health, a nationally representative, cross-sectional survey of U.S. youth. We restricted the sample to 12-17 year olds, and obtained unweighted and weighted descriptive statistics. Using weighted probit regression models, we examined differences in prevalence of comorbidities by adolescents with and without depression for each racial/ethnic group. RESULTS For black, Hispanic, and white adolescents with depression, the prevalence of comorbidities ranged from 8% to 61% and varied by race/ethnicity (e.g., depression and anxiety were comorbid for 47% of black, 54% of Hispanic, and 59% of white adolescents). For all racial/ethnic groups, adolescents with depression had a higher prevalence of attention deficit hyperactivity disorder than adolescents without depression. However, only black and Hispanic adolescents with depression had a significantly higher prevalence of anxiety and behavior problems than their counterparts without depression. In each racial/ethnic group, the prevalence of autism spectrum disorder did not differ between adolescents with and without depression. CONCLUSIONS This study detected important differences in the prevalence of comorbid psychiatric conditions by race/ethnicity. Findings highlight the need for targeted interventions for black and Hispanic adolescents with depression that concurrently treat anxiety and behavior problems.
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Affiliation(s)
- Bridget E Weller
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina.
| | - Kathryn L Blanford
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Ashley M Butler
- Department of Pediatrics, Section of Psychology, Baylor College of Medicine, Houston, Texas
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Young C, Hanson C, Craig JC, Clapham K, Williamson A. Psychosocial factors associated with the mental health of indigenous children living in high income countries: a systematic review. Int J Equity Health 2017; 16:153. [PMID: 28830449 PMCID: PMC5568067 DOI: 10.1186/s12939-017-0652-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 08/15/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Indigenous children living in high income countries have a consistently high prevalence of mental health problems. We aimed to identify psychosocial risk and protective factors for mental health in this setting. METHODS A systematic review of studies published between 1996 and 2016 that quantitatively evaluated the association between psychosocial variables and mental health among Indigenous children living in high income countries was conducted. Psychosocial variables were grouped into commonly occurring domains. Individual studies were judged to provide evidence for an association between a domain and either good mental health, poor mental health, or a negligible or inconsistent association. The overall quality of evidence across all studies for each domain was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) guidelines. RESULTS Forty-seven papers were eligible (mainland US 30 [64%], Canada 8 [17%], Australia 7 [15%], Hawaii 4 [9%]), including 58,218 participants aged 4-20 years. Most papers were cross-sectional (39, 83%) and measured negative mental health outcomes (41, 87%). Children's negative cohesion with their families and the presence of adverse events appeared the most reliable predictors of increased negative mental health outcomes. Children's substance use, experiences of discrimination, comorbid internalising symptoms, and negative parental behaviour also provided evidence of associations with negative mental health outcomes. Positive family and peer relationships, high self-esteem and optimism were associated with increased positive mental health outcomes. CONCLUSIONS Quantitative research investigating Indigenous children's mental health is largely cross-sectional and focused upon negative outcomes. Indigenous children living in high income countries share many of the same risk and protective factors associated with mental health. The evidence linking children's familial environment, psychological traits, substance use and experiences of discrimination with mental health outcomes highlights key targets for more concerted efforts to develop initiatives to improve the mental health of Indigenous children.
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Affiliation(s)
- Christian Young
- Sydney School of Public Health, The University of Sydney, Edward Ford Building (A27), Fisher Road, Camperdown, NSW 2006 Australia
- Centre for Kidney Research, Westmead Institute for Medical Research, 179 Hawkesbury Rd, Westmead, NSW 2145 Australia
| | - Camilla Hanson
- Sydney School of Public Health, The University of Sydney, Edward Ford Building (A27), Fisher Road, Camperdown, NSW 2006 Australia
- Centre for Kidney Research, Westmead Institute for Medical Research, 179 Hawkesbury Rd, Westmead, NSW 2145 Australia
| | - Jonathan C. Craig
- Sydney School of Public Health, The University of Sydney, Edward Ford Building (A27), Fisher Road, Camperdown, NSW 2006 Australia
- Centre for Kidney Research, Westmead Institute for Medical Research, 179 Hawkesbury Rd, Westmead, NSW 2145 Australia
| | - Kathleen Clapham
- Australian Health Services Research Institute, Innovation Campus, University of Wollongong, Building 234 (iC Enterprise 1), Wollongong, NSW 2522 Australia
| | - Anna Williamson
- The Sax Institute, Level 13, Building 10, 235 Jones Street, Ultimo, NSW 2007 Australia
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Lahey BB, Krueger RF, Rathouz PJ, Waldman ID, Zald DH. A hierarchical causal taxonomy of psychopathology across the life span. Psychol Bull 2017; 143:142-186. [PMID: 28004947 PMCID: PMC5269437 DOI: 10.1037/bul0000069] [Citation(s) in RCA: 249] [Impact Index Per Article: 35.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
We propose a taxonomy of psychopathology based on patterns of shared causal influences identified in a review of multivariate behavior genetic studies that distinguish genetic and environmental influences that are either common to multiple dimensions of psychopathology or unique to each dimension. At the phenotypic level, first-order dimensions are defined by correlations among symptoms; correlations among first-order dimensions similarly define higher-order domains (e.g., internalizing or externalizing psychopathology). We hypothesize that the robust phenotypic correlations among first-order dimensions reflect a hierarchy of increasingly specific etiologic influences. Some nonspecific etiologic factors increase risk for all first-order dimensions of psychopathology to varying degrees through a general factor of psychopathology. Other nonspecific etiologic factors increase risk only for all first-order dimensions within a more specific higher-order domain. Furthermore, each first-order dimension has its own unique causal influences. Genetic and environmental influences common to family members tend to be nonspecific, whereas environmental influences unique to each individual are more dimension-specific. We posit that these causal influences on psychopathology are moderated by sex and developmental processes. This causal taxonomy also provides a novel framework for understanding the heterogeneity of each first-order dimension: Different persons exhibiting similar symptoms may be influenced by different combinations of etiologic influences from each of the 3 levels of the etiologic hierarchy. Furthermore, we relate the proposed causal taxonomy to transdimensional psychobiological processes, which also impact the heterogeneity of each psychopathology dimension. This causal taxonomy implies the need for changes in strategies for studying the etiology, psychobiology, prevention, and treatment of psychopathology. (PsycINFO Database Record
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Affiliation(s)
| | | | - Paul J Rathouz
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine
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Wille SM, Kemp KA, Greenfield BL, Walls ML. Barriers to Healthcare for American Indians Experiencing Homelessness. JOURNAL OF SOCIAL DISTRESS AND THE HOMELESS 2017; 26:1-8. [PMID: 29375241 PMCID: PMC5783318 DOI: 10.1080/10530789.2016.1265211] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Members of American Indian (AI) communities face many barriers to receiving both mental and physical healthcare. These barriers can have a negative effect on overall health. Barriers are compounded for AIs who are also experiencing homelessness, and AI make up a disproportionate percentage of the homeless population nationwide. In-depth semi-structured interviews were conducted with 12 service providers and 16 homeless participants in a mid-size Midwestern city to identify barriers to care for homeless participants. Key barriers identified in this study for homeless participants were: transportation, phone accessibility, discrimination, and cold and bureaucratic cultures of healthcare systems. Major barriers identified by service providers were: access to care, discrimination and mistrust, and restrictive policies. Given generally higher disease prevalence within the homeless population and health disparities within the AI community, steps should be taken to reduce barriers to healthcare.
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Affiliation(s)
- Stephanie M Wille
- Department of Biobehavioral Health & Population Sciences, University of Minnesota Medical School, Duluth campus
| | - Katherine A Kemp
- Department of Biobehavioral Health & Population Sciences, University of Minnesota Medical School, Duluth campus
| | - Brenna L Greenfield
- Department of Biobehavioral Health & Population Sciences, University of Minnesota Medical School, Duluth campus
| | - Melissa L Walls
- Department of Biobehavioral Health & Population Sciences, University of Minnesota Medical School, Duluth campus
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Nelson SE, Wilson K. The mental health of Indigenous peoples in Canada: A critical review of research. Soc Sci Med 2017; 176:93-112. [PMID: 28135694 DOI: 10.1016/j.socscimed.2017.01.021] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 12/06/2016] [Accepted: 01/16/2017] [Indexed: 01/18/2023]
Abstract
Many scholars assert that Indigenous peoples across the globe suffer a disproportionate burden of mental illness. Research indicates that colonialism and its associated processes are important determinants of Indigenous peoples' health internationally. In Canada, despite an abundance of health research documenting inequalities in morbidity and mortality rates for Indigenous peoples, relatively little research has focused on mental health. This paper provides a critical scoping review of the literature related to Indigenous mental health in Canada. We searched eleven databases and two Indigenous health-focused journals for research related to mental health, Indigenous peoples, and Canada, for the years 2006-2016. Over two hundred papers are included in the review and coded according to research theme, population group, and geography. Results demonstrate that the literature is overwhelmingly concerned with issues related to colonialism in mental health services and the prevalence and causes of mental illness among Indigenous peoples in Canada, but with several significant gaps. Mental health research related to Indigenous peoples in Canada overemphasizes suicide and problematic substance use; a more critical use of the concepts of colonialism and historical trauma is advised; and several population groups are underrepresented in research, including Métis peoples and urban or off-reserve Indigenous peoples. The findings are useful in an international context by providing a starting point for discussions, dialogue, and further study regarding mental health research for Indigenous peoples around the world.
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Affiliation(s)
- Sarah E Nelson
- University of Toronto Mississauga, Department of Geography, 3359 Mississauga Road, Mississauga, ON L5L 1C6, Canada.
| | - Kathi Wilson
- University of Toronto Mississauga, Department of Geography, 3359 Mississauga Road, Mississauga, ON L5L 1C6, Canada
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Donovan DM, Thomas LR, Sigo RLW, Price L, Lonczak H, Lawrence N, Ahvakana K, Austin L, Lawrence A, Price J, Purser A, Bagley L. Healing of the canoe: preliminary results of a culturally tailored intervention to prevent substance abuse and promote tribal identity for Native youth in two Pacific Northwest tribes. AMERICAN INDIAN AND ALASKA NATIVE MENTAL HEALTH RESEARCH 2016; 22:42-76. [PMID: 25768390 DOI: 10.5820/aian.2201.2015.42] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Using Community-based and Tribal Participatory Research (CBPR/TPR) approaches, an academic-tribal partnership between the University of Washington Alcohol and Drug Abuse Institute and the Suquamish and Port Gamble S'Klallam Tribes developed a culturally grounded social skills intervention to promote increased cultural belonging and prevent substance abuse among tribal youth. Participation in the intervention, which used the Canoe Journey as a metaphor for life, was associated with increased hope, optimism, and self-efficacy and with reduced substance use, as well as with higher levels of cultural identity and knowledge about alcohol and drugs among high school-age tribal youth. These results provide preliminary support for the intervention curricula in promoting positive youth development, an optimistic future orientation, and the reduction of substance use among Native youth.
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Williamson A, Andersen M, Redman S, Dadds M, D'Este C, Daniels J, Eades S, Raphael B. Measuring mental health in Indigenous young people: a review of the literature from 1998-2008. Clin Child Psychol Psychiatry 2014; 19:260-72. [PMID: 23737609 DOI: 10.1177/1359104513488373] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Indigenous young people are disproportionately exposed to risk factors for poor mental health. Methodologically rigorous research will be critical in the development and evaluation of prevention and treatment programs. Research examining the mental health of Indigenous young people may have been undermined by poor measurement. The extent to which research has used measures with adequate psychometrics is unknown. METHODS MEDLINE, PsychINFO and PUBMED databases, were systematically searched to identify papers published between 1998-2008 measuring the mental health of Indigenous young people from Australia, Canada, New Zealand or the US. Data extracted included type of mental health instrument, psychometric analyses reported and results. RESULTS Fifty-four relevant studies were identified. Seventy-nine mental health instruments were used, and 18% were bespoke. Only 14% of instruments had been validated for the relevant Indigenous population. Few studies reported assessment of the reliability or validity of instruments. Data about both the reliability and validity of 10 measures were reported. None of the measures met the standards set by the review. Evidence of at least one type of reliability and validity was demonstrated for six measures. CONCLUSIONS From 1998-2008 few studies of mental health in Indigenous young people used measurement instruments with previously determined reliability and validity.
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North American Indigenous adolescent substance use. Addict Behav 2013; 38:2103-9. [PMID: 23434599 DOI: 10.1016/j.addbeh.2013.01.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 12/14/2012] [Accepted: 01/08/2013] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To investigate growth in problem drinking and monthly marijuana use among North American Indigenous adolescents from the upper Midwest and Canada. METHODS Panel data from a community-based participatory research project includes responses from 619 adolescents residing on or near 7 different reservations/reserves. All respondents were members of the same Indigenous cultural group. RESULTS Rates of problem drinking and monthly marijuana use increased steadily across the adolescent years, with fastest growth occurring in early adolescence (before age 15). In general, female participants reported higher rates of substance use prior to age 15; however, male reports of use surpassed those of females in later adolescence. CONCLUSIONS Results of this study highlight the importance of early adolescent substance use prevention efforts and the possible utility of gender responsive programming.
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Cheadle JE, Hartshorn KJS. Marijuana use development over the course of adolescence among North American Indigenous youth. SOCIAL SCIENCE RESEARCH 2012; 41:1227-40. [PMID: 23017929 PMCID: PMC3593240 DOI: 10.1016/j.ssresearch.2012.03.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Revised: 03/18/2012] [Accepted: 03/27/2012] [Indexed: 06/01/2023]
Abstract
This study investigated the links between marijuana use trajectories and marijuana abuse/dependence (DSM-IV) using five waves of data from 718 North American Indigenous adolescents between 10 and 17years from eight reservations sharing a common language and culture. Growth mixture models indicated that 15% of youth began using by 11-12years of age and that another 20% began shortly thereafter. These early users had odds of abuse/dependence 6.5 times larger than abstainers. Girls were also unexpectedly found to be particularly at risk of early use, and this did not reflect other background and psychosocial factors, including friend use. While the timing, patterns, and consequences of use were similar to those reported for alcohol use previously, the social influences on use differed in important ways.
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Affiliation(s)
- Jacob E. Cheadle
- The University of Nebraska – Lincoln, 737 Oldfather Hall, Lincoln, NE 68588-0324, United States
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Ginsburg GS, Barlow A, Goklish N, Hastings R, Baker EV, Mullany B, Tein JY, Walkup J. Postpartum Depression Prevention for Reservation-Based American Indians: Results from a Pilot Randomized Controlled Trial. CHILD & YOUTH CARE FORUM 2012; 41:229-245. [PMID: 22701296 PMCID: PMC3373958 DOI: 10.1007/s10566-011-9161-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
BACKGROUND: Postpartum depression is a devastating condition that affects a significant number of women and their offspring. Few preventive interventions have targeted high risk youth, such as American Indians (AIs). OBJECTIVE: To evaluate the feasibility of a depression prevention program for AI adolescents and young adults. METHODS: Expectant AI women (mean age = 18.15; N = 47) were randomized (1:1) to either the Living in Harmony program (LIH, an 8 lesson cognitive-behaviorally based program) or an Educational-Support program (ES, an 8 lesson education program). Both interventions were delivered by AI paraprofessionals. Adolescents were evaluated during their pregnancy at baseline, at post-intervention, and at 4, 12, and 24 weeks postpartum. The primary outcome measure was the Center for Epidemiological Studies-Depression scale (CES-D). Additional measures of depression included the onset of major depressive disorder (MDD; assessed via computerized diagnostic interview) and the Edinburgh Postpartum Depression Scale (EPDS). Secondary outcomes included changes in mothers' global functioning and social support. RESULTS: At all post intervention assessments, mothers in both groups showed similar reductions in depressive symptoms and similar rates of MDD (0 and 6% in LIH and ES respectively). Both groups of participants also showed similar improvements in global functioning. No changes in either group were found on the measure of social support. CONCLUSIONS: Findings suggest that both paraprofessional-delivered interventions may reduce symptoms of depression among AIs. Replication with a larger sample, a usual care control condition, blinded evaluators, and a longer follow-up is needed.
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Affiliation(s)
- Golda S. Ginsburg
- Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Allison Barlow
- Center for American Indian Health, Johns Hopkins University School of Public Health, Baltimore, MD, USA
| | - Novalene Goklish
- Center for American Indian Health, Johns Hopkins University School of Public Health, Baltimore, MD, USA
| | - Ranelda Hastings
- Center for American Indian Health, Johns Hopkins University School of Public Health, Baltimore, MD, USA
| | - Elena Varipatis Baker
- Center for American Indian Health, Johns Hopkins University School of Public Health, Baltimore, MD, USA
| | - Britta Mullany
- Center for American Indian Health, Johns Hopkins University School of Public Health, Baltimore, MD, USA
| | - Jenn-Yun Tein
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - John Walkup
- Department of Psychiatry, Weill Cornell Medical College and New York-Presbyterian Hospital, New York, NY, USA
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Goodkind J, LaNoue M, Lee C, Freeland L, Freund R. Feasibility, Acceptability, and Initial Findings from a Community-Based Cultural Mental Health Intervention for American Indian Youth and Their Families. JOURNAL OF COMMUNITY PSYCHOLOGY 2012; 40:381-405. [PMID: 25414529 PMCID: PMC4235231 DOI: 10.1002/jcop.20517] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Through a CBPR partnership, university and American Indian (AI) tribal members developed and tested Our Life intervention to promote mental health of AI youth and their families by addressing root causes of violence, trauma, and substance abuse. Based on premises that well-being is built on a foundation of traditional cultural beliefs and practices, and that it requires a process of healing and understanding, the 6-month intervention had four components: 1) recognizing/healing historical trauma; 2) reconnecting to traditional culture; 3) parenting/social skill-building; and 4) strengthening family relationships through equine-assisted activities. Feasibility, acceptability, appropriateness, and preliminary outcomes were examined in a mixed-method within-group design. Engagement and retention were challenging, suggesting that families faced numerous barriers to participation. Youth who completed the program experienced significant increases in cultural identity, self-esteem, positive coping strategies, quality of life, and social adjustment. Qualitative data supported these findings and suggested additional positive effects.
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Cheadle JE, Whitbeck LB. Alcohol use trajectories and problem drinking over the course of adolescence: a study of north american indigenous youth and their caretakers. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2011; 52:228-45. [PMID: 21558489 PMCID: PMC3252748 DOI: 10.1177/0022146510393973] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
This study investigated the links between alcohol use trajectories and problem drinking (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition abuse/dependence) using five waves of data from 727 North American Indigenous adolescents between 10 and 17 years from eight reservations sharing a common language and culture. Growth mixture models linking fundamental causes, social stressors, support, and psychosocial pathways to problem drinking via alcohol use trajectories over the early life course were estimated. Results indicated that 20 percent of the adolescents began drinking at 11 to 12 years of age and that another 20 percent began drinking shortly thereafter. These early drinkers were at greatly elevated risk for problem drinking, as were those who began drinking at age 13. The etiological analysis revealed that stressors (e.g., perceived discrimination) directly and indirectly influenced early and problem alcohol use by decreasing positive school attitudes while increasing feelings of anger and perceived delinquent friendships. Girls were found to be at risk independently of these other factors.
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Affiliation(s)
- Jacob E. Cheadle
- The University of Nebraska-Lincoln, 737 Oldfather Hall, Lincoln, NE 68588-0324, 402-472-6037
| | - Les B. Whitbeck
- The University of Nebraska-Lincoln, 739 Oldfather Hall, Lincoln, NE 68588-0324, 402-472-5562
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Whitbeck LB. The beginnings of mental health disparities: emergent mental disorders among Indigenous adolescents. NEBRASKA SYMPOSIUM ON MOTIVATION 2010; 57:121-49. [PMID: 21166307 DOI: 10.1007/978-1-4419-7092-3_6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Affiliation(s)
- Les B Whitbeck
- Department of Sociology, University of Nebraska-Lincoln, Lincoln, NE 68588-0324, USA.
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Storck M, Beal T, Bacon JG, Olsen P. Behavioral and mental health challenges for indigenous youth: research and clinical perspectives for primary care. Pediatr Clin North Am 2009; 56:1461-79. [PMID: 19962031 DOI: 10.1016/j.pcl.2009.09.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
After first discussing historical, community and epidemiologic perspectives pertaining to mental health problems of Indigenous youth and families, this article reviews available research data on behavioral and mental health interventions and the roles that Native and Indigenous research programs are serving. Given the legacy of transgenerational trauma experienced by Indigenous peoples, community-based research and treatment methods are essential for solving these problems. The primary care provider stands in a unique position within the community to offer a "coinvestigator spirit" to youth and families in the pursuit of improving behavioral health. Strategies are presented for using the research literature, and collaborating with communities and families to help solve behavioral and mental health problems.
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Affiliation(s)
- Michael Storck
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, P.O. Box 359300, Seattle, WA 98195, USA.
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Walls ML. Marijuana and Alcohol Use during Early Adolescence: Gender Differences among American Indian/First Nations Youth. JOURNAL OF DRUG ISSUES 2008. [DOI: 10.1177/002204260803800410] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examines the growth of alcohol and marijuana use during early adolescence among a sample of 746 Indigenous youth (aged 10–12 years at wave 1; 50.3% female) of the upper Midwest and Canada, with a special focus on potential gender differences in these patterns. Research documenting the disproportionately high rates of Indigenous substance use, coupled by our lack of understanding of gender patterns among this group—especially in very early adolescence—highlight the need for this culturally specific work. Results of latent growth curve analyses from three waves of annual data collection indicate that the females in our sample engage in alcohol and marijuana use at rates similar to or greater than their male peers. This finding counters conventional ideas of gender and substance use that place young males at elevated rates of use compared to females, and also adds to our understanding of gendered substance use patterns among Indigenous youth.
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Prevalence of DSM-IV disorders in Chinese adolescents and the effects of an impairment criterion: a pilot community study in Hong Kong. Eur Child Adolesc Psychiatry 2008; 17:452-61. [PMID: 18427862 DOI: 10.1007/s00787-008-0687-7] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/25/2008] [Indexed: 10/22/2022]
Abstract
PURPOSE To provide preliminary prevalence estimates of common DSM-IV (Diagnostic and Statistical Manual of Mental Disorders-4th Edition) disorders in a sample of Hong Kong Chinese adolescents. METHODS 541 Chinese adolescents were recruited from Grades 7, 8 and 9 of 28 mainstream high schools in Hong Kong (mean age=13.8 years; SD=1.2). The adolescents and their parents were separately administered the Youth and Parent versions of DISC-IV (Diagnostic Interview Schedule for Children-Version 4), respectively. RESULTS Based upon both symptom and impairment criteria, as required by DSM-IV, the overall prevalence estimate of DSM-IV disorders in our sample of Chinese adolescents was 16.4%. Estimates for such individual disorders/diagnostic groupings as anxiety disorders, depressive disorders, attention deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), conduct disorder (CD), and substance use disorders were 6.9, 1.3, 3.9, 6.8, 1.7, and 1.1%, respectively. These rates were largely compatible with those reported in previous studies with perhaps lower rates of generalized anxiety disorder (GAD), depressive disorders, CD, and substance use disorders, but a higher rate of ODD. The rate of ADHD was somewhat higher, but this might reflect the current DSM-IV diagnostic practice. The rate of anxiety disorders was not as high as predicted from some previous questionnaire surveys. The application of an impairment criterion had discernible impacts on prevalence estimates, greater on anxiety and substance use disorders, but smaller on depressive and disruptive behavior disorders. There was a lack of gender difference in rates of ODD and CD. DISCUSSION AND CONCLUSION While the findings reported here are broadly compatible with those of other studies, there may be cross-cultural differences in rates of some individual disorders, e.g., GAD, depressive disorders, ODD, CD, and substance use disorders, as well as in gender difference regarding rates of ODD and CD. However, exact comparison between studies is confounded by methodological differences in sample characteristics, measures, and case definition. Standardization of methodology in epidemiological surveys should allow more precise identification of any within- or between-culture variations in prevalence estimation.
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Diagnostic prevalence rates from early to mid-adolescence among indigenous adolescents: first results from a longitudinal study. J Am Acad Child Adolesc Psychiatry 2008; 47:890-900. [PMID: 18596558 PMCID: PMC2643437 DOI: 10.1097/chi.0b013e3181799609] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Investigate change in prevalence rates for mental and substance abuse disorders between early and mid-adolescence among a cohort of indigenous adolescents. METHOD The data are from a lagged, sequential study of 651 indigenous adolescents from a single culture in the northern Midwest United States and Canada. At waves 1 (ages 10-12 years) and 4 (ages 13-15 years), one adult caretaker and one tribally enrolled adolescent completed a computer-assisted personal interview that included Diagnostic Interview Schedule for Children-Revised assessment for 11 diagnoses. Multivariate analyses investigate effects of wave 1 adolescent diagnosis and wave 1 biological mother diagnosis (University of Michigan Composite International Diagnostic Interview) on wave 4 diagnostic outcomes. RESULTS The findings show a increase in prevalence rates for substance abuse disorders and conduct disorders between ages 10 and 12 years and 13 and 15 years among indigenous adolescents, with these disorders affecting more than one fourth of the children. The rate of lifetime conduct disorder is about twice that expected in general population studies (23.4% versus 5%-10%), and the rate of lifetime substance abuse disorder (27.2%) is three times that reported in the 2004 National Survey on Drug Use and Health (9.4%) for individuals 12 years or older. Prevalence rates for any single mental or substance use disorder (44.8 lifetime) for the 13- to 15-year-olds are similar to the lifetime prevalence rates reported in the National Comorbidity Survey-Replication (46.4%) for individuals 18 years and older. CONCLUSIONS A mental health crisis exists on the indigenous reservations and reserves that participated in this study. Current service systems are overwhelmed and unable to meet the demands placed upon them.
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Marrone S. Understanding barriers to health care: a review of disparities in health care services among indigenous populations. Int J Circumpolar Health 2007; 66:188-98. [PMID: 17655060 DOI: 10.3402/ijch.v66i3.18254] [Citation(s) in RCA: 127] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To review the current status of health care access and utilization among Indigenous people in the North America, Australia and New Zealand. STUDY DESIGN Literature review. METHODS A systematic search and critical review of relevant studies using online searches of electronic databases (PubMed, PsychINFO, MEDLINE) that examined issues relating to health care utilization and access. RESULTS Most studies found that health care access and utilization rates were found to be significantly lower among Indigenous populations. Factors such as rural location, communication and socio-economic status were found to be barriers to health care services that disproportionately affected Indigenous communities compared with the general population. CONCLUSIONS Inequalities in health care access and utilization among Indigenous populations may play an important role in understanding why disparities in the health status of Indigenous populations continue to exist despite public health interventions. Further research is needed to understand the factors that contribute to these inequalities and to develop specific interventions to increase access and utilization among Indigenous populations.
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Affiliation(s)
- Sonia Marrone
- Center for Health Promotion and Prevention Research, University of North Dakota, School of Medicine & Health Sciences, Grand Forks, USA.
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