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Rozenman M, Gonzalez A, Vreeland A, Thamrin H, Perez J, Peris TS. Resting State Psychophysiology in Youth with OCD and Their Caregivers: Preliminary Evidence for Trend Synchrony and Links to Family Functioning. Child Psychiatry Hum Dev 2024; 55:635-643. [PMID: 36107282 DOI: 10.1007/s10578-022-01426-4] [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: 04/23/2022] [Revised: 07/27/2022] [Accepted: 08/26/2022] [Indexed: 11/27/2022]
Abstract
The burden of OCD in children and adolescents extends to their caregivers. Prior work in other disorders and unaffected youth has found synchrony in psychophysiological arousal for youth-caregiver dyads. This preliminary study explored whether psychophysiological trend synchrony in youth-caregiver dyads (N = 48) occurred and was moderated by youth OCD diagnosis. We also explored whether psychophysiological indices (i.e., electrodermal activity, heart rate, respiratory sinus arrhythmia) were correlated with reported family functioning in the OCD subsample (n = 25). Youth with OCD had higher resting heart rate than unaffected peers; this was not replicated in caregivers. Trend synchrony was found across the full sample of dyads for electrodermal activity and heart rate, with no moderation by diagnostic group. In the OCD group, youth heart rate was correlated with family conflict and caregiver heart rate with expressiveness. Findings provide preliminary support for further examination of heart rate and family factors in OCD-affected youth and their caregivers.
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Affiliation(s)
- Michelle Rozenman
- Department of Psychology, University of Denver, 2155 S. Race St, 80209, Denver, CO, USA.
| | - Araceli Gonzalez
- Department of Psychology, California State University Long Beach, Long Beach, CA, USA
| | - Allison Vreeland
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Hardian Thamrin
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Jocelyn Perez
- Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Tara S Peris
- UCLA Semel Institute Division of Child & Adolescent Psychiatry, Los Angeles, CA, USA
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Duarté-Vélez Y, Jimenez-Colon G, Jones RN, Spirito A. Socio-Cognitive Behavioral Therapy for Latinx Adolescent with Suicidal Behaviors: A Pilot Randomized Trial. Child Psychiatry Hum Dev 2024; 55:754-767. [PMID: 36183051 DOI: 10.1007/s10578-022-01439-z] [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] [Accepted: 09/05/2022] [Indexed: 11/26/2022]
Abstract
Evidence-based treatment for Latinx/Hispanic (L/H) with suicidal behaviors (SB) is scarce. This study evaluated the acceptability and preliminary efficacy of a socio-cognitive-behavioral therapy protocol for SB (SCBT-SB) with L/H adolescents and the feasibility of conducting a randomized controlled trial (RCT) of SCBT-SB compared to treatment-as-usual (TAU). A pilot RCT was conducted with 46 L/H teens. The target outcomes included suicidal ideation (SI), suicide attempts (SAs), and depressive/internalizing symptoms. Results indicated that the SCBT-SB was acceptable and an RCT with diverse L/H families is feasible to implement. Within group analyses showed reductions over time for each group in SI and depressive/internalizing symptoms. Intent-to-treat between-group analyses showed a medium effect for the SCBT-SB at the twelve-month follow-up for depressive/internalizing symptoms and a large effect for SA. Although results must be interpreted cautiously given the small sample size, outcomes suggest that SCBT-SB may be a promising psychosocial treatment for depressive/internalizing symptoms, and SAs in L/H youth.
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Affiliation(s)
- Yovanska Duarté-Vélez
- Department of Psychiatry and Human Behavior, Emma Pendleton Bradley Hospital, 1011 Veterans Memorial Pkwy, East Providence, RI, 02915, USA.
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, 02912, USA.
| | - Gisela Jimenez-Colon
- Department of Psychiatry and Human Behavior, Emma Pendleton Bradley Hospital, 1011 Veterans Memorial Pkwy, East Providence, RI, 02915, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, 02912, USA
| | - Richard N Jones
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, 02912, USA
| | - Anthony Spirito
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, 02912, USA
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3
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Warren JS, Bullock M, Top DN, Salazar GC. Self-efficacy, motivation, social support, and alliance as predictors of youth psychotherapy outcomes in usual care. Psychother Res 2024:1-13. [PMID: 38735039 DOI: 10.1080/10503307.2024.2349996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 04/24/2024] [Indexed: 05/14/2024] Open
Abstract
OBJECTIVE We examined how youth self-efficacy, motivation for treatment, social support, and therapeutic alliance relate to psychotherapy outcomes of patients receiving services at outpatient community clinics. We hypothesized that (1) these variables would increase throughout the course of therapy, (2) baseline scores would predict initial ratings of distress, (3) baseline scores would predict the rate of change in symptoms throughout treatment, and (4) changes in these variables would be associated with symptom change over the course of treatment. METHOD Participants included 150 adolescents at community outpatient treatment centers. Data was collected prior to beginning treatment, and every three weeks afterward until termination. We used hierarchical linear modeling (HLM) to address our hypotheses. RESULTS We found that (1) youth ratings of self-efficacy, social support, and motivation increased throughout treatment, (2) initial self-efficacy and social support were associated with initial levels of distress, (3) ratings of youth self-efficacy at intake predicted its rate of change over therapy, and (4) changes in all variables during therapy were related to lower distress at termination. DISCUSSION Results suggest that these variables may affect the trajectory and course of treatment in community-based treatment settings. These results may have implications for treatment planning to maximize treatment effectiveness.
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Affiliation(s)
- Jared S Warren
- Department of Psychology, Brigham Young University, Provo, UT, USA
| | - Mariah Bullock
- Department of Psychology, Brigham Young University, Provo, UT, USA
| | - D Nicholas Top
- Department of Psychology, Brigham Young University, Provo, UT, USA
| | - Gus C Salazar
- Department of Psychology, Brigham Young University, Provo, UT, USA
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Gellatly R, Boustani M, Nair P, Mahajan R, Jambhale A, Sahu R, Chodankar B, Krishna M, Malik K, Mathur S, Becker K, Michelson D, Patel V, Chorpita B. Adolescent engagement in a stepped care, transdiagnostic mental health intervention delivered in Indian schools. DISCOVER PSYCHOLOGY 2024; 4:43. [PMID: 38686018 PMCID: PMC11057193 DOI: 10.1007/s44202-024-00154-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 04/12/2024] [Indexed: 05/02/2024]
Abstract
Given the relationship between poor engagement and worse treatment outcomes, improving engagement has been the focus of attention in recent years. Engagement is a particular challenge among minoritized and otherwise challenged youth, such as those from socioeconomically disadvantaged groups, including youth in low- and middle-income countries (LMICs), where they face lower levels of access to resources, including mental health treatment. The present study describes engagement challenges that arose in an uncontrolled pre-post evaluation of a school-based, modular, multi-problem, stepped-care intervention delivered in urban Indian communities. Specifically, the study aimed to (1) characterize barriers and facilitators of youth treatment engagement; and (2) evaluate treatment acceptability and fit of treatment from the youth perspective. Youth participants completed semi-structured interviews, which were transcribed and coded using thematic analysis. Participants described numerous facilitators to engagement (e.g., positive therapeutic relationship) and reported high overall satisfaction with the intervention, while also identifying barriers to engagement (e.g., concerns about confidentiality) and offering suggestions to increase fit and acceptability (e.g., more visually appealing treatment materials). Findings highlight ways in which engagement can be enhanced and implementation supports improved to maximize treatment effectiveness among minoritized and disadvantaged youth in LMICs. Supplementary Information The online version contains supplementary material available at 10.1007/s44202-024-00154-1.
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Affiliation(s)
- Resham Gellatly
- Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
| | | | | | | | | | | | | | | | - Kanika Malik
- PRIDE Project, Sangath, New Delhi India
- Jindal School of Psychology and Counselling, O.P. Jindal Global University, Sonipat, Haryana India
| | | | - Kimberly Becker
- Department of Psychology, University of South Carolina, Columbia, SC USA
| | - Daniel Michelson
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Vikram Patel
- PRIDE Project, Sangath, New Delhi India
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA USA
| | - Bruce Chorpita
- Department of Psychology, University of California, Los Angeles, CA USA
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Kitt ER, Zacharek SJ, Odriozola P, Nardini C, Hommel G, Martino A, Anderson T, Spencer H, Broussard A, Dean J, Marin CE, Silverman WK, Lebowitz ER, Gee DG. Responding to threat: Associations between neural reactivity to and behavioral avoidance of threat in pediatric anxiety. J Affect Disord 2024; 351:818-826. [PMID: 38290579 PMCID: PMC10981528 DOI: 10.1016/j.jad.2024.01.204] [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: 08/10/2023] [Revised: 01/18/2024] [Accepted: 01/22/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Despite broad recognition of the central role of avoidance in anxiety, a lack of specificity in its operationalization has hindered progress in understanding this clinically significant construct. The current study uses a multimodal approach to investigate how specific measures of avoidance relate to neural reactivity to threat in youth with anxiety disorders. METHODS Children with anxiety disorders (ages 6-12 years; n = 65 for primary analyses) completed laboratory task- and clinician-based measures of avoidance, as well as a functional magnetic resonance imaging task probing neural reactivity to threat. Primary analyses examined the ventral anterior insula (vAI), amygdala, and ventromedial prefrontal cortex (vmPFC). RESULTS Significant but distinct patterns of association with task- versus clinician-based measures of avoidance emerged. Clinician-rated avoidance was negatively associated with right and left vAI reactivity to threat, whereas laboratory-based avoidance was positively associated with right vAI reactivity to threat. Moreover, left vAI-right amygdala and bilateral vmPFC-right amygdala functional connectivity were negatively associated with clinician-rated avoidance but not laboratory-based avoidance. LIMITATIONS These results should be considered in the context of the restricted range of our treatment-seeking sample, which limits the ability to draw conclusions about these associations across children with a broader range of symptomatology. In addition, the limited racial and ethnic diversity of our sample may limit the generalizability of findings. CONCLUSION These findings mark an important step towards bridging neural findings and behavioral patterns using a multimodal approach. Advancing understanding of behavioral avoidance in pediatric anxiety may guide future treatment optimization by identifying individual-specific targets for treatment.
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Affiliation(s)
| | | | | | | | - Grace Hommel
- Yale University, New Haven, CT, United States of America
| | - Alyssa Martino
- Yale University, New Haven, CT, United States of America
| | - Tess Anderson
- Yale University, New Haven, CT, United States of America
| | - Hannah Spencer
- Yale University, New Haven, CT, United States of America
| | | | - Janice Dean
- Yale University, New Haven, CT, United States of America
| | - Carla E Marin
- Yale University, New Haven, CT, United States of America
| | | | - Eli R Lebowitz
- Yale University, New Haven, CT, United States of America
| | - Dylan G Gee
- Yale University, New Haven, CT, United States of America.
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McGuire A, Amaro CM, Singh MN, Brown S. Targeting Caregiver Psychopathology in Parent Management Training for Adolescents: A Scoping Review of Commercially Available Treatment Resources. CHILD & YOUTH CARE FORUM 2024; 53:269-291. [PMID: 38601299 PMCID: PMC11003757 DOI: 10.1007/s10566-023-09754-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2023] [Indexed: 04/12/2024]
Abstract
Background While parent management training (PMT) has been shown to be an effective treatment for adolescents with externalizing concerns, evidence suggests that effectiveness is not equitable across all types of families. Research suggests that caregiver psychopathology may adversely affect PMT success for adolescents. However, it remains unclear whether research on caregiver psychopathology is integrated within adolescent PMT resources (e.g., treatment manuals). Objective A scoping review of commercially available, clinician focused PMT resources was conducted to assess for information on caregiver psychopathology and clinical guidance for addressing caregiver psychopathology. Methods A search for commercially available resources was conducted among national treatment databases and book resource websites. Information on caregiver psychopathology was extracted from individual sessions of the PMT resources. Results Seven treatment resources met inclusion criteria. The majority of the treatment resources made at least one explicit comment that caregiver psychopathology may impact the course of treatment. There was very limited mention of caregiver psychopathology in skill building sections of the resources. Conclusions While most resources mentioned caregiver psychopathology, these comments lacked breadth and depth in providing clinicians with recommendations on how to tailor treatment to caregivers' needs. Recommendations are provided for how PMT programs might be improved in the future to support clinicians when faced with caregiver psychopathology by recognizing inequities and lack of diversity in resource development, using a transdiagnostic perspective (including a transdiagnostic approach to assessment of care-giver psychopathology), and integrating caregiver skill development.
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Affiliation(s)
- Austen McGuire
- Clinical Child Psychology Program, 2015 Dole Human Development Center, University of Kansas, 1000 Sunnyside Avenue, Lawrence, KS 66045-7556, USA
| | - Christina M. Amaro
- Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Ave, Boston, MA 02215, USA
- Division of Behavioral Health and Center for Healthcare Delivery Science, Nemours Children’s Hospital, 1600 Rockland Road, Delaware, Wilmington, DE 19803, USA
| | - Mehar N. Singh
- Clinical Child Psychology Program, 2015 Dole Human Development Center, University of Kansas, 1000 Sunnyside Avenue, Lawrence, KS 66045-7556, USA
| | - Shaquanna Brown
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Box G-BH, Providence, RI 02912, USA
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Coro West, Suite 309, 164 Summit Avenue, Providence, RI 02906, USA
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Toth SL, Cerulli C, Manly JT. The long and winding road: Pathways from basic research to implementation and evaluation. Dev Psychopathol 2024:1-11. [PMID: 38454781 DOI: 10.1017/s0954579424000452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
In this article, we celebrate Dante Cicchetti's extensive contributions to the discipline of developmental psychopathology. In his seminal article, he articulated why developmental psychopathology was imperative to create research portfolios that could inform the causes, consequences, and trajectories for adults often initiated by early lived experiences (Cicchetti, 1984). In this three-part article, we share our transdisciplinary efforts to use developmental psychopathology as a foundational theory from which to develop, implement, and evaluate interventions for populations who experienced early adversity or who were at risk for child abuse and neglect. After describing interventions conducted at Mt. Hope Family Center that spanned over three decades, we highlight the criticality of disseminating results and address policy implications of this work. We conclude by discussing future directions to facilitate work in developmental psychopathology. Currently, one of three national National Institute of Child Health and Human Development-funded child abuse and neglect centers, we look forward to continuing to build upon Dante's efforts to disseminate this important work to improve society for our children, our nation's often most vulnerable and forgotten citizens.
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Affiliation(s)
- Sheree L Toth
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
- Department of Psychology, University of Rochester, Rochester, NY, USA
| | - Catherine Cerulli
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
- Department of Psychiatry, Laboratory of Interpersonal Violence, University of Rochester, Rochester, NY, USA
- Susan B. Anthony Center, University of Rochester, Rochester, NY, USA
| | - Jody Todd Manly
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
- Department of Psychology, University of Rochester, Rochester, NY, USA
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Bounds DT, Rodrigues SM, Balsam D, Lennan N, Rodriguez KR, Milburn NG. Creating Space for Adolescents and Families With Lived Experience of Homelessness to Build Familial Empathy, Communication, and Emotional Regulation: A Qualitative Study of Facilitators of Implementation. J Psychosoc Nurs Ment Health Serv 2024; 62:27-35. [PMID: 37379121 DOI: 10.3928/02793695-20230622-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Youth experiencing homelessness are vulnerable to commercial sexual exploitation (CSE). Structural racism disproportionately entraps marginalized youth into CSE while simultaneously obscuring their identification as victims. Adaptation and tailoring of effective interventions to mitigate associated sequelae and inequities is warranted. Support To Reunite, Involve, and Value Each Other (STRIVE) is a strengths-based dyadic intervention with demonstrated efficacy in reducing delinquency, substance use, and high-risk sexual behaviors among marginalized adolescents experiencing homelessness. The adapted STRIVE+ was piloted to explore potential for reducing youth risk factors for CSE. The current article reports findings from interviews exploring participants' experiences with STRIVE+. Youth and caregivers reported increased empathy, communication, and emotional regulation post-STRIVE+ and found relevance and meaning through participating in the adapted intervention. Feasibility of recruitment, engagement, and retention of minoritized adolescents and their caregivers were also demonstrated. Findings warrant larger scale implementation trials of STRIVE+ among minoritized youth at highest risk for CSE. [Journal of Psychosocial Nursing and Mental Health Services, 62(1), 27-35.].
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DiGuiseppi GT, Prindle J, Rice ER, Davis JP. Longitudinal Associations between Homelessness and Substance Use: Investigating Demographic Differences for Young Adults in Treatment. Subst Use Misuse 2023; 59:243-253. [PMID: 37897085 PMCID: PMC10872782 DOI: 10.1080/10826084.2023.2267124] [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] [Indexed: 10/29/2023]
Abstract
Objective: To examine prospective, bidirectional associations between homelessness and substance use frequency among young adults receiving substance use treatment in the United States. We also investigated potential differences across demographic subgroups. Methods: Young adults (N = 3717, Mage = 20.1, 28% female, 7.3% sexual/gender minority, and 37% non-Hispanic White) receiving substance use treatment in the U.S. completed assessments at intake, 3 months, 6 months, and 12 months post-intake. Latent growth curve models with structured residuals (LGC-SR) were used to examine cross-lagged associations between homeless days and frequency of substance use and associated problems. Models were stratified by sex, race/ethnicity, and sexual and/or gender minority status. Results: Overall, days spent homeless (μ slope = -0.19, p = 0.046) and substance use frequency (μ slope 1 = -6.19, p < 0.001) significantly decreased during treatment, with no significant cross-lagged associations between homeless days and substance use frequency. However, results differed by race and ethnicity. For non-Hispanic White young adults, greater substance use at treatment entry was associated with steeper declines in homeless days between-persons (ϕ standardized = -0.14, p = 0.04). For African Americans, homeless days at treatment entry were associated with greater increases in substance use between-persons (ϕ standardized = 0.29, p = 0.04). No significant differences were found by sex or sexual/gender minority status. Conclusions: Despite overall declines in homelessness and substance use during treatment, these outcomes may unfold differently for non-Hispanic White and African American young adults. More support may be needed for African American young adults reporting homelessness at treatment entry.
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Affiliation(s)
- Graham T. DiGuiseppi
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 W 34 Street, Los Angeles, California 90089, USA
- RAND Corporation, 4750 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA
| | - John Prindle
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 W 34 Street, Los Angeles, California 90089, USA
| | - Eric R. Rice
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 W 34 Street, Los Angeles, California 90089, USA
| | - Jordan P. Davis
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 W 34 Street, Los Angeles, California 90089, USA
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Tuda D, Stefancic A, Lam P, John D, Sadaghiyani S, Choo TH, Galfalvy H, Coronel B, Gil R, Lewis-Fernández R. Life is precious: A quasi-experimental study of a community-based program to prevent suicide among Latina adolescents in New York City. Suicide Life Threat Behav 2023. [PMID: 38050824 PMCID: PMC11150327 DOI: 10.1111/sltb.13027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 11/09/2023] [Accepted: 11/18/2023] [Indexed: 12/07/2023]
Abstract
INTRODUCTION Rising rates of suicidal thoughts and behaviors (STBs) among U.S. Latina adolescents urgently need attention. Life is Precious (LIP) is a culturally responsive, community-based, afterschool-model program offering wellness-support services to supplement outpatient mental health treatment for Latina adolescents experiencing STB's. This 12-month quasi-experimental pilot study explored LIP's impact on clinical outcomes. METHODS Latina adolescents newly enrolled in LIP and receiving outpatient treatment (n = 31) and those newly starting outpatient treatment only (n = 12; Usual Care) were assessed for Suicidal Ideation (Suicidal Ideation Questionnaire; SIQ) and depressive symptoms (Patient Health Questionnaire-9). We estimated differences in mean scores using longitudinal linear mixed models and adjusted risk ratios (ARRs) of SIQ-25%, SIQ-50%, and PHQ-9-5-point improvements using exact logistic models. RESULTS The direction of the estimated impact of LIP was positive [differences (95% CIs): -15.5 (-34.16, 3.15) for SIQ; -1.16 (-4.39, 2.07) for PHQ-9], with small-to-moderate nonsignificant effect sizes (0.19-0.34). LIP participants saw two to three times higher prevalence than controls of SIQ-25%, SIQ-50%, and PHQ-9-5-point improvements; ARRs (95% CIs) were 1.91 (0.61, 3.45), 3.04 (0.43, 11.33), and 1.97 (0.44, 5.07), respectively. Suicidal behaviors also decreased in LIP. CONCLUSION The effects of LIP were in positive directions across clinical outcomes, warranting further research on its effectiveness in decreasing STBs.
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Affiliation(s)
- Daniela Tuda
- Brown School of Social Work, Washington University, St. Louis, Missouri, USA
- Center for Mental Health Services Research, Brown School, Washington University, St. Louis, Missouri, USA
- New York State Center of Excellence for Cultural Competence, New York State Psychiatric Institute, New York City, New York, USA
| | - Ana Stefancic
- New York State Center of Excellence for Cultural Competence, New York State Psychiatric Institute, New York City, New York, USA
- Department of Psychiatry, Columbia College of Physicians & Surgeons, New York City, New York, USA
| | - Peter Lam
- New York State Center of Excellence for Cultural Competence, New York State Psychiatric Institute, New York City, New York, USA
- Department of Psychiatry, Columbia College of Physicians & Surgeons, New York City, New York, USA
| | - Dolly John
- New York State Center of Excellence for Cultural Competence, New York State Psychiatric Institute, New York City, New York, USA
- Department of Psychiatry, Columbia College of Physicians & Surgeons, New York City, New York, USA
| | - Shima Sadaghiyani
- New York State Center of Excellence for Cultural Competence, New York State Psychiatric Institute, New York City, New York, USA
- Department of Psychiatry, Columbia College of Physicians & Surgeons, New York City, New York, USA
| | - Tse-Hwei Choo
- Department of Psychiatry, Columbia College of Physicians & Surgeons, New York City, New York, USA
| | - Hanga Galfalvy
- Department of Psychiatry, Columbia College of Physicians & Surgeons, New York City, New York, USA
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York City, New York, USA
| | | | - Rosa Gil
- Comunilife, Inc., New York City, New York, USA
| | - Roberto Lewis-Fernández
- New York State Center of Excellence for Cultural Competence, New York State Psychiatric Institute, New York City, New York, USA
- Department of Psychiatry, Columbia College of Physicians & Surgeons, New York City, New York, USA
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Kim BKE, Dierkhising CB, De Leon J, Sandoval J, Brissett A, Bounds D. Evaluation of Services for the Commercial Sexual Exploitation of Children and Youth: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:3236-3250. [PMID: 36197082 DOI: 10.1177/15248380221126185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Commercial sexual exploitation (CSE) of youth is a public health issue with multiple negative consequences. Despite the complexities and comprehensiveness of service needs for youth experiencing CSE, the evidence base of effective services and programs lags far behind. This scoping review seeks to identify the most up-to-date evidence on programs for youth experiencing CSE that have been evaluated and found to be effective. We conducted a scoping review of current literature, including peer-reviewed articles as well as gray literature using a scientific approach to identify programs and service provisions specifically focused on youth experiencing CSE and examine empirical evidence for their effectiveness. A comprehensive search of five databases was completed in September 2020 then updated in April 2021 to identify relevant publications from January 1, 2000 to present. Additional program mining was conducted on evaluations of programs mentioned in the search results. A total of 3,597 citations from the database searches were screened for title and abstract and 190 citations were included for full-text review. The search process yielded 11 eligible articles with one additional report found through program mining. Identified programs targeted youth, providers, and consumers of CSE. While scientific rigor was not high, all included studies reported positive outcomes. Evidence base for effective services and programs is sparse. While more programs and services are being developed, studies should use rigorous research designs to test the effectiveness of these programs and services. Implications for practice and policy are discussed.
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Hankin BL, Griffith JM. What Do We Know About Depression Among Youth and How Can We Make Progress Toward Improved Understanding and Reducing Distress? A New Hope. Clin Child Fam Psychol Rev 2023; 26:919-942. [PMID: 37285011 PMCID: PMC10245370 DOI: 10.1007/s10567-023-00437-4] [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: 05/08/2023] [Indexed: 06/08/2023]
Abstract
This paper summarizes many findings about depression among children and adolescents. Depression is prevalent, highly distressing, and exerts considerable burden worldwide. Rates surge from childhood through young adulthood and have increased over the last decade. Many risk factors have been identified, and evidence-based interventions exist targeting mostly individual-level changes via psychological or pharmacological means. At the same time, the field appears stuck and has not achieved considerable progress in advancing scientific understanding of depression's features or delivering interventions to meet the challenge of youth depression's high and growing prevalence. This paper adopts several positions to address these challenges and move the field forward. First, we emphasize reinvigoration of construct validation approaches that may better characterize youth depression's phenomenological features and inform more valid and reliable assessments that can enhance scientific understanding and improve interventions for youth depression. To this end, history and philosophical principles affecting depression's conceptualization and measurement are considered. Second, we suggest expanding the range and targets of treatments and prevention efforts beyond current practice guidelines for evidence-based interventions. This broader suite of interventions includes structural- and system-level change focused at community and societal levels (e.g., evidence-based economic anti-poverty interventions) and personalized interventions with sufficient evidence base. We propose that by focusing on the FORCE (Fundamentals, Openness, Relationships, Constructs, Evidence), youth depression research can provide new hope.
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Affiliation(s)
- Benjamin L Hankin
- Department of Psychology, University of Illinois Urbana Champaign, 603 E. Daniel Street, Champaign, IL, 61820, USA.
| | - Julianne M Griffith
- Department of Psychology, University of Illinois Urbana Champaign, 603 E. Daniel Street, Champaign, IL, 61820, USA
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Cooley-Strickland M, Wyatt GE, Loeb TB, Nicholas LA, Smith-Clapham A, Hamman A, Abraham M, Scott EN, Albarran G. Need for Sexual, Reproductive, and Mental Health Promotion Among Diverse College Students in a COVID-19 Era. Clin Child Fam Psychol Rev 2023; 26:1077-1096. [PMID: 37934361 PMCID: PMC10640429 DOI: 10.1007/s10567-023-00460-5] [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: 09/22/2023] [Indexed: 11/08/2023]
Abstract
In 2020, the COVID-19 pandemic forced unprecedented disruptions in higher education operations. While the adverse mental health effects experienced by college students due to these changes are well documented, less is known about the impact on their sexual and reproductive health (SRH), and the reciprocal relationships between SRH and mental health among adolescents and emerging adults. This position paper reviews existing literature on the effects of the COVID-19 pandemic on SRH, sexual violence, unintended pregnancy, sexually transmitted illness and human immunodeficiency virus rates and highlights issues specific to college-aged males, females, racial/ethnic and sexual minorities, and individuals with disabilities. The need to conceptualize SRH as an integral component of normal development, overall health, and well-being in the context of COVID-19 is discussed. The need to prioritize the design and implementation of developmentally appropriate, evidence-based SRH interventions specifically targeting college students is identified. Furthermore, an intergenerational approach to SRH that includes parents/caregivers and/or college faculty and staff (e.g., coaches, trainers) could facilitate comprehensive SRH prevention programming that enhances sexual violence prevention training programs currently mandated by many colleges. Policies and programs designed to mitigate adverse pandemic-related exacerbations in negative SRH outcomes are urgently needed and should be included in mainstream clinical psychology, not only focused on preventing unwanted outcomes but also in promoting rewarding interpersonal relationships and overall well-being. Recommendations for clinical psychologists and mental health researchers are made.
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Affiliation(s)
- Michele Cooley-Strickland
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90024-1759, USA.
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Gail E Wyatt
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90024-1759, USA
| | - Tamra Burns Loeb
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90024-1759, USA
| | - Lisa A Nicholas
- Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Amber Smith-Clapham
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90024-1759, USA
| | - Amina Hamman
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90024-1759, USA
| | - Misha Abraham
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Enricka Norwood Scott
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90024-1759, USA
| | - Graciela Albarran
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90024-1759, USA
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14
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Kemal S, Nwabuo A, Hoffmann J. Mental Health and Violence in Children and Adolescents. Pediatr Clin North Am 2023; 70:1201-1215. [PMID: 37865440 DOI: 10.1016/j.pcl.2023.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2023]
Abstract
This article examines the complex interplay between mental health and violence among children. Although children with mental illness are more likely to be victims of violence than perpetrators, this article describes the few mental health conditions associated with increased violent behavior among children. Next, the authors examine the spectrum of mental health sequelae among children following exposure to various forms of violence. Lastly, the authors discuss the underutilization of mental health services in this population and highlight screening and intervention tools available to pediatric clinicians caring for children exposed to violence.
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Affiliation(s)
- Samaa Kemal
- Division of Emergency Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Avenue, Box 62, Chicago, IL 60611, USA; Department of Pediatrics, Northwestern University Feinberg School of Medicine, 420 East Superior Street, Chicago, IL 60611, USA.
| | - Adaobi Nwabuo
- Department of Psychiatry and Behavioral Sciences, University of California Davis Health, 2230 Stockton Boulevard, Sacramento, CA 95817, USA
| | - Jennifer Hoffmann
- Division of Emergency Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Avenue, Box 62, Chicago, IL 60611, USA; Department of Pediatrics, Northwestern University Feinberg School of Medicine, 420 East Superior Street, Chicago, IL 60611, USA
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15
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Moore KL, Munson MR, Jaccard J. Ethnic Identity and Mechanisms of Mental Health Service Engagement Among Young Adults with Serious Mental Illnesses. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01842-9. [PMID: 37870731 PMCID: PMC11035489 DOI: 10.1007/s40615-023-01842-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/09/2023] [Accepted: 10/10/2023] [Indexed: 10/24/2023]
Abstract
PURPOSE Young adults from minoritized racial and ethnic groups have lower rates of engagement in treatment for serious mental illnesses (SMI). Previous research suggests a relationship between ethnic identity development and engagement in mental health services, but it remains unclear how a sense of belonging and attachment to one's racial and ethnic group influences participation in treatment among young adults with SMI. METHODS Bivariate analyses and structural equation modeling (SEM) were used to examine whether ethnic identity was associated with treatment engagement (attendance and investment in treatment) and how ethnic identity might influence engagement through theoretical proximal mediators. Eighty-three young adults with SMI (95% from minoritized racial and ethnic groups) were recruited from four outpatient psychiatric rehabilitation programs and assessed at least 3 months after initiating services. RESULTS Stronger ethnic identity was associated with greater investment in treatment but not with treatment attendance. The SEM analysis indicated that stronger ethnic identity may improve investment in treatment by enhancing hope (0.53, p < .05) and beliefs that mental health providers are credible (0.32, p < .05), and by increasing self-efficacy (-0.09, p < .05). Proximal mediators of engagement were associated with investment in treatment (hope and credibility, p < .05, and self-efficacy p = 0.055). CONCLUSIONS Findings provide preliminary evidence of an empirical and theoretical relationship between ethnic identity development and engagement in treatment among young adults with SMI. Assessment and strengthening of a young person's ethnic identity may be a promising approach for improving their engagement in services and reducing inequities in their care.
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Affiliation(s)
- Kiara L Moore
- New York University, Silver School of Social Work, 1 Washington Square North, New York, NY, 10003, USA.
| | - Michelle R Munson
- New York University, Silver School of Social Work, 1 Washington Square North, New York, NY, 10003, USA
| | - James Jaccard
- New York University, Silver School of Social Work, 1 Washington Square North, New York, NY, 10003, USA
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16
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Buckley PR, Murry VM, Gust CJ, Ladika A, Pampel FC. Racial and Ethnic Representation in Preventive Intervention Research: a Methodological Study. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:1261-1274. [PMID: 37386352 PMCID: PMC11161425 DOI: 10.1007/s11121-023-01564-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 07/01/2023]
Abstract
Individuals who are Asian or Asian American, Black or African American, Native American or American Indian or Alaska Native, Native Hawaiian or Pacific Islander, and Hispanic or Latino (i.e., presently considered racial ethnic minoritized groups in the USA) lacked equal access to resources for mitigating risk during COVID-19, which highlighted public health disparities and exacerbated inequities rooted in structural racism that have contributed to many injustices, such as failing public school systems and unsafe neighborhoods. Minoritized groups are also vulnerable to climate change wherein the most severe harms disproportionately fall upon underserved communities. While systemic changes are needed to address these pervasive syndemic conditions, immediate efforts involve examining strategies to promote equitable health and well-being-which served as the impetus for this study. We conducted a descriptive analysis on the prevalence of culturally tailored interventions and reporting of sample characteristics among 885 programs with evaluations published from 2010 to 2021 and recorded in the Blueprints for Healthy Youth Development registry. Inferential analyses also examined (1) reporting time trends and (2) the relationship between study quality (i.e., strong methods, beneficial effects) and culturally tailored programs and racial ethnic enrollment. Two percent of programs were developed for Black or African American youth, and 4% targeted Hispanic or Latino populations. For the 77% of studies that reported race, most enrollees were White (35%) followed by Black or African American (28%), and 31% collapsed across race or categorized race with ethnicity. In the 64% of studies that reported ethnicity, 32% of enrollees were Hispanic or Latino. Reporting has not improved, and there was no relationship between high-quality studies and programs developed for racial ethnic youth, or samples with high proportions of racial ethnic enrollees. Research gaps on racial ethnic groups call for clear reporting and better representation to reduce disparities and improve the utility of interventions.
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Affiliation(s)
- Pamela R Buckley
- Institute of Behavioral Science, University of Colorado Boulder, Boulder, USA.
| | - Velma McBride Murry
- Departments of Health Policy & Human and Organizational Development, Vanderbilt University Medical Center and Vanderbilt University, Nashville, USA
| | - Charleen J Gust
- Institute of Behavioral Science, University of Colorado Boulder, Boulder, USA
| | - Amanda Ladika
- Institute of Behavioral Science, University of Colorado Boulder, Boulder, USA
| | - Fred C Pampel
- Institute of Behavioral Science, University of Colorado Boulder, Boulder, USA
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17
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Ajayi KV, Garney WR. Understanding the Domains of Experiences of Black Mothers with Preterm Infants in the United States: A Systematic Literature Review. J Racial Ethn Health Disparities 2023; 10:2453-2469. [PMID: 36199006 DOI: 10.1007/s40615-022-01425-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To report the domains of Black mothers' experiences with preterm infants in the neonatal intensive care unit (NICU) and to determine the frameworks used. METHODS A systematic review of the literature using the PRISMA guideline was performed. An electronic database search of published literature between 2000 and 2022 was conducted based on predetermined search terms and parameters. RESULTS Twenty-seven articles met the inclusion and exclusion criteria. Eleven articles focused on feeding practices, ten reported on nursing/maternal care experiences, five reported mental health/social support, and only one focused on mother-infant relationships. Only five papers reported using any frameworks, comprising grounded theory framework (n = 2), theory of planned behavior (n = 1), research justice framework (n = 1), and the patient and public engagement protocol (n = 1). DISCUSSION A holistic approach to understanding the multifactorial experiences of Black mothers with preterm infants needs to be socio-culturally competent to ensure their diverse intersections and identities are accurately represented and understood. Rigorous research at the intersection of Black maternal health and the NICU hold promises for advancing maternal health equity in the United States.
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Affiliation(s)
- Kobi V Ajayi
- Department of Health Behavior, School of Public Health Texas A&M University, College Station, TX, 77843, USA.
- Laboratory for Community Health Evaluation and Systems Science, Department of Health Behavior, School of Public Health Texas A&M University, College Station, TX, 77843, USA.
| | - Whitney R Garney
- Department of Health Behavior, School of Public Health Texas A&M University, College Station, TX, 77843, USA
- Laboratory for Community Health Evaluation and Systems Science, Department of Health Behavior, School of Public Health Texas A&M University, College Station, TX, 77843, USA
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18
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Marlotte L, Klomhaus A, Ijadi-Maghsoodi R, Aralis H, Lester P, Griffin Esperon K, Kataoka S. Implementing depression care in under-resourced communities: a school-based family resilience skill-building pilot randomized controlled trial in the United States. Front Psychol 2023; 14:1233901. [PMID: 37790229 PMCID: PMC10542892 DOI: 10.3389/fpsyg.2023.1233901] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 08/11/2023] [Indexed: 10/05/2023] Open
Abstract
Introduction Youth in under-resourced communities are more likely to have greater social risk factors for mental health needs yet have less access to needed care. School-based mental health services are effective in treating common disorders such as adolescent depression; however, few have a family-centered approach, which may especially benefit specific populations. Methods Utilizing a community-partnered approach, we adapted an established, trauma-informed, resilience skill-building family intervention for adolescents with depression. We conducted a small randomized controlled feasibility pilot of an adapted intervention in a large school district that serves predominately low-income, Latinx students in the Southwest United States between 2014-2017. Youth between the ages of 12-18 years old with a Patient Health Questionnaire (PHQ-8) score of 10 or higher, who spoke English or Spanish, were recruited from 12 school mental health clinics. Twenty-five eligible adolescents with depression and their participating caregivers were enrolled and randomly assigned to receive either the adapted intervention, Families OverComing Under Stress for Families with Adolescent Depression (FOCUS-AD), or usual care, Cognitive Behavioral Therapy (CBT) only. Most of the sample was Latinx and female. We evaluated feasibility, acceptability, and preliminary effectiveness. Results Among participants who completed standardized assessments administered at baseline and approximately five months post-randomization (n = 10 FOCUS-AD, n = 11 CBT only), effectiveness was explored by identifying significant changes over time in adolescent mental health within the FOCUS-AD and CBT only groups and comparing the magnitude of these changes between groups. Nonparametric statistical tests were used. We found the FOCUS-AD intervention to be feasible and acceptable; participant retention was high. Adolescent symptoms of depression (measured by the PHQ-8) improved significantly from baseline to follow-up for youth in both FOCUS-AD (median decrease [MD] = 10, p = 0.02) and control (MD = 6, p = 0.01) groups, with no significant difference across the two groups. Results were similar for symptoms of PTSD (measured by the Child PTSD Symptom Scale; FOCUS-AD MD = 12.5, p = 0.01; CBT only MD = 7, p = 0.04; no significant difference between groups). Conclusion Family-centered approaches to depression treatment among adolescents living in under-resourced communities may lead to improved mental health, although further research is warranted.
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Affiliation(s)
- Lauren Marlotte
- Division of Population Behavioral Health, Jane and Terry Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Alexandra Klomhaus
- Department of Medicine Statistics Core, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Roya Ijadi-Maghsoodi
- Division of Population Behavioral Health, Jane and Terry Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
- VA Health Service Research & Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States
| | - Hilary Aralis
- Division of Population Behavioral Health, Jane and Terry Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States
| | - Patricia Lester
- Division of Population Behavioral Health, Jane and Terry Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | | | - Sheryl Kataoka
- Division of Population Behavioral Health, Jane and Terry Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
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19
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Clemente-Suárez VJ, Ramírez-Goerke MI, Redondo-Flórez L, Beltrán-Velasco AI, Martín-Rodríguez A, Ramos-Campo DJ, Navarro-Jiménez E, Yáñez-Sepúlveda R, Tornero-Aguilera JF. The Impact of Anorexia Nervosa and the Basis for Non-Pharmacological Interventions. Nutrients 2023; 15:2594. [PMID: 37299557 PMCID: PMC10255390 DOI: 10.3390/nu15112594] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023] Open
Abstract
Anorexia nervosa is a psychiatric disorder with an unknown etiology that is characterized by an individual's preoccupation with their weight and body structure while denying the severity of their low body weight. Due to the fact that anorexia nervosa is multifaceted and may indicate the coexistence of genetic, social, hormonal, and psychiatric disorders, a description of non-pharmacological interventions can be used to ameliorate or reduce the symptoms of this condition. Consequently, the purpose of the present narrative review is to describe the profile's context in the anorexic person as well as the support they would require from their family and environment. In addition, it is aimed at examining preventative and non-pharmacological interventions, such as nutritional interventions, physical activity interventions, psychological interventions, psychosocial interventions, and physical therapy interventions. To reach the narrative review aims, a critical review was conducted utilizing both primary sources, such as scientific publications, and secondary sources, such as bibliographic indexes, web pages, and databases. Nutritional interventions include nutritional education and an individualized treatment for each patient, physical activity interventions include allowing patients to perform controlled physical activity, psychological interventions include family therapy and evaluation of the existence of other psychological disorders, psychosocial interventions include management of the relationship between the patient and social media and physical therapy interventions include relaxation massages and exercises to relieve pain. All these non-pharmacological interventions need to be individualized based on each patient's needs.
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Affiliation(s)
- Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (M.I.R.-G.); (J.F.T.-A.)
| | - Maria Isabel Ramírez-Goerke
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (M.I.R.-G.); (J.F.T.-A.)
| | - Laura Redondo-Flórez
- Department of Health Sciences, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, C/Tajo s/n, Villaviciosa de Odón, 28670 Madrid, Spain;
| | - Ana Isabel Beltrán-Velasco
- Psychology Department, Facultad de Ciencias de la Vida y la Naturaleza, Universidad Antonio de Nebrija, 28240 Madrid, Spain;
| | - Alexandra Martín-Rodríguez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (M.I.R.-G.); (J.F.T.-A.)
| | - Domingo Jesús Ramos-Campo
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | | | - Rodrigo Yáñez-Sepúlveda
- Faculty of Education and Social Sciences, Universidad Andres Bello, Viña del Mar 2520000, Chile;
| | - José Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (M.I.R.-G.); (J.F.T.-A.)
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20
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Haroz EE, Sarapik LM, Adams LB, Nestadt PS, Athey A, Alvarez K, Slade EP, Cwik M, Berman AL, Wilcox HC. A Cascade of Care Model for Suicide Prevention. Am J Prev Med 2023; 64:599-603. [PMID: 36402646 PMCID: PMC10166000 DOI: 10.1016/j.amepre.2022.09.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 08/31/2022] [Accepted: 09/21/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Emily E Haroz
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
| | - Liina M Sarapik
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Leslie B Adams
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Paul S Nestadt
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Alison Athey
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Kiara Alvarez
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Eric P Slade
- Johns Hopkins School of Nursing, Baltimore, Maryland; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Mary Cwik
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Alan L Berman
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Holly C Wilcox
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
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21
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Singh MN, Gudiño OG. Translating Liberation Psychology for Children and Adolescents from Historically Marginalized Racial and Ethnic Backgrounds: A Synthesis of the Literature. Clin Child Fam Psychol Rev 2023; 26:65-81. [PMID: 36203010 DOI: 10.1007/s10567-022-00416-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2022] [Indexed: 01/31/2023]
Abstract
Youth from historically marginalized racial and/or ethnic backgrounds often face discrimination, oppression, prejudice, racism, and segregation (DOPRS). These experiences, in turn, impact well-being and psychological functioning. Though the field of clinical child psychology is on the path to address DOPRS in clinical practice, there is sparce guidance for clinicians. Liberation psychology aims to address oppression through understanding history, acknowledging and naming DOPRS, community solidarity, and healing. Liberation psychology may be a vehicle for clinical child psychologists to address the impacts of DOPRS and empower children and adolescents to promote joy and healing within clinical settings. The literature is reviewed and synthesized to provide practical guidance so clinical child psychologists may translate liberation psychology into clinical practice. Several conceptual frameworks are presented that may help in implementing liberation psychology. Suggestions are provided for how clinical child psychologists may move beyond notions of cultural competence to a psychologist-activist model. Specific methods to create a foundation of liberation psychology in mental health treatment are discussed, such as utilizing empowerment, community, critical consciousness, and ethnic-racial socialization. Finally, specific practice considerations are provided for clinical child psychologists when applying liberation psychology in treatment.
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Affiliation(s)
- Mehar N Singh
- Clinical Child Psychology Program, University of Kansas, 2015 Dole Human Development Center, 1000 Sunnyside Avenue, Lawrence, KS, 66045, USA
| | - Omar G Gudiño
- Clinical Child Psychology Program, University of Kansas, 2015 Dole Human Development Center, 1000 Sunnyside Avenue, Lawrence, KS, 66045, USA
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22
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Pettit JW, Rey Y, Marin CE, Bechor M, Lebowitz ER, Vasey MW, Jaccard J, Abend R, Pine DS, Bar-Haim Y, Silverman WK. Attention Training as a Low-Intensity Treatment for Concerning Anxiety in Clinic-Referred Youth. Behav Ther 2023; 54:77-90. [PMID: 36608979 PMCID: PMC9825787 DOI: 10.1016/j.beth.2022.07.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 06/27/2022] [Accepted: 07/10/2022] [Indexed: 01/11/2023]
Abstract
Although youth anxiety treatment research has focused largely on severe and impairing anxiety levels, even milder anxiety levels, including levels that do not meet full criteria for a diagnosis, can be impairing and cause for concern. There is a need to develop and test viable treatments for these concerning anxiety levels to improve functioning and reduce distress. We present findings from a randomized controlled efficacy trial of attention bias modification treatment (ABMT) and attention control training (ACT) for youths with concerning anxiety levels. Fifty-three clinic-referred youths (29 boys, M age = 9.3 years, SD age = 2.6) were randomized to either ABMT or ACT. ABMT and ACT consisted of attention-training trials in a dot-probe task presenting angry and neutral faces; probes appeared in the location of neutral faces in 100% of ABMT trials and 50% of ACT trials. Independent evaluators provided youth anxiety severity ratings; youths and parents provided youth anxiety severity and global impairment ratings; and youths completed measures of attention bias to threat and attention control at pretreatment, posttreatment, and 2-month follow-up. In both arms, anxiety severity and global impairment were significantly reduced at posttreatment and follow-up. At follow-up, anxiety severity and global impairment were significantly lower in ACT compared with ABMT. Attention control, but not attention bias to threat, was significantly improved at follow-up in both arms. Changes in attention control and attention focusing were significantly associated with changes in anxiety severity. Findings support the viability of attention training as a low-intensity treatment for youths with concerning anxiety levels, including levels that do not meet full criteria for a diagnosis. Superior anxiety reduction effects in ACT highlight the critical need for mechanistic research on attention training in this population.
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Affiliation(s)
| | | | - Carla E Marin
- Yale Child Study Center, Yale University School of Medicine
| | | | - Eli R Lebowitz
- Yale Child Study Center, Yale University School of Medicine
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23
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Natale R, Agosto Y, Bulotsky Shearer RJ, St George SM, Jent J. Designing a virtual mental health consultation program to support and strengthen childcare centers impacted by COVID-19: A randomized controlled trial protocol. Contemp Clin Trials 2023; 124:107022. [PMID: 36442806 PMCID: PMC9694403 DOI: 10.1016/j.cct.2022.107022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 11/16/2022] [Accepted: 11/21/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND The COVID-19 pandemic has had negative psychosocial impacts on young children; teachers in childcare centers continue to be overwhelmed by how to address the downstream psychological effects children are experiencing. This randomized controlled trial will study the role of a community-based, childcare center-support system in improving resilience and mitigating the long-term impacts of COVID-19 on children's development. METHODS This study will be modeled on a successful Early Childhood Mental Health Consultation (ECMHC) intervention which utilizes mental health consultants to deliver a Jump Start+: COVID 19 Support (JS + CS) virtual toolkit to childcare centers in Miami-Dade County via a Kubi robot. The toolkit comprises four strength-based strategies likely to be effective in improving resiliency following disasters: Safety Planning, Effective Communication, Adult Self-Care, and Trauma-Informed Behavior Support. Our first aim will utilize a cluster randomized trial to examine the effectiveness of JS + CS on improving the psychosocial functioning of young children, as compared to an obesity prevention intervention control group. Children will be followed at 6, 12, 18, and 24 months. The second aim will examine the mechanisms that contribute to effective uptake by teachers of the JS + CS support strategies on child outcomes. The third aim will explore implementation barriers/facilitators as well as potential societal contextual factors (e.g., vaccine uptake) to help centers serving disproportionately affected minority communities recover from and prepare for future crises. CONCLUSION This design will inform the refinement and scaling of JS + CS and generalize impacts to other childcare center interventions in the context of disasters.
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Affiliation(s)
- Ruby Natale
- University of Miami Miller School of Medicine, Department of Pediatrics, 1601 NW 12(th) Ave, Miami, Florida 33136, USA.
| | - Yaray Agosto
- University of Miami Miller School of Medicine, Department of Pediatrics, 1601 NW 12(th) Ave, Miami, Florida 33136, USA.
| | - Rebecca J Bulotsky Shearer
- University of Miami, Department of Psychology, 5665 Ponce de Leon Blvd, Coral Gables, Florida 33146, USA.
| | - Sara M St George
- University of Miami Miller School of Medicine, Department of Public Health Sciences, 1120 NW 14(th) St, Miami, Florida 33136, USA.
| | - Jason Jent
- University of Miami Miller School of Medicine, Department of Pediatrics, 1601 NW 12(th) Ave, Miami, Florida 33136, USA.
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Chu W, Chorpita BF, Becker KD. Race, racial matching, and cultural understanding as predictors of treatment engagement in youth mental health services. Psychother Res 2022; 33:669-682. [DOI: 10.1080/10503307.2022.2150582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Wendy Chu
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Bruce F. Chorpita
- Department of Psychology, University of California, Los Angeles, CA, USA
| | - Kimberly D. Becker
- Department of Psychology, University of South Carolina, Columbia, SC, USA
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Chen BC, Lui JHL, Benson LA, Lin YJR, Ponce NA, Innes-Gomberg D, Lau AS. After the Crisis: Racial/Ethnic Disparities and Predictors of Care Use Following Youth Psychiatric Emergencies. JOURNAL OF CLINICAL CHILD & ADOLESCENT PSYCHOLOGY 2022; 52:360-375. [DOI: 10.1080/15374416.2022.2127103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Affiliation(s)
| | - Joyce H. L. Lui
- Department of Psychology, University of California
- Department of Psychology, University of Maryland
| | | | | | | | | | - Anna S. Lau
- Department of Psychology, University of California
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26
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Felsman P, Seifert CM, Sinco B, Himle JA. Reducing Social Anxiety and Intolerance of Uncertainty in Adolescents with Improvisational Theater. ARTS IN PSYCHOTHERAPY 2022. [DOI: 10.1016/j.aip.2022.101985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Willis HA, Gonzalez JC, Call CC, Quezada D, Galán CA. Culturally Responsive Telepsychology & mHealth Interventions for Racial-Ethnic Minoritized Youth: Research Gaps and Future Directions. 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; 51:1053-1069. [PMID: 36227174 PMCID: PMC9627988 DOI: 10.1080/15374416.2022.2124516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Telepsychology and mHealth (TPmH) services for youth and their families have become increasingly prevalent in recent years. However, significant limitations in theory, research, and policy introduce questions about the effectiveness of such interventions, particularly for racial-ethnic minoritized youth and their families, who already contend with inequities in mental health treatment access and outcomes. Although TPmH have the potential to reduce barriers to mental health services in ways that may benefit racial-ethnic minoritized youth and their families, the mental health field must first grapple with limitations in culturally responsive TPmH work to avoid perpetuating existing mental health inequities. As such, this article begins by briefly reviewing extant literature on (1) TPmH for youth, (2) culturally adapted or culturally responsive evidence-based interventions for racial-ethnic minoritized youth and families, and (3) the intersection of TPmH and culturally responsive interventions. Informed by the gaps identified by this review, we provide recommendations for future directions in culturally responsive TPmH for racial-ethnic minoritized youth and families. These recommendations have been organized into four overarching categories: (1) conceptual and theoretical recommendations, (2) research priorities, (3) practice and policy recommendations, and (4) engagement and access recommendations. These recommendations offer novel ideas for researchers, clinicians, funding agencies, policy-makers, and other key stakeholders and are intended to facilitate equity in TPmH for racial-ethnic minoritized youth and their families.
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Affiliation(s)
| | - Juan Carlos Gonzalez
- Department of Counseling, Clinical, & School Psychology, University of California
| | | | - David Quezada
- Department of Psychology, University of Southern California
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Hoffmann JA, Alegría M, Alvarez K, Anosike A, Shah PP, Simon KM, Lee LK. Disparities in Pediatric Mental and Behavioral Health Conditions. Pediatrics 2022; 150:e2022058227. [PMID: 36106466 PMCID: PMC9800023 DOI: 10.1542/peds.2022-058227] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/12/2022] [Indexed: 12/31/2022] Open
Abstract
Mental and behavioral health conditions are common among children and adolescents in the United States. The purpose of this state-of the-art review article is to describe inequities in mental and behavioral health care access and outcomes for children and adolescents, characterize mechanisms behind the inequities, and discuss strategies to decrease them. Understanding the mechanisms underlying these inequities is essential to inform strategies to mitigate these health disparities. Half of United States children with a treatable mental health disorder do not receive treatment from a mental health professional. Children and adolescents in racial, ethnic, sexual, sex, and other minority groups experience inequities in access to care and disparities in outcomes for mental and behavioral health conditions. Suicide rates are nearly twice as high in Black compared to White boys 5 to 11 years old and have been increasing disproportionately among adolescent Black girls 12 to 17 years old. Children identifying as a sexual minority have >3 times increased odds of attempting suicide compared to heterosexual peers. Adverse experiences of children living as part of a minority group, including racism and discrimination, have immediate and lasting effects on mental health. Poverty and an uneven geographic distribution of resources also contribute to inequities in access and disparities in outcomes for mental and behavioral health conditions. Strategies to address inequities in mental and behavioral health among United States children include investing in a diverse workforce of mental health professionals, improving access to school-based services, ensuring equitable access to telehealth, and conducting quality improvement with rigorous attention to equity.
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Affiliation(s)
- Jennifer A. Hoffmann
- . Division of Emergency Medicine, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine; Chicago, IL
| | - Margarita Alegría
- . Disparities Research Unit, Massachusetts General Hospital, Boston, MA; Department of Medicine, Harvard Medical School, Boston, MA; Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Kiara Alvarez
- . Disparities Research Unit, Massachusetts General Hospital, Department of Medicine, Harvard Medical School, Boston, MA
| | - Amara Anosike
- . Office of Government Relations, Boston Children’s Hospital, Boston, MA
| | | | - Kevin M. Simon
- . Adolescent Substance use and Addiction Program, Boston Children’s Hospital, Boston, Massachusetts; Division of Developmental Medicine, Boston Children’s Hospital, Boston, Massachusetts; Department of Psychiatry and Behavioral Sciences, Boston Children’s Hospital, Boston, MA, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Lois K. Lee
- . Division of Emergency Medicine, Boston Children’s Hospital, Boston, MA
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Bertelsen TB, Hoffart A, Rekdal SS, Zahl-Olsen R. Bayes factor benefits for clinical psychology: review of child and adolescent evidence base. F1000Res 2022; 11:171. [PMID: 37809055 PMCID: PMC10558984 DOI: 10.12688/f1000research.76842.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/21/2022] [Indexed: 11/11/2023] Open
Abstract
Background: Statistical methods are a cornerstone of research in clinical psychology and are used in clinical trials and reviews to determine the best available evidence. The most widespread statistical framework, frequentist statistics, is often misunderstood and misused. Even when properly applied, this framework can lead to erroneous conclusions and unnecessarily prolonged trials. The implications for clinical psychology are difficulties in interpreting best available evidence and unnecessarily costly and burdensome research. An alternative framework, Bayesian statistics, is proposed as a solution to several issues with current practice. Methods: Statistical tests of primary outcome measures were extracted from 272 studies, which were cited in 11 recent reviews in the Evidence-based updates series in the Journal of Clinical Child and Adolescent Psychology. The extracted tests were examined regarding relevant features and re-analyzed using Bayes Factors. Results: When statistical tests were significant, the majority (98%) of re-analyzed tests agreed with such claims. When statistical tests were nonsignificant almost half (43%) of re-analyzed tests disagreed with such claims. Equally important for clinical research, an average of 13% fewer participants per study would have been required if the studies had used Bayes Factors. Conclusions: Bayes Factors offer benefits for research in clinical psychology through intuitive interpretations, and less costly trials.
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Affiliation(s)
- Thomas B. Bertelsen
- Department of Clinical Child and Adolescent Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
- Department of Child and Adolescent Mental Health, Sørlandet sykehus, Kristiansand, Agder, 4615, Norway
| | - Asle Hoffart
- Research institute of Modum Bad psychiatric hospital, Vikersund, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Sondre Sverd Rekdal
- Department of Child and Adolescent Mental Health, Sørlandet sykehus, Kristiansand, Agder, 4615, Norway
| | - Rune Zahl-Olsen
- Department of Child and Adolescent Mental Health, Sørlandet sykehus, Kristiansand, Agder, 4615, Norway
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Bertelsen TB, Hoffart A, Rekdal SS, Zahl-Olsen R. Bayes factor benefits for clinical psychology: review of child and adolescent evidence base. F1000Res 2022; 11:171. [PMID: 37809055 PMCID: PMC10558984 DOI: 10.12688/f1000research.76842.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/21/2022] [Indexed: 10/10/2023] Open
Abstract
Background: Statistical methods are a cornerstone of research in clinical psychology and are used in clinical trials and reviews to determine the best available evidence. The most widespread statistical framework, frequentist statistics, is often misunderstood and misused. Even when properly applied, this framework can lead to erroneous conclusions and unnecessarily prolonged trials. The implications for clinical psychology are difficulties in interpreting best available evidence and unnecessarily costly and burdensome research. An alternative framework, Bayesian statistics, is proposed as a solution to several issues with current practice. Methods: Statistical tests of primary outcome measures were extracted from 272 studies, which were cited in 11 recent reviews in the Evidence-based updates series in the Journal of Clinical Child and Adolescent Psychology. The extracted tests were examined regarding relevant features and re-analyzed using Bayes Factors. Results: When statistical tests were significant, the majority (98%) of re-analyzed tests agreed with such claims. When statistical tests were nonsignificant almost half (43%) of re-analyzed tests disagreed with such claims. Equally important for clinical research, an average of 13% fewer participants per study would have been required if the studies had used Bayes Factors. Conclusions: Bayes Factors offer benefits for research in clinical psychology through intuitive interpretations, and less costly trials.
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Affiliation(s)
- Thomas B. Bertelsen
- Department of Clinical Child and Adolescent Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
- Department of Child and Adolescent Mental Health, Sørlandet sykehus, Kristiansand, Agder, 4615, Norway
| | - Asle Hoffart
- Research institute of Modum Bad psychiatric hospital, Vikersund, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Sondre Sverd Rekdal
- Department of Child and Adolescent Mental Health, Sørlandet sykehus, Kristiansand, Agder, 4615, Norway
| | - Rune Zahl-Olsen
- Department of Child and Adolescent Mental Health, Sørlandet sykehus, Kristiansand, Agder, 4615, Norway
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Berk MS, Gallop R, Asarnow JR, Adrian M, Avina C, Hughes JL, Korslund KE, McCauley E. Trajectories of Treatment Response and Nonresponse in Youth at High Risk for Suicide. J Am Acad Child Adolesc Psychiatry 2022; 61:1119-1130. [PMID: 35122952 PMCID: PMC9343478 DOI: 10.1016/j.jaac.2022.01.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 11/21/2021] [Accepted: 01/26/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine trajectories of treatment response in suicidal youth who participated in a randomized controlled trial comparing dialectical behavior therapy (DBT) and individual and group supportive therapy. METHOD Using latent class analysis across both treatment conditions, secondary analyses were conducted of data from a multisite randomized controlled trial comprising 173 youths ages 12-18 with repetitive self-harm (SH) (including ≥1 lifetime suicide attempts) and elevated suicidal ideation (SI). The sample was 95% female, 56.4% White, and 27.49% Latina. Participants received 6 months of DBT or individual and group supportive therapy and 6 months of follow-up. Primary outcomes were SH and SI. RESULTS Of the sample, 63% and 74% were members of latent classes that showed improvement in SI and SH, respectively; 13% were total nonresponders, with no improvement in SI or SH. SH nonresponse emerged at the midpoint of treatment (3 months), with nonresponders showing a sharp increase in SH over the remainder of treatment and follow-up. Youth receiving DBT were significantly more likely to be an SH responder vs nonresponder than youths in individual and group supportive therapy (ꭓ21 = 6.53, p = .01). An optimal threshold cut point using multivariate predictors of total nonresponse (White, externalizing symptoms, total SH, and SI) predicted total nonresponders to DBT with 100% accuracy. CONCLUSION This is the first study to identify trajectories of both SI and SH response to treatment in a sample of adolescents at risk of suicide. Results may inform personalized treatment approaches. CLINICAL TRIAL REGISTRATION INFORMATION Collaborative Adolescent Research on Emotions and Suicide (CARES); https://www. CLINICALTRIALS gov/; NCT01528020.
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Affiliation(s)
| | - Robert Gallop
- West Chester University of Pennsylvania, West Chester
| | | | | | | | - Jennifer L Hughes
- Nationwide Children's Hospital, The Ohio State University, and UT Southwestern Medical Center
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Georgiadis C, Bose D, Wolenski R, Javadi N, Coxe S, Pettit JW, Comer JS. How Flexible are Treatments for Youth Internalizing Disorders? Examining Modification Guidelines Included across Supported Treatments. 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; 51:593-609. [PMID: 36007223 DOI: 10.1080/15374416.2022.2109649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Treatment protocols for youth-internalizing disorders have been developed, however these protocols have yielded mixed findings in routine care settings. Despite increased recognition of the importance of flexibility when delivering evidence-based treatments (EBTs), little is known about the extent to which protocols offer guidance to providers in flexible EBT implementation. The current study examined the extent to which supported EBTs for youth internalizing disorders explicitly incorporate guidance for treatment modification. METHODS Supported treatment protocols for youth internalizing disorders were identified (N = 44), from which 4,021 modification guidelines were extracted and coded using a structured coding system to classify modification strategies (i.e., the forms that recommended modifications take), and associated tailoring factors (i.e., the rationale for which modifications are recommended). RESULTS Across all EBTs, modification guidelines were quite common, with the average protocol including almost 91 text passages providing guidance for modification. The majority of modification guidelines functionally increase session or treatment length by recommending the addition or repetition of material, whereas less than 5% of modification guidelines provided strategies for condensing or streamlining care. Strikingly, less than 2% of modification guidelines in EBT protocols address patient cultural factors, and rarely address provider or setting issues that can challenge standard implementation. CONCLUSIONS Findings highlight critical gaps in the available guidance to modify EBTs for youth internalizing disorders, and suggest EBT protocols may not be optimally poised to flexibly address the broad diversity of children and adolescents across varied settings in need of mental health care.
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Affiliation(s)
- Christopher Georgiadis
- Center for Children and Families, Department of Psychology, Florida International University
| | - Deepika Bose
- Center for Children and Families, Department of Psychology, Florida International University
| | - Rebecca Wolenski
- Center for Children and Families, Department of Psychology, Florida International University
| | - Natalie Javadi
- Center for Children and Families, Department of Psychology, Florida International University
| | - Stefany Coxe
- Center for Children and Families, Department of Psychology, Florida International University
| | - Jeremy W Pettit
- Center for Children and Families, Department of Psychology, Florida International University
| | - Jonathan S Comer
- Center for Children and Families, Department of Psychology, Florida International University
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Alvarez K, Cervantes PE, Nelson KL, Seag DEM, Horwitz SM, Hoagwood KE. Review: Structural Racism, Children's Mental Health Service Systems, and Recommendations for Policy and Practice Change. J Am Acad Child Adolesc Psychiatry 2022; 61:1087-1105. [PMID: 34971730 PMCID: PMC9237180 DOI: 10.1016/j.jaac.2021.12.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 11/26/2021] [Accepted: 12/21/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Racism is a public health crisis that impacts on children's mental health, yet mental health service systems are insufficiently focused on addressing racism. Moreover, a focus on interpersonal racism and on individual coping with the impacts of racism has been prioritized over addressing structural racism at the level of the service system and associated institutions. In this paper, we examine strategies to address structural racism via policies affecting children's mental health services. METHOD First, we identify and analyze federal and state policies focused on racism and mental health equity. Second, we evaluate areas of focus in these policies and discuss the evidence base informing their implementation. Finally, we provide recommendations for what states, counties, cities, and mental health systems can do to promote antiracist evidence-based practices in children's mental health. RESULTS Our analysis highlights gaps and opportunities in the evidence base for policy implementation strategies, including the following: mental health services for youth of color, interventions addressing interpersonal racism and bias in the mental health service system, interventions addressing structural racism, changes to provider licensure and license renewal, and development of the community health workforce. CONCLUSION Recommendations are provided both within and across systems to catalyze broader systems transformation.
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Affiliation(s)
- Kiara Alvarez
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
| | | | - Katherine L Nelson
- Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania; Merck & Co., Inc., Kenilworth, New Jersey
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Huang YT, Leung VWY, Craig SL, Chui CHK. Cultural consideration for cognitive-behavioural therapy for sexual minority young people in Chinese societies: Perspectives from practitioners and target users. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e2277-e2286. [PMID: 34845775 DOI: 10.1111/hsc.13666] [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: 05/20/2021] [Revised: 09/21/2021] [Accepted: 11/17/2021] [Indexed: 06/13/2023]
Abstract
Although cognitive-behavioural therapy has demonstrated effectiveness in improving mental health outcomes for sexual minority young people (SMYP), existing interventions are primarily designed and evaluated in Western contexts, and their acceptability and responsiveness to culturally relevant issues in the Chinese contexts is uncertain. This study aimed to address this gap by exploring how a manualised community-based cognitive-behavioural intervention (AFFIRM) could be culturally reconsidered for SMYP in Taiwan and Hong Kong and suggest recommendations for future adaptation. Following an empirical, community-based participatory approach, qualitative data were collected between August and September 2018 through five focus groups with 15 SMYP and 18 frontline practitioners in Taiwan and Hong Kong. Thematic analysis revealed that at the surface structural level, translation and examples, and promotion strategies can be fine-tuned to better fit the Chinese context. On the deep structural level, self-differentiation and a pragmatic plan to come out to parents were identified as two concerns of cultural importance for Chinese SMYP. This study exemplifies an empirical, collaborative approach to identifying areas of cultural adaptation for mental health intervention for SMYP in the Chinese cultural milieu. The rationale and strategy for adapting existing intervention protocols to accommodate divergent cultural values are described.
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Affiliation(s)
- Yu-Te Huang
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, Hong Kong
| | - Vivian W Y Leung
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Shelley L Craig
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Cheryl H K Chui
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, Hong Kong
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Weersing VR, Gonzalez A, Hatch B, Lynch FL. Promoting Racial/Ethnic Equity in Psychosocial Treatment Outcomes for Child and Adolescent Anxiety and Depression. PSYCHIATRIC RESEARCH AND CLINICAL PRACTICE 2022; 4:80-88. [PMID: 36177440 PMCID: PMC9477232 DOI: 10.1176/appi.prcp.20210044] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 05/26/2022] [Accepted: 07/05/2022] [Indexed: 12/01/2022] Open
Abstract
Anxiety and depression are the most prevalent and least treated pediatric mental health problems. Racial/ethnic minority youths face greater risks for developing anxiety and depression and experience higher burden as they are less likely to receive adequate mental health services for these conditions or to have their needs met. Further, standard evidence‐based interventions for youth anxiety and depression may show diminished effects with racial/ethnic minority youths and with families of lower socioeconomic status. While community‐level interventions to combat structural racism and reduce population‐level risk are sorely needed, many youths will continue to require acute treatment services for anxiety and depression and interventionists must understand how to bring equity to the forefront of care. In this review, we adopt a health system framework to examine racial/ethnic disparities in system‐, intervention‐, provider‐, and patient‐level factors for psychosocial treatment of pediatric anxiety and depression. Current evidence on disparities in access and in efficacy of psychosocial intervention for anxious and depressed youths is summarized, and we use our work in primary care as a case example of adapting an intervention to mitigate disparities and increase equity. We conclude with recommendations for disparity action targets at each level of the health system framework and provide example strategies for intervening on these mechanisms to improve the outcomes of racial/ethnic minority youths. Racial/ethnic minority youths face greater risks for developing anxiety and depression and experience higher burden from disorder as they are less likely to receive adequate mental health services for these conditions or to have their needs met. Increasing access to services for anxiety and depression is of critical and immediate importance for racial/ethnic minority families. Issues of access may be associated with the physical location of services (e.g., primary care or telehealth) or with barriers of language, income, or financing. Both service settings and research treatment protocols frequently require families of ethnic/racial minority youths to fit themselves to the demands of care, in ways that may not be culturally compatible (e.g., little parent involvement in treatment) or practically feasible (i.e., weekly sessions during parent working hours). Whenever possible, non‐essential aspects of intervention should be freed to match patient preferences and constraints, and interventions for anxiety and depression should be adopted that have broad impacts and options for personalization of goals.
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Affiliation(s)
- V. Robin Weersing
- SDSU‐UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA (V. R. Weersing); California State University Long Beach, Long Beach, California, USA (A. Gonzalez); OCHIN Research, Oregon Health Sciences University (B. Hatch); OCHIN Research, Kaiser Permanente Center for Health Research, Portland, Oregon, USA (F. L. Lynch)
| | - Araceli Gonzalez
- SDSU‐UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA (V. R. Weersing); California State University Long Beach, Long Beach, California, USA (A. Gonzalez); OCHIN Research, Oregon Health Sciences University (B. Hatch); OCHIN Research, Kaiser Permanente Center for Health Research, Portland, Oregon, USA (F. L. Lynch)
| | - Brigit Hatch
- SDSU‐UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA (V. R. Weersing); California State University Long Beach, Long Beach, California, USA (A. Gonzalez); OCHIN Research, Oregon Health Sciences University (B. Hatch); OCHIN Research, Kaiser Permanente Center for Health Research, Portland, Oregon, USA (F. L. Lynch)
| | - Frances L. Lynch
- SDSU‐UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA (V. R. Weersing); California State University Long Beach, Long Beach, California, USA (A. Gonzalez); OCHIN Research, Oregon Health Sciences University (B. Hatch); OCHIN Research, Kaiser Permanente Center for Health Research, Portland, Oregon, USA (F. L. Lynch)
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Pumariega AJ. Editorial: Dismantling Structural Racism in Children's Mental Health Services: How Do We Do It? J Am Acad Child Adolesc Psychiatry 2022; 61:1078-1080. [PMID: 35364249 DOI: 10.1016/j.jaac.2022.03.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/22/2022] [Indexed: 01/02/2023]
Abstract
As our society becomes more sensitized to the reach and extent of structural racism embedded in our institutions, it is important that we do serious and intentional work to undo the harmful policies and practices resulting from this multicentury process. Structural racism is both endemic and epidemic in nature. As relates to children's mental health, there is literature that supports the presence of serious racial/ethnic disparities in both the quantity and quality of children' mental health services as a result of structural racism in our service system.1,2.
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Kitt ER, Lewis KM, Galbraith J, Abend R, Smith AR, Lebowitz ER, Pine DS, Gee DG. Family accommodation in pediatric anxiety: Relations with avoidance and self-efficacy. Behav Res Ther 2022; 154:104107. [PMID: 35613517 PMCID: PMC9271364 DOI: 10.1016/j.brat.2022.104107] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/06/2022] [Accepted: 05/04/2022] [Indexed: 11/02/2022]
Abstract
Pediatric anxiety disorders are common, impairing, and chronic when not effectively treated. A growing body of research implicates family accommodation in the maintenance of pediatric anxiety. The present study aimed to quantify previously untested relations among family accommodation and two theoretically linked constructs: avoidance and self-efficacy. Eighty youths between ages 8 and 17 (53 with anxiety disorders, 27 non-anxious controls) completed measures of family accommodation and self-efficacy. In addition, avoidance was assessed using two distinct measures of avoidance: a clinician rating of real-world behaviors and a laboratory task-based index. As predicted, youths with anxiety disorders reported greater family accommodation than non-anxious controls. Across the sample, greater family accommodation was associated with greater avoidance, as measured using both clinician rating and the laboratory task, as well as with lower self-efficacy. In an exploratory mediation model, self-efficacy partially mediated the relation between family accommodation and clinician-rated avoidance; however, it did not mediate the relation between family accommodation and task-based avoidance. Considering the robust association between family accommodation and anxiety in youths, this addition to our understanding of related cognitive and behavioral factors provides important preliminary insight, which can guide future research on potential targets for early identification and intervention for pediatric anxiety.
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Affiliation(s)
| | | | | | - Rany Abend
- National Institute of Mental Health, Bethesda, MD, USA
| | | | | | - Daniel S Pine
- National Institute of Mental Health, Bethesda, MD, USA
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ALEGRÍA MARGARITA, CRUZ‐GONZALEZ MARIO, ALVAREZ KIARA, CANINO GLORISA, DUARTE CRISTIANE, BIRD HECTOR, RAMOS‐OLAZAGASTI MARIA, LAPATIN MARKLE SHERI, O'MALLEY ISABEL, VILA DORILIZ, SHROUT PATRICKE. How Ethnic Minority Context Alters the Risk for Developing Mental Health Disorders and Psychological Distress for Latinx Young Adults. Milbank Q 2022; 100:424-463. [PMID: 35191095 PMCID: PMC9205660 DOI: 10.1111/1468-0009.12552] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
UNLABELLED Policy Points In low-income communities in the South Bronx and Puerto Rico, Puerto Rican youth are exposed to many of the same risk and protective factors for developing depression, anxiety, or psychological distress; yet it is unclear how the ethnic minority context of the South Bronx and ethnic majority context of Puerto Rico influence risk. Results from our quasi-experimental, longitudinal study demonstrate the importance of addressing social factors (parent-child relationships, youth peer relationships) for youth living in the majority context, and neighborhood and cultural factors (residential mobility, perceived discrimination, perceived social position in the neighborhood) for youth living in the minority context. Our findings support the need for tailoring programs specific to the needs of youth who reside in an ethnic majority or a minority context, since some of the risk factors might operate differently depending on context. Housing and neighborhood environment policies that address discrimination and eliminate structural inequities for ethnic minority groups may protect against the harm of minoritization on young people's mental health. CONTEXT Puerto Rican youth growing up in low-income communities in the South Bronx and Puerto Rico are exposed to many of the same risk factors for major depressive disorder, generalized anxiety disorder, and psychological distress. One potentially powerful factor differs: Puerto Ricans have been socially marginalized as an ethnic minority group in the South Bronx, but are the ethnic majority of the population in Puerto Rico. A growing body of literature demonstrates the influence of neighborhood, cultural, and social factors and parental psychopathology in the development of mental health problems. An important unanswered question is whether these risk and protective factors have the same impact for youth raised as members of an ethnic majority versus minority group. METHODS Using a population-based cohort study, with four waves of assessment from early childhood into young adulthood, we investigated whether ethnic minority context alters risk and protective factors for depression, anxiety, and psychological distress. Our longitudinal data set includes 2,491 young children at baseline (82.8% retained at wave 4). Using a quasi-experimental design, we examine how ethnic minority context can alter the development of mental health disorders as Latinx children transition to late adolescence and young adulthood. FINDINGS Some risk and protective factors operated differently across minority and majority contexts. Higher discrimination and social position were more powerful risk and protective factors, respectively, in the minority context, whereas positive peer relationships mattered more in the majority context. Children of mothers with depression were significantly more likely to develop anxiety in late adolescence and young adulthood in the majority context (60.0%) compared to the minority context (4.5%). CONCLUSIONS Preventing depression and anxiety disorders in Latinx young adults may require targeting different childhood factors depending on whether they reside within the ethnic majority or minority context. People in the ethnic minority context may benefit more from policies aimed at reducing discrimination and improving economic opportunity, while people in the majority context may benefit more from opportunities for strengthening family and peer relationships.
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Affiliation(s)
| | | | - KIARA ALVAREZ
- Massachusetts General Hospital
- Harvard Medical School
| | - GLORISA CANINO
- Behavioral Sciences Research InstituteUniversity of Puerto Rico Medical School
| | - CRISTIANE DUARTE
- New York State Psychiatric InstituteColumbia University Medical Center
| | - HECTOR BIRD
- New York State Psychiatric InstituteColumbia University Medical Center
| | | | | | | | - DORILIZ VILA
- Behavioral Sciences Research InstituteUniversity of Puerto Rico Medical School
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Stenersen MR, Kelly A, Bracey J, Marshall T, Cummins M, Clark K, Kaufman JS. Understanding Racial-Ethnic Disparities in Wraparound Care for Youths With Emotional and Behavioral Disorders. Psychiatr Serv 2022; 73:526-532. [PMID: 34470504 PMCID: PMC8888774 DOI: 10.1176/appi.ps.202100086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Systems of care (SOCs) were developed to increase access to and quality of care for children with emotional and behavioral difficulties and their families through the provision of coordinated, community-based, culturally competent, family-driven services. SOCs focus on wraparound care that is individualized to meet each family's needs. Previous research has illustrated significant disparities in outcomes of nonwraparound care on the basis of youths' race-ethnicity. This study aimed to fill a research gap by examining disparities in outcomes for families receiving wraparound care coordination within an SOC. METHODS This exploratory study examined racial-ethnic disparities in outcomes observed at intake, during service provision, and at 6-month follow-up among 1,138 youths and their caregivers who participated in wraparound care coordination as part of a statewide SOC between 2016 and 2020. Analyses of variance and regression analyses were executed to investigate whether receiving services and/or the youths' racial-ethnic identity predicted differences in behavioral health outcomes and characteristics of or satisfaction with care. Caregiver-reported outcomes were assessed with the Ohio Scales for Youth, the Child Trauma Screen, and the Caregiver Strain Questionnaire. RESULTS Results revealed few racial-ethnic disparities in the characteristics and outcomes of care coordination among participants at intake or in family involvement in the wraparound process. Participants across groups reported similar and significant improvement in outcomes. However, the results indicated some disparities in satisfaction with care. CONCLUSIONS Results revealed the positive impact of care coordination on the health and well-being of youths and caregivers across racial-ethnic groups.
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Affiliation(s)
- Madeline R Stenersen
- Division of Prevention and Community Research, Yale University School of Medicine, New Haven, Connecticut (Stenersen, Clark, Kaufman); Child Health and Development Institute of Connecticut, Farmington (Kelly, Bracey); Office of Community Mental Health, Connecticut Department of Children and Families, Hartford (Marshall, Cummins)
| | - Aleece Kelly
- Division of Prevention and Community Research, Yale University School of Medicine, New Haven, Connecticut (Stenersen, Clark, Kaufman); Child Health and Development Institute of Connecticut, Farmington (Kelly, Bracey); Office of Community Mental Health, Connecticut Department of Children and Families, Hartford (Marshall, Cummins)
| | - Jeana Bracey
- Division of Prevention and Community Research, Yale University School of Medicine, New Haven, Connecticut (Stenersen, Clark, Kaufman); Child Health and Development Institute of Connecticut, Farmington (Kelly, Bracey); Office of Community Mental Health, Connecticut Department of Children and Families, Hartford (Marshall, Cummins)
| | - Tim Marshall
- Division of Prevention and Community Research, Yale University School of Medicine, New Haven, Connecticut (Stenersen, Clark, Kaufman); Child Health and Development Institute of Connecticut, Farmington (Kelly, Bracey); Office of Community Mental Health, Connecticut Department of Children and Families, Hartford (Marshall, Cummins)
| | - Mary Cummins
- Division of Prevention and Community Research, Yale University School of Medicine, New Haven, Connecticut (Stenersen, Clark, Kaufman); Child Health and Development Institute of Connecticut, Farmington (Kelly, Bracey); Office of Community Mental Health, Connecticut Department of Children and Families, Hartford (Marshall, Cummins)
| | - Kathryn Clark
- Division of Prevention and Community Research, Yale University School of Medicine, New Haven, Connecticut (Stenersen, Clark, Kaufman); Child Health and Development Institute of Connecticut, Farmington (Kelly, Bracey); Office of Community Mental Health, Connecticut Department of Children and Families, Hartford (Marshall, Cummins)
| | - Joy S Kaufman
- Division of Prevention and Community Research, Yale University School of Medicine, New Haven, Connecticut (Stenersen, Clark, Kaufman); Child Health and Development Institute of Connecticut, Farmington (Kelly, Bracey); Office of Community Mental Health, Connecticut Department of Children and Families, Hartford (Marshall, Cummins)
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Sood E, Gramszlo C, Perez Ramirez A, Braley K, Butler SC, Davis JA, Divanovic AA, Edwards LA, Kasparian N, Kelly SL, Neely T, Ortinau CM, Riegel E, Shillingford AJ, Kazak AE. Partnering With Stakeholders to Inform the Co-Design of a Psychosocial Intervention for Prenatally Diagnosed Congenital Heart Disease. J Patient Exp 2022; 9:23743735221092488. [PMID: 35493441 PMCID: PMC9039438 DOI: 10.1177/23743735221092488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Input from diverse stakeholders is critical to the process of designing healthcare interventions. This study applied a novel mixed-methods, stakeholder-engaged approach to co-design a psychosocial intervention for mothers expecting a baby with congenital heart disease (CHD) and their partners to promote family wellbeing. The research team included parents and clinicians from 8 health systems. Participants were 41 diverse parents of children with prenatally diagnosed CHD across the 8 health systems. Qualitative data were collected through online crowdsourcing and quantitative data were collected through electronic surveys to inform intervention co-design. Phases of intervention co-design were: (I) Engage stakeholders in selection of intervention goals/outcomes; (II) Engage stakeholders in selection of intervention elements; (III) Obtain stakeholder input to increase intervention uptake/utility; (IV) Obtain stakeholder input on aspects of intervention design; and (V) Obtain stakeholder input on selection of outcome measures. Parent participants anticipated the resulting intervention, HEARTPrep, would be acceptable, useful, and feasible for parents expecting a baby with CHD. This model of intervention co-design could be used for the development of healthcare interventions across chronic diseases.
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Affiliation(s)
- Erica Sood
- Nemours Cardiac Center, Nemours Children’s Hospital Delaware, Wilmington, DE, USA
- Nemours Center for Healthcare Delivery Science, Nemours Children’s Hospital Delaware, Wilmington, DE, USA
- Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Colette Gramszlo
- Nemours Cardiac Center, Nemours Children’s Hospital Delaware, Wilmington, DE, USA
| | - Alejandra Perez Ramirez
- Nemours Center for Healthcare Delivery Science, Nemours Children’s Hospital Delaware, Wilmington, DE, USA
| | - Katherine Braley
- Nemours Cardiac Center, Nemours Children’s Hospital Florida, Orlando, FL, USA
| | | | - Jo Ann Davis
- Department of Pediatrics, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Allison A Divanovic
- Department of Pediatrics, Cincinnati Children’s Hospital, Cincinnati, OH, USA
| | | | - Nadine Kasparian
- Center for Heart Disease and Mental Health, Department of Pediatrics, Cincinnati Children’s Hospital, Cincinnati, OH, USA
| | - Sarah L Kelly
- Departments of Pediatrics and Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA
| | | | - Cynthia M Ortinau
- Department of Pediatrics, Washington University in St. Louis, St. Louis, MO, USA
| | - Erin Riegel
- Parent Research Partner, Wilmington, DE, USA
| | | | - Anne E Kazak
- Nemours Center for Healthcare Delivery Science, Nemours Children’s Hospital Delaware, Wilmington, DE, USA
- Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
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Lindegaard T, Wasteson E, Demetry Y, Andersson G, Richards D, Shahnavaz S. Investigating the potential of a novel internet-based cognitive behavioural intervention for Dari and Farsi speaking refugee youth: A feasibility study. Internet Interv 2022; 28:100533. [PMID: 35433279 PMCID: PMC9006765 DOI: 10.1016/j.invent.2022.100533] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 03/28/2022] [Accepted: 03/30/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Over half of the world's forcibly displaced persons are under the age of 25, with many suffering from symptoms of psychological disorders. Many refugees from Afghanistan or Iran speak either Dari or Farsi, which are mutually intelligible dialects of the Persian language. Previous research on adult refugees and immigrants have shown that internet-based cognitive behavioural therapy (ICBT) can be a valuable complement to other forms of treatment. However, there is a lack of knowledge if ICBT is a feasible and acceptable treatment for adolescents and young adults with a refugee background. METHOD Fifteen Dari/Farsi-speaking adolescents and young adults between 15 and 26 years of age participated in a feasibility study of a novel individually tailored guided ICBT intervention targeting symptoms of common mental disorders such as anxiety and depression. Self-reported symptoms of anxiety and depression were assessed using the Hopkins Symptom Checklist-25 (HSCL-25) as the primary outcome measure. Four of the treatment participants and three additional non-treatment participants consented to be interviewed regarding the programme's acceptability. The interviews were analysed using Thematic Analysis. RESULTS The intervention suffered from low adherence, with only 3 participants completing the post-treatment assessment and with participants completing 0.9 modules on average, which meant that the intended quantitative analysis of the pre to post change was not possible. The thematic analysis resulted in two overarching categories, barriers and facilitators, that each contained four themes and related subthemes. Overall, the intervention was deemed culturally relevant and easy to understand. The most salient barriers to participation across interviews concerned interference of symptoms such as concentration difficulties, low energy, and a lack of human contact and support. CONCLUSION The current version of the ICBT program demonstrated low feasibility and acceptability in the target population, which mainly seemed to be related to the delivery format. Future studies should investigate if a blended treatment format with regular phone/video calls with a therapist can increase adherence to the intervention.
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Affiliation(s)
- Tomas Lindegaard
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Corresponding author at: Department of Behavioural Sciences and Learning, Linköping University, SE-581 83 Linköping, Sweden.
| | - Elisabet Wasteson
- Department of Psychology and Social Work, Mid Sweden University, Östersund, Sweden
| | - Youstina Demetry
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
- Stockholm Health Care Services, Region Stockholm, The Centre for Psychotherapy, Education & Research, Sweden
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Derek Richards
- E-mental Health Group, School of Psychology, University of Dublin, Trinity College Dublin, Dublin, Ireland
- Clinical Research & Innovation, SilverCloud Health, Dublin, Ireland
| | - Shervin Shahnavaz
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
- Stockholm Health Care Services, Region Stockholm, The Centre for Psychotherapy, Education & Research, Sweden
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Alegría M, O'Malley IS, DiMarzio K, Zhen-Duan J. Framework for Understanding and Addressing Racial and Ethnic Disparities in Children's Mental Health. Child Adolesc Psychiatr Clin N Am 2022; 31:179-191. [PMID: 35361358 PMCID: PMC9382888 DOI: 10.1016/j.chc.2021.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In this framework, we synthesize the results of studies addressing racial/ethnic disparities in children's mental health through 4 domains hypothesized to impact minoritized children and their families: (1) policies, (2) institutional systems, (3) neighborhoods/community system, and (4) individual/family-level factors. We focus on children and adolescents, presenting findings that may impact mental health outcomes for major racial/ethnic groups in North America: Black/African American, Latinx, Asian, and American Indian youth. We conclude by suggesting areas for needed research, including whether certain domains of influence demonstrate differential impact for inequities reduction depending on the youth's race/ethnicity.
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Affiliation(s)
- Margarita Alegría
- Disparities Research Unit, Massachusetts General Hospital, 50 Staniford St, Suite 830, Boston, MA 02114, USA; Department of Medicine, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA; Department of Psychiatry, Harvard Medical School, 401 Park Drive, 2 West, Room 305, Boston, MA 02215, USA.
| | - Isabel Shaheen O'Malley
- Disparities Research Unit, Massachusetts General Hospital, 50 Staniford St, Suite 830, Boston, MA 02114, USA
| | - Karissa DiMarzio
- Department of Psychology, Center for Children and Families, Florida International University, 11200 SW 8th St, AHC-1, Miami, FL 33199, USA
| | - Jenny Zhen-Duan
- Disparities Research Unit, Massachusetts General Hospital, 50 Staniford St, Suite 830, Boston, MA 02114, USA; Department of Medicine, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
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Alegría M, Alvarez K, NeMoyer A, Zhen-Duan J, Marsico C, O'Malley IS, Mukthineni R, Porteny T, Herrera CN, Najarro Cermeño J, Kingston K, Sisay E, Trickett E. Development of a Youth Civic Engagement Program: Process and Pilot Testing with a Youth-Partnered Research Team. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 69:86-99. [PMID: 34350588 DOI: 10.1002/ajcp.12548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Although research suggests neighborhood-level factors influence youth well-being, few studies include youth when creating interventions to address these factors. We describe our three-step process of collaborating with youth in low-income communities to develop an intervention focused on civic engagement as a means to address neighborhood-level problems impacting their well-being. In the first step, we analyzed qualitative interviews from a project in which youth shared perceptions about their neighborhoods (e.g., interpersonal relations with neighbors and institutions). Three major themes were identified: pride in youth's communities, desire for change, and perceptions of power and responsibility. Based on these themes, we completed the second step: developing a civic engagement and leadership program, called LEAP, aimed at helping youth take an active role in addressing neighborhood problems. In the third step, we collaborated with youth who completed a pilot version of the civic program and provided feedback to finalize it for large-scale testing. While discussing our process, we highlight the importance of including youth voices when developing programs that affect them. Furthermore, we note the need for more research exploring whether civic engagement serves as a mechanism for encouraging youth involvement in addressing neighborhood-level health disparities and identifying potential psychological costs of such involvement.
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Affiliation(s)
- Margarita Alegría
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Kiara Alvarez
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Amanda NeMoyer
- Department of Psychology, Drexel University, Philadelphia, PA, USA
| | - Jenny Zhen-Duan
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Christine Marsico
- Wheelock College of Education & Human Development, Boston University, Boston, MA, USA
| | - Isabel Shaheen O'Malley
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Ravali Mukthineni
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Thalia Porteny
- Department of Community Health and Occupational Therapy, Tufts University, Medford, MA, USA
| | - Carolina-Nicole Herrera
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA
| | - Jesse Najarro Cermeño
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Kyle Kingston
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Emnet Sisay
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Edison Trickett
- School of Education and Human Development, University of Miami, Coral Gables, FL, USA
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Sanchez AL, Jent J, Aggarwal NK, Chavira D, Coxe S, Garcia D, La Roche M, Comer JS. Person-Centered Cultural Assessment Can Improve Child Mental Health Service Engagement and Outcomes. 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; 51:1-22. [PMID: 34905434 DOI: 10.1080/15374416.2021.1981340] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Disparities in child mental health service engagement suggest traditional evidence-based practices do not properly consider cultural and contextual factors relevant for marginalized families. We propose a person-centered approach to improve the cultural responsiveness of services. Preliminary research supports broadening standard assessments to include a person-centered evaluation of patient cultural factors, however, controlled studies have not been conducted in the context of children's mental health care. METHODS Participants included families (N = 89; 89% racial/ethnic minority) receiving services for child externalizing problems. Prior to intake, caregivers were randomized to receive either Assessment as Usual (AAU) or AAU augmented with the Cultural Formulation Interview (CFI+AAU), a brief caregiver assessment of cultural factors affecting their child's problems and family help-seeking. RESULTS Implementation data showed strong provider fidelity and clinical utility. Following assessments, CFI+AAU caregivers (relative to AAU caregivers) reported feeling better understood by their provider, and providers reported better understanding CFI+AAU families' values. Caregiver satisfaction was rated highly overall, yet providers reported being more satisfied with the assessment when the CFI was incorporated. Engagement outcomes found CFI+AAU families were significantly more likely than AAU families to subsequently complete the first phase of treatment. Further, among families receiving services in Spanish, CFI+AAU, relative to AAU, was associated with significantly higher treatment attendance, homework completion, and treatment response. CONCLUSIONS The results underscore the utility of incorporating a brief cultural assessment in pretreatment assessments. To improve the cultural responsiveness of services, efforts may do well to promote the uptake of person-centered approaches such as cultural assessment into usual care. Registered at clinicaltrials.gov (NCT03499600).
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Affiliation(s)
- Amanda L Sanchez
- Penn Center for Mental Health, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | - Jason Jent
- Mailman Center for Child Development, University of Miami Miller School of Medicine
| | | | - Denise Chavira
- Department of Psychology, University of California Los Angeles
| | - Stefany Coxe
- Center for Children and Families and Department of Psychology, Florida International University
| | - Dainelys Garcia
- Mailman Center for Child Development, University of Miami Miller School of Medicine
| | - Martin La Roche
- Harvard Medical School, Boston Children's Hospital at Martha Eliot
| | - Jonathan S Comer
- Center for Children and Families and Department of Psychology, Florida International University
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Davenport MA, Romero ME, Lewis CD, Lawson T, Ferguson B, Stichter J, Kahng S. An Initial Development and Evaluation of a Culturally Responsive Police Interactions Training for Black Adolescents with Autism Spectrum Disorder. J Autism Dev Disord 2021; 53:1375-1390. [PMID: 34448996 DOI: 10.1007/s10803-021-05181-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2021] [Indexed: 11/24/2022]
Abstract
The purpose of the current study was to conduct a qualitative and experimental analysis of a culturally informed police safety skills training for adolescents with autism spectrum disorder (ASD). The current study focused primarily on meeting the unique training needs of Black adolescents with autism spectrum disorder (ASD). A single case design was used to evaluate the initial efficacy and acceptability of a culturally responsive training method. Preliminary evidence about the physiological ramifications of police contact were also collected to begin to examine the broader behavioral and psychophysiological nature of youth's experiences. The current experimental design included in-person simulated contexts that youth, and caregivers, endorsed as relevant to their normal lives, which greatly strengthened the ecological validity of the approach.
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Affiliation(s)
- Mattina A Davenport
- Nationwide Children's Hospital, Columbus, OH, USA. .,Department of Educational, School, and Counseling Psychology, University of Missouri-Columbia, Columbia, MO, USA.
| | - Monica E Romero
- Department of Educational, School, and Counseling Psychology, University of Missouri-Columbia, Columbia, MO, USA
| | - Christopher D Lewis
- Department of Educational, School, and Counseling Psychology, University of Missouri-Columbia, Columbia, MO, USA
| | - Tamara Lawson
- Department of Counseling and School Psychology, University of Massachusetts-Boston, Boston, MA, USA
| | - Brad Ferguson
- Departments of Health Psychology, Radiology, & the Thompson Center for Autism & Neurodevelopmental Disorders, University of Missouri-, Columbia, Columbia, MO, USA
| | - Janine Stichter
- Department of Special Education, University of Missouri-Columbia, Columbia, MO, USA
| | - SungWoo Kahng
- Department of Applied Psychology, Rutgers University, New Brunswick, NJ, USA
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Conroy K, Salem H, Georgiadis C, Hong N, Herrera A, Furr JM, Greif Green J, Comer JS. Gauging Perceptions and Attitudes About Student Anxiety and Supports Among School-Based Providers. SCHOOL MENTAL HEALTH 2021. [DOI: 10.1007/s12310-021-09470-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ramos G, Brookman-Frazee L, Kodish T, Rodriguez A, Lau AS. Community providers' experiences with evidence-based practices: The role of therapist race/ethnicity. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2021; 27:471-482. [PMID: 32391705 PMCID: PMC7655698 DOI: 10.1037/cdp0000357] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
OBJECTIVES Examining therapists' experiences implementing evidence-based practices (EBPs) is fundamental to understanding how these interventions are perceived, adapted, and delivered in community settings. However, little is known about racial/ethnic variation in the experiences of therapists serving racial/ethnic minority youth and their families. Through an innovative QUAN → qual → QUAN mixed-methods approach, we examined differences in therapists' perceptions, adaptations performed, and client-engagement challenges in the largest county-operated department of mental health in the United States. METHOD Surveys were completed by 743 therapists (Latinx [44%], White [34%], other ethnic minority [22%]), most of whom were female (88%), master's level (85%), and unlicensed (58%). A subset of therapists (n = 60) completed semistructured interviews. RESULTS Latinx therapists reported more positive experiences implementing EBPs, making more adaptations to EBPs, and encountering fewer client-engagement challenges than therapists from other racial/ethnic groups. Qualitative analyses expanded on these results, revealing that Latinx therapists commonly described adapting EBPs in terms of language and culture to improve fit and promote client engagement. Informed by these qualitative themes, a refined statistical model revealed that the ability to deliver EBPs in languages other than English might have accounted for differences in therapist-reported EBP adaptations and client-engagement challenges. CONCLUSIONS The findings suggest that racial/ethnic minority therapists have positive experiences in implementing EBPs in community settings. In the case of Latinx therapists, bilingual/bicultural competence may facilitate adapting EBPs in ways that reduce perceptions of engagement challenges with racially/ethnically diverse clients. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Giovanni Ramos
- Department of Psychology, University of California, Los Angeles
| | - Lauren Brookman-Frazee
- Department of Psychiatry, Child and Adolescent Services Research Center, University of California, San Diego
| | - Tamar Kodish
- Department of Psychology, University of California, Los Angeles
| | - Adriana Rodriguez
- Children and Youth Behavioral Health, Health Care Agency, Orange County
| | - Anna S Lau
- Department of Psychology, University of California, Los Angeles
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Sanchez AL, Comer JS, LaRoche M. Enhancing the Responsiveness of Family-Based CBT Through Culturally Informed Case Conceptualization and Treatment Planning. COGNITIVE AND BEHAVIORAL PRACTICE 2021. [DOI: 10.1016/j.cbpra.2021.04.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Kurian J, Murray DW, Kuhn L, LaForett DR. Examining frequency and modality of parent engagement in an elementary school mental health intervention. JOURNAL OF APPLIED SCHOOL PSYCHOLOGY 2021. [DOI: 10.1080/15377903.2021.1911896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Jennifer Kurian
- Department of Psychology, Illinois Institute of Technology, Chicago, Illinois
- Frank Porter Graham Child Development Institute, University of North Carolina-Chapel Hill, North Carolina
| | - Desiree W. Murray
- Frank Porter Graham Child Development Institute, University of North Carolina-Chapel Hill, North Carolina
- Child Trends, Inc, Chapel Hill, North Carolina
| | - Laura Kuhn
- Frank Porter Graham Child Development Institute, University of North Carolina-Chapel Hill, North Carolina
| | - Doré R. LaForett
- Frank Porter Graham Child Development Institute, University of North Carolina-Chapel Hill, North Carolina
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Bearman SK. Introduction to special issue: clinical supervision in implementation science. CLINICAL SUPERVISOR 2021. [DOI: 10.1080/07325223.2021.1911900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Sarah Kate Bearman
- Department of Educational Psychology, The University of Texas at Austin, Austin, USA
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