Measurement of adolescent psychological wellbeing: A test of factor structure and measurement invariance.

Gains in holistic approaches to adult mental health have been associated with increasing interest in understanding psychological wellbeing (PWB) among adolescents. Empirical examination of measurement models for PWB in adolescence is lacking. Thus, the current study examined PWB in a longitudinal, diverse sample of 433 adolescents (non-Latinx Black: 37.6%; non-Latinx White: 25.9%; Latinx: 36.5%; Male adolescents: 50.1%). A one-factor, correlated six-factor and hierarchical models were examined across racial/ethnic (White, Black, and Hispanic) and gender (female, male) identities, after which the best fitting model was selected to undergo invariance testing. A one-factor structure was superior, and exhibited strict invariance across racial/ethnic and gender identities at each wave of the study, as well as longitudinal invariance within the entire sample.

Behavioral activation is associated with post-disaster mental health: Secondary longitudinal analysis from a population-based study.

OBJECTIVE: Interventions in post-disaster environments may be accelerated by identifying protective behavioral factors adding incremental value to models of psychopathology using longitudinal methods. One protective behavior applicable to post-disaster contexts is behavioral activation (BA). BA is defined here as a behavioral pattern involving presence of valued activity engagement. While relevant post-disaster, the incremental value of BA behaviors in predicting longitudinal post-disaster outcomes is not well understood. We hypothesized that higher baseline engagement in behaviors consistent with a BA framework would predict decreased posttraumatic stress disorder (PTSD) symptom severity, depression symptom severity, and sleep disturbance approximately 3, 6, and 12 months after hurricane survivors completed baseline measures. METHODS: The current study is a secondary analysis from a randomized controlled trial of a disaster mental health digital intervention. Participants completed surveys at baseline and approximately 3, 6, and 12 months post-enrollment. Correlations and hierarchical regression analyses were calculated following data screening to predict PTSD symptom severity, depression symptom severity, and sleep disturbances. RESULTS: Controlling for alcohol use, prior trauma, displacement, and intervention condition, higher baseline BA consistently predicted less PTSD symptom severity, depression symptom severity, and sleep disturbances. CONCLUSION: Results suggest that post-disaster interventions should consider addressing BA. The study provides evidence that BA is potentially an important protective factor longitudinally predicting sleep disturbances and psychopathology after natural disasters.

Longitudinal and bidirectional associations between posttraumatic stress disorder and emotional support among disaster-affected men and women.

Research has demonstrated a negative association between social support and symptoms of posttraumatic stress disorder (PTSD). This has been interpreted as a protective influence of social support against the development of posttraumatic stress symptoms (PTSS). Research on the opposite association is more limited, but findings suggest that PTSS have a negative impact on social support. There is conflicting evidence that these effects are moderated by gender. Few studies have assessed both associations and gender moderation in a postdisaster context. We examined the longitudinal and bidirectional effects of emotional support and PTSS and whether gender moderates these effects among U.S. survivors of the 2017-2018 season. Participants (N = 1,347) were assessed at four time points over 1 year. Bidirectional effects were assessed using cross-lagged, autoregressive analyses with the combined sample (Model 1) and grouped by gender (Model 2) to assess gender moderation. The results supported small bidirectional negative effects of social support and PTSS on one another from one assessment point (e.g. Wave 1) to the subsequent point (e.g., Wave 2) for all waves, ßs = -.07-.15, p < .001-p = .040. Multigroup analyses suggested the effects were not significantly different by gender. Overall, the results suggest that social support and PTSS may mutually diminish one another. Such effects may result in a positive or negative cascade wherein high PTSS may lead to lower social support and, therefore, even higher PTSS and vice versa. These findings support the importance of including social support in interventions to promote PTSS prevention and recovery.

Perceived Barriers and Preliminary PTSD Outcomes in an Open Pilot Trial of Written Exposure Therapy With Latinx Immigrants.

Latinx immigrants experience substantial disparities in mental health treatment access, particularly for posttraumatic stress disorder (PTSD). The availability of brief, flexible interventions in Spanish may assist in reducing these disparities. Written Exposure Therapy (WET) is a five-session PTSD intervention that appears as effective as longer, gold-standard interventions, but has yet to be tested among Latinx immigrants. To test the acceptability and preliminary effectiveness of WET, 20 Spanish-speaking, Latinx immigrants conducted structured interviews at pretreatment, were offered WET, and completed posttreatment structured interviews. Open thematic coding of pre- and posttreatment interview questions examined perceived barriers and benefits of WET. Quantitative components examined symptom change across PTSD (PCL-IV-C) and depression (PHQ-9). Quantitative results indicated clinically meaningful and statistically significant change in PTSD symptoms using intent-to-treat analyses (Mdiff = 17.06, SDdiff = 9.97, range = 0-29, t(15) = 6.84, p < .001). Open thematic coding identified four barrier-related themes and three benefit-related themes at pretreatment. At posttreatment, three barrier-related themes and two benefit-related themes were identified. Qualitative results largely suggested that perceived barriers were common to other PTSD interventions (e.g., exposure components). Only one participant identified barriers specific to WET. Results suggested WET may reduce PTSD symptoms among Latinx immigrants. WET also appeared to be acceptable and primarily viewed as beneficial among this population. WET is a promising intervention with Latinx immigrants and warrants further testing larger trials, including testing implementation strategies that may improve access to care.

Emotional Maltreatment and Adolescent Depression: Mediating Mechanisms and Demographic Considerations in a Child Welfare Sample.

Emotional maltreatment is a risk factor for adolescent depression. Yet, it remains unclear whether commissions and omissions of emotional maltreatment (a) confer vulnerability via distinct mechanisms and (b) demonstrate similar risk across adolescent subpopulations. The present, multiwave study examined whether school engagement and peer relationships explain the depressive effects of distinct emotional maltreatment subtypes in an at-risk child welfare sample (N = 657; ages 11-14, AgeMean  = 12.49). The findings indicated that commission subtypes of emotional maltreatment predicted increasing depressive symptoms via increasing peer relationship problems, especially for girls. Meanwhile, decreasing school engagement was a depressogenic risk pathway for Hispanic adolescents reporting omission subtypes of emotional maltreatment. The results emphasize the importance of distinguish between emotional maltreatment subtypes to identify specific risk pathways for adolescent depression.

Racial/ethnic differences in trauma exposure and mental health disorders in adolescents.

OBJECTIVE: Research has cited increased prevalence of mood disorders, anxiety disorders, and exposure to interpersonal violence for Hispanics and non-Hispanic Black adolescents, as well as ethnic differences in externalizing behavior (e.g., substance use, delinquency). The current study combined these areas by examining racial/ethnic differences in mental health correlates of trauma exposure. METHOD: Interviews were conducted to assess polyvictimization, posttraumatic stress disorder (PTSD), major depressive disorder (MDD), substance use, and delinquency in a nationally representative sample of adolescents (N = 3,614; 15.4% non-Hispanic Black; 11.3% Hispanic; 64.9% non-Hispanic White). RESULTS: Hispanic and non-Hispanic Black adolescents endorsed greater polyvictimization than non-Hispanic Whites; however, differences in MDD and PTSD were only significant when assessed with symptom counts. Non-Hispanic Black adolescents reported the least drug use. Non-Hispanic Black and Hispanic adolescents endorsed more delinquency than non-Hispanic White adolescents. Polyvictimization only accounted for ethnic disparities in delinquency. CONCLUSION: Trauma-related disparities may differ across internalizing and externalizing concerns. Subsequent research should continue to examine other factors that may contribute to racial/ethnic differences in trauma sequelae. (PsycINFO Database Record

Polyvictimization, income, and ethnic differences in trauma-related mental health during adolescence.

PURPOSE: The purpose of the present study was to investigate ethnic differences in trauma-related mental health symptoms among adolescents, and test the mediating and moderating effects of polyvictimization (i.e., number of types of traumas/victimizations experienced by an individual) and household income, respectively. METHODS: Data were drawn from the first wave of the National Survey of Adolescents-replication study (NSA-R), which took place in the US in 2005 and utilized random digit dialing to administer a telephone survey to adolescents ages 12-17. Participants included in the current analyses were 3312 adolescents (50.2 % female; mean age 14.67 years) from the original sample of 3614 who identified as non-Hispanic White (n = 2346, 70.8 %), non-Hispanic Black (n = 557, 16.8 %), or Hispanic (n = 409, 12.3 %). Structural equation modeling was utilized to test hypothesized models. RESULTS: Non-Hispanic Black and Hispanic participants reported higher levels of polyvictimization and trauma-related mental health symptoms (symptoms of posttraumatic stress and depression) compared to non-Hispanic Whites, though the effect sizes were small (γ ≤ 0.07). Polyvictimization fully accounted for the differences in mental health symptoms between non-Hispanic Blacks and non-Hispanic Whites, and partially accounted for the differences between Hispanics and non-Hispanic Whites. The relation between polyvictimization and trauma-related mental health symptoms was higher for low-income youth than for high-income youth. CONCLUSIONS: Disparities in trauma exposure largely accounted for racial/ethnic disparities in trauma-related mental health. Children from low-income family environments appear to be at greater risk of negative mental health outcomes following trauma exposure compared to adolescents from high-income families.

Investigating the Potential Double-Edged Score of Immigration-Related Stress, Discrimination, and Mental Health Access.

Prior work has suggested that discrimination and immigration-related stress may impede mental health care seeking and utilization among Latinx populations. These effects may be more nuanced as both discrimination and immigration-related stress may increase symptomology, particularly post-traumatic stress disorder (PTSD) and depression. Both symptoms may, in turn, prompt attempts to seek care. The current study examined the direct effects of discrimination and immigration-related stress on care access, as well as potentially indirect effects with PTSD and depression symptoms as mediators. Interviews and online surveys were completed with 234 Latinx residents of the Midwest, assessing everyday discrimination, discrimination in healthcare, PTSD symptoms, depression symptoms, current mental health utilization, and previous unsuccessful attempts to seek care. Direct effects of discrimination and immigration-related stress were largely unrelated to care access variables. Discrimination in healthcare settings predicted both unsuccessful attempts to seek care and current use, but this effect was positive. The indirect effect was largely supported, but only for PTSD symptoms and not depression. Results indicate that further investigation is necessary to understand the direct effects of discrimination on care access. Further, discrimination and immigration-related stress may indirectly prompt attempts to seek mental health care.

Mental Health and Marginalization Stress in Transgender and Gender Diverse Adults: Differences between Urban and Non-Urban Experiences.

Background: Transgender and gender diverse (TGD) individuals face high rates of psychological distress, including depression, anxiety, and suicide risk. Further, TGD individuals living outside of urban areas experience additional disparities compared to their urban counterparts. Minority stress theory states that minority stressors (termed marginalization stressors for this paper), such as experiences of discrimination and internalized transphobia, lead to psychological distress. The current study compared marginalization stressors across rural (population less than 2,500), urban cluster (population between 2,500 and 50,000), and urban (population greater than 50,000) samples and tested the degree to which these stressors account for differences across areas of residence. Methods: Participants were 225 TGD individuals who completed an online survey that included measures of depression, anxiety, suicidal ideation marginalization stress, and protective factors. Results: In the first model, mental health outcomes, marginalization stressors, and protective factors differed between areas. Urban cluster participants reported experiencing higher levels of depression, anxiety, and suicidal ideation and rural participants reported experiencing higher levels of depression suicidal ideation than urban participants. Both rural and urban cluster participants reported more experiences of several marginalization stressors. In the subsequent path model, indirect effects between area and marginalization stress variables were significant, but urban cluster participants still reported higher depression, anxiety, and suicidal ideation symptoms (p-values < .05). Discussion: We demonstrate that marginalization stress processes appear to account for some of the differences between TGD individuals living in urban, rural, and urban cluster areas. The differences between areas largely persist, however, after controlling for marginalization stress, especially when comparing urban with urban cluster areas.

Clinical diversity in a randomized trial that explicitly sought racial/ethnic diversity in its sample: Baseline comparisons in a treatment of youth substance use and posttraumatic stress.

OBJECTIVE: For more than two decades, federal agencies have sought to address a persistent lack of inclusion of Black, Latinx, Asian, and indigenous peoples in randomized controlled trials (RCTs), often with an underlying hypothesis that such efforts will increase diversity across clinically-relevant dimensions. We examined racial/ethnic and clinical diversity, including racial/ethnic differences in prior service access and symptom dimensions, in an RCT focusing on trauma-related mental health and substance use among adolescents. METHOD: Participants were 140 adolescents in an RCT of Reducing Risk through Family Therapy. Recruitment followed several recommendations for enhancing diversity. Structured interviews examined trauma exposure, posttraumatic stress disorder (PTSD) and depression symptoms, substance use, service utilization, and demographics. RESULTS: Non-Latinx (NL) Black youth were more likely to receive mental health services for the first time and have greater trauma exposure, but less likely to report symptoms of depression (ps < .05) relative to NL White youth. Relevant caregiver differences included that NL Black caregivers were more likely to be unemployed and looking for work (p < .05) despite having similar levels of education relative to NL White caregivers (p > .05). CONCLUSION: Results suggest that efforts to expand racial/ethnic diversity in an RCT of combined substance use and trauma-focused mental health may also expand other clinical dimensions. Many of these differences reflect multiple dimensions of racism experienced by NL Black families that clinicians must attend to. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A Distinction Without a Difference? A Multi-Method Approach to Understanding PTSD and Depression Symptom Overlap Among Disaster-Exposed Adolescents.

Among adolescents exposed to trauma, posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) commonly co-occur. Despite the prevalence of comorbidity, the question of how PTSD and MDD are related and appropriate conceptual models for understanding their linkage in adolescence remains unclear. This study applies a multi-methodological approach to advance conceptual and theoretical understanding of the overlap between PTSD and MDD diagnoses/symptoms. We tested three methodological approaches with three distinct theoretical underpinnings on the structure of each disorder proposed in the literature: confirmatory factor analysis (CFA) with dimensional constructs, latent class analysis (LCA) with person-based categorical constructs, and network analysis with symptom-to-symptom associations. Across the three different analytical approaches, there was a significant overlap between PTSD and MDD. Overall, there was no compelling evidence for distinct boundaries between disorders among trauma-exposed adolescents. Instead, we found considerable evidence that the typical latent-construct-based conceptualizations, whether categorical or dimensional, may need revision.

Immigrant and U.S.-born migrant farmworkers: Dual paths to discrimination-related health outcomes.

Research with immigrant Latino populations often point to findings that immigrants tend to evidence better health outcomes than nonimmigrants. When exploring differences based on nativity, comparisons often end with just comparing these two groups. Exploring these variables alone may oversimplify the shared and unique paths of risk and resilience between these groups. Experimental research shows that discrimination is often directed toward immigrants, but U.S.-born Latinos report more frequent exposure. We sought to address this by examining two distinct pathways by which discrimination leads to negative health. A sample of 240 Latino migrant farmworkers completed questionnaires regarding immigration-related fears, discrimination, physical and mental health, demographics, and other outcomes. While U.S.-born participants reported similar or worse outcomes across health measures, the pathways to these outcomes appeared to differ between the two groups, with immigration-related fears accounting for substantial portions of these health outcomes, especially in the dual paths with discrimination (p values < .05). Simply comparing Latino groups across U.S. nativity may paper over important differences in how they arrive at those health outcomes, including that immigration-related concerns may exacerbate exposure to and severity of discrimination, which in turn leads to negative health outcomes. On the other hand, discrimination itself may account for numerous negative health outcomes more directly for U.S.-born Latinos. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Refining the Migrant Farmworker Stress Inventory among Latino Migrant Farmworkers in Rural Nebraska.

The Migrant Farmworker Stress Inventory (MFWSI) was developed to measure the distinct stressors faced by migrant farmworkers. The most appropriate measurement and factor structure, however, has been primarily examined with exploratory methods with no studies of confirmatory factor analyses to date. The current study built on prior exploratory factor analytic approaches using the MFWSI by applying confirmatory factor analyses and other tests of validity to better delineate the component parts of migrant farmworker stress that contribute to anxiety and depression. Participants were 241 Latino migrant farmworkers recruited from rural farmworker campsites in Nebraska. Neither of the previously identified factor structures fit the data well initially. Following model respecification, only three factors remained from the original exploratory approaches. These models produced both common and unique factors, which were combined to produce a four-factor model. Results suggest that rural migrant farmworker stress may operate with at least four distinct domains: 1) economic difficulties, 2) immigration and legal status, 3) parenting and child difficulties, and 4) social isolation and related challenges. Finally, only economic difficulties predicted depression and anxiety scores, such that those reporting more stress around economic difficulties reported higher depression and anxiety symptoms. Results point to the need for additional measurement and construct refinement to inform empirical, clinical, policy, and social advocacy work.

Examining recipient and provider perceptions of mental health treatments and written exposure therapy for posttraumatic stress disorder with a Spanish-speaking sample.

Treatments of Posttraumatic Stress Disorder (PTSD) often evidence high rates of dropout, ranging from 25% to 40%, among English-speaking samples. Written Exposure Therapy (WET), a novel manualized treatment for PTSD, evidences lower dropout rates and noninferiority to CPT, one of the most efficacious interventions for PTSD. Spanish-speaking Latinxs often experience greater dropout and barriers to care. WET appears promising for this population, but acceptability and perceived barriers to WET have not been examined among Spanish-speaking Latinxs. The present study assessed perceptions and acceptability of a Spanish-language version of WET among Spanish-speaking Latinxs who scored greater than 45 on the Spanish-language version of the PCL-IV, indicating likely PTSD (n = 20) and providers (n = 12). Participants completed a mixed-methods interview regarding reasons they/clients would not want to receive the treatment, why they/clients would want to receive the treatment, potential solutions for any identified barriers, and reasons for not seeking mental health services generally. Providers, but not potential recipients, identified low literacy as a barrier for WET. Providers and potential recipients identified time as a barrier to WET and other mental health services, but the time reduction was perceived as a potential facilitator of WET. Results also suggest no specific cultural barriers were identified for WET (e.g., provider cultural competency) and that Spanish WET may reduce time-related barriers and is perceived as effective and acceptable among Spanish-speaking Latinxs. Additional work is needed to expand the reach of the intervention, given that mental health services were often perceived as untrustworthy. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Combinatorial Effects of Discrimination, Legal Status Fears, Adverse Childhood Experiences, and Harsh Working Conditions among Latino Migrant Farmworkers: Testing Learned Helplessness Hypotheses.

Migrant farmwork is often characterized by harsh working conditions that carry significant physical and mental health consequences. Using a learned helplessness framework, the current study examined the extent to which discrimination, immigration legal status difficulties, and adverse childhood experiences moderated the effects of harsh working conditions on depression and anxiety. The study also examined the extent to which harsh working conditions mediated the effects of discrimination, immigration legal status difficulties, and adverse childhood experiences on depression and anxiety. Participants were 241 migrant farmworkers recruited in the Midwest. Participants completed interviews consisting of the Migrant Farmworker Stress Index (MFWSI), Adverse Childhood Events scale (ACEs), Everyday Discrimination Scale, the Centers for Epidemiology Scale for Depression (CES-D), and the seven item Generalized Anxiety Disorder scale (GAD-7). Tests of indirect effects suggested, working conditions mediated the effects of ACEs, immigration legal status fears, and discrimination on CES-D and GAD-7 scores (p-values < .05). Higher ACEs and discrimination also appeared to be associated with larger effects of harsh working conditions on depression and anxiety (p-values < .05), while legal status fears did not significantly moderate the effect of harsh working conditions on either outcome (p-values > .05). Likely through different mechanisms, adverse childhood experiences, discrimination and immigration legal status are associated with higher risk of harsh working conditions and subsequently these conditions account for much of the relations between these three stressors with depression and anxiety. Additionally, discrimination and adverse childhood experiences appear to then enhance the effects of working conditions.

El trabajo de agrícolas migrantes se caracteriza por condiciones severas que incrementanel riesgo de enfermedades médicas y de salud mental. Nuestro estudio examinó qué tantola discriminación, el miedo por el estado legal, y las experiencias adversas durante la niñez (ACEs) aumentaron el efecto de condiciones laborales severas en la depresión y ansiedad. El estudio también examinó si las condiciones laborales explican los efectos de discriminación, el miedo del estado legal, y ACEs en la depresión y ansiedad. Participantes eran 241 trabajadores migrantes agrícolas Latinos del medioccidente (midwest) de los Estados Unidos. Participantes completaron entrevistas de Migrant Farmworker Stress Index (MFWSI; una medida de estrés por trabajadores agrícolas), escala de ACEs, Everyday Discrimination Scale (medida de discriminación), Centers for Epidemiology Scale for Depression (CES-D: medida de síntomas de depresión) y Generalized Anxiety Scale (GAD-7; medida de síntomas de ansiedad). Una serie de modelos de ecuaciones estructurales examinaron ACEs, miedo por estado legal y condiciones laborales severas como predictores de CES-D y GAD-7. Pruebas de efectos indirectos indicaron que las condiciones laborales explicaron parte de los efectos de discriminación, ansiedad y miedo por estado legal en la depresión y ansiedad. También, ACEs y discriminación aumentaron los efectos de las condiciones laborales en los síntomas de depresión y ansiedad (p < .05) pero el miedo por el estado legal no cambió estos efectos (p > .05). Probablemente por mecanismos diferentes, ACEs, discriminación y miedo por el estado legal predicen condiciones laborales severas y estas condiciones incrementan el riesgo de síntomas de depresión y ansiedad. Además, la discriminación y ACEs quizás incrementan los efectos de las condiciones laborales.

Más allá de las barreras: Competency and practice considerations in language, cultural, and social issues when delivering group CPT to Hispanic immigrants.

High rates of under-assessed trauma and psychiatric disorders, particularly posttraumatic stress disorder (PTSD) have been reported among Hispanic immigrants, especially as related to immigration trauma. Multiple studies have shown group cognitive processing therapy (CPT) to be an effective evidence-based practice (EBP) for treatment of PTSD across a number of clinical populations. To date, however, no studies have examined important competency and practice issues in linguistic, cultural, and ethical areas that group CPT providers should consider when delivering group CPT to Hispanic immigrants. This paper aims to outline these and provide future directions for research.

Polyvictimization, Related Symptoms, and Familial and Neighborhood Contexts as Longitudinal Mediators of Racial/Ethnic Disparities in Violence Exposure Across Adolescence.

African American and Hispanic adolescent experience more violence exposure relative to White youth. The present study examined the mediating role of posttraumatic stress symptoms (PTSS), delinquency, earlier victimization, and familial and neighborhood factors in disparities in future victimization. The study utilized data from the National Survey of Adolescents-Replication (N = 3,312), which consists of three waves of data collected approximately 1 year apart. A series of path models, tested polyvictimization, PTSS, delinquency, familial socioeconomic factors, and neighborhood safety as mediators of disparities in new polyvictimization. All cross-lagged and autoregressive paths positively predicted past-year polyvictimization and mediated longitudinal disparities. Familial socioeconomic variables and neighborhood safety mediated initial violence exposure disparities. Overall, results indicate that prior violence exposure, related mental health symptoms, and familial and neighborhood factors account for significant portions of disparities in new violence exposure across adolescence.

Pilot Evaluation of a Tablet-Based Application to Improve Quality of Care in Child Mental Health Treatment.

Mental health systems need scalable solutions that can reduce the efficacy-effectiveness gap and improve mental health outcomes in community mental health service settings. Two major challenges to delivery of high-quality care are providers' fidelity to evidence-based treatment models and children's and caregivers' engagement in the treatment process. We developed a novel, tablet-based application designed to enhance via technology the quality of delivery of trauma-focused cognitive-behavioral therapy (TF-CBT). We piloted its use in four community mental health service organizations using a blocked randomized controlled trial to examine the feasibility of implementing tablet-facilitated TF-CBT versus standard TF-CBT with 13 providers and 27 families. Provider fidelity and child engagement in treatment were observationally measured via session audio recording. Parent and child perceptions of the tablet application were assessed using structured interviews and mixed-method analyses. Providers actively and appropriately used tablet TF-CBT to facilitate treatment activities. Providers and families expressed high satisfaction with its use, demonstrating acceptability of this approach. Youth and caregivers in both conditions reported high alliance with their providers. Overall, we found that tablet-facilitated treatment is accepted by providers and families and may be integrated into mental health treatment with minimal training. Further study is needed to examine the extent to which technology-based applications may enhance the reach, quality, and clinical outcomes of mental health treatment delivered to children and families.

Anxiety and Depression During Childhood and Adolescence: Testing Theoretical Models of Continuity and Discontinuity.

The present study sought to clarify the trajectory (i.e., continuous vs. discontinuous) and expression (i.e., homotypic vs. heterotypic) of anxiety and depressive symptoms across childhood and adolescence. We utilized a state-of-the-science analytic approach to simultaneously test theoretical models that describe the development of internalizing symptoms in youth. In a sample of 636 children (53% female; M age = 7.04; SD age = 0.35) self-report measures of anxiety and depression were completed annually by youth through their freshman year of high school. For both anxiety and depression, a piecewise growth curve model provided the best fit for the data, with symptoms decreasing until age 12 (the "developmental knot") and then increasing into early adolescence. The trajectory of anxiety symptoms was best described by a discontinuous homotypic pattern in which childhood anxiety predicted adolescent anxiety. For depression, two distinct pathways were discovered: A discontinuous homotypic pathway in which childhood depression predicted adolescent depression and a discontinuous heterotypic pathway in which childhood anxiety predicted adolescent depression. Analytical, methodological, and clinical implications of these findings are discussed.

The Role of Sex-Related Alcohol Expectancies in Alcohol-Involved Consensual and Nonconsensual Sex Among Women of Asian/Pacific Islander and Women of European Race/Ethnicity.

Alcohol-involved sexual experiences, including incapacitated sexual assault and alcohol-involved sex, are major public health concerns among college women. Further, racial/ethnic diversity among college students is increasing, particularly with regard to increases in college students of Asian/Pacific Islander (API) race/ethnicity. Of relevance, evidence suggests differences in sexual assault rates across ethnicities and cultures; however, no known study to date has examined differences by ethnicity and first language in expectancies and experiences specifically surrounding alcohol and sex. The current study sought to examine differences in incapacitated sexual assault, alcohol-involved sex, and heavy episodic drinking, as well as differences in sex-related alcohol expectancies among native English-speaking college women of European (EU) race/ethnicity, native English-speaking women of API race/ethnicity, and non-native English-speaking women of API race/ethnicity (NNES-API). EU reported higher frequency of heavy episodic drinking, alcohol-involved sex, and incapacitated sexual assault compared to API and NNES-API. In addition, API reported more frequent alcohol-involved sex and incapacitated sexual assault compared to NNES-API, in part due to API's stronger endorsement of sexual disinhibition-related alcohol expectancies (indirect effects: ß = -.04, p = .04, and ß = -.07, p = .04, respectively). Findings highlight the important role of expectancies in acculturation and influence on actual alcohol-involved sex and sexual assault.