Black Clinicians' Perceptions of the Cultural Relevance of Parent-Child Interaction Therapy for Black Families.

Parent-child interaction therapy (PCIT) is a highly efficacious, evidence-based treatment for children with disruptive behaviors and their families. PCIT is a dyadic therapy designed to improve parent-child relationships and decrease children's behavioral problems. PCIT research specific to Black families is currently sparse. Given findings that Black families have a higher attrition rate and demonstrate fewer significant improvements in parental well-being outcomes, we sought to assess clinicians' perceived cultural alignment of PCIT with Black families. We conducted individual interviews via Zoom with 10 Black clinicians, trained in PCIT, who had experience treating Black families using PCIT. The research team generated the following themes using thematic analysis: cultural misalignment, manualization, barriers to treatment, generational patterns of discipline, racial considerations, and protocol changes. Findings indicate that Black clinicians have identified various points of cultural misalignment in providing PCIT with Black families, for which they have modified treatment or suggested changes to improve cultural sensitivity. Collating suggested clinician modifications to inform a cultural adaptation of PCIT for Black families may contribute to a reduction in the attrition rate and improvement in outcomes for Black families participating in PCIT.

Black mothers' ethnic-racial socialization one year after highly publicized anti-Black murders during the pandemic.

Although research on ethnic-racial socialization is well established, limited studies have examined the influence of specific, highly publicized anti-Black murders. We assessed Black mothers' (N = 12, mean age = 37.45) concerns and ethnic-racial socialization with adolescents aged 11-18 years old approximately 1 year following the murders of George Floyd and other unarmed Black people. Researchers generated the following themes using reflexive thematic analysis: protecting adolescents from physical harm; protecting adolescents from psychological harm; parents' emotional distress; and parents' lack of confidence in their ethnic-racial socialization practices. Black mothers exhibit exceptional amounts of strength and courage as they navigate pervasive physical and psychological threats to their adolescents while experiencing worry and low confidence in their ability to socialize their adolescents about anti-Black racism.

"Shouldn't Nobody Make a Woman do What they Don't Want to do with their Body": Black Women's Reactions to the Supreme Court's Overturn of Roe v. Wade.

Black women, particularly those with low-income, are projected to be the most negatively impacted group following the Supreme Court's overturn of Roe v Wade. It is expected that the rate of increase in live births, as well as the rate of maternal mortality, will be steepest for Black women due to high rates of unmet needs for contraception, unintended pregnancies, poverty, barriers to legal abortion access, and systemic racism. Previous research has shown that the legalization of abortion in 1973 significantly improved educational and employment outcomes for Black women, in particular. The current study seeks to assess the perceptions of predominantly under-resourced Black women following the overturning of Roe v Wade. Eighteen Black women participated in one of five focus groups during the summer of 2022 and shared their reactions to the Supreme Court ruling. Using grounded theory, researchers generated the following themes: sexism via forced births, economic implications, and dangers of banned abortions. Based on participants' concerns resulting from the Roe v Wade overturn, policy implications are provided for improving the following systems: safety net, child welfare, and infant and perinatal mental health care.

Implications of built and social environments on the academic success among African American youth: testing Strong African American Families intervention effects on parental academic racial socialization.

Studies exploring widening academic disparities have highlighted the role of racialized school settings, which have given way to incidents of discrimination and unfair treatment for students of color, disproportionately affecting African American youth. Research also shows that family-based preventive interventions may avert negative outcomes for this population through the promotion of protective socialization practices. Consequently, the current study tests the efficacy of a culturally tailored preventive family-based program to foster induced changes in academic promotive parenting practices that prepare youth to advance academically by navigating negative race-related experiences in school settings. Data collected over four time periods from the Strong African American Families (SAAF) efficacy trial (Murry and Brody, 2004) with 667 African American families in rural Georgia were used for this study. Structural equation modeling analyses demonstrated that the SAAF program was associated with positive intervention induced changes in parental academic race-related socialization, which in turn, was indirectly associated with reduced school compromising behaviors through the enhancement of racial pride. While discrimination compromised academic success, our findings highlight the protective nature of racial pride in dissuading academic failure and school dropout through the promotion of academic success. This study confirms that a family-based prevention program holds promise to address academic disparities through the enhancement of parenting and youth protective processes that buffer youth from succumbing to racialized social environments such as schools. Implications for research, educational policy, and preventive interventions are discussed.

"It was Just Good to Have an Outlet for Other Parents to Talk to": Feasibility and Acceptability of Integrating Mental Health and Wellness Services into Predominantly Black Early Childhood Education Centers During the COVID-19 Pandemic.

Racial disparities in mental health care access and quality are associated with higher levels of unmet need for Black parents and families, a population disproportionately affected by the COVID-19 pandemic. Integrating services within early childhood education centers may increase mental health care access for Black families with young children. The current study examined the feasibility, acceptability, and perceived impact of an integrated program offering mental health care for parents, children, and dyads during the pandemic. Black parents (N = 61) completed measures of program satisfaction and perceived benefits of participation, and 47 parents also participated in focus groups further assessing perceptions of the program. Results demonstrated high levels of satisfaction and perceived benefit of the program for parents and children. Themes generated through analysis included: social support, creating a safe space, prioritizing self-care, and sharing parenting strategies. Parents' feedback provides preliminary feasibility and acceptability for the integrated mental health program.

Leveraging the Expertise of the Community: A Case for Expansion of a Peer Workforce in Child, Adolescent, and Family Mental Health.

The rise in child and adolescent mental health concerns has led to the need for an expanded workforce to meet the needs of our nation's families. Peer paraprofessionals (PPs) have proven to be impactful in the areas of adult mental health (MH) and substance use disorders, and for persons with chronic medical conditions. PPs can contribute to addressing child, adolescent, and family MH needs by being deployed in community settings and providing both emotional and tangible support to families and children. Additional use of PPs can address equity gaps in MH services by improving access to support and enhancing the cultural acceptability of MH interventions. A concentrated effort to expand and develop this workforce may help to alleviate the strain on the current MH system. The Georgetown University Infant and Early Childhood Certificate program is a paraprofessional training program that prepares community members to meet the MH needs of families with young children. The authors will describe the results of a qualitative study examining the landscape of peer paraprofessional services in DC that was conducted to support the expansion of the peer workforce to include individuals with expertise in infant and early childhood mental health.

Editorial: Racial Battle Fatigue: The Toll of Policing Black Students.

The current pediatric mental health crisis, recently named by AACAP and the American Academy of Pediatrics (AAP),1 is inextricably linked to school-based policies and practices. Fueled by public fears of crime and violence, "tough on crime" approaches took root in the United States during the 1980s, when school systems became an extension of a national-scale punitive apparatus. Punitive policies (eg, zero-tolerance policies) became a reflex response to disruptive behaviors at school, and police presence within schools increased. Envisioned to deter crime and violence, these policies instead too often criminalized routine, nonviolent misbehaviors, producing an intimate connection between school discipline and incarceration systems,2 often referred to as the "school-to-prison pipeline" disproportionately affecting Black students. In the contemporary context of calls for racial justice, local and state officials are re-examining the impacts of school-based police and strict discipline policies to better understand the potential academic and psychological consequences.

Observed dyadic racial socialization disrupts the association between frequent discriminatory experiences and emotional reactivity among Black adolescents.

Understanding the underlying mechanisms by which racism degrades mental health and the factors that disrupt these mechanisms is paramount. Black adolescents (Mage  = 15.5) and their mothers (Mage  = 44) were observed discussing a hypothetical discriminatory situation and surveyed about their discriminatory experiences (N = 110). Results indicated that adolescents' submissive emotional reactivity (e.g., sadness, embarrassment) in direct response to discrimination, rather than dominant reactivity (e.g., anger, frustration), was the primary mechanism explaining the link between discrimination and internalizing and externalizing symptoms. Maternal advocacy combined with high levels of dyadic warmth and emotion expression reduced girls' submissive reactivity, whereas a more directive "no-nonsense" advocacy approach reduced boys' submissive reactivity. Findings demonstrate how racial socialization can disrupt the pain of discrimination.

Longitudinal study of the cascading effects of racial discrimination on parenting and adjustment among African American youth.

Attachment theory posits that parenting plays akey role in children's attachment and subsequent development. Given the normativity of racial discrimination on everyday life experiences of African American families, there is a need to integrate historical and socio-environmental processes in studies to understand how minoritized parents raise secure and stable children. Results from the current study revealed direct associations between mothers' reports of discrimination and heightened depression and anxiety. Maternal discriminatory experiences were indirectly associated with more negative parenting and compromised parent-child relationship quality, through mothers' psychological functioning. Elevated emotional and behavioral management problems among youth were directly associated with exposure to racial discrimination. Exposure to discrimination during middle childhood facilitated adapted or learned strategies to manage similar situations as youth transitioned into adolescence, with reduced patterns of depressive symptomology. No significant gender effects emerged. Implications for theoretical advancement and future research are provided.

Advancing Antiracism in Community-Based Research Practices in Early Childhood and Family Mental Health.

Structural racism-the ways that institutional policies, practices, and other norms operate to create and sustain race-based inequities1-has historically been foundational to the operations of academic medical centers and research institutions. Since its inception, academic medicine has depended on the exploitation of vulnerable communities to achieve medical, educational, and research goals.2 Research practices have long ignored or taken advantage of the individuals purportedly benefiting from the research, a dynamic most manifestly true for Black, Indigenous, and People of Color (BIPOC) communities in the United States. Reflecting current practices in racial justice work, we intentionally use the term "BIPOC" to highlight shared experiences within racially and ethnically minoritized communities, given the history of White supremacy in the United States. We acknowledge limitations of this term, which collapses myriad unique communities and histories into one construct. Specifically, child and adolescent psychiatry has historically been driven by Eurocentric approaches, paradigms, and methodology. These nonparticipatory dominant research practices have contributed to a lack of culturally responsive interventions for BIPOC communities, a paucity of evidence-based practices with demonstrated effectiveness within BIPOC communities, and disparities in access and quality of care.3 Mental health research involving BIPOC communities has been replete with exploitation and inequality.2.

Editorial: Sharpening Our Focus on Early Adversity, Development, and Resilience Through Cross-National Research.

The impacts of the Adverse Childhood Experiences (ACEs) Study continue to reverberate across medicine, influencing clinical practice, research, and public policy, prompting reexamination of the original ACEs research, and generating a range of new research questions that are critical for understanding health and development across the lifespan.1,2 Within child and adolescent psychiatry, this explosion of interest in childhood trauma and its consequences is generating rich new areas of inquiry: how does adversity become biologically embedded in brain structure and functioning? What familial, environmental, and genetic factors influence resilience and risk? How should we update and adapt the original ACEs framework to account for cultural, ethnic, and geographic differences across populations with various exposures during childhood and distinct ways of experiencing and understanding these exposures? What positive experiences during childhood might have equally profound lifelong health impacts? In this issue of the Journal, Salhi et al.3 present findings from a large cross-national survey of parents of young children to examine their hypotheses that particular household exposures, physical discipline, and lack of cognitive stimulation represent adverse experiences associated with specific developmental outcomes in young children. Like much related research emerging in this area, the present study may provoke more new questions than it answers, and the article sharpens our focus to better understand the developmental science of early adversity and its implications for mental health promotion and clinical care.

Parenting, coparenting, and adolescent adjustment in African American single-mother families: An actor-partner interdependence mediation model.

This study examined family processes on the adjustment of adolescents from single-mother households using a dyadic approach. Participants included 107 noncohabiting Black parental dyads of adolescents aged 12 to 18 years. Each parent completed measures of positive parenting, parent-child relationship quality, parental depressive symptoms, coparenting relationship quality, and adolescent adjustment. Data were analyzed using the actor-partner interdependence model (APIM) and extended mediational model (APIMeM) within a structural equation modeling framework. APIM demonstrated significant actor effects from parent-child relationship quality and parental depressive symptoms to both adolescent externalizing and internalizing problems as well as significant partner effects from parent-child relationship quality to adolescent externalizing problems for both mothers and fathers. Additionally, APIMeM revealed significant indirect actor and partner effects from parent-child relationship quality to externalizing behavior through one's own and one's coparent's coparenting relationship quality for both parents. Indirect actor effects were also observed from positive parenting to externalizing behavior through one's own perception of coparenting relationship quality for both parents. Both APIM and APIMeM models found a significant gender difference for the direct effect from positive parenting to externalizing problems. Specifically, the association was negative for mothers in both models; whereas it was nonsignificant (APIM) and positive (APIMeM) for fathers. This study highlights the unique contributions of mother's and father's parent and coparent factors on one's own, and one's coparent's, perception of adolescent adjustment. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The Relationship of Reflective Functioning to Parent Child Interactions in a Sample of Fathers With Concurrent Intimate Partner Violence Perpetration and Substance Abuse Problems.

This study is the first to examine reflective functioning (RF) and direct parent-child interactions of fathers with concurrent intimate partner violence (IPV) perpetration and substance abuse (SA) problems. Twenty-four fathers, with children between the age of one and seven, completed a structured interview to assess RF, self-report measures of hostile-aggressive parenting behaviors, IPV perpetration severity, SA severity, and a coded play session with their children. Results of three simultaneous multiple regressions revealed that RF in fathers was not associated significantly with observed parenting behaviors. However, fathers' SA severity emerged as a significant predictor for child avoidant behavior and dyadic tension, and fathers' IPV perpetration severity contributed unique variance to child avoidant behavior and dyadic constriction. These results suggest that fathers' SA severity and IPV perpetration behaviors may be more salient factors in predicting their father-child interactions than paternal RF.

Child problem recognition and help-seeking intentions among black and white parents.

Parents play a central role in utilization of mental health services by their children. This study explored the relationship between parents' recognition of child mental health problems and their decisions to seek help. Participants included 251 parents (49% Black, 51% White; 49% fathers, 51% mothers) recruited from community settings. Parents ranged in age from 20 to 66 years old with at least one child between ages 2 and 21. Parents read three vignettes that described a child with an anxiety disorder, ADHD, and no clinically significant diagnosis. Parents completed measures of problem recognition, perception of need, willingness to seek help, and beliefs about causes of mental illness. Findings from Generalized Estimating Equations revealed that parents were more likely to report intentions to seek help when they recognized a problem (odds ratio [OR] = 41.35, p < .001), 95% confidence interval (CI) [14.81, 115.49]; when it was an externalizing problem (OR = 1.85, p < .05), 95% CI [1.14, 3.02]; and when parents were older (OR = 1.04, p < .05), 95% CI [1.01, 1.08]. Predictors of parental problem recognition included perceived need, prior experience with mental illness, and belief in trauma as a cause of mental illness. Predictors of help-seeking intentions included problem recognition, perceived need, externalizing problem type, and being female. Given the relationship between parental problem recognition and willingness to seek help, findings suggest that efforts to address disparities in mental health utilization could focus on problem-specific, gender-sensitive, mutable factors such as helping parents value help-seeking for internalizing as well as externalizing problems.

Observed coparenting and triadic dynamics in African American fragile families at 3 months' postpartum.

This report examines coparenting and triadic interactions in 19 unmarried, first-time African American families as fathers, mothers, and 3-month-old infants navigated the Lausanne Trilogue Play (LTP; E. Fivaz-Depeursinge & A. Corboz-Warnery, ). Parents in 10 of the 19 families reported coresidence at the time of the 3-month assessment, and the other 9 sets of coparents lived apart. All participating families had taken part in a prenatal intervention emphasizing the importance of father engagement in children's lives, and in all families, parents reported episodic to regular father contact with the children at 3 months. Analyses of LTP sessions revealed that 9 of the 19 families exhibited high levels of coparenting solidarity-cooperation and family warmth accompanied by low levels of coparenting competition and disengagement. Among the remaining 10 families, competitiveness (verbal sparring, interference) and/or disengagement (repeated, episodic absenting by one or both parents from the ongoing interaction) signaled strain and challenges to solidarity. Differences between the higher and lower solidarity groups were found in father-reported relationship rapport. However, coresidentiality versus noncoresidentiality of the parents did not distinguish high- from low-solidarity groups. A case analysis of one family's triadic session is presented to elucidate the rich potential for clinical intervention in triadic work with fragile family systems. Implications of the study and its findings for theory, research, and clinical work with unmarried fathers and families, along with limits of the study design and generalizability of findings, are discussed.

Psychometric properties of the Connor-Davidson Resilience Scale 10 among low-income, African American men.

The Connor-Davidson Resilience Scale 10 (CD-RISC 10; Campbell-Sills & Stein, 2007) is a self-report measure of resilience that has been found to provide reliable and valid scores among U.S. and international samples, although its psychometric properties have not been validated among African Americans. This study used confirmatory factor analysis (CFA) and structural equation modeling to examine the psychometric properties of the CD-RISC 10 among a community sample of 127 low-income, African American men. Participants completed measures of resilience, spirituality, and psychological distress. CFA results supported the unidimensional factor structure of the CD-RISC 10. The CD-RISC 10 scores also evidenced construct validity by being related to theoretically relevant constructs (i.e., spirituality and psychological distress). Satisfactory internal consistency score reliability was demonstrated. These results support the validity of the CD-RISC 10 scores in a sample of low-income, African American men.