Integrating trauma-informed services in out-of-school time programs to mitigate the impact of community gun violence on youth mental health.

Community gun violence disproportionately impacts youth in low-income urban neighborhoods. Integrating trauma-informed mental health care in community-based out-of-school time (OST) programs is an innovative method of service delivery for these youth. This article provides justification for integrating evidence-based, trauma-informed services in OST programs within communities characterized by high rates of violent crime to minimize the impact of violence exposure on youth mental health. We describe the initial feasibility of a model program, the Violence Intervention and Prevention (VIP) Initiative, implemented in a small city in southeastern Pennsylvania. Within the first six months of the VIP Initiative, 95 community residents (90% under age 18; 51% Hispanic) received intervention services, primarily through single-session and short-term weekly group intervention in OST programs, and 80% of OST youth development staff participated in at least one trauma-informed professional development training. Recommendations to enhance and expand the delivery of trauma-informed services in the novel setting of OST programs are provided.

Lower Levels of Classroom Aggression Predict Stronger Relations Between Peer Victimization and Reactive Versus Proactive Aggression.

We examined the concurrent relations of children's reactive and proactive aggression with their experience of peer victimization. Extending previous research, we assessed these relations at both the child and classroom levels. We predicted that reactive aggression would relate positively to peer victimization, proactive aggression would relate negatively to peer victimization, and that these relations would vary with classroom levels of aggression. Participants included 1,291 fourth- and fifth-grade children (681 girls; M age = 10.14 years) and their 72 teachers from 9 schools in one public school district in the Mid-Atlantic United States. Children completed self-report measures of peer victimization and teachers completed measures of aggression for each child in their classrooms. Via two-level regression (level 1 = child; level 2 = classroom), reactive aggression related positively to peer victimization and proactive aggression related negatively to peer victimization. The positive relation between reactive aggression and peer victimization was only significant in classrooms with low levels of reactive aggression. The negative relation between proactive aggression and peer victimization was only significant in classrooms with low levels of proactive aggression. Our hypotheses were supported and offered further evidence for differential relations of reactive and proactive aggression with peer victimization at the child level, while demonstrating the important role of classroom norms for aggression in moderating these relations.

Using Three Reporters to Identify Pre-Adolescent Peer Victims through Latent Profile Analysis.

The goals of the current study were to use a three-reporter methodology and multi-level Latent Profile Analysis: (a) to determine the victim groups that emerge; (b) to evaluate the stability of victim groups over one school year; and (c) to examine differences among victim groups across the adjustment constructs of aggression, depression, anxiety, and negative peer relations. Our sample included 1440 racially/ethnically diverse 4th- and 5th-grade children (Mage = 10.15; 50% female). At the beginning (T1) and end (T2) of the school year, children completed both self and peer reports of victimization, teachers reported on students' victimization, and we collected data from multiple reporters on aggression, depression, anxiety, and negative peer relations. At T1, two groups emerged: non-victims (low across all reporters) and victims (high across all reporters). At T2, four groups emerged: non-victims (low across all reporters), moderate victims (moderate across all reporters), discordant high victims (high on self report, very high on peer report, moderate on teacher report), and concordant high victims (high across all reporters). The stability of victim groups from T1 to T2 was largely driven by non-victims; T1 victims dispersed fairly evenly across the four groups at T2. In term of adjustment, non-victims fared best across time points and adjustment constructs. At T2, the three victim groups increased in maladjustment from moderate victims to discordant high victims to concordant high victims. These findings support the use of three-reporter assessment and a multi-level LPA approach to identify children victimized by their peers.

Evaluating referral, screening, and assessment procedures for middle school trauma/grief-focused treatment groups.

There is a need to delineate best practices for referring, assessing, and retaining students suspected of posttraumatic stress (PTS) and maladaptive grief (MG) in school-based treatment. Evidence-based risk-screening procedures should accurately include students who are appropriate for group treatment and exclude students who do not require treatment or who are better served by other forms of intervention and support. We described and evaluated the sequence of steps used to screen 7th- and 8th-grade students (N = 89) referred by school staff as candidates for an open trial of group-based Trauma and Grief Component Therapy for Adolescents (TGCTA; Saltzman et al., in press). We used t tests to compare included versus excluded students on PTS symptom and MG reaction scores (University of California at Los Angeles Posttraumatic Stress Disorder Reaction Index; Grief Screening Scale) during the group screen, individual interview, and treatment-implementation phases. Logistic regressions tested the incremental utility of including measures of both trauma exposure and related emotional and conduct problems (Strengths and Difficulties Questionnaire) in the screening battery. Results suggest that the group screen helped to detect mental health needs and that the individual interview further identified students with PTS and emotional problems. Conduct problems and trauma exposure predicted attrition among students who qualified for treatment. MG incrementally predicted students who advanced from the group screening to the individual interview, and trauma exposure incrementally predicted attrition from treatment. Findings yield implications for improving research and practice, including procedures for enhancing school-based referral, screening, assessment, and selection procedures. (PsycINFO Database Record

Caregivers' Advice and Children's Bystander Behaviors During Bullying Incidents.

Many bullying prevention programs take a bystander approach, which encourages children to intervene when they are bystanders to bullying incidents. Little is known about how caregivers' advice to children might promote or undermine the positive bystander behaviors targeted by these programs. Accordingly, the aim of the current study was to investigate relations between caregivers' advice and children's bystander behavior during bullying situations. Participants were 106 racially/ethnically diverse 4th- and 5th-grade students (M age = 10.5 years, SD = .71 years), their classmates, and their caregivers. During classroom visits, peers reported on children's bystander behaviors. During home visits, caregivers and children completed a coded interaction task in which caregivers advised children about how to respond to bullying situations at school. Results suggested that (a) bystander intervention was positively predicted by caregivers' advice to help/comfort the victim, (b) bystander passivity was positively predicted by caregivers' advice to not intervene and negatively predicted by caregivers' advice to help/comfort the victim, and (c) bystander reinforcement/assistance of the bully was positively predicted by caregivers' advice not to intervene and not to tell adults. Results support a link between caregivers' advice at home and children's corresponding behavior when they are bystanders to bullying situations at school. These results emphasize the importance of collaboration between families and schools to reduce school bullying. Implications and directions for future research are discussed.

The many facets of mindfulness and the prediction of change following mindfulness-based stress reduction (MBSR).

OBJECTIVES: Mindfulness-based stress reduction (MBSR) promotes numerous psychological benefits, but few studies have identified for whom MBSR is most effective. The current study tested the hypothesis that lower baseline mindfulness invites more "room to grow" and, thus, predicts greater improvement during MBSR. METHOD: We examined three facets of mindfulness (awareness, acceptance, decentering) among 131 MBSR participants prior to enrollment, to test the hypothesis that lower baseline mindfulness predicts greater improvements in perceived stress, positive affect (PA), and negative affect (NA) following MBSR. RESULTS: Lower acceptance and decentering predicted greater decreases in perceived stress. Higher awareness, acceptance, and decentering predicted greater increases in PA. Higher awareness predicted greater reductions in NA. Lower decentering predicted greater reductions in NA. CONCLUSION: Findings partly supported the hypothesis that lower baseline mindfulness predicts greater improvement following MBSR and emphasize the importance of assessing multiple mindfulness facets given their unique, contrasting relations to outcomes.

Teacher factors contributing to dosage of the KiVa anti-bullying program.

The KiVa Anti-Bullying Program (KiVa) seeks to meet the growing need for anti-bullying programming through a school-based, teacher-led intervention for elementary school children. The goals of this study were to examine how intervention dosage impacts outcomes of KiVa and how teacher factors influence dosage. Participants included 74 teachers and 1409 4th- and 5th-grade students in nine elementary schools. Teachers and students completed data collection at the beginning and end of the school year, including measures of bullying and victimization, correlates of victimization (depression, anxiety, peer rejection, withdrawal, and school avoidance), intervention cognitions/emotions (anti-bullying attitudes, and empathy toward victims), bystander behaviors, and teacher factors thought to relate to dosage (self-efficacy for teaching, professional burnout, perceived principal support, expected effectiveness of KiVa, perceived feasibility of KiVa). The dosage of KiVa delivered to classrooms was measured throughout the school year. Results highlight dosage as an important predictor of change in bullying, victimization, correlates of victimization, bystander behavior, and intervention cognitions/emotions. Of the teacher factors, professional burnout uniquely predicted intervention dosage. A comprehensive structural equation model linking professional burnout to dosage and then to child-level outcomes demonstrated good fit. Implications for intervention design and implementation are discussed.

Relations Between Actual Group Norms, Perceived Peer Behavior, and Bystander Children's Intervention to Bullying.

The goals of the study were (a) to predict children's intervention in bullying situations from class-level norms for intervention, as well as child-level perceptions of the number of peers who would intervene, and (b) to determine whether these predictions held when accounting for children's levels of empathy, prosocial behavior, and callous-unemotional traits. Participants were 751 racially and ethnically diverse fourth- and fifth-grade students (53.8% female) in 43 classes. Participants completed peer nominations about which classmates they perceived would intervene during bullying situations. Empathy and callous-unemotional traits were assessed via self report, whereas prosocial behavior was measured through peer report. Using multilevel modeling, each child's intervention in bullying was positively predicted from class-level norms for intervention (class means for the percentage of children who nominated each child as intervening) but negatively predicted from child-level perceptions of the number of peers who would intervene, after accounting for the 3 child traits. Class-level findings support past research on group norms which suggest that children are more likely to display a behavior if their peers display the same behavior. Child-level findings support the presence of the "bystander effect" in children's bullying episodes, in which children are less likely to intervene if they believe that more peers will do so. Thus, although children were more likely to intervene in classrooms with cultures that made intervention more normative, within the context of each class's culture, children were more likely to intervene if they perceived that fewer peers would do so.

Dimensions of distress tolerance and the moderating effects on mindfulness-based stress reduction.

BACKGROUND AND OBJECTIVES: This study examined the relationship between distress tolerance and psychosocial changes among individuals participating in Mindfulness-Based Stress Reduction (MBSR). The objective of the analysis was to discern whether individuals with lower distress tolerance measured before MBSR showed larger reductions in perceived stress following MBSR. DESIGN AND METHODS: Data were collected from a sample of convenience (n = 372) using a quasi-experimental design. Participants completed self-report measures immediately prior to course enrollment and following course completion. RESULTS: Perceived stress, distress tolerance, and mood states showed favorable changes from pre- to post-MBSR in the current study. Baseline distress tolerance significantly moderated reductions on perceived stress, supporting the primary hypothesis that individuals with lower baseline distress tolerance evidenced a greater decline in perceived stress following MBSR. For a one-unit increase on the self-reported baseline Distress Tolerance Scale, reported perceived stress scores decreased by 2.5 units (p < .0001). CONCLUSIONS: The finding that individuals with lower baseline distress tolerance evidenced a greater decline in perceived stress may offer hints about who is most likely to benefit from MBSR and other mindfulness-based treatments. Identifying moderators of treatment outcomes may yield important benefits in matching individuals to treatments that are most likely to work for them.

Narrative Focus Predicts Symptom Change Trajectories in Group Treatment for Traumatized and Bereaved Adolescents.

Growing evidence supports the effectiveness of Trauma and Grief Component Therapy for Adolescents (TGCT-A) in reducing posttraumatic stress disorder (PTSD) symptoms and maladaptive grief (MG) reactions. This pilot study explored whether the specific focus of students' narratives (i.e., focus on trauma vs. focus on loss) as shared by TGCT-A group members would predict initial pretreatment levels, as well as pre- to posttreatment change trajectories, of PTSD symptoms and MG reactions. Thirty-three adolescents from three middle schools completed a 17-week course of group-based TGCT-A. PTSD and MG symptoms were assessed at pretreatment, twice during treatment, and at posttreatment. The focus (trauma vs. loss) of each student's narrative was coded using transcripts of members' narratives as shared within the groups. The reliable change index showed that 61% of students reported reliable pre-post improvement in either PTSD symptoms or MG reactions. Students whose narratives focused on loss both reported higher starting levels and showed steeper rates of decline in MG reactions than students whose narratives focused on trauma. In contrast, students whose narratives focused on trauma reported higher starting levels of PTSD than students who narrated loss experiences. However, narrative focus was not significantly linked to the rate at which PTSD symptoms declined over the course of treatment. This study provides preliminary evidence that TGCT-A treatment components are associated with reduced PTSD symptoms and MG reactions. Loss-focused narratives, in particular, appear to be associated with greater decreases in MG reactions.

Positive communication moderates the relationship between corporal punishment and child depressive symptoms.

BACKGROUND: Findings are few and mixed regarding the moderating influence that supportive parenting might have on the link between corporal punishment and child depressive symptoms. METHOD: A multiple regression model was estimated to examine proposed relationships in a 1-year longitudinal community-recruited sample of 89 children (56% male; 9-12 years). RESULTS: High levels of corporal punishment in tandem with high levels of supportive communication were associated with the highest levels of depressive symptoms. CONCLUSIONS: Although supportive parenting behaviors have been shown to be beneficial for child outcomes, when considering a stress-process framework, simultaneous experiences of harsh and positive parenting may yield more negative outcomes.