The Impact of Adverse Childhood Experiences and Community Violence Exposure on a Sample of Anxious, Treatment-Seeking Children.

Screening for adverse childhood experiences (ACEs) can help prevent and reduce adverse outcomes on child development, including increased risk for anxiety disorders. Emerging studies strongly support the inclusion of community-level adversities in ACE screeners to consider diverse contexts and populations. Recent studies suggest that community violence exposure (CVE) may have a distinct impact on youth mental health. Although recent studies have examined the association between ACEs, CVE, and mental health in primary care settings, this association has not been examined on treatment-seeking children in urban mental health settings. The present study employs a mediation model using the PROCESS macro to examine community violence exposure mediating the effect on the association between ACEs and somatic symptoms (SS) on a sample of anxious treatment-seeking children. A total of 98 participants (Mage = 11.7, SD = 3.79, 51.6% males, 54.1% ethnic minority children) who sought services at a specialized anxiety clinic completed self-report measures. Results indicated that exposure to ACEs is associated with endorsement of somatic symptoms as a result of reporting hearing, witnessing, or experiencing CVE. Evidence of mediation was found in a statistically significant indirect effect of ACEs on SS through CREV (Effect = .17, 95% CI = .069-.294). These findings support recent evidence that CVE is a distinct ACE as it contributes to toxic stress similar to individual-level ACEs. The use of a comprehensive ACE screening that includes CVE is warranted, particularly when working with culturally and socioeconomically diverse populations, as it would better capture a broader range of adversities across demographic groups.

THE ASSOCIATION BETWEEN BEHAVIORAL AND ATTITUDINAL ACCULTURATION ON LATINX IMMIGRANTS AND U.S.-BORN LATINXS: A MULTIDIMENSIONAL ACCULTURATION MODEL.

Disparities in access and utilization of substance abuse treatment (SAT) among Latinxs, accentuated by this population's rapid growth, create a public health issue. Although substance abuse literature has given more consideration to environmental factors and social support concerning treatment outcomes, current substance abuse models fail to address important contextual and cultural aspects for Latinxs in recovery, including acculturation. The proposed study aims to test out a multidimensional acculturation model on a sample of 131 Latinxs (Mage= 36.3; SD±10.4, 117 males, 49% immigrants) who recently completed SAT. Specifically, the proposed study employed a conditional process model using the PROCESS Macro for SPSS to examine the association between behavioral acculturation and substance use behavior in the past six months on nativity status at different levels of attitudinal acculturation. Results yielded that, after controlling for age and substance use, higher endorsement of U.S. mainstream cultural practices was associated with a higher frequency of days using alcohol among Latinx immigrants, specifically those reporting high and very high affiliation to the U.S. mainstream culture. Also, a negative association between U.S. mainland-born Latinx and frequency of days using illicit drugs in the past six months was observed, but only among those who endorse very high affiliation of U.S. mainstream culture.

Factors Associated with Community Corrections Involvement among Formerly Incarcerated People in Recovery.

The current study examined whether current community supervision status was associated with differences in demographic characteristics, lifetime substance use patterns, and criminal history among a sample of formerly incarcerated individuals with a history of substance use problems. Results of multivariate analyses revealed participants on community supervision were more likely to have graduated from high school or earned a GED (OR = 1.60; 95% CI [0.15, 17.24]) and were less likely to have a history of psychiatric hospitalization (OR = .88; 95% CI = [0.08, 9.35]). These characteristics may be proxies for social and emotional functioning that influence eligibility for community supervision. Despite these apparent advantages, the community supervision group did not significantly differ from the formerly incarcerated group without current justice involvement on lifetime substance use patterns or criminal history, suggesting formerly incarcerated individuals with substance use disorders may require more intensive interventions to promote existing strengths.

Culturally Grounded Stress Reduction and Suicide Prevention for African American Adolescents.

Suicide is an often-overlooked manifestation of violence among African American youth that has become more prevalent in the last two decades. This article reports on the process used to culturally adapt a cognitive-behavioral coping with stress prevention intervention for African American adolescents. We implemented this adapted school-based suicide prevention intervention with 758 African American 9th, 10th and 11th grade students at four high schools in a large Midwestern city. The findings presented are preliminary. The adolescents in this sample endorsed high levels of suicide risk, with females endorsing significantly more suicide risk than males. Those receiving the prevention intervention evidenced an 86% relative suicide risk reduction, compared to the standard care control participants. The presented model of adaptation and resulting culturally-grounded suicide prevention intervention significantly reduced suicide risk among African American adolescents. Clinical, research and policy implications are discussed.

Parental Monitoring, Association with Externalized Behavior, and Academic Outcomes in Urban African-American Youth: A Moderated Mediation Analysis.

African-American adolescents exposed to neighborhood disadvantage are at increased risk for engaging in problem behavior and academic underachievement. It is critical to identify the mechanisms that reduce problem behavior and promote better academic outcomes in this population. Based on social disorganization and socioecological theories, the current prospective study examined pathways from parental monitoring to academic outcomes via externalizing behavior at different levels of neighborhood disadvantage. A moderated mediation model employing maximum likelihood was conducted on 339 African-American students from 9th to 11th grade (49.3% females) with a mean age of 14.8 years (SD ± 0.35). The results indicated that parental monitoring predicted low externalizing behavior, and low externalizing behavior predicted better academic outcomes after controlling for externalizing behavior in 9th grade, intervention status, and gender. Mediation was supported, as the index of mediation was significant. Conversely, neighborhood disadvantage did not moderate the path from parental monitoring to externalizing behavior. Implications for intervention at both community and individual levels and study limitations are discussed.

Testing a Multidimensional Acculturation Model on Latinos who Completed Substance Abuse Treatment.

Disparities in substance abuse treatment (SAT) utilization and completion suggest that traditional substance abuse models may fall short of addressing the complex needs of Latinos, increasing the odds of relapsing. The need for substance use models that integrate multiple acculturation domains in relation to substance abuse is warranted. The goal of the present study is twofold: a) test a multidimensional acculturation model on Latinos who completed SAT; and b) examine the association between the proposed multidimensional acculturation and days consuming alcohol and illicit drugs in the past six months. A total of 131 participants (Mage=36.15, SD ± 10.5, 86.3% males, 48.1% non-U.S. born with a mean length of stay of 19 years in the U.S. (SD ± 13.71) were interviewed upon completion of SAT. Results from the SEM indicated adequate model fit to the population under study, supporting the use of a multidimensional acculturation approach for this population. Subsequent results from the structured regression analysis suggest that multidimensional acculturation is negatively associated with days using alcohol in the past 6 months. The implications of these findings are discussed.

The Role of Familismo and Acculturation as Moderators of the Association Between Family Conflict and Substance Abuse on Latino Adult Males.

The significant research gap on Latino adults who completed substance abuse treatment (SAT) impacts the provision of substance use prevention and treatment for this population. Given the need for culturally-appropriate SAT for Latinos, research that examines the role of cultural constructs and acculturation in relation to substance use behavior is warranted. The purpose of the present study is to test, based on the social control theory, a multiple moderation model using the PROCESS macro1 to examine the moderating effect of Familismo on the association between history of family conflict and years of substance abuse on Latino males who completed SAT at different levels of acculturation (i.e., cultural orientation). Generational status (i.e., immigrant, U. S. born) and age are used as covariates. A total of 117 Latino male participants (Mage= 37, 54% non-U.S. born with a mean length of stay of 19 years in the U.S.) who completed SAT from facilities located in the metropolitan area of Chicago completed self-report measures. Results from the multiple moderation analysis showa significant three-way interaction (family conflict × Familismo × acculturation), indicating that participants with Latino and bicultural orientation who endorse average to high levels of Familismo have fewer years of substance abuse compared to those with U.S. mainstream culture orientation and low Familismo. Findings illustrate the need for SAT that assesses for family conflict and integrates cultural aspects to reduce substance use behavior on Latino males.

Psychosocial Factors Associated with Substance Abuse and Anxiety on Immigrant and U.S. Born Latinos.

Latinos are exposed to adverse psychosocial factors that impact their health outcomes. Given the heterogeneity and rapid growth of this population, there is an urgent need to understand the mechanisms through which psychosocial factors impact substance abuse and anxiety between immigrant and U.S. born Latino adults. The present study employs a multi-group path analysis using Mplus 7.2 to examine generational differences in the paths between affiliation culture, years of formal education, contact with important people, and length of full-time employment to substance abuse and anxiety in immigrant and U.S. born Latino adults who completed substance abuse treatment. A total of 131 participants (Mage= 36.3, SD ± 10.5, 86.3% males, 48.1% non-U.S. born with a mean length of stay of 19 years in the U.S. (SD ± 13.71) in recovery from substance abuse completed self-report measures. Results from the multi-group path analysis suggest that being more affiliated to the U.S. culture is associated with substance abuse, whereas years of formal education and longer full-time employment is associated with reduced anxiety in the immigrant group. Conversely, frequent contact with important people and affiliation to the U.S. culture are associated with fewer years of substance abuse, whereas longer full-time employment is associated with substance abuse in the U.S. born group. Anxiety and substance abuse was correlated only in the U.S. born group. The implications of these findings are discussed.

Evaluating a bilingual voluntary community-based healthcare organization.

The current study compared traditional recovery homes for individuals with substance use disorders with homes that had been modified to feature culturally congruent communication styles. Findings indicated significant increases in employment income, with the size of the change significantly greater in the culturally modified houses. Significant decreases in alcohol use over time were also found, with larger decreases over time in the traditional recovery homes. Use of prescribed medications and days using drugs significantly decreased over time, but not differentially for those in the two types of recovery homes. The implications of these findings are discussed.