Do dimensions of childhood adversity differ in their direct associations with youth psychopathology? A meta-analysis.

Growing evidence supports the unique pathways by which threat and deprivation, two core dimensions of adversity, confer risk for youth psychopathology. However, the extent to which these dimensions differ in their direct associations with youth psychopathology remains unclear. The primary aim of this preregistered meta-analysis was to synthesize the associations between threat, deprivation, internalizing, externalizing, and trauma-specific psychopathology. Because threat is proposed to be directly linked with socioemotional development, we hypothesized that the magnitude of associations between threat and psychopathology would be larger than those with deprivation. We conducted a search for peer-reviewed articles in English using PubMed and PsycINFO databases through August 2022. Studies that assessed both threat and deprivation and used previously validated measures of youth psychopathology were included. One hundred and twenty-seven articles were included in the synthesis (N = 163,767). Results of our three-level meta-analyses indicated that adversity dimension significantly moderated the associations between adversity and psychopathology, such that the magnitude of effects for threat (r's = .21-26) were consistently larger than those for deprivation (r's = .16-.19). These differences were more pronounced when accounting for the threat-deprivation correlation. Additional significant moderators included emotional abuse and youth self-report of adversity. Findings are consistent with the Dimensional Model of Adversity and Psychopathology, with clinical, research, and policy implications.

Ecological-Systems Contributors to Internalizing Symptoms in a US Sample of Adolescents During the COVID-19 Pandemic.

OBJECTIVE: Internalizing problems are common in adolescence and increased substantially during the COVID-19 pandemic. Although rates of anxiety and depression have since improved, the general increase in the prevalence of mental health problems and disruptions to mental health services during the COVID-19 pandemic has resulted in huge gaps in care. Although research has primarily focused on proximal correlates of internalizing problems, a growing literature suggests that factors outside youths' immediate microsystems are equally crucial for their mental well-being. Thus, it is important to investigate multisystemic correlates of internalizing problems to inform individual and community-based interventions to address the current mental health burden. METHOD: Leveraging secondary data from a nationally diverse U.S. sample of 2,954 adolescents (ages 13-16), we examined the associations between factors at multiple levels of youths' ecologies - spanning indicators of threat and deprivation - and their depression and anxiety symptoms during the COVID-19 pandemic. Furthermore, in follow-up exploratory analyses, we examined if these associations differed by adolescents' racial/ethnic groups. RESULTS: Consistent with socioecological models, we found that indicators of threat and deprivation in the adolescents' immediate home and more distal neighborhood environments were associated with depression and anxiety symptoms. The patterns of associations were similar across racial/ethnic groups in multigroup structural equation models. Additionally, we found that mean levels of internalizing symptoms and socioecological predictors significantly differed across racial/ethnic groups. CONCLUSION: These findings have important implications for understanding multi-level contributors to adolescent mental health, which may inform research, practice, and policy.

From plan to practice: A qualitative study of public mental health therapists' session-planning practices.

Therapists must dedicate considerable time to session plan to implement evidence-based practices (EBPs) flexibly and with fidelity. It is unclear whether public mental health settings offer the structural and organizational support for therapists to engage in session planning and, therefore, whether they provide the necessary infrastructure for EBP implementation. In Fall 2022, 18 therapists working in public mental health settings in New York City were recruited through snowball sampling to participate in 90-min semistructured qualitative interviews. Therapists were prompted to review their session-planning practices using a chart-stimulated recall strategy; to describe structural, organizational, and individual barriers and facilitators to session planning; and to generate recommendations to support their session planning. Qualitative data were analyzed using thematic analysis. A diverse group of therapists participated in the study-22% identified as Black; 22% as Asian; and 11% as Hispanic/Latinx. Seventy-eight percent of therapists were social workers; and they had on average 6.18 (SD = 5.70) years of clinical experience. The research team identified four multilevel session-planning barriers and three multilevel session-planning facilitators. Therapists proposed seven multilevel recommendations to support their session planning. Overall, therapists indicated that managing high productivity standards, severe clinical presentations, and clients' social needs often prevent them from having time to plan for sessions. Efforts to implement EBPs in public mental health settings cannot neglect the structural realities faced by agencies, therapists, and clients. Multilevel resources and reforms to support therapists' session planning are necessary. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Exposure to community violence and parenting behaviors: A meta-analytic review.

This meta-analysis examines the association between exposure to community violence and parenting behaviors (i.e., positive parenting, harsh/neglectful parenting, parent-child relationship quality, and behavior control). A systematic search yielded 437 articles that measured community violence exposure before or at the time of parenting, assessed parenting, and were available in English. There were 342 effect sizes across parenting constructs: positive (k = 101; 68 studies), harsh/neglectful (k = 95; 60 studies), relationship quality (k = 68; 41 studies), and behavior control (k = 78; 51 studies), from 160 reports representing 147 distinct studies. Results of the three-level meta-analyses found small but significant effects between community violence and positive parenting (r = -.059, 95% CI [-.086, -.032]; 95% PI [-.268, .151]), harsh/neglectful parenting (r = .133, 95% CI [.100, .166]; 95% PI [-.107, .372]), parent-child relationship quality (r = -.106, 95% CI [-.145, -.067]; 95% PI [-.394, .182]), and behavior control (r = -.047, 95% CI [-.089, -.005]; 95% PI [-.331, .237]). The association between exposure to community violence and harsh/neglectful parenting and behavior control was moderated by the type of exposure to community violence, informant or source of community violence and parenting data, child age, sex, and race/ethnicity. Given the substantial degree of heterogeneity in overall effect sizes, implications for policy and intervention are tentatively considered while emphasizing that more empirical research on the association between community violence and parenting is essential for advancing the field. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Prospective Associations Between Early Childhood Intimate Partner Violence Exposure and Middle Childhood Internalizing and Externalizing Psychopathology.

Co-occurring adversities are common for young children with child protective services (CPS) involvement, with high rates of intimate partner violence (IPV) exposure in this population. Despite extensive research linking childhood IPV exposure to later psychopathology, fewer studies have examined the prospective associations between IPV exposure and psychopathology using a dimensional approach. Here, we conducted secondary analyses of data from a randomized controlled trial of a parenting intervention for CPS-involved children, examining the associations between early childhood IPV exposure (i.e., threat), co-occurring deprivation, and middle childhood internalizing and externalizing symptoms. Adversity variables were coded from data collected when children were infants (N = 249, Mage = 7.97 months) through 48-month assessments; internalizing and externalizing psychopathology were modeled as latent variables reflecting the mean of data from yearly assessments between ages 8 to 10. Results of our structural equation model demonstrated that, accounting for the effects of co-occurring deprivation, IPV exposure was significantly associated with both internalizing, ß = .38, p = .001, and externalizing, ß = .26, p = .019, symptoms. Results suggest links between early childhood IPV exposure (i.e., threat) and later psychopathology. Findings support screening and intervention efforts to mitigate the developmental sequelae of IPV exposure among CPS-involved children.

The impact of co-occurring opioid misuse and PTSD on response inhibition.

BACKGROUND: Posttraumatic Stress Disorder (PTSD) and opioid misuse are commonly co-occurring disorders. Both disorders are associated with deficits in response inhibition; however, these associations have not considered their comorbidity. Response inhibition has not been examined in a sample with comorbid PTSD and opioid misuse. The present study examined the effect of PTSD symptom severity on response inhibition in current and past opioid misusers. METHODS: Participants were currently (used within the last month) misusing opioids (56.6%) or in recovery (43.4%). All participants met DSM 5 criteria for PTSD. Response inhibition was measured with the stop signal task. RESULTS: Response inhibition was associated with increased PTSD symptom severity for those in recovery but not among current users. Additionally, across both groups, there were deficits in response inhibition when withholding automatic responses for a threatening stimulus compared to a neutral stimulus. CONCLUSIONS: PTSD Symptoms may exert a stronger effect on response inhibition among those in recovery as opposed to those who are actively using opioids.

The intervening role of urgency on the association between childhood maltreatment, PTSD, and substance-related problems.

A range of risk factors lead to opioid use and substance-related problems (SRP) including childhood maltreatment, elevated impulsivity, and psychopathology. These constructs are highly interrelated such that childhood maltreatment is associated with elevated impulsivity and trauma-related psychopathology such as posttraumatic stress disorder (PTSD), and impulsivity-particularly urgency-and PTSD are related. Prior work has examined the association between these constructs and substance-related problems independently and it is unclear how these multi-faceted constructs (i.e., maltreatment types and positive and negative urgency) are associated with one another and SRP. The current study used structural equation modeling (SEM) to examine the relations among childhood maltreatment, trait urgency, PTSD symptoms, and SRP in a sample of individuals with a history of opioid use. An initial model that included paths from each type of childhood maltreatment, positive and negative urgency, PTSD and SRP did not fit the data well. A pruned model with excellent fit was identified that suggested emotional abuse, positive urgency, and negative urgency were directly related to PTSD symptoms and only PTSD symptoms were directly related to SRP. Furthermore, significant indirect effects suggested that emotional abuse and negative urgency were related to SRP via PTSD symptom severity. These results suggest that PTSD plays an important role in the severity of SRP.