Measurement invariance of the Grief Facilitation Inventory with respect to youth gender, race, ethnicity, and age.

The Grief Facilitation Inventory (GFI) assesses caregiver grief facilitation behaviors among bereaved youth. Initial analyses supported the GFI's reliability and validity. The purpose of this study was to evaluate measurement invariance of the GFI across gender, race/ethnicity, and age. Participants were 558 clinic-referred youth aged 7-18 (58.8% female; 43.6% Latino(a), 24.9% White, 14.9% Black, 16.6% Multiracial). Multigroup confirmatory factor analyses provided evidence of measurement invariance for ongoing connection, caregiver grief expression, and existential continuity and support-but not grief inhibition/avoidance-across subgroups. Results suggest that ongoing connection, caregiver grief expression, and existential continuity and support are measuring similar constructs, to a similar degree, across demographics, thereby supporting generalizability and clinical utility of these subscales. The grief inhibition/avoidance subscale should be used with caution and interpreted in the context of low reliability for Black, Latino(a), and younger youth, with further research needed to improve conceptualization and measurement of this subscale.

Protective Factors in the Context of Childhood Bereavement: Youth Gratitude, Future Orientation, and Purpose in Life.

The objective of the study was to examine potential associations between positive youth development constructs (gratitude, future orientation, purpose in life) and psychological functioning (posttraumatic stress symptoms, depressive symptoms, maladaptive grief reactions) among bereaved youth and test whether these associations vary by age. A diverse sample of 197 clinic-referred bereaved youth (56.2% female; M = 12.36, SD = 3.18; 36.1% Hispanic, 23.7% White, 20.1% Black, 11.9% Multiracial, and 8.2% another race/ethnicity) completed self-report measures of psychological functioning and positive youth development constructs. Linear regression models indicated that gratitude and purpose were associated with lower posttraumatic stress and depressive symptoms among bereaved youth. Future orientation was associated with higher posttraumatic stress symptoms. Results were consistent across age. If replicated longitudinally, gratitude and purpose may be important protective factors against negative mental health outcomes in the aftermath of losing a loved one.

Caregiver behaviors associated with positive youth development among bereaved children.

Grounded in Multidimensional Grief Theory, this study examined the cross-sectional associations between child-reported caregiver grief facilitation behaviors (ongoing connection, grief expression, existential continuity and support, grief inhibition/avoidance) and positive youth development outcomes (future orientation, gratitude, social responsibility) in treatment-seeking bereaved children ages 7 to 18 (N = 170; 54.1% girls; 35.9% Hispanic/Latinx, 24.9% White, 17.8% Black) from the United States. Results indicate that higher levels of perceived caregiver existential continuity and support (behaviors theorized to promote the continuity of child routines and reassurance of a positive future after experiencing a death) were associated with greater future orientation and social responsibility values among participants. Findings suggest that in the wake of a death, structured and supportive caregiver responses may be related to children's positive outlook on their future and commitment to others.

Validation of the four-item very brief University of California at Los Angeles Posttraumatic Stress Disorder Reaction Index screening tool for children and adolescents.

OBJECTIVE: Experiencing traumatic events places children and adolescents at risk for developing posttraumatic stress disorder (PTSD), often leading to adverse mental health consequences. Although well-validated measures of PTSD are available, very brief screening tools are needed to assess PTSD when resources are limited. This study was conducted to develop and validate the four-item University of California at Los Angeles (UCLA) PTSD Reaction Index for DSM-5-Very Brief Form (RI-5-VBF) to be used in settings requiring rapid and efficient screening. METHOD: Item response theory (IRT) models were used to derive RI-5-VBF scores from the UCLA PTSD Reaction Index for DSM-5 and assess its internal consistency using a sample of 1,785 youth (Mage = 12.32 years, SD = 2.78) seeking support at an academic medical center clinic or bereavement center. Receiver operating characteristic (ROC) analyses and diagnostic efficiency statistics were used to assess discriminant groups validity and screening utility of the RI-5-VBF scores. Differential item functioning (DIF) analyses were used to examine possible bias across age, gender, race, ethnicity, and clinical setting versus bereavement center setting. RESULTS: IRT models identified four items with the highest discrimination within each PTSD subscale. The RI-5-VBF scores exhibited acceptable internal consistency (α = .74). ROC analyses indicated that an RI-5-VBF score of 9 maximized sensitivity and specificity. DIF analyses did not find evidence of bias across age, gender, race, ethnicity, or clinical versus bereavement center settings. CONCLUSION: These findings provide support for the reliability and validity of the RI-5-VBF. Findings highlight the utility of the RI-5-VBF as a brief screening measure for PTSD in children and adolescents. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Identity-based bullying and mental health among Black and Latino youth: The moderating role of emotional suppression.

The current study examined the prevalence of identity-based bullying, the unique links between identity-based bullying and mental health (i.e., depressive and posttraumatic stress symptoms [PTSS]), and emotional suppression as a potential moderator of these links. Participants were 899 clinic-referred Black and Latino youth aged 7-18 years (M = 13.37 years, SD = 2.75, 60.8% female). Regression analyses indicated youth who experienced identity-based bullying victimization reported worse depressive symptoms and PTSS, controlling for co-occurring trauma exposure and demographic characteristics. We did not find evidence that emotional suppression moderated these associations. The findings highlight the potentially traumatic nature of identity-based bullying victimization in treatment-seeking Black and Latino youth and speak to the need for identity-based bullying risk screening.

Developmental Manifestations of Grief in Children and Adolescents: Caregivers as Key Grief Facilitators.

The death of a loved one represents one of the most distressing and potentially traumatic life events in childhood and adolescence. Grief reactions in youth are influenced by ongoing developmental processes and manifest differently depending on the child's age and developmental stage. These grief-related processes unfold within youths' caregiving context, as children and adolescents rely heavily on the adults in their environment to navigate and cope with the death of a loved one. Despite the field's increasing recognition of the potential for maladaptive grief reactions to impede functioning over time, few longitudinal research studies on childhood grief currently exist. In this article, we will (a) provide a brief overview of the childhood bereavement literature; (b) review the new DSM-5 and ICD-11 Prolonged Grief Disorder diagnostic criteria through a developmentally-informed lens; (c) describe how grief reactions manifest in children and adolescents of different ages through the lenses of multidimensional grief theory and relational developmental systems theory; (d) highlight key moderating factors that may influence grief in youth, and (e) discuss a primary moderating factor, the caregiving environment, and the potential mechanisms through which caregivers influence children's grief.

Prevalence and correlates of externalizing behaviors among youth seeking treatment following trauma exposure.

OBJECTIVE: Trauma-exposed youth often experience impairing externalizing problems (EXTs), yet the relationship between EXTs, trauma exposure, and posttraumatic stress symptoms (PTSS) are not well understood. To examine the extent of their co-occurrence, we report the rates and correlates of youth EXTs relative to clinically elevated PTSS in a sample of youth referred to a trauma and grief specialty clinic. METHOD: Self- and caregiver-report measures were obtained from 260 youth ages 7-19 years (M = 11.92, SD = 3.21; 53.5% female) during a pretreatment assessment. The sample was divided into 4 groups according to the youths' PTSS and EXT score elevations, and these groups were then compared according to rates of youth depressive symptoms, youth suicidal ideation, and caregiver strain. RESULTS: The 4 groups were comorbid PTSS and EXTs (18%); EXTs-only group (36%); PTSS-only group (13%), and subclinical symptom group (34%). The comorbid PTSS and EXTs group had the highest scores on all other child and caregiver symptom measures. Compared to the subclinical group, youth in the PTSS-only group had increased depressive symptoms and suicidal ideation, whereas youth in the EXTs-only group had elevated levels of caregiver strain. CONCLUSION: Co-occurring PTSS and EXTs is a common presentation among trauma-exposed youth referred to treatment. These youth are also likely to suffer from other problems of clinical concern, including suicidal ideation, and their problems are associated with caregiver distress. More research is needed to examine unique risk and resiliency factors related to the development of youth EXTs in response to trauma exposure. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Adolescents' developing awareness of inequality: Racial and ethnic differences in trajectories.

To advance knowledge of critical consciousness development, this study examined age-related change in awareness of inequality by race and ethnicity, gender, parent education, generation status, and their interactions. With longitudinal data (2013-2017) from 5019 adolescents in grades 6-12 (55.0% female) from California, Minnesota, and West Virginia, multigroup second-order latent growth curves were estimated for Black (13.7%), Latinx (37.0%), Asian (8.1%), and white (41.3%) youth. Black, Latinx, and Asian adolescents increased awareness of inequality longitudinally; white youth showed no change. Multiracial youth accelerated awareness of inequality in mid-adolescence; changes in race and ethnicity predicted decline, followed by increases. Girls with more educated, immigrant-origin parents started out more aware of inequality. Results signal the need for race-specific and intersectional approaches to studying critical consciousness development.

Assessing the Link between Adolescents' Awareness of Inequality and Civic Engagement across Time and Racial/Ethnic Groups.

Adolescents' awareness of societal inequality has been linked to higher civic engagement. This study expands prior research by testing whether awareness of inequality differentially motivates prosocial and political forms of civic engagement, whether adults' modeling of civic agency moderates links between awareness of inequality and civic engagement, and whether associations differ by race/ethnicity. Longitudinal data came from 3208 youth (Mage = 14.1, Range = 7-20, 56.1% female, 39.7% White, 38.4% Latinx, 12.3% Black, and 6.9% Asian). Across racial/ethnic groups, awareness of societal inequality predicted increased political behaviors and beliefs 2 years later. Adults' modeling of civic agency predicted certain forms of civic engagement but did not moderate links. The findings advance theory and research on the motivating role of awareness of inequality for political beliefs and actions.

Associations between adolescents' prosocial experiences and mental health during the COVID-19 pandemic.

Natural disasters and times of crisis, such as the COVID-19 pandemic, are extremely stressful events, with severe mental health consequences. However, such events also provide opportunities for prosocial support between citizens, which may be related to mental health symptoms and interpersonal needs. We examined adolescents' prosocial experiences as both actors and recipients during the early stages of the COVID-19 pandemic and assessed whether these experiences were associated with indicators of mental health. Adolescents (N = 426; 78% female) aged 13 to 20 years (M age = 16.43, SD = 1.10; 63.6% White, 12.9% Hispanic/Latinx, 8.5% Asian, 4.2% Black, 2.8% Native American) were recruited across the US in early April of 2020. Participants reported on their COVID-19 prosocial experiences (helping others, receiving help) and mental health (depressive symptoms, anxiety symptoms, burdensomeness, belongingness). Multiple regression models indicated greater engagement in COVID-19 prosocial behavior was associated with greater anxiety symptoms and greater burdensomeness. Receiving more COVID-19 help was associated with lower depressive symptoms and higher belongingness. Findings highlight the importance of furthering our understanding of the nuanced connections between prosocial experiences and adolescents' mental health to help inform post-pandemic recovery and relief efforts. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12144-021-02670-y.

Caregiver behaviors and childhood maladaptive grief: Initial validation of the Grief Facilitation Inventory.

The Grief Facilitation Inventory (GFI) is a newly-developed measure of caregiver behaviors theorized to facilitate or hinder children's adaptive grief reactions. We examine its factor structure, reliability, and validity. An exploratory factor analysis identified four factors: Ongoing Connection, Existential Continuity/Support, Caregiver Grief Expression, and Grief Inhibition/Avoidance. Both child- and caregiver-report versions had adequate-to-good internal consistency. The child-report GFI showed evidence of criterion-referenced validity via significant correlations with measures of child maladaptive grief and other psychological symptoms. Results provide preliminary evidence of the reliability, validity, and clinical utility of the GFI as a measure of caregiver grief-facilitation behaviors.

Racial, ethnic, and neighborhood income disparities in childhood posttraumatic stress and grief: Exploring indirect effects through trauma exposure and bereavement.

Previous findings suggest that experiences with systems of oppression that disproportionately affect individuals based on race and neighborhood residency (e.g., systemic racism, neighborhood income disadvantage [NID]) can be associated with higher odds of developing psychological problems following traumatic events. Although race/ethnicity and NID residency are often associated, they are separate concepts that play unique roles in mental health outcomes among youth. Residents of Black, Latinx, and income-disadvantaged communities also have an increased risk of exposure to polyvictimization and the loss of multiple loved ones. Studies have not carefully delineated the potential relations between race/ethnicity and NID residency, polyvictimization, accumulated losses, and trauma and grief outcomes in youth. We examined mediation models to investigate whether polyvictimization, the loss of multiple loved ones, and exposure to violent death were potential mechanisms through which race/ethnicity and NID would predict trauma and grief outcomes in youth. Participants (N = 429) included Black (19.9%), Latinx (36.0%), and White (27.3%) children and adolescents who were assessed through a routine baseline assessment at a trauma and grief outpatient clinic. Black youth reported significantly elevated posttraumatic stress and maladaptive grief symptoms through higher polyvictimization and violent death exposure relative to White youth, ßs = .06-.12, ps <.001. Latinx identity and NID were positively and directly associated with specific domains of maladaptive grief reactions, ßs = .10-.17, ps < .001. If replicated longitudinally, these findings suggest that polyvictimization and violent death exposure may be mechanisms through which Black youth develop more severe traumatic stress and grief reactions.

Civic Development within the Peer Context: Associations between Early Adolescent Social Connectedness and Civic Engagement.

Social connectedness is theorized to contribute to civic development and in turn, civic engagement is thought to cultivate social connectedness. Little research has examined how social connectedness is linked with early adolescent civic engagement. The current study used a social network research design to examine associations between early adolescent social connectedness via their position within their peer network and their civic engagement. Middle-school students (N = 213) aged 11-15 years (M = 12.5; 57% female) were recruited from a remote US community and provided nominations for peer connections and reported on multiple aspects of civic engagement. Early adolescents who had identified more peer nominations had higher civic efficacy. Youth who had fewer connections with different peer groups and fewer connections with popular peers were more engaged in political behavior. Greater popularity was associated with higher political engagement for boys, but not girls. Greater connections with different peer groups was associated with greater environmentalism for younger but not older teens. These findings highlight the need to consider adolescent civic development within the peer context.

Geospatial identification of high youth suicide risk areas via electronic health records: Avenues for research and prevention efforts.

OBJECTIVE: As suicide risk screening becomes more common in healthcare settings, geospatial coding of behavioral health data may offer a means for identifying areas of elevated suicide risk for use in public health prevention efforts. The present study demonstrates an analytic approach for using universal suicide risk screening data to identify areas of elevated suicide risk. METHOD: Data were drawn from standard suicide risk screens recorded in electronic health records of a large pediatric emergency department. A total of 12,400 suicide risk screening responses were recorded, among youth aged 11-19 years (mean = 14.60, SD = 2.16; 57.2% girls, 47.8% Hispanic/Latinx, 72.1% White). A total of 86 unique ZIP codes had at least 50 completed screens, representing 9139 respondents. RESULTS: Rates of positive screens ranged from 6.17% to 31.03% (mean = 18.33, SD = 5.14) for any suicide-related behavior and from 0.0% to 19.61% (mean = 9.14, SD = 3.43) for suicide attempt. Rates of positive screens approximated a normal distribution. CONCLUSIONS: Results demonstrated several areas with elevated rates of positive suicide risk screens, within the hospital catchment area. The proposed method capitalizes on large-scale screening data, provides an estimate of areas of relative increased risk, and may be used to inform public health responses to suicide prevention.

Performance of the interpersonal needs questionnaire in adolescent clinical samples: Confirmatory factor analyses and evaluation of measurement invariance.

OBJECTIVE: This study evaluated the factor structure, internal consistency reliability, construct and criterion validity, and measurement invariance of the Interpersonal Needs Questionnaire (INQ) among adolescents. METHOD: Participants (N = 539) included three distinct samples of youth drawn from two outpatient psychology clinics and an inpatient psychiatric unit. The combined sample was 63.3% female and had a mean age of 14.95 years (SD = 1.31 years). All participants completed the INQ as well as measures of depressive symptoms and suicide ideation. RESULTS: Confirmatory factor analyses indicated that the removal of three items from the thwarted belongingness subscale of the INQ was needed to achieve acceptable model fit. The resulting combined 12-item scale demonstrated good factor structure, internal consistency reliability, construct validity, and criterion validity. The modified 12-item INQ also demonstrated scalar invariance across subgroups defined by sex, race, and age. CONCLUSIONS: Findings support the use of this reduced 12-item version of the INQ among adolescents. Youth may have difficulty accurately responding to changes in item valence; thus, future research with youth should consider using a 12-item version of the INQ that avoids valence changes within subscales.

Initial Validation and Measurement Invariance of the Active Inhibition Scale Among Traumatized and Grieving Youth.

The Active Inhibition Scale (AIS; Ayers, Sandler, & Twohey, 1998) is an 11-item, self-report measure of emotional suppression among children and adolescents. Previous research with the AIS has linked emotional suppression to several clinically significant outcomes, such as posttraumatic stress symptoms (PTSS) and suicide, among trauma-exposed and bereaved youth; however, there are no published evaluations of its psychometric properties. We examined the factor structure and criterion validity of the AIS in two samples. Sample 1 included youth (M = 12.22 years, SD = 2.96, range: 6-18 years; 55.4% female) referred to an outpatient psychology clinic specializing in childhood trauma and grief. Sample 2 included youth (M = 13.18 years, SD = 2.58, range: 8-18 years; 61.8% female) referred to a community grief counseling center. Confirmatory factor analytic results supported a one-factor solution, Cronbach's α = .94. Additionally, AIS scores correlated positively with PTSS, depression, and maladaptive grief, rs = .43-.64. Evidence of factorial invariance was found across gender, race/ethnicity, and age group. Emotional suppression scores were higher among girls compared to boys, Black and Hispanic youth compared to White youth, and older compared to younger age groups. The magnitude of correlations between AIS and symptom measure scores was comparable across groups. These results support the reliability and criterion validity of the AIS with diverse youth populations and underscore the role that emotional suppression may play in explaining group differences in mental health symptoms.

Adolescents' Evaluations of Political Leaders: The Case of President Donald Trump.

The current study explored youths' views of President Donald Trump using quantitative ratings and open-ended responses from a diverse sample of 1,432 U.S. adolescents from three geographic regions. Adolescent demographic characteristics (i.e., gender, race, geographic location) were systematically associated with their views about Trump. Open-ended responses demonstrated substantial variability in youths' rationales for approving or disapproving of the president. Adolescents' attitudes were informed by knowledge of the president's leadership attributes, political views and policies, and their own experiences. Findings indicate that adolescents draw upon and synthesize a broad range of information when formulating their political views and coordinate this knowledge with their own opinions and experiences when evaluating political figures.

Similarities and Differences in Adolescents' Organized and Civic Activity Networks across Rural and Non-Rural Communities.

Youth are often involved in multiple organized and civic activities simultaneously, resulting in complex patterns or "networks" of participation. Little research has examined the network structure of adolescents' organized and civic participation and whether these networks vary across communities. Examining activity networks may help identify specific forms of participation that are more widely and strongly connected with other activities, and may thus provide a gateway for becoming multiply involved. Youth (N= 902; Mage = 15.90; 55.7% female) from a rural (n= 476) and non-rural (n= 426) community completed measures assessing engagement in 25 civic and organized activities. Network analysis indicated that activities in the rural community had greater network density relative to the non-rural community. Volunteering to clean up the neighborhood was most central to both networks. Church attendance and community sports were more central for the rural network, whereas protesting and school arts were more central for the non-rural network. These findings suggest that volunteer activities may serve as a "hub" for organized and civic activity participation and highlight similarities and differences in the co-occurrence of activities across two distinct communities.

The Intersection of Emotional and Sociocognitive Competencies with Civic Engagement in Middle Childhood and Adolescence.

Civic developmental theory anticipates connections between normative developmental competencies and civic engagement, but little previous research has directly studied such links. The current study sought to contribute to civic development theory by examining associations between emotional and sociocognitive competencies (empathy, emotion regulation, prosocial moral reasoning, future-orientation) and civic engagement (volunteering, informal helping, political behaviors and beliefs, environmental behaviors, social responsibility values, civic skills). Data came from a geographically and racially diverse sample of 2467 youth (Mage = 13.4, Range: 8-20 years, 56% female). The results indicated that empathy and future-orientation significantly predicted nearly all forms of civic engagement, whereas emotion regulation and prosocial moral reasoning were uniquely associated with specific forms of civic engagement. Exploratory multi-group models indicated that empathy and emotion regulation were more strongly associated with civic engagement among younger youth and prosocial moral reasoning and future-orientation were more strongly related to civic engagement among older youth. The findings help to advance developmental theory of youth civic engagement.