Referrals to Community and State Agencies to Address Social Determinants of Health for Improving Mental Health, Functioning, and Quality of Care Outcomes for Diverse Adults.

Objectives. To examine whether referral for social determinants of health (SDH) needs decreases psychological distress and posttraumatic stress disorder (PTSD) symptoms and improves level of functioning and quality of care among diverse adults. Methods. Data are from control participants (n = 503 adults) in a randomized controlled trial testing a mental health intervention in North Carolina and Massachusetts. We fitted multilevel mixed-effects models to repeated assessments (baseline, 3, 6, and 12 months) collected between September 2019 and January 2023. Results. After referral to services for trouble paying utility bills, participants reported lower PTSD symptoms. Participants reported better quality of care when receiving referrals to mental health care. After adjusting for income and employment status, we found that participants who were referred more often also had lower PTSD symptoms and better levels of functioning. Conclusions. Referrals for certain SDH needs might decrease PTSD symptoms and improve self-reported quality of care and functioning. However, referrals alone, without ensuring receipt of services, might be insufficient to affect other mental health outcomes. Research is needed on training and providing care managers time for offering interpersonal support, securing services, and understanding agencies' contexts for addressing high SDH needs. (Am J Public Health. 2024;114(S3):S278-S288. https://doi.org/10.2105/AJPH.2023.307442).

Resilience in the Time of COVID-19: Familial Processes, Coping, and Mental Health in Latinx Adolescents.

OBJECTIVE: This study investigated COVID-19 stressors and silver linings, familism values, familial resilience, and coping, and their relation to internalizing symptoms among Latinx youth. METHOD: A community sample of 135 Latinx adolescents completed online surveys 6-months apart (M age = 16, 59.3% female; majority U.S-born). RESULTS: COVID-19 stress was associated with more depressive (ß = .18, p = .027) and anxiety (ß = .21, p = .010) symptoms. However, COVID-19 stress was related to higher levels of depressive and anxiety symptoms only for youth who engaged in low (ß = .38, p < .001; ß = .38, p = .001) and medium (ß = .19, p = .004; ß = .22, p = .011) levels of problem-focused engagement coping. Higher levels of family resilience were associated with lower cross-sectional depressive symptoms (ß = -.28, p = .004). For longitudinal models, a significant relation between COVID-19 stress and problem-focused engagement predicted Time 2 depressive symptoms (ß = -.20, p < .041). CONCLUSION: Latinx youth who experienced high levels of COVID-19 stress who enacted problem-focused coping fared better across the pandemic. Familial resilience did not carry the same longitudinal benefit but did bolster mental health concurrently. Clinicians should endeavor to buttress familial resilience processes in addition to problem-engaged coping for Latinx youth in treatment.

Intermediary processes in Hispanic/Latinx/o youths' coping responses to cultural stressors.

Cultural stressors related to racism, xenophobia, and navigating bicultural contexts can compromise the healthy development of Hispanic/Latinx/o (H/L) youth. Youth' coping can minimize the adverse impact of this stress. Less is known about the intermediary processes related to youths' cultural stressor experiences and coping responses. We analyzed focus group data from H/L youth (N = 45; 50% girls; 0% nonbinary; Mage = 15.3) to hear their voices on how they interpret, react to, are impacted by and cope with cultural stressors. Using a Grounded Theory approach, we constructed four themes of intermediary processes (e.g., meaning making) and four themes of coping (e.g., distancing oneself). Youth actively processed their experiences, which informed their coping choices, pointing to youths' agency and resilience.

Service utilization among adolescents seeking trauma-related care: Differences by risk for suicide and ethnoracial background.

Adolescents from ethnoracially minoritized backgrounds increasingly report high rates of attempted suicide, trauma exposure, and limited access to mental healthcare services. However, less is known regarding their use of services across different youth-serving systems. This study examines the associations and interactions between self-injurious thoughts and behaviors (SITBs), race/ethnicity, and service sector utilization (mental healthcare, general healthcare, school, and social services) among a sample of trauma-exposed and treatment-seeking adolescents. Participants were treatment-seeking adolescents (N = 4406) ages 12-17 from the National Child Traumatic Stress Network Core Data Set who had available data for SITBs, race/ethnicity, services utilized, and other key variables. Mixed effects logistic regression was used to examine main and interactive effects for whether adolescents' race/ethnicity and SITBs were associated with service utilization in each of the identified service sectors. SITBs were associated with adolescents' utilization of mental healthcare (OR = 1.38 p < 0.001), general healthcare (OR = 2.30; p < 0.001), and school services (OR = 1.38 p < 0.001). NH Black adolescents reporting SITBs were less likely to use mental health services than other NH Black youths (OR = 0.53; p = 0.004). Hispanic adolescents reporting SITBs were more likely to utilize healthcare services than other Hispanic youths (OR = 1.51; p = 0.039). Trauma-exposed adolescents reporting SITBs are more likely to utilize mental healthcare, general healthcare, and school-based services than other trauma-exposed adolescents. However, NH Black adolescents experiencing SITBs may face additional barriers to utilizing mental healthcare services. Findings can be used to develop nursing practices and policies to address barriers faced by adolescents reporting SITBs.

It's how I was raised: How ethnic-racial socialization patterns influence antiracism actions in minoritized emerging adults.

OBJECTIVES: Research highlights the benefits of critical action on individual and community well-being; however, more needs to be understood about the ways ethnic-racial socialization (ERS) influences emerging adults' participation in antiracism actions. METHOD: The present study examined patterns of parental ERS messages received by a sample of 668 racially and ethnically minoritized emerging adult college students (Mage = 18.76, SD = 1.23; female = 81.8%), and their associations with the emerging adults' demographic characteristics and three forms of antiracism actions. RESULTS: A latent profile analysis revealed a five-profile solution and showed variability in patterns of parental cultural socialization and preparation for bias messages. Participants in profiles reflecting far higher than average frequencies of both messages (high frequency) and those who received mean preparation for bias and above-average cultural socialization (culturally focused) tended to engage most frequently across all forms of antiracism. CONCLUSIONS: Our findings suggest the importance of parental ERS messages for fostering engagement in antiracism actions among diverse college students. Results are informative for those who work with minoritized emerging adults navigating racist contexts. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Latinx/Hispanic youths' experiences of cultural stressors, emotional reactions, and coping within the family context.

OBJECTIVES: This qualitative investigation examined how Latinx/Hispanic youth experience cultural stressors, emotionally react to, and cope with these stressors within the family context. METHOD: Forty-five youth participated in six focus groups (51% female; 49% male; 0% nonbinary; Mage = 15.26; SD = 0.79). RESULTS: Using reflexive thematic analysis, we constructed two themes with four accompanying subthemes centering on (a) observing family members experience cultural stressors and (b) experiencing cultural stressors together with family members. CONCLUSIONS: Findings highlight the need for cultural stress theory to focus on the family context in Latinx/Hispanic youths' experiences of cultural stressors, their emotional reactions and coping responses to these stressors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Longitudinal links between maternal cultural socialization, peer ethnic-racial discrimination, and ethnic-racial pride in Mexican American youth.

This paper used cross-lagged panel models to test the longitudinal interplay between maternal cultural socialization, peer ethnic-racial discrimination, and ethnic-racial pride across 5th to 11th grade among Mexican American youth (N = 674, Mage  = 10.86; 72% born in the United States; 50% girls; Wave 1 collected 2006-2008). Maternal cultural socialization predicted increases in subsequent youth ethnic-racial pride, and youth ethnic-racial pride prompted greater maternal cultural socialization. However, peer ethnic-racial discrimination was associated with subsequent decreases in ethnic-racial pride. The magnitude of these associations was consistent across 5th to 11th grades suggesting that maternal cultural socialization messages are necessary to maintain ethnic-racial pride across adolescence, thus families must continually support the development of ethnic-racial pride in their youth to counter the effects of discrimination.

Talking through the tough: Identifying facilitating factors to preparation for bias and racial-ethnic discrimination conversations among families from minoritized ethnic-racial groups.

Parent-child conversations about race-related issues serve a protective function for minoritized families and are needed to help children of color thrive in the United States (Hughes et al., Advances in Child Development and Behavior, 51, 2016 and 1). Despite the difficulties that parents experience in having such conversations to prepare youth to cope with discrimination (Priest et al., International Journal of Intercultural Relations, 43, 2014 and 139), parents are actively engaging in these courageous conversations with the aim of protecting their youth. In order to fully understand and support parents having these conversations, our study sought to identify conversation facilitators (i.e., strategies currently being implemented and viewed as successful and/or viewed as potentially helpful) to engage in preparation for bias and racial-ethnic discrimination conversations from the perspective of parents and youth. The current qualitative study draws upon focus group data collected from parents and youth from African American, Chinese American, Mexican American, and Indian American (South Asian) families (N = 138 individuals; 30 focus groups). Reflections were transcribed and coded by a racially and ethnically diverse research team using an inductive thematic analysis approach (Braun & Clarke, Qualitative Research in Psychology, 3, 2006 and 77). Shared and unique facilitators to engaging in preparation for bias and racial-ethnic discrimination conversations were identified across the four racial-ethnic groups. Shared facilitators broadly centered on parent-youth relationship quality, conversation characteristics, and quality, and conversation content and relevance. Unique facilitators broadly centered on communication style and needs and conversation content. Shared and unique facilitators warrant more attention to best support minoritized families. The use of findings in developing interventions to support marginalized parents, youth, and families is addressed.

Making my family proud: The unique contribution of familism pride to the psychological adjustment of Latinx emerging adults.

OBJECTIVES: Familism values serve to provide key cultural scripts in Latinx families, and these values have been associated with positive psychosocial outcomes for Latinx youth (Stein et al., 2014). Yet, how familism values intersect with the experience of positive emotions remains relatively unknown. In particular, familism pride may be an important positive emotion that links familism values to positive psychosocial outcomes. To fill this gap in the literature, the current study developed a measure of familism pride and examined its unique prediction to psychosocial outcomes. METHOD: Self-report survey data were collected from 2 samples of Latinx emerging adults who were part of a psychology subject pool at a comprehensive university in Los Angeles designated as an Hispanic-serving institution. Sample 1 (n = 352) was 72.2% women with a mean age of 18.9 years, whereas Sample 2 was 68.6% women with a mean age of 19.3 years. RESULTS: Factor analyses supported that familism pride was distinct from familism values (familial support, obligation, reference, respeto). Familism pride was associated with fewer depressive symptoms and greater experience of joy when controlling for familism values in both samples. CONCLUSIONS: Our study underscores the importance of examining emotional processes in the study of familism and suggests a new dimension of familism that has not received research attention. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

When Discrimination Hurts: The Longitudinal Impact of Increases in Peer Discrimination on Anxiety and Depressive Symptoms in Mexican-origin Youth.

Life course models of the impact of discrimination on health and mental health outcomes posit that the pernicious effects of discrimination may not be immediate, but instead may become apparent at later stages in development. This study tests whether peer discrimination changes at particular transition points (i.e., transition to middle and high school) predict subsequent internalizing symptoms in Mexican-origin youth. In a sample of 674 Mexican-origin youth (50% female), this study used a latent change score framework to model changes in peer discrimination across time and to test whether changes in peer discrimination at 7th and 9th grades predicted greater depressive and anxiety symptoms in 12th grade controlling for 5th grade symptoms. Irrespective of longitudinal changes, greater peer discrimination in 5th grade predicted greater depressive and anxiety symptoms in 12th grade. Further, significant increases in peer discrimination from 7th to 8th grade and in 9th to 10th grade uniquely predicted greater anxiety symptoms in 12th grade. These findings suggest that longitudinal research on peer discrimination needs to take into account unique periods of risk. Future research implications are discussed.

Coping and Culture: The Protective Effects of Shift-&-Persist and Ethnic-Racial Identity on Depressive Symptoms in Latinx Youth.

Shift-&-persist is a coping strategy that has been shown to lead to positive health outcomes in low-SES youth but has not yet been examined with respect to psychological health. This study tests whether the shift-&-persist coping strategy works in tandem with ethnic-racial identity to protect against depressive symptoms in the face of two uncontrollable stressors: economic hardship and peer discrimination. In a sample of 175 Latinx youth (51.4% female; Mage = 12.9), shift-&-persist buffered the positive relation between economic hardship and depressive symptoms. In terms of peer discrimination, among youth who reported little use of shift and persist, discrimination was related to higher depressive symptoms, whereas youth who reported higher amounts of shift and persist (at and above the mean) were protected and did not evidence this association. However, among youth with high ethnic-racial identity, shift-&-persist failed to protect against the deleterious association between peer discrimination and depressive symptoms. These findings suggest that shift-&-persist is protective for Latinx youth, although the context in which it is protective changes based on the racialized/non-racialized nature of the stressor.

Measurement invariance of the Interpersonal Needs Questionnaire (INQ-15) across sexual orientation, gender identity, and race/ethnicity in a sample of sexual minority young adults.

Sexual minority (e.g., gay, lesbian, bisexual) people are at increased risk for suicidal thoughts and behaviors compared to their heterosexual peers. The interpersonal theory of suicide proposes that perceived burdensomeness and thwarted belongingness are central to the desire to die, and both are associated with suicidal ideation in sexual minority samples. The Interpersonal Needs Questionnaire (INQ) was developed to measure these risk factors and has become the most commonly used measure. However, it is unknown whether the INQ demonstrates similar measurement properties across subgroups of sexual minority people. Therefore, the goal of this study was to examine whether the 15-item version of the INQ exhibited measurement invariance (MI) across sexual orientation (gay/lesbian vs. bi +), gender identity (cisgender men vs. cisgender women vs. transgender/gender diverse individuals), and race/ethnicity (non-Latinx White individuals vs. people of color) in a sample of 792 sexual minority young adults (ages 18-29). A series of multigroup measurement invariance models indicated that the INQ-15 met strict invariance (i.e., equal factor loadings, item intercepts, and residual variances) across all three dimensions of identity. This indicates that it can be used and compared across diverse samples of sexual minority young adults. Results also indicated that perceived burdensomeness was greater for transgender/gender diverse individuals than for cisgender men and women, and that perceived burdensomeness and thwarted belongingness were greater for people of color than for non-Latinx White individuals. In contrast, gay/lesbian and bi + individuals did not differ. Additional research is needed to understand the factors that account for these group differences. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Role of social determinants in anxiety and depression symptoms during COVID-19: A longitudinal study of adults in North Carolina and Massachusetts.

Trajectory studies of the COVID-19 pandemic have described patterns of symptoms over time. Yet, few have examined whether social determinants of health predict the progression of depression and anxiety symptoms during COVID-19 or identified which social determinants worsen symptom trajectories. Using a racially, ethnically, and linguistically diverse sample of adults participating in a randomized clinical trial with pre-existing moderate to severe depression and/or anxiety symptoms, we compare symptom patterns before and during COVID-19; characterize symptom trajectories over a 20-week follow-up period; and evaluate whether social determinants are associated with within- and between- person differences in symptom trajectories. Data were collected before and during COVID-19 in Massachusetts and North Carolina. On average, depression and anxiety symptoms did not seem to worsen during the pandemic compared to pre-pandemic. During COVID-19, anxiety scores at follow-up were higher for participants with baseline food insecurity (vs no food insecurity). Depression scores at follow-up were higher for participants with food insecurity and for those with utilities insecurity (vs no insecurity). Participants with child or family care responsibilities at baseline had depression symptoms decreasing at a slower rate than those without these responsibilities. We discuss the important implications of these findings.

Ethnic differences among adolescents beginning treatment for depression.

This study examines ethnic/racial differences at the start of treatment among participants in the Treatment for Adolescents with Depression Study (TADS). African American and Latino youth were compared to Caucasian youth on symptom presentation and cognitive variables associated with depression. Contrary to hypothesis, there were no significant differences in symptom presentation as measured by the interview-based items of the Children's Depression Rating Scale--Revised (CDRS-R). However, African American and Latino youth were both rated as demonstrating more severe symptoms on the observational items of the CDRS-R compared to Caucasian youth. In terms of cognitive variables associated with depression, African Americans reported fewer negative cognitive biases compared to Caucasians, but cognitive biases were significantly correlated with depression severity across ethnic groups.

Hidden populations: Uncovering the developmental experiences of minoritized populations across contexts.

This introduction to the special section on hidden populations across contexts in developmental science defines what is meant by "hidden populations" and summarizes the studies along thematic lines. Hidden populations are generally minoritized populations embedded in larger systems of oppression and inequality encapsulated within historical time and place, and importantly, they are underrepresented in developmental science. The set of 8 empirical articles discusses how being "hidden" is contextualized and operationalized through explicit and implicit ways and uses multiple methodologies to elucidate the experiences of children, youth, and families. The collection of articles is grounded in developmental and sociocultural developmental theories highlighting important cultural and contextual developmental mechanisms that impact and promote the well-being of hidden populations. Thematically, the set of articles, implicitly and explicitly, addresses minoritization and its consequences as well as elucidates resilience through multiple processes at different levels. Together, the special section advances developmental science by diversifying the populations that are represented to understand normative and culturally and contextually dependent development. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Familism in action in an emerging immigrant community: An examination of indirect effects in early adolescence.

Familism values promote the positive adaptation of Latinx youth, but few studies have examined potential indirect effects associated with these positive effects. In emerging immigrant communities, where fewer resources are available to youth and families to maintain cultural values and ties, familism may be especially important. In this study of 175 primarily second-generation Latinx youth in such a community, we tested whether familism values were indirectly associated with adolescent outcomes through positive parent-child relationships, private racial/ethnic regard, meaning in life, and support seeking coping. Familism values were associated with greater academic motivation. Additionally, there were significant indirect effects in terms of positive parent-child relationships explaining the links between familism and fewer parent-reported externalizing symptoms, and for meaning in life explaining the links between familism and fewer depressive symptoms and greater academic motivation. Familism was also associated with greater support seeking coping, but this was associated with greater depressive symptoms. Our study suggests that in an emerging immigrant community familism values are primarily associated with positive adaptation through distinct mechanisms. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Typologies of discrimination: Latinx youth's experiences in an emerging immigrant community.

Few studies examine how racial-ethnic peer discrimination experiences of Latinx youth vary across the race-ethnicity of the perpetrator. In a sample of 170 Latinx early adolescents (Mage = 12.86 years, range = 10.33-15.23; 51% female), we identified 4 latent profiles of youth: (a) relatively low likelihood of experiencing discrimination regardless of peers' racial-ethnic group (38%; low discrimination); (b) relatively high probability of experiencing discrimination from the majority outgroup peers (33%; outgroup); (c) relatively high likelihood of experiencing discrimination from ingroup peers (14%; ingroup); (d) the highest probability of discrimination experiences across the in- and outgroup (15%; high discrimination group). Overall, Latinx youth classified in a typology characterized by a higher likelihood of experiencing discrimination from both ingroup and outgroup peers also reported the worst internalizing and externalizing symptoms relative to those in the low discrimination typology. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Multicultural Developmental Experiences: Implications for Resilience in Transitional Age Youth.

Transitional age youth were born into a world that is becomingly increasingly diverse. Youth who are ethnic or racial minorities encounter cultural stressors, including acculturative stress and discrimination that undermine their health and mental health. Decades of research demonstrate that cultural assets can serve as risk-reducing and resilience-enhancing mechanisms among minority and immigrant youth. Cultural assets include the development of a healthy ethnic-racial identity and maintenance of cultural values. Practitioners should assess for culturally relevant stressors and incorporate cultural assets such as ethnic-racial identity and cultural values to support the mental health of these youth.

Ethnic differences among substance-abusing adolescents in a treatment dissemination project.

Despite evidence of ethnic differences in substance use patterns among adolescents in community samples, clinical studies have not found ethnic differences in posttreatment outcomes. Prior clinical studies have been limited by small samples, focus on broad treatment modalities, and lack of consideration of important covariates. We investigated ethnic differences in substance use frequency and problems in a large sample of White (60%), African American (12%), and Latino (28%) adolescents prior to and following an evidence-based treatment. Participants included 4,502 adolescents (29% female), with ages 13-18 years, who received Motivational Enhancement Therapy/Cognitive Behavior Therapy 5 Sessions. At baseline, African American adolescents demonstrated less frequent use, fewer problems, and less comorbidity than Whites or Latinos. Consistent with prior research, there were no ethnic differences in substance use outcomes among assessment completers (71%) when controlling for baseline differences. However, African Americans, older adolescents, and males were less likely to complete the posttreatment assessment. Implications for clinical service and effectiveness research are discussed.