Confirmatory factor analysis of Beck Depression Inventory-II with two American Indian samples.

The Beck Depression Inventory-II (BDI-II) is used to assess depression with people from many cultures and ethnicities; however, the scale has been validated with very few populations other than the majority (Gray et al., 2016). Secondary analysis of data included two-factor confirmatory factor analyses (CFA) of the BDI-II with two independent American Indian samples, which were compared with the results in the BDI-II Manual (Beck et al., 1996). Sample 1 included 527 adult American Indians recruited from seven tribal communities, and Sample 2 included a community sample of 440 American Indian adults. The results of both CFA matched the original factor structure reported in Beck et al. (1996) supporting the construct validity of the BDI-II in Northern Plains American Indians. The internal consistency of the BDI-II was very high in Sample 1 (r = .94) but somewhat lower in Sample 2 (r = .72). Measures of convergent validity and discriminant validity were below acceptability for both Sample 1 and Sample 2. The results of this study support the construct validity of the BDI-II in Northern Plains American Indians. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Diet Quality and Depression in a Cohort of American Indians: The Strong Heart Family Study.

Diet quality has been shown to be inversely associated with depression, but this has not been studied in American Indians (AIs). We examined the prospective association of diet quality and probable depression in a family-based cohort of rural AIs. Using data from the Strong Heart Family Study, we included 1,100 AIs ≥14 years old who were free of probable depression at baseline. We defined probable depression as the presence of moderate or severe depressive symptoms on the Center for Epidemiologic Studies Depression Scale or current use of antidepressant medications. We calculated baseline diet quality from food frequency questionnaires using the Alternative Healthy Eating Index-2010 (AHEI). We used GEE-based multivariate logistic regression to estimate the odds ratio of probable depression at follow up associated with a 10-point higher AHEI score at baseline, adjusted for demographic, psychosocial, and health factors. At follow up, 19% (n = 207) of the sample reported probable depression. Diet quality was not associated with report of probable depression at follow up (OR = 1.16, 95% CI [0.96, 1.39]). Research is needed to examine other temporal dimensions of this relationship and unique aspects of rural AI diets and psychosocial factors that may influence depression.

The three sisters garden: A cultural approach to cultivating American Indian/Alaska Native (AI/AN) psychological service providers.

Less than 300 practicing Native American (NA) psychologists are available to support over 5.2 million American Indian and Alaska Natives (AI/AN) who reside in the U.S., according to the 2010 census (2010; Society of Indian Psychologists [SIP], 2016). The Three Sisters Model represents a training approach for NA behavioral health students to help address the need for culturally competent behavioral health services for individuals living in Indian country. The model utilizes a socially relevant approach including culture, spirituality, and education as key components to successful recruitment, retention, and training of NA behavioral health professionals. By incorporating culturally informed approaches and a culturally inclusive environment, this model provides a supportive, nurturing and affirming approach to help AI/AN students overcome challenges and complete their degrees. Upon completion, students are culturally proficient in skills which can be applied to Native communities in utilizing the Indigenous lens which can be used with tribes in the Midwestern U.S., but with local cultural adaptation it could be used in other regions. The 15 programs of the Three Sisters Model provide the steps for students to manage the completion of the steps (e.g., from high school to college) toward licensure while managing and balancing Western and Indigenous approaches to proficiency of care. The model includes supports to address barriers which have inhibited past AI/AN from reaching education and professional goals. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Psychometric evaluation of the Substance Abuse Subtle Screening Inventory-3 with Northern Plains American Indians.

The efficacy of the Substance Abuse Subtle Screening Inventory-3 (SASSI-3) was assessed among northern plains American Indians (AIs). The current study examined the efficacy of the SASSI-3 for identification of substance abuse in AIs. Northern plains AIs from 7 reservations participated in the study. The participants were either a clinical sample receiving substance abuse (SA) or mental health diagnoses from behavioral health clinicians and receiving outpatient treatment services or a community sample that had no substance abuse or mental health diagnoses and were not currently in treatment (no diagnosis). The internal consistency for Face Valid Alcohol (FVA), Face Valid Other Drugs, and Symptoms (SYM) subscales were excellent, and the consistency for the other subscales was moderate, ranging from .21 to 73. The results of the study suggest that the SASSI-3 has good positive predictive power (PPP) and negative predictive power (NPP), particularly when the criterion group substance abuse is larger in the sample. Additionally, the PPP and NPP varied depending on the decision rules. For the analysis that included individuals with just SA, the clinical group scored significantly higher than the no diagnosis group on all measures of the SASSI-3, except for Defensiveness. When the SA group included all individuals with the diagnosis (regardless of the comorbid diagnosis), the clinical group scored significantly higher than the no diagnosis group for all the SASSI-3 subscales. A discriminant examination of the standardized function coefficients indicated that the FVA and SYM subtests contributed the most to the function. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Suicidal behaviors among American Indian/Alaska Native firefighters: Evidence for the role of painful and provocative events.

Firefighters represent a group at elevated suicide risk. Identifying segments of the fire service at increased risk may facilitate the targeted provision of suicide prevention initiatives. Among the general population, American Indian/Alaska Native (AI/AN) individuals report higher rates of suicide attempts. This study sought to examine suicide attempt rates among AI/AN firefighters and to determine if greater exposure to painful and provocative events and/or fearlessness about death explains the relationship between AI/AN identity and suicidal behaviors. A total of 917 US firefighters completed a web-based mental health survey (6.2% AI/AN). Participants completed a modified version of the Self-Injurious Thoughts and Behaviors Interview-Short Form, the Painful and Provocative Events Scale, and the Acquired Capability for Suicide Scale-Fearlessness About Death scale. Bootstrap mediation analyses were conducted, controlling for years of service as a firefighter. Although AI/AN firefighters accounted for only 6.2% of the sample, they accounted for 34.4% of the career suicide attempts. AI/AN firefighters were 16.31 (95% CI = 7.96, 33.42) times more likely to report a career suicide attempt history than non-AI/AN firefighters, adjusting for years of service as a firefighter. Painful and provocative events, but not fearlessness about death, was a statistically significant mediator of the relationship between AI/AN identity and suicide attempts. Firefighters identifying as AI/AN represent a subgroup within the fire service at increased risk for suicide. Findings suggest that greater exposure to painful and provocative events among AI/AN firefighters may explain the elevated suicide risk among this population.

Wac'inyeya: Hope Among American Indian Youth.

This article examines what gives American Indian youth hope. The project included 56 rural tribal youth in focus groups across a Northern Plains reservation. The participants completed a Youth Personal Balance Tool to provide perspective on the balance according to a medicine wheel model of their lives. The focus groups asked questions from a strengths-based perspective about what gives them hope and how they could show others they were hopeful. The project culminated with the youth developing creative representations of hope and presenting these projects to family and community.

Psychometric evaluation of depression measures with Northern Plains Indians.

Numerous psychometric measurements are used to assess for mental health problems in Native American and Alaskan Native (AI/AN) populations; however, few studies have been carried out to assess their validity and reliability within these populations. This study was designed to assess the validity and reliability of numerous measures among the Northern Plains Indians. This article is a partial report, focused on the psychometric measures directed at detecting depression, namely the Beck Depression Inventory (BDI) II, the Center for Epidemiologic Studies Depression (CES-D) Scale, the Tri-Ethnic Depression Scale (TEDS), the Beck Hopelessness Scale (BHS), the Beck Anxiety Inventory (BAI), and the Symptom Checklist-90-Revised (SCL-90-R). Results revealed moderate to strong correlation across all measures, alpha coefficients that exceeded published alphas for the general population, and overall indicated their validity and reliability of these measures, and a 2-factor solution for the BDI-II. While there were limitations to the study, analysis of the results supports the use of each measure with the Northern Plains Indians (NPI) subpopulation, that the NPI subpopulation scored similar to the general population. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Assessment of anxiety among Northern Plains Indians.

This study is an examination of the reliability and validity of the Beck Anxiety Inventory (BAI; Beck, Epstein, Brown, & Steer, 1988) in a sample of NPIs (N = 529). Validity was assessed by comparing BAI scores among 3 different diagnostic categories in a clinical sample (anxiety disorder, mood disorder, and comorbid anxiety/mood disorder diagnostic groups) and a community sample of participants with no self-reported mental health diagnoses. The BAI was also compared with depression, quality of life, and anxiety measures to assess validity. Support toward the validity of the BAI was demonstrated through high correlations with similar measures of anxiety, as well as higher scores among the clinical samples compared to the control sample. The BAI also demonstrated strong internal consistency (α = .95). An exploratory factor analysis indicated the presence of 3 factors: (a) fear, (b) cardiorespiratory, and (c) body instability symptoms. The BAI was unable to accurately differentiate between mood disorder and anxiety disorder groups. Results of this study indicate that the BAI may be a useful instrument in the assessment of anxiety with NPIs; however, the BAI is potentially unsuited to differentiating between mood disorders and anxiety disorders with this population. (PsycINFO Database Record

Growing our own: building a native research team.

In 2006, American Indian/Alaska Natives (AI/AN) made up less than 1% of the science, engineering and health doctorates in the U.S. Early introduction of AI/AN students to research and continued opportunities are necessary to develop successful AI/AN researchers who can better serve their communities. This team was developed to form a cohort of American Indian students, staff and faculty interested in research and becoming researchers. Since implementation, the program grew from one student to over 20 AI students ranging from freshmen just entering college to doctoral students working to complete their dissertations. This article highlights the team growth, increasing structure, student needs and the faculty and staff involved. It further addresses the support and educational aspects of growing an ongoing, multidisciplinary research team committed to ethical research in Native communities. The team addresses substance use prevalence, the relationship of substance abuse to other mental health diagnoses, and treatment issues. The team includes weekly team meetings, a Blackboard site on the Internet that is populated with resources and focused on sharing materials and information, a weekly journal club discussion of research articles, and collaborative discussions on each project and the barriers and challenges that need to be addressed to move forward.

Circle of strength: a case description of culturally integrated suicide prevention.

This article presents a case description of an American Indian female at high risk for suicide in effort to document the potential effectiveness of a college student suicide prevention program designed for Northern Plains American Indian students. The program is integrative and culturally grounded within the Medicine Wheel, stressing continuity of care through programming and ongoing communication across support systems. The composite case description presented illustrates the secondary prevention aspects of the model, and how utilizing the model within the framework of continuous care was helpful for a suicidal person and produced a successful outcome over the course of 6 months.

Health risks in American Indian adolescents: a descriptive study of a rural, non-reservation sample.

OBJECTIVE: To identify health risks among a rural, non-reservation group of American Indian adolescents. METHODS: A non-reservation sample of 243 American Indian students from a total sample of 1,815 students in a southwestern state completed health-risk screenings in the public schools. The students were between 14 and 18 years of age and in grades 9 through 12. Archival survey data were analyzed by age, gender, and race. RESULTS: Student reports of health-risk behaviors in the areas of physical health, substance use, emotional health, risk of injury, perceived grades, and academic expectations were examined. The majority of study participants reported average or below levels of health risks. CONCLUSIONS: Non-reservation American Indian students have average or better health habits and expect to continue their educations beyond high school. There are some differences by gender and age.