Associations of School Diversity with Students' Race-based Victimization and School Connectedness: A Combined Influence of Student and Teacher Racial/Ethnic Diversity and Socioeconomic Diversity.

School diversity has been shown to be associated with students' school experiences. However, most studies have focused solely on student racial/ethnic diversity, in spite of the multifaceted nature of diversity. This study assessed how the combined influence of student and teacher racial/ethnic diversity and socioeconomic diversity were related to race-based victimization, school connectedness, and racial/ethnic disparities of these outcomes. The participants were Asian, Black, Latinx, and White students (n = 100,408; 46.2-53.5% female) in Grade 7 to Grade 12 attending 278 public schools in California. The participating schools' diversity contexts were categorized into four latent profiles differentiated by varying levels of student and teacher racial/ethnic diversity and socioeconomic diversity. Race-based victimization was the least prevalent in schools with low student racial/ethnic diversity, low socioeconomic diversity, and moderate teacher racial/ethnic diversity. The magnitude of racial/ethnic disparities in race-based victimization differed across the four latent profiles; racial/ethnic disparities were minimal when there were similar numbers of students in each racial/ethnic group. School diversity's relation with school connectedness was minimal. White students perceived higher school connectedness than other racial/ethnic groups across profiles, but the White-Latinx gap was smaller in profiles with schools having a homogeneous Latinx student population. The findings underline the importance of understanding school diversity's interaction with students' characteristics, particularly racial/ethnic identity, on students' school experiences.

Ten frequently asked questions about latent transition analysis.

Latent transition analysis (LTA), also referred to as latent Markov modeling, is an extension of latent class/profile analysis (LCA/LPA) used to model the interrelations of multiple latent class variables. LTA methods have become increasingly accessible and in-turn are being utilized in applied research. The current article provides an introduction to LTA by answering 10 questions commonly asked by applied researchers. Topics discussed include: (1) an overview of LTA; (2) a comparison of LTA to other longitudinal models; (3) software used to run LTA; (4) sample size suggestions; (5) modeling steps in LTA; (6) measurement invariance; (7) the inclusion of auxiliary variables; (8) interpreting results of an LTA; (9) the nature of data (e.g., longitudinal, cross-sectional); and (10) extensions of LTA. An applied example of LTA is included to help understand how to build an LTA and interpret results. Finally, the article suggests future areas of research for LTA. This article provides an overview of LTA, highlighting key decisions researchers need to make to navigate and implement an LTA analysis from start to finish. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Extending Validation of a Social Emotional Health Measure For Middle School Students.

The Social Emotional Health Survey-Secondary-2020 (SEHS-S-2020) is a well-studied option for assessing social emotional health to support students within a multitiered system of school support. While a growing body of literature supports the SEHS-S-2020 measure for assessing student covitality, there is less validation evidence specifically for middle-school-aged students. The present study aimed to fill this gap in the literature by examining its use for younger adolescents. Study participants were from two samples, including a cross-sectional sample with 9,426 students in Grades 7-8 from 32 counties in California and a longitudinal sample with 414 students in Grades 6-8 from two middle schools. Data analyses examined structural validity, internal consistency, measurement invariance, criterion validity, predictive validity, and response stability. Results indicate excellent fit indices for a four-level higher-order measurement model, with adequate concurrent and one-year predictive validity coefficients, supporting the use of the SEHS-S-2020 measure with young adolescents in middle school settings. The discussion focuses on implications for assessing students' psychosocial assets, universal school-based screening, and cultural and intersectionality considerations when interpreting SEHS-S-2020 responses. Supplementary Information: The online version contains supplementary material available at 10.1007/s40688-022-00411-x.

Child Maltreatment Prevention Service Cases are Significantly Reduced During the COVID-19 Pandemic: A Longitudinal Investigation Into Unintended Consequences of Quarantine.

Unprecedented financial and emotional stress, paired with measures to slow the spread of COVID-19 (e.g., school closures), place youth at risk for experiencing increased rates of abuse. We analyzed data from New York City's Administration for Children's Services to investigate the frequency of child maltreatment prevention service case openings during this time. Longitudinal counts of case openings were compiled for January through June of the years 2014-2020. An independent samples Kruskal-Wallis H-test suggested that pre-quarantine case openings were significantly larger than case openings during quarantine. To account for the possible influence of other historical events impacting data, a secondary Kruskal-Wallis H-test was conducted comparing only the 4 months of quarantine data available to the 4 months immediately preceding quarantine orders. The second independent samples Kruskal-Wallis H-test again suggested that pre-quarantine case openings were significantly larger than case openings during quarantine. A Poisson regression model further supported these findings, estimating that the odds of opening a new child maltreatment prevention case during quarantine declined by 49.17%. These findings highlight the severity of COVID-19 impacts on child maltreatment services and the gap between demand for services and service accessibility. We conclude with recommendations for local governments, community members, and practitioners.

Social support profiles associations with adolescents' psychological and academic functioning.

Social support is empirically linked to improved adolescent psychological and academic functioning. This study explored typologies characterized by family, peer, and school support among students in early (Grade 7; n = 27,399) and late (Grade 11; n = 27,984) adolescence. We assessed how each latent profile related to key aspects of psychological and academic functioning and the moderation of gender in these associations. Three convergent profiles (i.e., High, Moderate, and Low Support) and two divergent profiles (i.e., Minimum Peer Support and Minimum Family Support) were found in both grade levels, with psychological and academic functioning differentiated by the profiles. The Minimum Peer Support and Minimum Family Support profiles showed the lowest functioning in all domains across grade levels. The High Support profile showed the highest psychological health and academic performance. Gender moderation was observed in the associations between social support profiles and psychological functioning and was more prominent among 7th graders than 11th graders. Findings suggest that social support's impact is determined by combinations of various support sources, age, and gender. The social support profiles and their associations with students' characteristics and outcomes may inform practitioners in supporting vulnerable groups and planning interventions.

Heterogeneity Among Moderate Mental Health Students on the Mental Health Continuum-Short Form (MHC-SF).

Measures of positive well-being are needed to support the shift away from a deficit-based approach to mental health. This study examined one measure, the Mental Health Continuum-Short Form (MHC-SF), as a measure of positive well-being used in school-based mental health monitoring efforts. This study used latent profile analysis (LPA) to explore the mental health classifications of 10,880 California high school students' responses to MHC-SF emotional, psychological, and social well-being items. Five latent mental wellness profiles emerged, including two ordered profiles (i.e., High Well-Being and Low Well-Being) and three profiles spanning the two ordered profiles. The High Well-Being profile had the most favorable psychological adjustment, and the three moderate well-being range profiles had differentiated functioning. Informing the utility of the MHC-SF, this study also compared the MHC-SF categorical diagnostic criteria with the LPA's empirical classification approach and found the two classification approaches to be congruent. The findings provide an impetus for educators to attend to students in moderate well-being ranges and emphasize promoting positive mental well-being as an essential component of school-based mental health services.

Elementary school teacher well-being and supportive measures amid COVID-19: An exploratory study.

As frontline education providers, teachers have encountered many challenges since the outbreak of the COVID-19 pandemic. To better understand teacher well-being during this crisis and inform practices to support them, this study employed an online survey with a mixed-methods approach to assess teacher well-being and the support they need to work effectively. A sample of 151 elementary school teachers in the United States was recruited in summer 2020 to complete an online survey through emails and social media outlets. Participants were asked to provide retrospective reports of their experiences teaching in spring 2020 after schools closed due to COVID-19. The majority of participants reported feeling emotionally exhausted and high levels of task stress and job ambiguity. Consistent with hypotheses, path analysis testing a model informed by the job demand-resources framework indicated that task stress and job ambiguity were robustly related to teacher well-being. Moreover, three job resources (i.e., teaching efficacy, school connectedness, and teaching autonomy) were related to job satisfaction. A moderation finding revealed that teachers who reported high teaching efficacy felt emotionally exhausted when they were unclear of their job duties. Thematic analysis of responses to an open-ended question found that teachers would feel supported if provided resources to develop competence in distance learning, workplace emotional support, and flexibility during COVID-19. The findings identified a critical need to allocate more attention and resources to support teacher psychological health by strengthening emotional support, autonomy, and teaching efficacy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Individual Differences in Patterns of Community Violence Exposure and Internalizing and Externalizing Behaviors.

Youth community violence has been linked with depressive and anxious symptoms, and aggressive behavior; however, little research has examined different combinations of emotional and behavioral adjustment among community-violence-exposed youth, or individual characteristics that may account for different patterns of emotional and behavioral adjustment in community-violence-exposed youth. This research used person-centered methods to examine how gender, temperament characteristics, and prior exposure to community violence were linked with classes of community violence exposure and internalizing and externalizing adjustment among a sample of urban African American youth. Participants were 464 African American adolescents (46.7% female; mean age = 14.83, SD = .43) who reported their community violence exposure in Grade 9 and for whom reports of depressive and anxious symptoms, and aggressive behavior were available. Latent class analysis identified four classes of adolescents distinguished by their exposure to community violence exposure and internalizing and externalizing behavior. The two classes with high community violence exposure were characterized by internalizing symptoms or aggressive behavior; the two classes with low community violence exposure had low internalizing symptoms with moderate aggression or had all moderate symptoms. These community violence adjustment classes were distinguished by gender, history of community violence exposure, behavioral inhibition, and fight-flight-freeze systems. Findings highlight heterogeneity in internalizing and externalizing responses of community-violence-exposed youth and suggest factors that explain community violence exposure, repeat exposure, and responses to community violence exposure.

Syndemic behavioral risk and suicidality among bisexual adolescents: A latent class analysis.

OBJECTIVE: We explored the internal structure of within-group variation in the syndemic construct among bisexual adolescents, an understudied and highly vulnerable population known to experience health disparities compared with monosexuals (those attracted to a single gender). We sought to identify patterns of co-occurrence among three domains of high priority behavioral risks-sexual risk factors, substance use, and victimization-and their implications for suicidality. METHOD: We used a national sample of 1,053 ethnically/racially diverse, high school age bisexual adolescents drawn from the 2015 Youth Risk Behavior Surveillance System (YRBSS). We applied latent class analysis (LCA) to 15 indicators measuring the three aforementioned domains and modeled predictors and an outcome of class membership. RESULTS: Within-group variation in the syndemic construct appears categorical, systematic, and comprised of Low Risk (38%), Alcohol Use (20%), Peer-victimization (14%), Sexually Active (11%), Syndemic (11%), and Risk-taking (7%) classes. Classes were well-separated per classification statistics. The proportions of bisexual identification, sex, and race varied significantly across classes. Syndemic and Peer-victimization classes were equivalent and elevated in their suicidality risk, out of all classes. CONCLUSIONS: Results revealed multiple and diverging forms of conjoint behavioral risk that conferred differential health implications; illuminated the shape and functional form of the syndemic construct among bisexual adolescents; and illustrated the utility of LCA for classifying typologies of risky and normative health behavior patterns. Psychologists are recommended to carefully consider the comorbidly operant nature of behavioral risks in this population. Future directions include addressing replication, multiple-group invariance, additional auxiliary variables, and alternative mixture techniques. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Mental Health Attribution for Mexican-Origin Latinx and Non-Latinx Older Adults: A Latent Class Analysis.

BACKGROUND AND OBJECTIVES: Providing appropriate and culturally sensitive care to the rapidly growing number of U.S. Latinx older adults with psychiatric conditions presents a major public health challenge. We know little about older Latinx adults' perceived causes of mental health problems, offering clinicians limited insight to guide successful and culturally congruent treatment. Moreover, there is a paucity of mental health research examining heterogeneity in how Latinx individuals may attribute mental health symptoms. The present study sought to identify how Latinx and non-Latinx older adults attributed the sources of their mental health problems and how these types of attributions differ by ethnicity. RESEARCH DESIGN AND METHODS: This study analyzed data collected from a retrospective chart review and survey of 673 adults aged 55-95 years (430 Mexican origin and 244 non-Latinx) from a rural psychiatric outpatient clinic near the California-Mexico border. We conducted stratified latent class analysis (LCA) by race/ethnicity to explore the mental health attribution beliefs of Mexican-origin and non-Latinx clinic patients. RESULTS: Different LCA patterns for Mexican-origin Latinx versus non-Latinx groups were found. For non-Latinx adults, there was a class of individuals who attributed their mental health issues to social and financial problems. For Mexican-origin adults, there was a class of individuals who attributed their mental health issues to spiritual and/or supernatural factors, unaffected by acculturation level, depressive symptom severity, and time spent in the United States, but differing by gender. We found within-group heterogeneity: Not all Mexican-origin or non-Latinx older adults were alike in how they conceptualized their mental health. DISCUSSION AND IMPLICATIONS: Mexican-origin Latinx and non-Latinx older adults attributed their mental health issues to different causes. More Mexican-origin older adults attributed their symptoms to spiritual causes, even after controlling for contextual factors. Further research is needed to determine whether attribution beliefs are affected by specific mental health diagnoses and other cultural factors not measured in this study.

Co-Occurring Youth Profiles of Adverse Childhood Experiences and Protective Factors: Associations with Health, Resilience, and Racial Disparities.

It is important to understand racial/ethnic differences in adverse childhood experiences (ACEs), given their relationship to long-term physical and mental health, and the public health cost of the significant disparities that exist. Moreover, in order to inform interventions and promote resilience, it is critical to examine protective factors that mitigate the relationship between adversity and poor health. The current study utilized latent transition analyses (LTA) to examine co-occurring profiles of ACEs and protective factors (from school, family, and community contexts) and links to health outcomes among 30,668 Black (10.4%), Latinx (12.3%), and White youth (77.3%) ages 12-17 (52.5% male) who participated in the 2011-12 National Survey of Children's Health (NSCH). Results suggested that greater adversity was associated with worse health, while more access to protective factors was associated with better health. White youth had consistently lower endorsement of ACEs, greater access to protective factors, and better health compared to their Black and Latinx counterparts. Efforts to improve child health and racial/ethnic disparities in research and practice must consider adversity, protective factors, and the systemic inequities faced by racial/ethnic minority youth in the United States.

The influence of flood exposure and subsequent stressors on youth social-emotional health.

Most disaster mental health research focuses on the relationship between disaster exposure and distress, often neglecting its influence on social-emotional health, despite implications for resilience and well-being after the disaster. Following multiple floods in Texas, a sample of 486 youth aged 10-19 years old (M = 13.74 years, SD = 2.57; 52.9% male) completed measures of disaster exposure, life stressors since the disaster, and social-emotional health. Using mixture regression modeling, we examined differences in the relationship between life stressors and social-emotional health across latent classes of disaster exposure (high, moderate, community, and low exposure). After accounting for mean levels of life stressors, the mean levels of social-emotional health did not differ across exposure classes; however, the strength of the relationship between life stressors and social-emotional health did. Youth in the high exposure group had the highest mean level of life stressors since the disaster. Thus, each additional life stressor did not result in changes in social-emotional health, suggesting saturated stress levels. For youth in the moderate and community exposure classes, increases in life stressors did lower social-emotional health, perhaps pushing them into stress overload. For the low exposure group, life stressors did not have an influence. This has implications for postdisaster mental health screening and support, tailored by levels of exposure and attuned to ongoing stressors that may impact long-term social-emotional health. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

An Empirical Approach to Complete Mental Health Classification in Adolescents.

Using latent profile analysis (LPA), this study empirically identified dual-factor mental health subtypes, with a goal of examining structural stability of emerging latent classes over three high school years. Profiles' relations with distal indicators of well-being, psychosocial distress, and self-reported grades were examined to explore the validity of emerging classes. A sample of 332 high school students reported on their social-emotional strengths and psychological distress during the fall term of their ninth-, tenth-, and eleventh-grade years. In Grade 12, students reported on measures assessing their grades and social-emotional experiences. Independent LPAs for each grade year yielded four mental health subtypes - complete mental health, moderately mentally healthy, symptomatic but content, and troubled - and provided evidence for the structural stability of the dual-factor mental health construct. Across high school years, most students were in the complete or moderately mentally healthy classes, with the troubled class consistently representing the smallest proportion of the sample. Students in classes with higher levels of strengths and lower levels of distress reported higher grades, prosocial contribution to community, and higher life satisfaction, and fewer symptoms of anxiety and depression. Implications and future directions for research and school-based practice are discussed.

Correction to: A Latent Profile Analysis of Bisexual Identity: Evidence of Within-Group Diversity.

This article has been corrected with the following revisions for errors unaddressed in the copy editing process. All of the revisions herein were technical in nature and did not substantively change any aspect of the content of the article, including main arguments and findings. The first author appreciates the understanding of the readers.

Patterns of Family, School, and Community Promotive Factors and Health Disparities Among Youth: Implications for Prevention Science.

Increasing knowledge of factors that promote health among youth from diverse backgrounds is an important step towards addressing health disparities. Although many promotive factors have been identified individually, there is an overabundance of research on risk factors, and a comparable dearth of knowledge regarding the influence of combinations of promotive factors. The current study examined how promotive factors across family, school, and community contexts co-occur to promote health among youth of different race/ethnicity. Utilizing a nationally representative sample of Black (10%), Latinx (12%), and White (77%) youth ages 12-17 (N = 30,668), latent class analysis was employed to identify classes of youth who endorsed homogenous patterns of promotive factors. Associations between class membership and health were explored. Each subsample was best characterized by its own 4-class model, with significant differences in patterns of promotive factors experienced by Black, Latinx, and White youth. Youth health outcomes also varied significantly by class membership (p < .05). Greater access to more promotive factors was associated with better health, and low access to community and school promotive factors was associated with worse health. Results suggest that increasing promotive factors in school, family, and community settings may help to prevent poor health outcomes; however, jointly addressing discrimination against racial/ethnic minority youth through education, policy, and practice is also needed to address health disparities.

A latent transition analysis of the longitudinal stability of dual-factor mental health in adolescence.

Dual-factor models of mental health are increasingly supported but little is known about longitudinal trends in dual-factor mental health. The current study used latent profile analysis (LPA) to empirically identify dual-factor mental health classes at each of Grades 9 through 12 and latent transition analysis (LTA) to examine stability of classes over four academic years. A sample of 875 adolescents from two cohorts reported on their social-emotional strengths and psychological distress. Cross-sectional LPAs for each grade year resulted in four mental health classes: complete mental health, moderately mentally healthy, symptomatic but content, and troubled. An LTA model indicated that the complete mental health class exhibited the most stability, followed by moderately mentally healthy and symptomatic but content classes. The troubled class exhibited the least stability. Less than 24% of participants remained in the same mental health class across all years. Findings support regular monitoring of students' dual-factor mental health to accurately inform mental health promotion, prevention, and intervention efforts.

Addressing Disaster Exposure Measurement Issues With Latent Class Analysis.

Disaster exposure can put survivors at greater risk for subsequent mental health (MH) problems. Within the field of disaster MH research, it is important to understand how the choice of analytic approaches and their implicit assumptions may affect results when using a disaster exposure measure. We compared different analytic strategies for quantifying disaster exposure and included a new analytic approach, latent class analysis (LCA), in a sample of parents and youth. Following exposure to multiple floods in Texas, a sample of 555 parents and 486 youth were recruited. Parents were predominantly female (70.9%) and White (60.8%). Parents were asked to have their oldest child between the ages of 10 and 19 years old participate (M = 13.74 years, SD = 2.57; 52.9% male). Participants completed measures on disaster exposure, posttraumatic stress, depression, and anxiety. The LCA revealed four patterns of exposure in both parents and youth: high exposure (15.5% parent, 9.5% child), moderate exposure (19.8% parent, 28.2% child), community exposure (45.9% parent, 34.4% child), and low exposure (18.8% parent, 27.8% child). In terms of MH, there were similarities across analytic approaches, but the LCA highlighted a threshold effect, with the high exposure class doing worse than all others, d = 1.12. These results have important implications in understanding the different exposure experiences of survivors and the linkage to MH outcomes. The findings are also informative in the development and use of screening tools used in postdisaster contexts in determining who may or may not need MH services.

Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) Abordando los Problemas de Medición de la Exposición a los Desastres con un Análisis de Clases Latentes ABORDANDO LA MEDICION DE LA EXPOSICION A DESASTRES La exposición a los desastres puede poner a los sobrevivientes en un riesgo más alto de posteriores problemas de salud mental (SM). En el campo de investigación de la SM sobre desastres, es importante entender como la elección de perspectivas analíticas y sus supuestos implícitos podrían afectar los resultados cuando se usa una medida de exposición al desastre. Comparamos estrategias analíticas diferentes para cuantificar la exposición al desastre e incluimos una perspectiva analítica nueva, análisis de clase latente (LCA en sus siglas en inglés), en una muestra de padres y jóvenes. Luego de la exposición a numerosas inundaciones en Texas, se reclutó una muestra de 555 padres y 486 jóvenes. Los padres fueron principalmente mujeres (70.9%) y de raza blanca (60.8%). Se les pidió a los padres la participación de su hijo mayor entre las edades de 10 y 19 años (M = 13.74 años, DE = 2.57; 52.9% varones). Los participantes completaron las medidas sobre exposición a desastres, estrés postraumático, depresión, y ansiedad. El LCA reveló cuatro patrones de exposición en ambos padres y jóvenes: alta exposición (15.5% padres, 9.5% niños), exposición moderada (19.8% padres, 28.2% niños), exposición comunitaria (45.9% padres, 34.4% niños), y baja exposición (18.8% padres, 27.8% niños). En términos de la SM, hubo similitudes a lo largo de los enfoques analíticos, pero el LCA destacó un efecto umbral, con la clase de alta exposición presentando características peores que todas las otras, d = 1.12. Estos resultados tienen implicaciones importantes para entender las diferentes experiencias de exposición de los sobrevivientes y su vínculo con resultados de la SM. Los hallazgos son también informativos en el desarrollo y el uso de herramientas de tamizaje usadas en los contextos post-desastres en determinar quién podría o no necesitar servicios de SM.

A Latent Profile Analysis of Bisexual Identity: Evidence of Within-Group Diversity.

Bisexual people experience unique psychosocial vulnerabilities and their mental health needs and social identity remain underserved and understudied, respectively. We report results from a latent profile analysis where we identified a preliminary typology of bisexual identity subgroups and its association with demographic and mental health variables. Bisexual+ adults (N = 292) residing in the U.S. were recruited from Amazon Mechanical Turk and administered a demographic survey, indicators of bisexual identity, and measures of internalizing symptoms and self-esteem. Joint consideration of statistical and substantive criteria in the modeling process yielded a well-differentiated and qualitatively distinctive three-profile solution comprised of Affirmative (e.g., having a positive orientation towards one's bisexuality), Vigilant (e.g., being significantly concerned about others' reactions to one's bisexuality), and Ambivalent (e.g., endorsing mixed but generally negative attitudes and beliefs about one's bisexuality) profiles of bisexual identity. Auxiliary analyses revealed conceptually and statistically significant associations among profile membership, demographic covariates, and mental health outcomes. Some key findings included that compared to the Affirmative profile, men and people of color were overrepresented in the Ambivalent profile, whereas men were overrepresented in the Vigilant profile. Bisexuals with a Vigilant profile displayed the poorest mental health constellation. Our findings highlight the categorically heterogeneous nature of bisexual identity, support the relevance of social identity to mental health among bisexuals, and represent the first attempt to model bisexual identity using mixture techniques. Future studies should consider larger and more demographically diverse samples, address replicability and generalizability, examine additional auxiliary variables, and investigate longitudinal developments in profiles.

A naturalistic study exploring mental health outcomes following trauma-focused treatment among diverse survivors of crime and violence.

BACKGROUND: Although considerable research has tested evidence-based practices in clinical trials, research is needed on the use of trauma-focused treatments by victims of crime and violence in naturalistic settings. This study investigated four trauma-focused treatments, prolonged exposure therapy (PE), cognitive behavioral therapy (CBT), eclectic therapy, and person-centered therapy (PCT), and assessed treatment dropout and symptom improvement over five assessment time-points. METHODS: Descriptive comparisons and pattern mixture multigroup growth models were used to assess differences between treatments on time in treatment, rate of dropout, and improvement in posttraumatic stress (PTSD) and depression symptoms in an outpatient sample of 526 clients seeking routine clinical care. RESULTS: PCT was significantly associated with the highest number of therapy sessions completed and the lowest rate of dropout (41.75%) compared to CBT and eclectic treatments. All treatment groups reported PTSD symptom improvement with no significant differences based on therapy type. For depression, the rate of improvement for clients in PCT who dropped out of treatment after session 3 was significantly steeper than the rate of improvement for clients in eclectic treatment who dropped out of treatment after session 3. Clients who stayed in treatment longer generally had larger decreases in symptoms compared to those who dropped out earlier. LIMITATIONS: The small sample size in each of the treatment groups may have limited power to detect change. CONCLUSIONS: Several trauma-focused treatments offered in a community-based setting may result in significant symptomatic improvement.

Patterns of adversity and pathways to health among White, Black, and Latinx youth.

Research has demonstrated the negative impact of Adverse Childhood Experiences (ACEs) on long-term trajectories of mental and physical health. Yet existing literature on this topic is limited in its understanding of outcomes among youth samples, optimal measurement items and methods, and differences in adverse experiences across race/ethnicity. The current study used a person-centered approach to measure ACEs and their impact on youth health outcomes across three different racial/ethnic groups from a large national database. Patterns of exposure to adverse experiences among Black, Latinx, and White youth (N = 30,668, ages 12-17) were determined empirically using latent class analysis (LCA). Significant differences in class membership by demographic indicators (age, household income, sex) and concurrent health outcomes were identified. Different models emerged for Black (2 classes), Latinx (3 classes), and White youth (3 classes). Older and lower-income youth were more likely to have experienced adversities, but there were no differences in adversity likelihood by sex. Additionally, racial/ethnic minority youth were at greater risk of experiencing higher levels of adversity, poverty, and poor health when compared to their White counterparts. Rather than occuring in meaningful clusters, adverse experiences among youth reflected a cumulative risk model such that classes were defined by the overall intensity of adverse experiences (i.e., low, moderate, high). Findings provide greater knowledge regarding the relationship between ACEs and health and future research directions to inform more targeted and culturally-appropriate screening, prevention, and intervention programs.