Self- and collective care as radical acts: A mixed-method study on racism-based traumatic stress among emerging adults.

Racism has been declared a public health threat. With increased direct and vicarious exposure to racism-based violence through social media, we explored the associations between racism-based events and traumatic stress symptomatology, as well as self- and collective care (inclusive of coping, activism, and ethnic and racial identity) through a mixed-methods approach. A total of 104 racism-based events were reported across 43 Black and/or Latine/x emerging adults in the sample, with a majority endorsing racism-based stress or traumatic stress (i.e., the symptomatology associated with a racism-based event). Individuals who reported higher racism-based traumatic stress symptoms immediately following a racism-based event also reported higher ethnic identity resolution scores. Further, 19%-42% of participants reported racism-based traumatic stress and racism-based stress more recently (respectively), showing that racism-based events may be traumatic stressors with long-term mental health consequences. Participants provided thick descriptions of how they defined and engaged in self- and collective care as wellness and activism and reported engaging in cultural, ancestral, spiritual, and religious practices in an attempt to heal. The findings of this study underscore the importance of radical hope and radical healing for Black and Latine/x communities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Predictors and moderators of marijuana and heavy alcohol use outcomes in adolescents treated for co-occurring substance use and psychiatric disorders in a randomized controlled trial.

BACKGROUND: The current study identifies predictors and moderators of substance use outcomes for 111 adolescents with co-occurring substance use and psychiatric disorders who participated in a randomized controlled trial that compared the effectiveness of two home-based treatments: an integrated cognitive behavioral therapy (I-CBT) protocol, in which masters-level clinic staff received intensive training and ongoing supervision in the use of this protocol versus a treatment-as-usual (TAU) comparison condition in which therapists received a continuing education-style CBT workshop in the same protocol. METHOD: The study conducted exploratory predictor and moderator analyses of marijuana and heavy alcohol use outcomes using candidate variables across four domains of psychological characteristics: adolescent substance use, adolescent psychiatric symptoms, parent, and family. RESULTS: Regardless of treatment condition, low parental monitoring at baseline, as assessed by a videotaped interaction task, but not self-report, predicted greater percentage of marijuana use and heavy alcohol use days over the 6-month follow-up period. If parents entered treatment with low levels of parental monitoring, adolescents in the I-CBT condition reduced their percentage of heavy alcohol use days significantly more than adolescents in TAU over the 6-month follow-up period. Greater adolescent aggression and parental emotion dysregulation at baseline also predicted greater percentage of marijuana use days over the 6-month follow-up period for the sample as a whole. Adolescents in the I-CBT condition who reported low positive urgency at baseline reduced their percentage of heavy alcohol use days significantly more than adolescents in TAU care over the 6-month follow-up period. CONCLUSION: The article discusses implications for clinical decision-making, improving treatment effectiveness, and tailoring interventions for adolescents with co-occurring substance use and psychiatric disorders.

Alcohol Use and Intimate Partner Violence Among Community College Women: An Exploration of Protective Factors.

Little is known regarding the association between alcohol use and violence among community college women. Accordingly, this study investigated daily-level associations between alcohol use and intimate partner victimization (IPV) in a sample of young women (ages 18-24) in a community college setting, and the potentially protective role of education aspirations and living with family. Using a calendar-based assessment, women enrolled in a large community college (N = 212) completed past-month surveys of IPV and alcohol use. Unadjusted Generalized Estimating Equations showed nonsignificant positive associations between alcohol consumption (any alcohol use and number of drinks) and IPV at the daily level. Adjusted models showed a slight (but nonsignificant) increase in the odds of experiencing IPV on a drinking day. Those reporting a family income above $20,000 were at increased risk of experiencing violence. Living with family and wanting to attain a master's or doctoral degree reduced the risk of experiencing IPV on drinking days. Although the literature suggests that drinking among 4-year college women elevates the odds of experiencing IPV, our findings suggest the importance of examining contextual variables when understanding risk among community college women. Particularly, the role of family and educational aspirations may serve as protective factors in the association between alcohol use and IPV on a daily basis. As this is the first day-level study of IPV and alcohol use among community college women, further research is warranted to better explicate these findings.

Socio-Cognitive Behavioral Therapy for Suicidal Behavior with a Puerto Rican Male Adolescent.

In 2015, fifteen percent of Puerto Rican adolescents attempted suicide. In general, females have more suicidal thoughts while males are more likely to die by suicide. However, few evidence-based treatments have been developed for this population. OBJECTIVES: The aim of this study was to illustrate the therapeutic process of a male Puerto Rican adolescent treated with the Socio-Cognitive Behavioral Therapy for Suicidal Behavior (SCBT-SB), a culturally informed protocol, and to discuss how developmental, feminist, and family system perspectives were incorporated in the SCBT-SB treatment model. METHOD: A case study is presented: Julio received the SCBT-SB after a psychiatric hospitalization subsequent to threating to commit suicide. Baseline and post-treatment assessments evaluated diagnosis, risk factors (e.g. hopelessness), treatment satisfaction, and suicidal behaviors. RESULTS: Julio demonstrated clinically significant change in depressive symptoms, hopelessness, suicidal ideation, and aggressive/impulsive behaviors. CONCLUSIONS: The SCBT-SB was feasible to implement and proved acceptable to the client and his family.

Stress-Related Symptoms and Suicidal Ideation: The Roles of Rumination and Depressive Symptoms Vary by Gender.

There is a growing body of literature suggesting that reactions to stressful life events, such as intrusive thoughts, physiological hyperarousal, and cognitive/behavioral avoidance (i.e., stress-related symptoms) may increase risk for thinking about and attempting suicide. Cognitive vulnerability models have identified rumination (i.e., perseverating on a negative mood) as a maladaptive response that may increase risk for suicidal behavior, as it has also been linked to depression. The present study examined the direct and indirect effects of stress-related symptoms on suicidal ideation through rumination and depressive symptoms. Participants were 1375 young adults, primarily non-White (78 %) females (72 %), recruited from a public university in the Northeastern U.S., who completed measures of stress-related symptoms (as a response to a stressful event), rumination, depressive symptoms, and suicidal ideation. The relation between stress-related symptoms and suicidal ideation was accounted for by the brooding subtype of rumination and depressive symptoms among females. Depressive symptoms, but not rumination, better accounted for suicidal ideation among males. These findings suggest that the role of brooding and depressive symptoms in the relationship between stress-related symptoms and suicidal ideation may vary by gender.

Interactive Effect of Child Maltreatment and Substance Use on Depressed Mood Among Adolescents Presenting to Community-Based Substance Use Treatment.

Adolescents referred to community behavioral health centers (CBHC) for substance use (SU) problems report high rates of child maltreatment. Although SU and maltreatment are independent risk factors for adolescent depression, few studies have examined their interactive effects. This study examined the interactive effects of SU (alcohol and marijuana) and exposure to different types of trauma on depressed mood among 74 adolescents referred to a CBHC for SU. Hierarchical regressions controlling for sex and common adolescent comorbidities showed that sexual abuse had a stronger relationship with depressed mood than other types of maltreatment. Although SU was not independently related to depressed mood, consistent with the self-medication hypothesis, increased SU was associated with lower levels of depressed mood among adolescents with greater exposure to sexual abuse. Results suggest that teens presenting to CBHCs for SU should be assessed for multiple forms of maltreatment and for depressed mood.

Cognitive behavioral therapy for PTSD and somatization: an open trial.

No treatment, to date, has been developed to improve both posttraumatic stress disorder (PTSD) and medically unexplained physical symptoms (MUPS), despite mounting evidence of high comorbidity between PTSD and MUPS. This study assessed the feasibility, acceptability, and treatment outcomes of an adapted cognitive behavioral therapy for PTSD and abridged somatization in a sample of eight participants. Fifteen percent of completers did not meet PTSD criteria after treatment completion and 62.5% improved their somatic symptoms. There was a significant difference between pre- and post-treatment depression symptoms, as well as in psychological and physical functioning measures. Results indicated a small to moderate effect size (d = 0.27-0.78) in PTSD severity scores, and moderate to large effect size in depression symptoms and psychosocial and physical functioning variables (d = 0.39-1.12). Preliminary evidence of acceptability indicates that the current CBT intervention may be suitable for Latinos individuals with PTSD and MUPS.

Acculturative stress, perceived discrimination, and vulnerability to suicide attempts among emerging adults.

Cultural factors are often neglected in studies of suicidal behavior among emerging adults. The present study examined acculturative stress and perceived discrimination as statistical predictors of a suicide attempt history among an ethnically diverse sample of 969 emerging adults, ages 18-25 (M = 18.8). Females made up 68% of the sample, and the racial/ethnic composition included Asian, Latino, Black, and White (US-born and non-US-born) individuals. There were no statistically significant racial/ethnic differences in endorsement of a suicide attempt history, with an overall rate of 8% in the sample. Asian participants reported higher acculturative stress than all other racial/ethnic groups, while both Asian and Black participants reported having experienced more discrimination in the previous year, compared to other groups. Logistic regression analyses suggested that familial acculturative stress was associated with 2 times higher odds of endorsing a past suicide attempt, overall. More specifically, it was associated with over 2 times higher odds among Asian participants, over 4 times higher odds among Black participants, and over 3 times higher odds among non-US-born White participants, while social acculturative stress was associated with over 3 times higher odds of endorsing a past suicide attempt among Latino participants. Environmental acculturative stress was associated with decreased odds of endorsing a suicide attempt history, overall, but not when examined separately by racial/ethnic group. Perceived discrimination was associated with over 5 times higher odds of a suicide attempt, overall, and specifically was associated with over 3 times higher odds among Latino participants and over 10 times higher odds among White, US-born participants. These findings suggest the importance of addressing culturally-related variables in treatment with emerging adults of racially/ethnically diverse backgrounds to reduce risk for suicidal behavior.