Prospective Associations of Maternal Depressive Symptoms and Emotion Dysregulation with Children's Internalizing Problems: The Moderating Role of Fathers.

The occurrence of internalizing symptoms is prevalent among young children and can be observed as early as preschool years. Using a longitudinal approach, this study examined the moderating role of paternal depressive symptoms/emotion dysregulation in the prospective associations between maternal depressive symptoms/emotion dysregulation and children's internalizing problems (depressive and anxiety symptoms). Ninety-four preschoolers and their mothers and fathers participated in the study. Mothers and fathers completed online questionnaires for all variables when their children were 4 years old and one year later. The results indicated that paternal depressive symptoms moderated the association between maternal emotion dysregulation and children's later depressive, but not anxiety, symptoms. Specifically, higher levels of depressive symptoms in fathers exacerbated the negative influence of maternal emotion dysregulation on children's later depressive symptoms, whereas fathers with low levels of depressive symptoms served a protective role. The findings enhance our understanding of the interaction between maternal and paternal psychological characteristics in contributing to children's anxiety and depressive symptoms.

Mediation of Psychological Capital in Youth Experiencing Homelessness.

BACKGROUND: Youth who experience homelessness engage in behaviors that place them at high risk for disease and injury. Despite their health risk behaviors, these youth display psychological capital, positive attributes of hope, efficacy, resilience, and optimism that motivate them to engage in health-promoting behaviors such as safer sex. However, this array of positive psychological attributes has not been studied in this vulnerable population. OBJECTIVES: The specific aim of this analysis was to determine whether factors of psychological capital mediated the relationship between background risk factors (e.g., race/ethnicity, educational attainment, reason for being homeless, sexual abuse history, and HIV status) and outcomes of condom intention, safer sex behaviors, and life satisfaction among youth who participated in a longitudinal intervention study. METHODS: Using a Solomon four-group design, 602 youth were recruited from drop-in centers in two large cities (Columbus, Ohio, and Austin, Texas) to participate in a brief intervention that included outcomes of enhanced communication skills, goal setting, safer sex behaviors, drug refusal skills, and life satisfaction. Using an autoregressive, cross-lagged, longitudinal mediation model, we tested the direct and indirect effects of background factors, psychological capital, and intervention outcomes. Models were tested for the intervention group alone and the total sample. RESULTS: There were no significant direct or indirect effects of background factors on intervention outcomes among the intervention group, and the model fit was poor. There were also no significant mediating paths via factors of psychological capital and poor model fit for the combined group. DISCUSSION: Findings provide important information about intrinsic strengths of youth experiencing homelessness and psychological capital as a significant construct for understanding health behaviors among disadvantaged and underserved youth. The lack of significant mediation effects may have been due, in part, to the lack of a robust measure of psychological capital. Further study with various background factors and outcomes would contribute further to our understanding of how best to support this population.

Suicide prevention for substance using youth experiencing homelessness: study protocol for a randomized controlled trial.

BACKGROUND: While research on substance using youth experiencing homelessness (YEH) is increasing, there is a dearth of information regarding effective prevention interventions for these youth. Suicide is the leading cause of death among YEH and most youth do not access services that may be available to them. Therefore, this study seeks to address this gap in the research literature with the goal to identify an effective suicide prevention intervention that can be readily adopted by communities that serve these youth. METHODS: Three hundred (N = 300) YEH with recent substance use and suicidal ideation or a recent suicide attempt will be recruited from the streets as well as a drop-in center serving YEH. After the baseline assessment, all youth will be randomly assigned to Cognitive Therapy for Suicide Prevention (CTSP) + Services as Usual (SAU) (N = 150) or to SAU alone (N = 150). SAU includes outreach, advocacy, and service linkage whereas YEH who receive CTSP will also receive ten CTSP sessions and an optional nine booster sessions. Follow-up assessments will be conducted at 3, 6, 9, and 12 months post-baseline. Theoretically derived mediators (e.g., cognitive distortions) will be tested to shed light on mechanisms associated with change, and the moderating effects of sex, race, sexual orientation, and baseline service connection will be examined. In order to ease future dissemination of the intervention to agencies serving YEH, we will rigorously assess acceptability, feasibility, fidelity, and cost associated with the delivery of our intervention approach using a mixed-methods approach. DISCUSSION: This study adds to a very small number of clinical trials seeking to prevent lethal suicide among a very high-risk group by addressing suicidal ideation directly rather than underlying conditions. It is hypothesized that youth receiving CTSP + SAU will show greater reductions in suicidal ideation (primary outcome), substance use, and depressive symptoms (secondary outcomes) over time compared to SAU alone, as well as improved risk and protective factors. TRIAL REGISTRATION: NCT05994612. Date of Registration: August 16, 2023.

Association between longitudinal patterns of child maltreatment experiences and adolescent substance use.

BACKGROUND: Although there is a well-established link between child maltreatment and adolescent substance use, it remains unclear if and how longitudinal patterns of maltreatment experiences are associated with substance use in adolescence. OBJECTIVE: The purpose of the study was to examine how distinct patterns of longitudinal maltreatment experiences are associated with adolescent substance use. PARTICIPANTS AND SETTING: The participants were 899 adolescents from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). METHODS: We conducted repeated measures latent class analysis (RMLCA) to identify patterns of physical abuse, sexual abuse, and neglect from birth to age 17 and their relations to tobacco, alcohol, and marijuana use at age 18. RESULTS: RMLCA identified three physical abuse classes (Stable low physical abuse; School age peak physical abuse; Physical abuse primarily in infancy/toddlerhood), two sexual abuse classes (Stable no/low sexual abuse; School age peak sexual abuse), and three neglect classes (High neglect in childhood; Neglect primarily in infancy/toddlerhood; Neglect primarily at school age). Adolescents in the school age peak physical abuse class showed greater alcohol, cigarette, and marijuana use, compared to other physical abuse classes. Similarly, adolescents in the school age peak sexual abuse class showed greater substance use than those in the stable no/low sexual abuse class. Lastly, adolescents in the neglect primarily in infancy/toddlerhood class showed significantly less substance use than those in the other two neglect classes. CONCLUSIONS: Findings highlight the importance of early intervention and ongoing maltreatment prevention.

Mental health in society's margins: poor n-3 PUFA intake and psychological well-being of homeless youth.

Dietary intake of long-chain n-3 PUFA (n-3 PUFA), particularly EPA and DHA, has been associated with psychological well-being, but little is known about the n-3 PUFA intake of homeless youth. The current study determined the association between depression and anxiety symptoms and n-3 PUFA intake and erythrocytes status in homeless youth. Totally, 114 homeless youth aged 18-24 years were recruited from a drop-in centre. n-3 PUFA dietary intake was assessed using an FFQ, and erythrocytes status was determined by gas chromatography (GC). Linear regression models were used to determine the relationship between psychological well-being and n-3 PUFA intake and status. The mean intakes of EPA and DHA for all participants (0·06 ± 0·13 g/d and 0·11 ± 0·24 g/d) were well below recommended levels, and mean erythrocytes EPA + DHA (n-3 index) in the cohort (2·42 %) was lower than reported for healthy, housed adolescents and those with clinical depression. There was no association of n-3 PUFA intake and erythrocytes status with either depression or anxiety. However, the relationships of depression with dietary EPA (P = 0·017) and DHA (P = 0·008), as well as erythrocytes DHA (P = 0·007) and n 3-index (P = 0·009), were significantly moderated by sex even after adjusting for confounders. Specifically, among females, as the intake and status of these n-3 PUFA decreased, depression increased. Our findings show poor dietary intake and low erythrocytes status of n-3 PUFA among homeless youth, which is associated with depressive symptoms among females.

Co-occurring trajectory of housing stability and parenting stress with child behavior problems: A randomized trial of a housing intervention for young mothers experiencing homelessness.

This study examined the effects of an integrative housing intervention (Ecologically Based Treatment, EBT - independent housing and supportive services) on the co-occurring pattern of housing stability and parenting stress among a sample of substance-using mothers who experience homelessness and have young children in their care. The association between the co-occurring patterns of housing stability and parenting stress and child internalizing and externalizing behaviors was also examined. Mothers were randomized to one of the three conditions: EBT (n = 80), Housing-only (HOU; n = 80), or Services as Usual (SAU; n = 80). Follow-up assessments were completed at 3-, 6-, 9-, and 12-months post-baseline. The dual-trajectory latent class growth analyses identified five subgroups of co-occurring patterns: low-greatly improved housing paired with moderate-improved parenting stress, low-greatly improved housing paired with high-improved parenting stress, low-moderately improved housing paired with moderate-static parenting stress, low-worse housing paired with moderate-improved parenting stress, and low-worse housing paired with high-static parenting stress. Findings showed that EBT was more effective in improving housing stability and reducing parenting stress compared to HOU and SAU conditions, and further, HOU was more effective than SAU. Additionally, children whose mothers reported increased housing stability together with improved parenting stress had lower levels of internalizing and externalizing behaviors. The findings provide support to the efficacy of EBT in increasing housing stability and reducing parenting stress. The observed improvements subsequently benefited children's behavioral outcomes.

Lessons learned from housing first, rapid rehousing trials with youth experiencing homelessness.

BACKGROUND: Youth, 18 to 24 years, experiencing homelessness (YEH) are recognized as having developmental challenges dissimilar to older adults. Yet, research on efforts to end homelessness and prevent or intervene in drug use and mental health problems among youth have lagged behind that of adults. The Housing First (HF) Model which underlies Permanent Supportive Housing (PSH) and Rapid Re-Housing (RRH) has become preferred over treatment-first models. METHODS AND RESULTS: We provide an overview of PSH and RRH studies to date and summarize our current understanding of their utility for use with YEH. Finally, we review our team's current and past randomized trials testing RRH with YEH, providing lessons learned and recommendations. CONCLUSION: Current research efforts to guide best practices are hampered by a lack of fidelity to HF principles, lack of randomized design, and lack of focus on youth. Lessons learned and recommendations from our work are offered to facilitate the future work of those who seek to end homelessness and address drug use and mental health problems among youth.

Hair Collection for Cortisol Among Youth Experiencing Homelessness.

BACKGROUND: Investigations of chronic physiological stress measured by hair cortisol are rapidly expanding among community samples of adolescents and adults. However, research examining physiological stress among youth experiencing homelessness is nascent despite the youth's increased risk for adverse exposures and subsequent impaired mental health. OBJECTIVE: This article aimed to examine the feasibility of collecting hair for measuring cortisol among diverse youth experiencing homelessness and gain an understanding of variation in participation. METHODS: Analysis of survey and hair participation data from three pilot studies among youth experiencing homelessness was conducted. Survey measures included sociodemographic characteristics (age, race and ethnicity, sex assigned at birth, and sexual orientation) and reasons for nonparticipation. Descriptive analysis examined participation rates in hair collection for cortisol measurement, including sociodemographic differences in participation. RESULTS: Participation in the hair sampling for cortisol was high for the combined sample (88.4%), with some variation across the three pilot studies. Insufficient hair for cutting was the most common reason for not participating; Black and multiracial youth, as well as male youth, had a higher prevalence of nonparticipation. DISCUSSION: The collection of hair for cortisol research among youth experiencing homelessness is feasible, and integration of physiological measures of stress into research with this vulnerable population should be considered, given their high risk for adversity and death by suicide and drug overdose. Methodological considerations and avenues for potential research are discussed.

Application of the ecobiodevelopmental model for research among youth experiencing homelessness.

Youth experiencing homelessness (YEH) often face increased levels of adversity and higher rates of trauma, suicide, and mortality compared to their housed peers. A multi-level life course lens is proposed by applying the ecobiodevelopmental model to examine social support mechanisms as a buffer to psychopathologies following adversity within YEH. Further discussion contributes to the theoretical basis for future public health research and intervention work addressing youth homelessness and related adversities.

Associations between psychological evaluation outcomes, psychiatric diagnoses, and outcomes through 12 months after bariatric surgery.

BACKGROUND: There is limited evidence about how patients' initial preoperative psychological evaluation outcomes (require follow-up [RFU], no required follow-up [NFU], and place on hold [POH]) and current psychiatric diagnoses associate with postoperative outcomes. OBJECTIVES: To test the hypotheses that patients who receive a clinical decision of RFU versus NFU from their initial psychological evaluation will be (1) more likely to experience postoperative complications, readmissions, and emergency room visits and (2) experience less weight loss over 12-months. Specific diagnoses (any psychiatric diagnosis, depression, and anxiety) are also examined for their association with weight loss over 12 months. SETTING: Midwestern medical center, United States. METHODS: The sample included 322 patients (81.1% female and 64.0% White) with completed psychological evaluations between August 2019 and December 2020. Patient demographics, psychological evaluation outcomes, current diagnoses, and postoperative outcomes were extracted from the health record. Bivariate analyses determined associations between NFU/RFU and postoperative complications (yes, no), readmissions (yes, no), and emergency room visits (yes, no). Mixed multilevel models were conducted with dichotomous variables NFU/RFU, any psychiatric diagnoses (yes, no), depression diagnoses (yes, no), or anxiety diagnoses (yes, no) as the main fixed within-group factors with weight loss (weight or percent total weight loss) used as the repeated measures. Insurance and surgical procedure were included as covariates. RESULTS: There were no significant differences in postoperative complications, readmissions, and emergency room visits between NFU and RFU groups. Patients who received a RFU versus an NFU had higher weights over 12 months (P = .001). CONCLUSION: Hypothesis 2 was only partially supported. Patients who received an RFU versus an NFU had higher weights over 12 months, but this association was not found for percent total weight loss or any of the psychiatric within-subjects variables (i.e., psychiatric diagnoses, depression, and anxiety).

Heterogeneous trajectories of suicidal ideation among homeless youth: predictors and suicide-related outcomes.

The current study examined heterogeneous trajectories of suicidal ideation among homeless youth experiencing suicidal ideation over 9 months in a randomized controlled intervention study. Suicidal homeless youth (N = 150) were randomly assigned to Cognitive Therapy for Suicide Prevention (CTSP) + Treatment as Usual (TAU) or TAU alone. Youth reported their suicidal ideation four times during a 9-month period. We also assessed pretreatment mental health, demographic information and session attendance as predictors of the subgroups, as well as suicide-related factors as outcomes at the 9-month follow-up. Growth mixture models suggested three distinct trajectory groups among youth: Fast Declining (74.7%), Chronic (19.3%), and Steadily Declining (6.0%). Youth in the Chronic group used more substances at baseline than the Steadily Declining group, were more likely to be White, non-Hispanic than the Fast Declining group, and attended more CTSP sessions than other groups. Contrastingly, youth in the Steadily Declining group all experienced childhood abuse. Finally, youth in the Chronic group showed significant higher risk for future suicide compared to those in the Fast Declining group at 9 months. Findings support the heterogeneity of treatment responses in suicide intervention among homeless youth, with implications to improve treatment efforts in this very high-risk population.

Early childhood maltreatment and profiles of resilience among child welfare-involved children.

Given the high burden of child maltreatment, there is an urgent need to know more about resilient functioning among those who have experienced maltreatment. The aims of the study were to: 1) identify distinct profiles of resilience across cognitive, emotional, behavioral, and social domains in young children involved in the child welfare system; and 2) examine maltreatment characteristics and family protective factors in relation to the identified resilience profiles. A secondary analysis was conducted using data from the National Survey of Child and Adolescent Well-Being (NSCAW-II). Latent profile analysis was performed on a sample of 827 children aged 3-5 years (46% girls, Mean age = 3.96). Three distinct resilience profiles were identified: 1) low cognitive resilience (24%); 2) low emotional and behavioral resilience (20%); and 3) multidomain resilience (56%). Caregiver cognitive stimulation, no out-of-home placement, higher caregiver education level, older child age, and being a girl were associated with the multidomain resilience profile. The findings provide empirical support for the multifaceted nature of resilience and suggest that practitioners need to help children achieve optimal and balanced development by assessing, identifying, and targeting those domains in which children struggle to obtain competence.

Preoperative Psychological Evaluation Outcomes, Reasoning, and Demographic and Diagnostic Correlates.

PURPOSE: Little is known about associations between preoperative psychiatric, disordered eating, and substance use diagnoses with the clinical decision to require follow-up after the preoperative psychological evaluation. To determine the proportion of patients who require follow-up (no required follow-up (NFU), required follow-up (RFU), placed on hold (POH)) from the preoperative psychological evaluation, associations with diagnoses, and noted reasons for follow-up. MATERIALS AND METHODS: The sample included 508 patients (77.6% female; 64.4% White) pursuing bariatric metabolic surgery with completed psychological evaluations between August 2019 and December 2020 at a Midwest medical center. Patient demographics, psychological evaluation outcome and corresponding reasoning, and psychiatric, disordered eating, and substance use diagnoses were extracted from the health record. Descriptive and bivariate analyses determined associations between demographics and diagnoses with psychological evaluation outcomes and corresponding reasoning. RESULTS: The breakdown of psychological evaluation outcomes was 60.6% (n = 308) NFU, 38.4% (n = 195) RFU, and 1.0% (n = 5) POH. Demographic correlates of RFU included higher BMI, being single, lower educational attainment, unemployment, public/no insurance, and receiving multiple or any psychiatric diagnosis (all p-values < 0.05). Diagnostic correlates of RFU included anxiety, depression, not having a current trauma or stressor-related disorder, disordered eating, and substance use diagnoses (all p-values < 0.001). RFU/POH was primarily due to psychiatric (61%) reasons. CONCLUSION: Higher rates of RFU were observed for patients with higher economic need and with psychiatric, disordered eating, or substance use diagnoses. Future work should establish preoperative programming to assist patients with addressing ongoing psychiatric concerns prior to bariatric metabolic surgery.

Housing and supportive services for substance use and self-efficacy among young mothers experiencing homelessness: A randomized controlled trial.

AIMS: Homeless mothers with young children in their care contend with high rates of substance use and low self-efficacy. However, a limited number of studies have examined these outcomes associated with housing and supportive services. DESIGN: Participants were randomly assigned to: (1) housing + support services (n = 80), (2) housing-only (n = 80), or (3) services as usual (SAU) (n = 80) and were re-assessed at 3-, 6-, 9- and 12-months postbaseline. SETTINGS: The study recruited a community-based sample from homeless service agencies and advertisements in a large Midwestern city. PARTICIPANTS: The study recruited two hundred forty (N = 240) women between the ages of 18 to 24 years, experiencing homelessness and with a substance use disorder (SUD) who also had a biological child under the age of 6 years in their care. MEASUREMENTS: We measured frequency of alcohol and drug use using the Form 90 semi-structured interview, and self-efficacy using Pearlin and Schooler's (1978) 7-item Mastery Scale. FINDINGS: Overall, mothers showed significant improvement in substance use and self-efficacy over time in each condition. However, as expected, patterns of change differentiated intervention groups with more mothers showing better substance use and self-efficacy outcomes in housing + supportive services than in SAU. Unexpectedly, more mothers in SAU showed better outcomes than those in housing-only. CONCLUSIONS: Substance use decreased and self-efficacy increased over time, but patterns of change characterized the intervention groups. In particular, findings suggest that when providing housing to this population, supportive services should also be offered.

Family functioning screening, referral, and behavioral health utilization in a family medicine setting.

INTRODUCTION: The objective of this study was to determine the preliminary feasibility and acceptability of screening for family functioning in a family medicine setting, and secondarily to explore differences in parent-child dyad interest in behavioral health service utilization by demographics, pediatric behavioral symptoms, and pediatric QOL. METHOD: The McMaster Family Assessment Device General Functioning subscale was used to assess family functioning among 58 parent-child (ages 11-26) dyads in family medicine. Feasibility and acceptability were assessed through study interest and participation and interest and attendance in behavioral health services. Associations with interest in services, Child Behavior Checklist, Pediatric QOL Inventory, and select demographics were conducted using independent samples t-tests and Mann-Whitney tests. RESULTS: Fifty-eight parent-child dyads participated in the study. Close to half of dyads who expressed interest in the survey completed the assessment (46%). Dyads who completed the assessment had a family functioning impairment rate of 45%, and 54% of dyads with impairment expressed interest in services. Interest in services was significantly associated with several domains of childrens' behavioral health symptoms and pediatric QOL, but no demographics. DISCUSSION: Dyads experienced high rates of clinically significant family functioning impairment, without interest in receiving colocated behavioral health services. Future research should continue to explore how family functioning assessment can be utilized to identify child behavioral health symptoms broadly and engage families in colocated behavioral health services. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Promoting Healthy Attitudes and Behaviors in Youth Who Experience Homelessness: Results of a Longitudinal Intervention Study.

PURPOSE: The aim of this study is to determine the effectiveness of a brief intervention to promote responsible substance use and safe sex behaviors in youths experiencing homelessness (YEH). METHODS: Design: A Solomon four-group (double randomized controlled trial) longitudinal design with repeated measures (3- and 6-month follow-ups) was used in drop-in centers for YEH in Austin, Texas and Columbus, Ohio from which 602 youths, 18-24 years-old (M = 21 ± 1.8), 50% white; 69.9% heterosexual were recruited. A manualized one-on-one intervention consisted of six modules delivered via laptop computers. Modules focused on communication, goal-setting, substance use refusal, safe sex behaviors, enhanced psychological capital (hope, optimism, resilience, self-efficacy, gratitude), and life satisfaction. Valid and reliable measures of hope, optimism, future time perspective, resilience, social connectedness, gratitude, condom intention, self-efficacy for safe sex, safe sex behaviors, self-efficacy for substance use refusal, and life satisfaction were used to collect data for which three hypotheses were tested, using intent to treat, with multi-level modeling (R). RESULTS: The analysis showed partial support for all hypotheses: (1) post-test outcomes were greater than pretests; (2) intervention group outcomes were greater than control group measures; and (3) significant effects for pretesting. YEH in Ohio completed significantly more sessions than YEH in Texas (p = .001), but took significantly longer to complete all six sessions (p = .001). DISCUSSION: This brief intervention had significant effects on YEH to promote healthy attitudes and behaviors that merit further testing in larger samples.

Illicit Drug Use, Cognitive Distortions, and Suicidal Ideation Among Homeless Youth: Results From a Randomized Controlled Trial.

Illicit drug use and cognitive distortions confer significant risks to youth suicidal thoughts and behaviors. However, there has been limited evidence regarding the efficacy of suicide prevention interventions with homeless youth, especially studies testing whether such interventions can reduce the risk for suicidal ideation associated with illicit drug use. Suicidal homeless youth (N = 150) between the ages of 18 to 24 years were recruited from a drop-in center. Youth were randomly assigned to Cognitive Therapy for Suicide Prevention (CTSP) + Treatment as Usual (TAU) or TAU alone. Youth reported their illicit drug use, cognitive distortions, and suicidal ideation 4 times over 9 months. A multiple-group multilevel structural equation model showed that higher illicit drug use at baseline predicted a slower reduction in cognitive distortions and suicidal ideation in the TAU group. These associations were not found in the CTSP + TAU group, suggesting an interruption of such risk from illicit drug use. Findings suggest that CTSP can reduce the risk of illicit drug use as a treatment barrier towards cognitive distortions and suicidal ideation among homeless youth, with implications to improve treatment efforts and to reduce premature mortality in a vulnerable population.

"Prevention of opioid use disorder: the HOME (housing, opportunities, motivation and engagement) feasibility study".

Young adults experiencing homelessness are at high risk of opioid and other substance use, poor mental health outcomes, exposure to trauma, and other risks. Providing access to stable housing has the potential to act as a powerful preventive intervention, but supportive housing programs have been studied most often among chronically homeless adults or adults with serious mental illness. The Housing First model, which does not precondition supportive housing on sobriety, may reduce drug use in homeless adults. In the present study, we piloted an adapted model of Housing First plus prevention services that was tailored to the needs of young adults (18-24 years) experiencing homelessness in the USA. Preventive services were added to the Housing First model and included youth-centered advocacy services, motivational interviewing, and HIV risk prevention services. This model was piloted in a single-arm study (n = 21) to assess the feasibility, acceptability, and initial efficacy of a Housing First model over a 6-month period in preparation for a larger randomized trial. We use repeated measures ANOVA to test for changes in alcohol and drug use (percent days of use; alcohol or drug use consequences), housing stability, social network support, and cognitive distortions over 6 months of follow-up. A total of 17 youth completed the study (85% retention), and a high proportion of youth were stably housed at 6-month follow-up. Participation in intervention services was high with an average of 13.57 sessions for advocacy, 1.33 for MI, and 0.76 for HIV prevention. Alcohol use did not change significantly over time. However, drug use, drug use consequences, and cognitive distortions, and the size of youths' social networks that were drug using individuals decreased significantly. The Housing First model appeared to be feasible to deliver, and youth engaged in the supportive intervention services. The study demonstrates the potential for an adapted Housing First model to be delivered to youth experiencing homelessness and may improve outcomes, opening the way for larger randomized trials of the intervention.

Profiles of Resilience among Children Exposed to Non-Maltreatment Adverse Childhood Experiences.

Considering the high prevalence and negative consequences of non-maltreatment adverse childhood experiences (NM-ACEs), it is critical to understand their impacts on the resilient functioning of young children. This study sought to examine heterogeneity in resilience among first-grade children who were exposed to NM-ACEs during kindergarten and explore demographic and adversity characteristics that distinguish between resilience profiles. Latent profile analysis (LPA) was conducted on 4929 children drawn from the Early Childhood Longitudinal Study-Kindergarten (ECLS-K). The results of the LPA revealed four distinct resilience profiles: (1) low cognitive and executive functioning (4%); (2) low social and behavioral functioning (14%); (3) low average functioning (31%); and (4) multi-domain resilience (51%). Female children and those in families characterized by older maternal age, higher parental education level, household income above 200% federal poverty level, not receiving welfare benefits, and races other than Black were more likely to be in the multi-domain resilience profile. The findings highlight heterogeneity in resilience among children exposed to NM-ACEs and point to the need for a comprehensive, multi-domain assessment of child functioning to support optimal resilience development in this population.

Family Functioning Assessment and Child Psychosocial Symptoms in Family Medicine.

PURPOSE: Children and young adults underutilize behavioral health services, in part due to the challenges with identifying and providing services for child behavioral health in primary care. The objective of this study was to determine if a brief assessment of family functioning captures specific child psychosocial symptoms in a Family Medicine practice. DESIGN AND METHODS: Eighty-three parent child dyads, in which the parent or child was a patient at the Family Medicine practice, participated in a cross-sectional study, including assessments of demographics, family functioning, child behavioral health symptoms, and health related pediatric quality of life (HRQOL). Bivariate correlations, independent samples t-test, and linear and logistic regression tested associations of parent and child reported family functioning with child behavioral health symptoms and HRQOL. RESULTS: Parent and child reports of family functioning were significantly associated. Child, but not parent reports of family functioning were significantly associated with parent and child reports of behavioral health symptoms. Parent's reports of increased family functioning impairment were only significantly associated with parent's reports of decreased HRQOL. Family functioning impairment was associated with parent and child reports of increased behavioral health symptoms and decreased HRQOL. CONCLUSION: Future work should determine if screening for family functioning impairment, may serve as a means of identifying and treating child behavioral health symptoms in Family Medicine. PRACTICE IMPLICATIONS: Identifying impaired family functioning may serve to engage children and their parents in services, who may otherwise not be identified as having symptoms.