"I just check 'other'": Evidence to support expanding the measurement inclusivity and equity of ethnicity/race and cultural identifications of U.S. adolescents.

OBJECTIVE: In nationally funded research in the U.S., ethnicity and race are measured with checkbox questions, the limited categories of which may yield significant missing data and low salience to available categories, particularly among adults of color. How adolescent-generated data compare to these limited categories, and how adolescents, not just those of color, describe their culture are understudied. In our sample, we asked the following: (a) how do adolescents' ethnicity/race and culture identifications compare?, (b) how do adolescents' open-ended ethnicity/race and checkbox ethnicity/race labels compare?, and (c) how do adolescents' ethnicity/race labels compare to available categories for identification on the National Institutes of Health's (NIH's) demographic form? METHOD: Data from 76 adolescents (64.5% female, Mage = 15.78 years) were qualitatively and quantitatively analyzed. RESULTS: White adolescents were as likely as adolescents of color to identify with cultural labels, and most adolescents described culture differently than race/ethnicity. White adolescents' open-ended and checkbox labels overlapped more (38.8%) than adolescents of colors' (22.5%). Only 17% of adolescents' open-ended race/ethnicity identification labels and 54% of their checkbox identifications were available on the NIH's demographic form. CONCLUSIONS: As measurement of demographic data is reduced to few options that favor privileged identities, innovative methods to measure individuals' identities are warranted. Using tools that do not reflect individuals' identity labels may increase error and reflects structural problems of research inequity. Our findings provide initial evidence of this methodological issue in a sample of adolescents. Building inclusive demographic tools from individuals' self-descriptors that remain feasible and practical for use can diminish inequity associated with describing "diverse" populations. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

How do you define recovery? A qualitative study of patients with eating disorders, their parents, and clinicians.

OBJECTIVE: Recovery from an eating disorder (ED) may be defined differently by different stakeholders. We set out to understand the definition of ED recovery from the perspective of patients, their parents, and clinicians. METHOD: We recruited patients with EDs (n = 24, ages 12-23 years) representing different diagnoses (anorexia nervosa n = 17, bulimia nervosa n = 4, binge-ED n = 2, avoidant/restrictive food intake disorder n = 1), along with their parents (n = 20), dietitians (n = 11), therapists (n = 14), and primary care providers (n = 9) from three sites: Boston Children's Hospital, University of Michigan C. S. Mott Children's Hospital, and Penn State Hershey Children's Hospital. In-depth, semi-structured, qualitative interviews explored participants' definitions of recovery. Interviews were analyzed using inductive data-driven thematic analysis. Statistical analyses followed to examine the distribution within each theme by respondent type. RESULTS: Qualitative analysis resulted in the emergence of four overarching themes of ED recovery: (a) psychological well-being, (b) eating-related behaviors/attitudes, (c) physical markers, and (d) self-acceptance of body image. Endorsement of themes two and four did not significantly differ between patients, parents, and clinicians. Clinicians were significantly more likely to endorse theme one (χ2 = 9.90, df = 2, p = .007, φc = 0.356) and theme three (χ2 = 6.42, df = 2, p = .04, φc = 0.287) than patients and parents. DISCUSSION: Our study demonstrates overwhelming support for psychological markers as indicators of ED recovery by all three groups. Clinicians should remain open to additional markers of recovery such as body acceptance and eating-related behaviors/emotions that may be of critical importance to patients and their caregivers.

Risk and Resilience in Minority Youth Populations.

This review presents current theory and empirical research that address the interplay between risk and resilience processes among minority youth in the United States. To move the clinical sciences forward in their research and treatment approaches to solving minority-majority health and well-being disparities, ecological, intersectional, and emic (within-group) approaches must be adopted. We discuss the consequences of systematic oppression and marginalization for children in the United States, focusing primarily on research regarding xenophobia, discrimination, and racism. Lastly, we provide examples of recent interventions that take emic approaches to closing minority-majority gaps in developmental outcomes.

Suicidality associated with decreased help-seeking attitudes in college students: Implications for identifying and treating at-risk students.

Suicide is a leading cause of death in college-aged youth, yet only half of all college students report engaging in professional mental health help-seeking. We examined how the various aspects of young adults' suicidality were associated with their openness to pursue professional mental health care in the future (i.e., "future help-seeking intentions"). Multilevel binary logistic regressions were tested in a sample of 24,446 U.S. college undergraduates with suicidality. The moderating effect of past service utilization on future help-seeking intentions was also tested. Strikingly, young people reporting past-year suicidal ideation, past-year suicidal attempts, and self-reported likelihood of a future suicide attempt demonstrated decreased likelihood of future help-seeking intentions, while those reporting prior diagnosis of a mental health condition and/or past service utilization demonstrated an increased likelihood. Past service utilization also significantly moderated the effect of suicide disclosure, such that youth reporting prior disclosure and prior professional treatment-seeking demonstrated greater odds of future help-seeking intentions relative to those who had disclosed suicidality but never utilized professional services. In order to mitigate the mental health crisis facing youth, further exploration is necessary to understand why students with suicidality do not report openness to seek help. It is also imperative to develop and implement novel strategies to identify at-risk students, understand and alleviate relevant barriers to treatment, and promote positive help-seeking attitudes and behaviors.

Transgender Adolescents' Experiences in Primary Care: A Qualitative Study.

PURPOSE: Transgender adults may avoid medical settings due to concerns about discrimination or past experiences of maltreatment. Emerging evidence shows improved outcomes and psychosocial functioning when transgender adolescents receive gender-affirming care, but little is known about transgender adolescents' experiences in primary care. The objective of this study was to learn about the experiences in primary care of transgender and gender nonconforming (TGN) adolescents and their recommendations for primary care practices and clinicians. METHODS: Participants were recruited from primary care clinics, gender care clinics, and list serves. Semistructured qualitative interviews were conducted with 20 TGN adolescents aged 13-21 years (75% white/non-Hispanic, average age 16.7 years). Participants answered questions about primary care experiences, how to improve care, suggestions regarding how to ask about gender identity, and recommendations for making offices more welcoming for TGN adolescents. Interviews were transcribed verbatim, coded, and analyzed for themes. RESULTS: Overall, participants reported positive experiences in primary care. Most participants commented on distress resulting from being called the incorrect name or the incorrect pronoun. Several concrete recommendations emerged from the interviews, including asking all patients about their gender identity and pronouns at every primary care visit and not asking about gender identity when caregivers are in the room. Participants emphasized the importance of using their affirmed name and pronouns and wanted providers to be knowledgeable about transgender health. CONCLUSION: Delivery of primary care services for transgender adolescents may be optimized if offices provide a welcoming environment, use correct names and pronouns, and discuss gender confidentially with patients.