Attachment to Peers and School: Longitudinal Moderators of the Relation Between Caregiver Psychological Distress and Adolescent Hopelessness.

Research has yet to determine how relationships outside of the family system may buffer negative outcomes associated with hopelessness among racial minority youth. In a sample of Black American youth (N = 512; 49% females) and their parents or caregivers, this study used longitudinal growth models to explore whether youth relationships (attachment to peers and attachment to school) moderated the association between caregiver distress (depressive symptoms and traumatic stress), and youth hopelessness. Adolescents' gender was examined to determine if there were gender differences present in these associations. Four linear growth models showed a significant change in levels of hopelessness over time for youth and a significant positive relation between caregiver distress and youth level of hopelessness. Attachment to peers and attachment to school did not equally moderate the relation between caregiver psychological distress and youth hopelessness. The type of caregiver distress had a differential effect on youth hopelessness in the context of the moderation models and based on gender. The type of caregiver distress had a differential effect on youth hopelessness in the context of the moderation models and based on gender. Implications for the importance of non-familial attachments among Black American youth with distressed parents are discussed.

Wellbeing among Black American adults living in low-resourced communities.

Very little is known about how Black Americans living in low-resourced communities define and maintain wellbeing. Utilizing a culturally tailored research design, we explored the phenomenon of wellbeing as it resonated with the lived experiences of our informants (N = 35). Using a thematic analysis, we found that existing conceptualizations and theorizing of wellbeing did not consistently emerge from our data. First, we noted paradoxical tensions between descriptions of wellbeing as indicated by the participants (e.g., being alive and having a pain-free life) and the Western, Eurocentric views evidenced in the wellbeing literature. Second, participants identified intergenerational family ties and community networks as ways that foster wellbeing. These findings suggest that we can no longer delimit and apply existing views in theorizing and measuring wellbeing. Our findings elucidated the mindsets, relationships, activities, and practices that define and foster wellbeing among Black Americans living in low-resourced communities.

Insights and experiences of chaplain interns and social work interns on palliative care teams.

Interdisciplinary palliative care teams provide critical, comprehensive end-of-life care, although the accumulated literature points toward barriers that impede their effectiveness. The current phenomenological qualitative study presents perceptions of chaplaincy interns (N = 24) and social work interns (N = 23) after a semester-long end-of-life clinical training experience with interdisciplinary palliative care teams. Analysis of the end of semester reflections resulted in seven themes, which are fairly consistent with the literature base. The described experiential learning and reflections in the current study are powerful and can inform how to prepare practitioners for teamwork and compassionate end-of-life care.

A longitudinal study of the impact of school delinquency on self-worth development among Black American adolescents.

Previous research found adolescents with low self-worth often utilize delinquency as a method of "self-enhancing" as proposed by Kaplan, which suggests the effects of delinquency can be both enhancing and damaging to adolescents' later reports of self-worth. We tested Kaplan's self-enhancing thesis to determine the extent to which different levels of self-worth in early adolescents foretell long-term levels of self-worth associated with delinquency among adolescents placed at-risk. Data from a sample of 982 primarily Black American (95%) adolescents living in high-poverty neighborhoods were analyzed using global and behavioral self-worth measures collected annually between the ages of 12-17, with school delinquency as the self-enhancing mechanism. Gender (45% female, 55% male) and baseline self-worth measures were included in the model. We found empirical support for the positive effects of school delinquency consistent with self-enhancing theories, although with younger female participants only. Specifically, engaging in delinquent behaviors at age 12 had a positive effect on a females' behavioral self-worth. There were, however, differential effects for males. Although delinquency increased self-worth among females in the short-term, long-term effects were negative, as greater school delinquency resulted in lower self-worth at age 17. Additional gender results and implications for findings are discussed.

The interrelationships among pain interference, depressive symptoms, loneliness, and employment status: a moderated mediation study.

OBJECTIVE: To explore the mediating effect of loneliness on the relationship between pain interference and depressive symptoms and to determine whether this mechanism is contingent on employment status. DESIGN: Cross-sectional study. SUBJECTS: A total of 876 adult caregivers of adolescents living in extremely impoverished conditions. ANALYSIS: Mediation and moderated mediation analyses using standard path-analytic approaches. RESULTS: The mean age of the sample was 39.0 (SD = 12.8) years and 80.7% ( n = 707) identified as female. Almost half (48.9%, n = 425) of the participants did not report any pain, while 32.5% ( n = 285) reported non-disabling pain, and 19.0% ( n = 166) reported disabling pain. The mean depressive symptoms score was 16.20 (SD = 10.6), and the mean loneliness score was 40.09 (SD = 10.5). Loneliness mediated the effect of both non-disabling and disabling pain on depressive symptoms. However, the indirect effect of pain interference on depressive symptoms through loneliness was more pronounced among participants reporting disabling pain (coefficient, 2.11; Boot 95% confidence interval (CI) (1.25-3.01)) than non-disabling pain (coefficient, 0.99; Boot 95% CI (0.25-1.76)). Moderated mediation results showed that the indirect effect of pain interference on depressive symptoms, via loneliness varied in magnitude as a function of employment status among participants reporting disabling pain but not those reporting non-disabling pain. CONCLUSION: Loneliness provides an important link in the relationship between depressive symptoms and pain interference. Furthermore, employment status is an important factor to consider, especially among individuals reporting disabling pain with comorbid depressive symptoms.

Associations Among Depressive Symptoms, Wellness, Patient Involvement, Provider Cultural Competency, and Treatment Nonadherence: A Pilot Study Among Community Patients Seen at a University Medical Center.

Treatment nonadherence is a pernicious problem associated with increasing rates of chronic diseases, escalating healthcare costs, and rising mortality in some patients. Although researchers have suggested numerous factors related to treatment nonadherence, several understudied aspects warrant attention, such as primary-care settings, provider cultural competence, and patient involvement. Adding to the research base, the present pilot study examined 88 primarily Black American and White American community patients from a large university medical center in the southern part of the United States. The study explored two research questions: (a) To what extent are there associations among depressive symptoms, wellness, patient involvement, cultural competency, and treatment nonadherence in a racially diverse community patient population? And (b) to what extent do the study exploratory variables and background characteristics predict treatment nonadherence, both separately and jointly? Depressive symptoms, the patient's perception of a provider's cultural competence, and marital/partnered status were found to be statistically significantly associated with treatment nonadherence, but not entirely in the directions expected.

Relations among suicidality, recent/frequent alcohol use, and gender in a black american adolescent sample: a longitudinal investigation.

OBJECTIVE: Examine longitudinally select factors that may contribute to suicide ideations and attempts in adolescents. METHOD: Using a multiple cohort research design, surveys were administered to a longitudinal sample of Black American adolescents aged 11-18 years. RESULTS: Two logistic growth models were tested with the probability of a suicide ideation (n = 977) and identified suicide attempt (n = 457) as the outcome variables and the recency and frequency of alcohol use and gender as the predictor variables. The recency and frequency of alcohol use was significantly related to suicide ideations and identified attempts in both females and males. These findings were differentiated based on the age effects for recency and frequency of alcohol use. More recent and frequent alcohol use among younger adolescents exacerbated probabilities of suicide ideations and identified suicide attempts compared to older adolescents. CONCLUSION: Results indicate that early systematic assessment of suicidal behavior and alcohol use in Black American adolescents can inform developmentally and culturally responsive prevention and intervention efforts.

Preventing Sexual Harassment in Higher Education: A Framework for Prevention Science Program Development.

Sexual harassment is an intractable problem that harms the students, community, culture, and success of institutes of higher education (IHEs). The alarming prevalence of sexual harassment at IHEs highlights the urgent need for effective prevention programs. However, there are few empirically supported preventive interventions that effectively target the factors that most impact the determinants, trajectory, and short- and intermediate-term effects of sexual harassment. In this paper, we overview the problem of sexual harassment and propose an organizing framework to help IHEs develop effective interventions to prevent sexual harassment. Guided by prevention science, we propose a framework-modified from SAMHSA's (2019) guidelines for prevention practitioners-that underscores the criticality of trauma- and equity-informed characteristics in prevention programs. We offer a discussion on how IHEs must consider and evaluate the empirical evidence of effectiveness, flexibility, cultural competency, and sustainability when developing and adapting prevention programs to reduce and-ultimately-ameliorate sexual harassment. We conclude with recommendations that can provide a roadmap for higher education stakeholders and researchers to prevent this urgent public health concern.

Genetic Risk, Neighborhood Characteristics, and Behavioral Difficulties Among African American Adolescents Living in Very Low-Income Neighborhoods.

Behavioral difficulties among African American youth are disproportionately detrimental to their future well-being compared to when demonstrated by White American youth. The majority of gene-environment studies of behavior have been conducted with European ancestry samples, limiting our knowledge of these processes among African Americans. This study examined the influence of positive and negative neighborhood conditions, in the context of genetic risk, on behavioral difficulties among low-income African American adolescents. Data were from the Genes, Environment, and Neighborhood Initiative study of African American youth in high-poverty neighborhoods, n = 524, M age = 15.89, SD = 1.42. DNA samples were collected using the Oragene Discovery 500 series, and polygenic risk scores for behavioral difficulties computed. Neighborhood informal social control, social cohesion, physical disorder, and social disorder were assessed. Adolescent alcohol use, hyperactivity/inattention and conduct problems were examined as outcomes. After controlling for polygenic risk, lower levels of neighborhood social disorder and higher levels of social cohesion were associated with fewer youth-reported hyperactivity/inattention and conduct problems. Less social disorder also was associated with fewer parent-reported behavioral difficulties. Neighborhood characteristics did not moderate associations between genetic risk and the outcomes. Higher levels of positive and lower levels of negative neighborhood characteristics can be associated with lower levels of behavioral difficulties among African American youth living in poverty, even after taking into account genetic risk.

Examining the aftereffects of Hurricane Katrina in New Orleans: a qualitative study of faculty and staff perceptions.

Researchers have reported how Hurricane Katrina has affected teachers who work with Kindergarten to Grade 12 (K-12), yet little is known about how the natural disaster has affected other important K-12 faculty and staff (e.g., coaches, librarians, school counselors, and cafeteria workers). Missing from the literature is the impact that this natural disaster has had on these formal (school counselors) and informal (coaches, librarians) helpers of K-12 students. Using a focus group methodology, the authors examined the aftereffects of Hurricane Katrina on 12 school employees in New Orleans, Louisiana, 18 months after the hurricane. Informed by qualitative content analysis, three emergent themes were identified: emotion-focused aftereffects, positive coping, and worry and fear. The implications for future research and promoting hope in mental health counseling are discussed.

Using attachment theory in medical settings: implications for primary care physicians.

BACKGROUND: Mental health researchers, clinicians and clinical psychologists have long considered a good provider-patient relationship to be an important factor for positive treatment outcomes in a range of therapeutic settings. However, primary care physicians have been slow to consider how attachment theory may be used in the context of patient care in medical settings. AIMS: In the current article, John Bowlby's attachment theory and proposed attachment styles are proffered as a framework to better understand patient behaviors, patient communication styles with physicians and the physician-patient relationship in medical settings. CONCLUSION: The authors recommend how primary care physicians and other health care providers can translate attachment theory to enhance practice behaviors and health-related communications in medical settings.

ARCCH Model of Resilience: A Flexible Multisystemic Resilience Framework.

The increasing prevalence and impact of trauma, such as adverse childhood experiences, race-based trauma, and a global pandemic, highlight the critical need for a flexible multisystemic framework of resilience. This manuscript outlines the universality of trauma and resilience and also provides a description of the gaps in existing resilience frameworks that led to the development of a flexible multisystemic resilience framework entitled the ARCCH Model of Resilience. Attachment, Regulation, Competence, Culture, and Health are elements of personal and cultural identities, families, communities, and systems that can be used to evaluate strengths, identify areas that need support, and provide steps for culturally responsive and ecologically valid interventions. A multisystemic application of ARCCH is provided.

Parentification in Polish Adolescents: a Prevalence Study.

This study investigated the prevalence of parentification in a nationwide cross-sectional study. There were N = 47,984 Polish adolescents aged 12-21 (M = 15.60; SD = 1.98; female 52.7%, male 47.3%). The results indicated that more adolescents experienced emotional parentification (toward parents 35.9%; toward siblings 25.2%) as compared to instrumental parentification (toward parents 7.2%; toward siblings 15.5%), which is noteworthy, since emotional parentification is the most detrimental form of parentification in USA samples. Overall, 15.5% of the participants reported a sense of injustice related to their family caregiving roles and 61.2% reported satisfaction related to their family caregiving roles. The results are important given the dearth of prevalence studies.

Mental and physical health profile of Syrian resettled refugees.

BACKGROUND: Newly arriving Syrian refugees can present with specific health characteristics and medical conditions when entering the United States. Given the lack of epidemiological data available for the refugee populations, our study examined the demographic features of Syrian refugees resettled in the state of Kentucky. Specifically, we examined mental and physical health clinical data in both pre-departure health screenings and domestic Refugee Health Assessments (RHA; Kentucky Office for Refugees, n.d.) performed after resettlement. METHOD: The current study adopted a cross-sectional research design. We analyzed outcome data collected from participants from 2013 and 2015. Specifically, a comparative cross-sectional analysis was performed using clinical data from Syrian refugees who underwent an RHA as part of the resettlement process between January 2015 and August 2016. Those data were compared to data derived from refugees from other countries who resettled in Kentucky between 2013 and 2015. RESULTS: Mental health screenings using the Refugee Health Screener (RHS-15; Hollifield et al., 2013) found that 19.5% (n = 34) of adult Syrian refugees reported signs and symptoms from posttraumatic stress, depressive symptoms, and/or anxiety, and nearly 40% (n = 69) reported personal experiences of imprisonment or violence, and/or having witnessed someone experiencing torture or violence. Intestinal parasites and lack of immunity to varicella were the most prevalent communicable diseases among Syrian refugees. Dental abnormalities and decreased visual acuity account for the first and second most prevalent non-communicable conditions. When comparing these results to all refugees arriving during the same years, significant differences arose in demographic variables, social history, communicable diseases, and non-communicable diseases. CONCLUSION: This study provides an initial health profile of Syrian refugees resettling in Kentucky, which reflects mental health as a major healthcare concern. Posttraumatic stress and related symptoms are severe mental health conditions among Syrian refugees above and beyond other severe physical problems.

Characterizing the magnitude of the relation between self-reported childhood parentification and adult psychopathology: a meta-analysis.

Several decades of research have shown that people who experience parentification in childhood are at an increased risk of experiencing psychopathology in adulthood. A meta-analysis was conducted to examine the magnitude of the relation between self-reported parentification experienced in childhood and psychopathology evidenced in adulthood. Results from 12 nonoverlapping studies (N = 2,472), which were conducted between 1984 and 2010, revealed a small significant but reliable effect (r = .14; 95% confidence interval = .10 to .18). Moderator analyses were performed to explore possible explanations for the variance evidenced between parentification and psychopathology. Moderators that were examined include population factors, methodological factors, and type of psychopathology. The present findings indicate that four factors-types of psychopathology, type of sample, race, and parentification measure used-moderated the relation between parentification and psychopathology. The meta-analytic findings that emerged highlight the need for additional empirical research. Possible explanations and clinical

The Relations Among Types of Parentification, School Achievement, and Quality of Life in Early Adolescence: An Exploratory Study.

Children who experience parentification may have trouble performing developmental tasks due to being overwhelmed by their family caregiving roles and responsibilities. Past studies have found that parentification is negatively associated with academic achievement. However, most of these studies are limited in that they are retrospective and examine the association but not the mechanisms shaping them. The aim of the study was to explore to what extent diverse types of parentification relate to academic achievement and to what extent these relations are mediated by self-reported quality of life among adolescents. The study sample was composed of Polish early adolescents (N = 191; age: M = 14.61; SD = 1.26). Types of parentification were measured with the Parentification Questionnaire for Youth, and quality of life was assessed with KidScreen27. School achievement was measured based on mean semester grade. We explored the associations among study variables and performed six mediation models in the planned analyses. Overall, bivariate relations were significant in a theoretically expected way, although the effect sizes for these associations were rather small. In the mediation analyses, the results showed that four of the six models were not significant. Different from previous studies, instrumental parentification was positively related to school achievement. Additionally, this positive association was mediated by adolescents' general quality of life. Taken together, the findings were similar and different from the empirical literature base on types of parentification and select outcomes.

Racial and Language Microaggressions in the School Ecology.

The growth trajectory of ethnically and linguistically diverse individuals in the United States, particularly for youth, compels the education system to have urgent awareness of how diverse aspects of culture (e.g., Spanish-speaking, Black Latina student) are implicated in outcomes in American school systems. Students spend a significant amount of time in the school ecology, and this experience plays an important role in their well-being. Diverse ethnic, racial, and linguistic students face significant challenges and are placed at considerable risk by long-observed structural inequities evidenced in society and schools. Teachers must develop the capacity to be culturally sensitive, provide culturally responsive pedagogy, and regularly self-assess for biases implicated in positive academic outcomes for students in kindergarten through Grade 12. Research and practice have suggested that racism and discrimination in the form of racial microaggressions are observed daily in schools and classrooms. This article provides an overview of racial microaggressions in the school context and their damaging effects on students. We provide specific examples of microaggressions that may be observed in the U.S. classroom environment and how schools can serve as a positive intervention point to ameliorate racism, discrimination, and racial and language microaggressions. This comprehensive approach blends theory with practice to support the continued development of cultural humility, culturally sustaining pedagogy, and an equity-responsive climate.

Depression and intimate partner violence among urban Kenyan caregivers of children with disabilities.

WHAT IS KNOWN ON THE SUBJECT?: Caregivers of children with disabilities are at increased risk of experiencing interpersonal violence and its consequences; however, there is limited research targeting this population. This problem is understudied in Sub-Saharan Africa. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Study examines intimate partner violence and depression among men and women caregivers of children with disabilities. Study findings showed that while a higher proportion of women caregivers of children with disabilities than men reported experiencing intimate partner violence and were at increased risk depression, the differences were not statistically significant. Participants reporting any form of violence (i.e. psychological aggression or physical assault) were at increased risk for depression, with those experiencing a combination of physical assault and psychological aggression having the highest risk for depression. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Professionals working families of individuals with disabilities should be cognizant of the added stress and comorbid factors associated with caring for a child with a disability. Future research should examine whether there is a causal relationship between intimate partner violence and depression among caregivers of children with disabilities and compare this relationship with the general population. ABSTRACT: Introduction Mental health correlates of intimate partner violence (IPV) victimization are well documented. However, caregivers of children with disabilities (CCWDs) are underrepresented in empirical investigations and may have an increased risk of experiencing IPV and its consequences. This is particularly important in Sub-Saharan Africa where this problem is understudied. Method The present study estimated the prevalence of IPV victimization and examined the association between IPV and depression in a sample of CCWDs living in Nairobi, Kenya. Results Nearly half (49.8%) of the participants experienced some form of IPV and more than half (51.8%) were at risk of depression. Participants reporting psychological and physical violence were 1.76 and 4.81 times more likely to be at risk for depression, respectively. Those experiencing a combination of physical and psychological violence were 4.85 times more likely to be at risk for depression. Discussion Both men and women CCWDs are at an increased risk for IPV and depression. Social-cultural factors are also important in the prediction of depression risk and should be taken into account when working with CCWDs. Implications Mental health professionals should be cognizant of the added stress of being a CCWD, and the link between CCWDs and comorbid mental health outcomes.

Traumatic Experiences and Mental Health Risk for Refugees.

Refugees who settle in Western countries exhibit a high rate of mental health issues, which are often related to experiences throughout the pre-displacement, displacement, and post-displacement processes. Early detection of mental health symptoms could increase positive outcomes in this vulnerable population. The rates and predictors of positive screenings for mental health symptoms were examined among a large sample of refugees, individuals with special immigrant visas, and parolees/entrants (N = 8149) from diverse nationalities. Logistic regression analyses were used to determine if demographic factors and witnessing/experiencing violence predicted positive screenings. On a smaller subset of the sample, we calculated referral acceptance rate by country of origin. Refugees from Syria, Iraq, and Afghanistan were most likely to exhibit a positive screening for mental health symptoms. Refugees from Sudan, Iraq, and Syria reported the highest rate of experiencing violence, whereas those from Iraq, Sudan, and the Democratic Republic of Congo reported the highest rate of witnessing violence. Both witnessing and experiencing violence predicted positive Refugee Health Screener-15 (RHS-15) scores. Further, higher age and female gender predicted positive RHS-15 scores, though neither demographic variable was correlated with accepting a referral for mental health services. The findings from this study can help to identify characteristics that may be associated with risk for mental health symptoms among a refugee population.