Parental Monitoring, Association with Externalized Behavior, and Academic Outcomes in Urban African-American Youth: A Moderated Mediation Analysis

African-American adolescents exposed to neighborhood disadvantage are at increased risk for engaging in problem behavior and academic underachievement. It is critical to identify the mechanisms that reduce problem behavior and promote better academic outcomes in this population. Based on social disorganization and socioecological theories, the current prospective study examined pathways from parental monitoring to academic outcomes via externalizing behavior at different levels of neighborhood disadvantage. A moderated mediation model employing maximum likelihood was conducted on 339 African-American students from 9th to 11th grade (49.3% females) with a mean age of 14.8 years (SD ± 0.35). The results indicated that parental monitoring predicted low externalizing behavior, and low externalizing behavior predicted better academic outcomes after controlling for externalizing behavior in 9th grade, intervention status, and gender. Mediation was supported, as the index of mediation was significant. Conversely, neighborhood disadvantage did not moderate the path from parental monitoring to externalizing behavior. Implications for intervention at both community and individual levels and study limitations are discussed.

Poor CD4 count is a predictor of untreated depression in human immunodeficiency virus-positive African-Americans

AIM: To determine if efforts to improve antiretroviral therapy (ART) adherence minimizes the negative impact of depression on human immunodeficiency virus (HIV) outcomes.

METHODS: A cross-sectional study of a clinic-based cohort of 158 HIV seropositive (HIV+) African Americans screened for major depressive disorder (MDD) in 2012. CD4 T lymphocyte (CD4+) counts were obtained from these individuals. Self-report on adherence to ART was determined from questionnaire administered during clinic visits. The primary outcome measure was conditional odds of having a poorer CD4+ count (< 350 cells/mm³). Association between CD4+ count and antidepressant-treated or untreated MDD subjects was examined controlling for self-reported adherence and other potential confounders.

RESULTS: Out of 147 individuals with available CD4+ T lymphocyte data, 31% hadCD4+ count < 350 cells/mm³ and 28% reported poor ART adherence. As expected the group with > 350 cells/mm³ CD4+ T lymphocyte endorsed significantly greater ART adherence compared to the group with < 350 cells/mm³ CD4+ T lymphocyte count (P < 0.004). Prevalence of MDD was 39.5% and 66% of individuals with MDD took antidepressants. Poor CD4+ T lymphocyte count was associated with poor ART adherence and MDD. Adjusting for ART adherence, age, sex and education, which were potential confounders, the association between MDD and poor CD4+ T lymphocyte remained significant only in the untreated MDD group.

CONCLUSION: Therefore, CD4+ count could be a clinical marker of untreated depression in HIV+. Also, mental health care may be relevant to primary care of HIV+ patients.

Mother-adolescent relationship quality as a moderator of associations between racial socialization and adolescent psychological adjustment

Parents' racial socialization messages, including messages focused on awareness, preparation, and strategies for managing racial discrimination, are necessary to help African American youth successfully navigate their daily lives. However, mixed findings regarding the utility of preparation for bias messages for African American youth's mental health adjustment raise questions about the conditions under which these protective racial socialization messages are most beneficial to African American youth. The current study examined the degree to which communication and trust as well as anger and alienation in the mother-adolescent relationship moderated associations between 2 types of preparation for bias messages, cultural alertness to discrimination and cultural coping with antagonism, and adolescent mental health. Participants were 106 African American adolescents (57% female; mean age = 15.41) who reported about their receipt of racial socialization messages, mother-adolescent relationship quality, and depressive symptoms. Hierarchical regression analyses indicated that positive associations between cultural alertness to racial discrimination and youth depressive symptoms were weaker for boys in the context of higher mother-adolescent communication and trust; communication and trust were not similarly protective for girls. For boys, the positive associations between cultural coping with antagonism messages and depressive symptoms were stronger in the context of high anger and alienation in the mother-adolescent relationship. Findings suggest that qualities of the mother-adolescent relationship, in which preparation for bias messages are delivered, are important for understanding the mental health adjustment of African American adolescents.

The protective role of maternal racial socialization for African American adolescents exposed to community violence

Urban African American youth's disproportionate exposure to community violence and increased risk for its adverse consequences have heightened interest in identifying protective factors that mitigate the effects of community violence exposure for these youth. Thus, the present study examined whether maternal racial socialization messages protect African American adolescents against the adverse effects of community violence exposure. Participants were a community sample of African American adolescents (N = 106; mean age = 15.41 years) and their female guardians. For community-violence-exposed youth, maternal racial socialization messages protected against aggressive behaviors and depressive symptoms, such that maternal messages about cultural pride attenuated the association between community violence exposure and parent-reported aggressive behaviors, and cultural appreciation of legacy messages attenuated the association between community violence exposure and adolescent-reported depressive symptoms. Findings highlight the need to integrate race-relevant factors into preventive interventions targeting African American youth at risk for or exposed to community violence, and suggest that family interventions promoting parents' efficacy to implement racial socialization practices are useful for youth exposed to violence.

Neighborhood racial composition, racial discrimination, and depressive symptoms in African Americans

While evidence indicates that experienced racial discrimination is associated with increased depressive symptoms for African Americans, there is little research investigating predictors of experienced racial discrimination. This paper examines neighborhood racial composition and sociodemographic factors as antecedents to experienced racial discrimination and resultant levels of depressive symptoms among African American adults. The sample included 505 socioeconomically-diverse African American adults from Baltimore, MD. Study data were obtained via self-report and geocoding of participant addresses based on 2010 census data. Study hypotheses were tested using multiple pathways within a longitudinal Structural Equation Model. Experienced racial discrimination was positively associated with age and sex such that older individuals and males experienced increased levels of racial discrimination. In addition, the percentage of White individuals residing in a neighborhood was positively associated with levels of experienced racial discrimination for African American neighborhood residents. Experienced racial discrimination was positively associated with later depressive symptoms. Neighborhood-level contextual factors such as neighborhood racial composition and individual differences in sociodemographic characteristics appear to play an important role in the experience of racial discrimination and the etiology of depression in African American adults.

Long-term consequences of pubertal timing for youth depression: Identifying personal and contextual pathways of risk

This research explored sex differences in the pathways linking pubertal timing to depression across 4 years. A sample of 167 youth (M age = 12.41 years, SD = 1.19) and their caregivers completed measures of puberty and semistructured interviews of interpersonal stress and youth depression. Youth reported on psychological (negative self-focus, anxious arousal) and social-behavioral (coping) characteristics; parents reported on youths' social-behavioral characteristics (withdrawal/social problems) and deviant peer affiliations. Early maturation predicted stable high trajectories of depression in girls; although early maturing boys showed low initial levels of depression, they did not differ from girls by the final wave of the study. Latent growth curve analyses identified several psychological, social-behavioral, and interpersonal pathways accounting for the contribution of pubertal timing to initial and enduring risk for depression in girls as well as emerging risk for depression in boys. These findings provide novel insight into multilevel processes accounting for sex differences in depression across the adolescent transition.

Depressive symptoms in low-income, urban adolescents: cognitive and contextual factors

This study examined the relationships among cognitive variables, family immigration history, negative life events, and depressive symptoms in a sample of 306 low-income, urban fifth- and sixth-grade children. Explanatory style and negative automatic thoughts were the cognitive variables examined. There were three key findings. First, children who were immigrants reported significantly more depressive symptoms, more negative life events, and more negative automatic thoughts than children who were not immigrants. Second, both explanatory style and negative automatic thoughts were significantly associated with depressive symptoms above and beyond the effects of child immigration history and negative life events. Finally, negative automatic thoughts mediated the relationship between child immigration history and depressive symptoms. We discuss the clinical and research implications of these findings.

The role of socially prescribed perfectionism in the link between perceived racial discrimination and African American adolescents' depressive symptoms

Research examining the social origins of perfectionism has focused on negative evaluative experiences in the family, with less attention to negative social evaluations in other contexts and situations relevant for African American adolescents. The experience of racial discrimination is common for African American youth, and may trigger maladaptive perfectionistic beliefs if the youth perceive that they do not meet others' standards (socially prescribed perfectionism) or internalize discriminatory messages. Thus, the present study examined longitudinal associations among racial discrimination, socially prescribed perfectionism, and depressive symptoms among a community sample of urban and predominantly low income African American adolescents (n = 492; 46.7 % female). In each of grades 7, 8 and 9, participants reported their experiences with racial discrimination, perfectionistic beliefs, and depressive symptoms. Analyses revealed that experiences with racial discrimination in grade 7 were associated with socially prescribed perfectionism in grade 8 which, in turn, was linked with depressive symptoms in grade 9. Results suggest that prospective associations between the experience of racial discrimination and depressive symptoms are due, in part, to increased socially prescribed perfectionism. Implications for interventions targeting depression in African American are discussed.

Longitudinal associations between experienced racial discrimination and depressive symptoms in African American adolescents

While recent evidence has indicated that experienced racial discrimination is associated with increased depressive symptoms for African American adolescents, most studies rely on cross-sectional and short-term longitudinal research designs. As a result, the direction and persistence of this association across time remains unclear. This article examines longitudinal associations between experienced racial discrimination and depressive symptoms among a community sample of African American adolescents (N = 504) from Grade 7 to Grade 10, while controlling for multiple alternative causal pathways. Sex was tested as a moderator of the link between experienced racial discrimination and later depressive symptoms. Structural equation modeling revealed that experienced racial discrimination was positively associated with depressive symptoms 1 year later across all waves of measurement. The link between experienced racial discrimination at Grade 7 and depressive symptoms at Grade 8 was stronger for females than males. Findings highlight the role of experienced racial discrimination in the etiology of depressive symptoms for African Americans across early adolescence.

Psychological symptoms linking exposure to community violence and academic functioning in African American adolescents

African American adolescents are exposed disproportionately to community violence, increasing their risk for emotional and behavioral symptoms that can detract from learning and undermine academic outcomes. The present study examined whether aggressive behavior and depressive and anxious symptoms mediated the association between exposure to community violence and academic functioning, and if the indirect effects of community violence on academic functioning differed for boys and girls, in a community sample of urban African American adolescents (N = 491; 46.6 % female). Structural equation modeling was used to examine the indirect effect of exposure to community violence in grade 6 on grade 8 academic functioning. Results revealed that aggression in grade 7 mediated the association between grade 6 exposure to community violence and grade 8 academic functioning. There were no indirect effects through depressive and anxious symptoms, and gender did not moderate the indirect effect. Findings highlight the importance of targeting aggressive behavior for youth exposed to community violence to not only improve their behavioral adjustment but also their academic functioning. Implications for future research are discussed.

Relationship proximity to victims of witnessed community violence: associations with adolescent internalizing and externalizing behaviors

Witnessing community violence has been linked with several adverse outcomes for adolescents, including emotional and behavioral problems. Among youth who have witnessed community violence, proximity to the victim of community violence is one factor that may determine, in part, the nature of adolescents' responses to community violence exposure. The present study examines whether relationship proximity to the victim of community violence is associated with internalizing and externalizing behaviors among a sample of urban and predominantly African American adolescents (N = 501) who have witnessed community violence. In 10th grade, participants reported whether they had witnessed 10 community violence events during the past year, and, if so, whether the victim of the violence was a family member, close friend, acquaintance, or stranger. Witnessed community violence against a family member or close friend was associated with depressive symptoms, and witnessed community violence against known individuals was associated with anxiety symptoms. Witnessing community violence against familiar persons and strangers was linked with aggressive behavior. Gender differences in these associations and implications for assessment and intervention with community violence-exposed youth are discussed.

Life events and depressive symptoms in African American adolescents: do ecological domains and timing of life events matter?

Considerable research has documented associations between adverse life events and internalizing symptoms in adolescents, but much of this research has focused on the number of events experienced, with less attention to the ecological context or timing of events. This study examined life events in three ecological domains relevant to adolescents (i.e., family, peers, themselves) as predictors of the course of depressive symptoms among a community epidemiologically defined sample of 419 (47.2% females) urban African American adolescents. Given that youth depressive symptoms change over time, grade level was examined as a moderator. For males, the strength of associations between life events happening to participants, family life events, and peer life events and depressive symptoms did not change from grades 6-9. For females, the strength of the association between peer life events and depressive symptoms did not change over time, but the strength of associations between life events happening to participants and family life events and females' depressive symptoms decreased over time. Implications of the findings and directions for future research are discussed.

Examining the developmental process of risk for exposure to community violence among urban youth

Considerable research has documented the effects of community violence exposure on adolescents' behavior and mental health functioning, yet there has been less research on the process by which early risks increase the likelihood that youth will be exposed to community violence. The current study used data from a community epidemiologically defined sample of 623 urban youth followed from 1st grade through adolescence to examine the process by which early-onset aggressive behavior and poor academic readiness influenced risk for community violence exposure. Consistent with transactional developmental theories, early-onset aggressive and disruptive behavior was associated with poor academic readiness; these early risks contributed to later peer rejection, and subsequent conduct problems and greater affiliation with deviant peers, which in turn increased youths' exposure to community violence. Having an enhanced understanding of the risk process directs attention to potential targets for preventive interventions for youth at risk for subsequent exposure to violence.

DISCREPANCIES BETWEEN COMMUNITY VIOLENCE EXPOSURE AND PERCEIVED NEIGHBORHOOD VIOLENCE

Community violence exposure (CVE) has been identified as a significant public health concern given its association with numerous mental health problems. Perceptions of neighborhood violence (PNV) also may adversely affect youth adjustment. In recognition that PNV may differ from individuals own experience of CVE, the current study utilized latent class analysis to examine the degree and consequences of consistency and discrepancy in adolescents community violence exposure and PNV. Participants included an epidemiologically-defined community sample of 456 African American adolescents (52% male; mean age=11.77). Results revealed three groups of youth: high CVE/high PNV, low CVE/low PNV, and low CVE/high PNV. Longitudinal analyses suggest that a discrepancy between CVE and PNV is important for understanding depressive and anxious symptoms among urban African American youth. Implications for intervention are discussed.

Patterns of community violence exposure during adolescence

This study examined cross-sectional and longitudinal patterns of community violence exposure and malleable predictors of these exposure patterns among a community sample of 543 urban African American early adolescents (45.3% female; mean age: 11.76). In each of grades 6, 7, and 8, latent class analyses revealed two patterns of community violence exposure: high exposure and low exposure. For the majority of participants, experiences with community violence were similar at each grade. Impulsive behavior and depressive symptoms distinguished adolescents in the high and low exposure classes in grade 6. Implications for interventions to prevent community violence exposure are discussed.

Social network influences on service use among urban, African American youth with mental health problems

PURPOSE

To examine the associations between the size and quality of African-American adolescents' social networks and their mental health service use, and to examine whether these social network characteristics moderate the association between need for services because of emotional or behavioral difficulties and use of services.

METHOD

Participants were a community sample of African-American adolescents (N = 465; 46.2% female; mean age, 14.78) initially recruited in 1st grade for participation in an evaluation of two preventive intervention trials. Social network influences and adolescents' mental health service use in schools and community were accessed.

RESULTS

A significant positive association between adolescents' perception that their social network was helpful and their use of school mental health services was identified. The significant associations between need for services for anxiety, depression, or behavior problems, and school and outpatient service use were moderated by size of the social network. Specifically, among youth in need of services for anxiety or depression, school-based service use was higher for those with larger social networks.

CONCLUSIONS

Implications for enhancing access to formal mental health services include further examination of key social network influences that potentially serve as facilitators or barriers to formal help-seeking. The findings also suggest that it might be important to integrate social network members into interventions to address the mental health needs of adolescents.

Community violence, protective factors, and adolescent mental health: a profile analysis

This study examined interrelationships among community violence exposure, protective factors, and mental health in a sample of urban, predominantly African American adolescents (N = 504). Latent Profile Analysis was conducted to identify profiles of adolescents based on a combination of community violence exposure, self-worth, parental monitoring, and parental involvement and to examine whether these profiles differentially predict adolescents' depressive symptoms and aggressive behavior. Three classes were identified-a vulnerable class, a moderate risk/medium protection class, and a moderate risk/high protection class. The classes differentially predicted depressive symptoms but not aggressive behavior for boys and girls. The class with the highest community violence exposure also had the lowest self-worth.

Contextual stress and health risk behaviors among African American adolescents

This study examined the longitudinal association between contextual stress and health risk behaviors and the role of protective factors in a community epidemiologically-defined sample of urban African American adolescents (N = 500; 46.4% female). Structural equation modeling was used to create a latent variable measuring contextual stress (community violence, neighborhood disorder, and experiences with racial discrimination). Contextual stress in 8th grade was associated with aggressive behavior and substance use 2 years later for boys. For girls, contextual stress predicted later substance use, but not aggressive behavior. High academic competence and self-worth reduced the impact of contextual stress on substance use for boys. Implications for intervention and directions for future research on health risk behaviors among African American adolescents are discussed.

Contextual stress and health risk behaviors among African American adolescents

This study examined the longitudinal association between contextual stress and health risk behaviors and the role of protective factors in a community epidemiologically-defined sample of urban African American adolescents (N = 500; 46.4% female). Structural equation modeling was used to create a latent variable measuring contextual stress (community violence, neighborhood disorder, and experiences with racial discrimination). Contextual stress in 8th grade was associated with aggressive behavior and substance use 2 years later for boys. For girls, contextual stress predicted later substance use, but not aggressive behavior. High academic competence and self-worth reduced the impact of contextual stress on substance use for boys. Implications for intervention and directions for future research on health risk behaviors among African American adolescents are discussed.

Depressed mood and the effect of two universal first grade preventive interventions on survival to the first tobacco cigarette smoked among urban youth

INTRODUCTION

As part of an evaluation of two first-grade, universal preventive interventions whose proximal targets were early learning and behavior, we investigated the influence of depressed mood, the interventions, and their interaction on survival to the first tobacco cigarette smoked through age 19. One intervention focused on improving teacher behavior management and instructional skills (Classroom-Centered, CC) as a means of improving student behavior and learning and the other on the family-school partnership (FSP). Variation in the relationship between depressed mood and first cigarette smoked by gender and grade was also examined.

METHODS

Self-reports of smoking behavior and depressed mood were collected on an annual basis from grade 6 through age 19. The present analyses were restricted to the 563 youth who had never smoked by grade 6, or 83% of the original sample of first grade participants. Discrete-time survival analysis was used to examine the effects of depressed mood and the interventions on survival to the first tobacco cigarette smoked.

RESULTS

Depressed mood was associated with reduced survival time to the first cigarette smoked (adjusted hazard ratio, aHR: 1.4; 95% CI: 1.1-1.9), whereas the CC intervention prolonged survival time (aHR: 0.8; 95% CI: 0.7-0.9). No significant variation in the effect of depressed mood on survival was found by gender or grade, nor was the effect of the CC intervention moderated by depressed mood.

CONCLUSIONS

Strategies to prevent tobacco cigarette smoking should include both a focus on depressed mood in adolescence as well as on early success in elementary school.

Low Academic Competence in First Grade as a Risk Factor for Depressive Cognitions and Symptoms in Middle School

The present study investigated the role of low academic competence in the emergence of depressive cognitions and symptoms. Structural equation modeling was conducted on a longitudinal sample of African American boys (n = 253) and girls (n = 221). Results supported the hypothesized path models from academic competence in 1st grade to depressive symptoms in 7th grade, controlling for a host of correlated constructs (conduct problems, inattention, social problems). Perceived control in 6th grade mediated the effect of academic competence on depressive symptoms. Although the models fit the data well for both boys and girls, the path coefficients were notably larger for girls; in particular, multiple-group analysis revealed a statistically stronger effect of low academic competence on perceptions of control for girls. The study and findings fit well with counseling psychologists' commitment to prevention activities and to culture-specific research. Implications for designing interventions and prevention strategies for children with early academic problems are discussed.

Academic pathways between attention problems and depressive symptoms among urban African American children

The present study investigated the pathways between attention problems and depressive symptoms, particularly the role of academic incompetence, among a community sample of urban African American children. Results supported the hypothesized path models from inattention to depressive symptoms for girls and boys. Academic performance in the spring of first grade mediated the relationship between inattention in fall of first grade and depressive symptoms in spring of 3rd grade. The effects held when controlling for conduct problems and academic competence in first grade suggesting the path was specific to attention problems rather than a more general externalizing or school readiness pathway. Implications for designing interventions and prevention strategies for children with attention problems and depressive symptoms are discussed.

Traumatic stress symptoms in women exposed to community and partner violence

Prior research documents increased trauma symptoms associated with exposure to violence, primarily by examining types of violence separately. This study extends prior research by examining traumatic stress symptoms associated with two types of violence exposure, community violence and partner violence. A sample of 90 low-income African American women from an urban area completed measures assessing exposure to community violence, partner violence, and trauma symptoms. Exposure to community violence and partner violence were associated with increased reporting of trauma symptoms. Participants who experienced high levels of exposure to both types of violence reported more trauma symptoms than women who were exposed to only one type of violence or neither type of violence. The results suggest that the accumulation of exposures to violence is linked with greater distress. Thus, interventions with women exposed to violence should assess violence exposure in multiple domains and attend to the implications of multiple exposures to violence.

Risk factors for community violence exposure in adolescence

Community violence is recognized a significant public health problem. However, only a paucity of research has examined risk factors for community violence exposure across domains relevant to adolescents or using longitudinal data. This study examined youth aggressive behavior in relation to community violence exposure among a community epidemiologically defined sample of 582 (45% female) urban adolescents. Internalizing behaviors, deviant peer affiliation, and parental monitoring were examined as moderators of the association between aggressive behavior and exposure to community violence. For males with aggressive behavior problems and deviant peer affiliation or low parental monitoring, co-occurring anxiety symptoms protected against subsequent witnessing community violence. In contrast, males with aggressive behavior problems and co-occurring depressive symptoms were at increased risk for witnessing community violence. Implications of the findings for preventive interventions and future research are discussed.