The Ethnic Context of Child and Adolescent Problem Behavior: Implications for Child and Family Interventions

The Strong African American Families Program: Disrupting the Negative Consequences of Racial Discrimination Through Culturally Tailored, Family-Based Prevention

Racism continues to be a major source of stress for African Americans and can impair psychological functioning. Adolescents experiencing discrimination may engage in self-soothing, but risky behaviors, which leave them at risk for negative life trajectories. Black pride has been identified as a key factor in explaining the heterogeneity in responses to discrimination. Racial socialization, strategies parents use to promote Black pride and protect youth from discrimination, is an important focus of family-based prevention programs serving African American families. This study tests the efficacy of a culturally tailored preventive intervention for rural African American families to disrupt the negative consequences of discrimination on adolescent psychological functioning. Four waves of data from the Strong African American Families (SAAF) efficacy trial (Murry & Brody in Journal of Marital & Family Therapy 30(3):271-283, 2004) with 667 African American families in rural Georgia were used for this study. Structural equation modeling was used to test study hypotheses. Adolescent experiences with discrimination at age 15 predicted concurrent psychological functioning and multiple risk behaviors at age 16, including sexual risk behavior, substance use problems, academic failure, and juvenile justice involvement. Mediation analyses demonstrated that psychological functioning was a significant mediator of these relations. The SAAF program was associated with increases in racial socialization, which in turn fostered gains in adolescent Black pride. Black pride was indirectly associated with reduced risk behavior through adolescent psychological functioning, but Black pride did not moderate the effect of discrimination on psychological functioning. This study confirms that family-based prevention can support African American adolescent mental health in the context of discrimination. However, more emphasis on reducing exposure to discrimination is needed.

Challenges Associated with Parenting While Incarcerated: A Review

Of the 2.5 million people who are incarcerated in the United States, over half are parents. While it is well-established that incarceration has a detrimental impact on the children of incarcerated parents, less is known regarding the psychological impact of incarceration on parents themselves. The present review summarizes existing literature on the impact of incarceration on parents retrieved via online databases. Published articles were classified according to their overall themes and summarized. Pertinent studies include the psychological and emotional consequences of incarceration on parents, the experience of parenting while incarcerated, including barriers to parenting, the utility of parenting program interventions during periods of incarceration, and how these results differ for mothers and fathers. While the existing evidence introduces these issues, there is a need for additional research on the impact of incarceration on parents. These areas for future research as well as clinical implications are discussed.

Influencing Factors of Depression among Adolescent Asians in North America: A Systematic Review

Background: Asian American adolescents experience rates of depression comparable to or greater than those of other ethnic minorities. The purpose of this systematic review is to summarize psychosocial factors related to depressive symptoms of Asian American adolescents between the ages of 10 to 19. Methods: Various electronic databases were systematically searched to identify research articles published from 2000 to 2021, and the psychosocial factors influencing depression among Asian adolescents in North America were examined. Results: A total of 81 studies were included in this systematic review. Consistent findings on relationships between depressive symptoms and influencing factors included (a) acculturative stress, (b) religious or spiritual significance for females, (c) parent–child cohesion, (d) harsh parenting style, (e) responsive parenting style, (f) racial or ethnic discrimination, (g) being bullied, (h) positive mentor presence, and (i) exposure to community violence. Collectively, the majority of included studies suggest that depressive symptoms were more likely found among Asian American adolescents who (a) are older, (b) are female, (c) have immigrant status, (d) exhibit coping behaviours, (e) face academic challenges, (f) face a poor socioeconomic situation, (g) perceive parent–child conflict, (h) perceive maternal disconnectedness, and (i) perceive negative peer relations. A number of conflictive findings also existed. Discussion/Conclusions: This systematic review provides a summary of the various psychosocial factors on individual, familial, and social levels, which influenced the depressive symptoms of Asian American adolescents. Such findings offer a starting point to examine what factors should be necessarily included in related depression-preventive intervention design and evaluation. Culturally sensitive care, strengthened family–school–community collaboration, and targeted research efforts are needed to meet the needs of Asian adolescents experiencing a range of depressive symptoms.

Parent-child relationship quality and sleep among adolescents: modification by race/ethnicity

BACKGROUND

Both parent-child relationship quality (PCRQ) and sleep are important for health and development, but few studies have examined links between PCRQ and adolescent sleep and potential interactions by race/ethnicity or sex.

METHODS

We used cross-sectional data from 6,019 participants (mean = 15.9 years; 50% male; 66% non-Hispanic White, 16% non-Hispanic Black, 5% Hispanic all races) from the National Longitudinal Study of Adolescent to Adult Health, a nationally representative sample of U.S. adolescents. Our exposure was current adolescent-rated PCRQ score. Outcomes were adolescents' reports of chronic insufficient sleep, sleep duration (mins), and frequency of insomnia symptoms (i.e., trouble falling or staying asleep "almost every day"/"every day" versus "never"/"just a few times"/"about once a week").

RESULTS

Adjusting for demographic characteristics, each 1-point increase in PCRQ score was associated with lower odds of insomnia symptoms (odds ratio [OR] = 0.92, 95% confidence interval [CI]: 0.90, 0.94), chronic insufficient sleep (OR = 0.93, 95% CI: 0.91, 0.95), and longer sleep duration (B = 2.56, 95% CI: 1.90, 3.22). After adjustment for depressive symptoms, the association with insomnia symptoms was no longer statistically significant. Race/ethnicity moderated the association between PCRQ and chronic insufficient sleep such that the magnitude of the association was greater in Hispanics vs. Whites and Blacks. There were no interactions of PCRQ with sex.

CONCLUSIONS

Among adolescents, better PCRQ was associated with better sleep, and this association varied by race/ethnicity for perceived chronic insufficient sleep. Longitudinal studies with objective and subjective sleep measures are needed to further understand these associations.

Are parenting practices associated with the same child outcomes in sub-Saharan African countries as in high-income countries? A review and synthesis

Introduction

There is increasing interest in the transferability of parenting interventions from high-income countries (HICs) to low-income countries (LICs) in order to improve child development and health outcomes. This is based on the premise that associations between parenting practices and child outcomes are similar in both settings. Many parenting interventions in HICs are evidence-based, but less evidence exists on associations of parenting practices with child outcomes in LICs, in particular, sub-Saharan African (SSA) countries. This review synthesises evidence on the association of parenting practices with child outcomes in SSA in order to compare findings with those from HICs.

Methods

We searched electronic databases—Web of Science, ASSIA, Embase, IBSS and PsycINFO—to identify studies from SSA that reported quantitative associations between parenting practices and child health or psychosocial outcomes (eg, sexual and reproductive health (SRH), mental health, conduct disorders). Due to inconsistent conceptual framing of parenting across studies, we used a modified version of the international WHO classification of parenting dimensions to guide synthesis of the results.

Results

Forty-four studies met our inclusion criteria. They were conducted in 13 SSA countries and included cross-sectional and longitudinal studies, and were predominantly descriptive studies rather than intervention research. Synthesis of results showed that associations between patterns of parenting (‘positive’/‘harsh’) and child outcomes (including SRH, mental health and conduct disorders) in studies from SSA were broadly similar to those found in HICs.

Conclusions

These findings suggest that the impacts of parenting practices on child outcomes are similar across contrasting global regions and, therefore, parenting interventions from HICs might be successfully transferred to SSA, subject to appropriate adaptation. However, this review also highlights the paucity of evidence in this area and the urgent need for higher quality studies to confirm these findings to help develop effective parenting interventions in SSA.

Responsive Aggression Regulation Therapy (Re-ART): An Evaluation Study in a Dutch Juvenile Justice Institution in Terms of Recidivism

This article describes a quasi-experimental study of the effectiveness of Responsive Aggression Regulation Therapy (Re-ART) in terms of recidivism for 16- to 21-year-old juveniles with aggression problems and high risk of recidivism. In a Dutch juvenile justice institution, an experimental group received Re-ART ( n = 63, Re-ART group) and a waitlist control group received Treatment as Usual ( n = 28, TAU group). Results indicated that Re-ART is significantly more effective than TAU in reducing the juveniles' recidivism risk for violent offending. Compared with the TAU group, the Re-ART group showed significantly less violent crimes after 2 and 3 years, less property crimes after 2 years, and less general recidivism after 2 and 3 years. There was no significant difference between groups in recidivism of property crimes with violence. Ethnicity, mild intellectual disabilities, substance abuse, and age did not moderate the effects on recidivism outcome, which indicates that Re-ART was equally effective for various groups.

Development of Coping Strategies From Childhood to Adolescence

Abstract. Extensive research exists on coping in children and adolescents. However, developmental issues have only recently started to receive more attention. The present study examined age differences and developmental changes in six coping strategies (social support seeking, problem solving, avoidant coping, palliative emotion regulation, anger-related emotion regulation, and media use) assessed by a coping questionnaire (German Stress and Coping Questionnaire for Children and Adolescents, SSKJ 3–8; Lohaus, Eschenbeck, Kohlmann, & Klein-Heßling, 2006 ) in middle/late childhood and early adolescence. At the initial assessment, 917 children from grades 3 to 7 (age range 8–15 years) were included (cross-sectional sample). Three cohorts (grades 3–5 at baseline) were traced longitudinally over 1½ years with four assessments (longitudinal sample: n = 388). The cross-sectional coping data showed significant effects for grade level in four coping strategies. Older children scored higher in problem solving and media use, and lower in avoidant coping. Seventh graders scored lower than fourth and fifth graders in social support seeking. Longitudinal data confirmed time effects and cohort effects indicating developmental changes. Increases over time were found for problem solving and media use; decreases were found for avoidant coping and anger-related emotion regulation. For social support seeking, an increase within the youngest cohort (grades 3–5) was found. Developmental trends (in cross-sectional and longitudinal data), with especially strong increases for problem solving or declines in avoidant coping in the youngest cohort, differed for the two studied stressful situations (social, academic) but were independent of the child’s gender. To conclude, particularly in the age range of 9–11 years relevant developmental changes toward a more active coping seem to appear.

Parenting style and mental disorders in a nationally representative sample of US adolescents

PURPOSE

We examined associations between parenting style and past-year mental disorders in a nationally representative cross-sectional survey of US adolescents and whether the associations differed by adolescent demographic characteristics.

METHODS

The sample included 6483 adolescents aged 13-18 years who were interviewed for a full range of DSM-IV mental disorders. Parenting style was assessed by adolescent-reported maternal and paternal care and control using items from the Parental Bonding Instrument. We controlled for socio-demographics, parental history of mental disorders, stressful life events, sexual violence, inter-parental conflict, and household composition. We also tested for two-way interactions between parental care and control and adolescent age, sex, and race/ethnicity.

RESULTS

In adjusted models, high maternal care was associated with lower odds of depressive, eating, and behavioral disorders, and high maternal control was associated with greater odds of depressive, anxiety, eating, and behavioral disorders. High paternal care was associated with lower odds of social phobia and alcohol abuse/dependence. High paternal control was associated with greater odds of agoraphobia and alcohol abuse/dependence but with lower odds of attention-deficit/hyperactivity disorder. Associations of maternal and paternal control with anxiety disorders and substance abuse/dependence differed by sex. High paternal care was associated with lower odds of anxiety disorders only among Hispanics and non-Hispanic blacks.

CONCLUSIONS

Perceived parental care and control were associated with adolescent mental disorders after controlling for multiple potential confounders. Differential patterns of association were found according to adolescent sex and race/ethnicity. Findings have implications for prevention and intervention programs that incorporate familial contextual factors.

Could scale-up of parenting programmes improve child disruptive behaviour and reduce social inequalities? Using individual participant data meta-analysis to establish for whom programmes are effective and cost-effective

Background

Child disruptive behavioural problems are a large and costly public health problem. The Incredible Years®(IY) parenting programme has been disseminated across the UK to prevent this problem and shown to be effective in several trials. It is vital for policy to know for which families IY is most effective, to be sure that it helps reduce, rather than widen, socioeconomic inequalities. Individual trials lack power and generalisability to examine differential effects; conventional meta-analysis lacks information about within-trial variability in effects.

Objectives

To overcome these limitations by pooling individual-level data from the IY parenting trials in Europe to examine to what extent it benefits socially disadvantaged families. Secondary objectives examine (1) additional moderators of effects on child behaviour, (2) wider health benefits and potential harms and (3) costs, cost-effectiveness and potential long-term savings.

Design

Individual participant data meta-analysis of 14 randomised trials of the IY parenting intervention.

Settings

UK (eight trials), the Netherlands, Ireland, Norway, Sweden and Portugal.

Participants

Data were from 1799 families, with children aged 2–10 years (mean 5.1 years; 63% boys).

Interventions

IY Basic parenting programme.

Main outcome measures

Primary outcome was disruptive child behaviour, determined by the Eyberg Child Behavior Inventory Intensity scale (ECBI-I). Secondary outcomes included self-reported parenting practices, parenting stress, mental health, children’s attention deficit hyperactivity disorder (ADHD) and emotional symptoms.

Results

There were no differential effects of IY on disruptive behaviour in families with different levels of social/socioeconomic disadvantage or differential effects for ethnic minority families, families with different parenting styles, or for children with comorbid ADHD or emotional problems or of different ages. Some moderators were found: intervention effects were strongest in children with more severe baseline disruptive behaviour, in boys, and in children with parents who were more depressed. Wider health benefits included reduced child ADHD symptoms, greater parental use of praise, and reduced harsh and inconsistent discipline. The intervention did not improve parental depression, stress, self-efficacy or children’s emotional problems. Economic data were available for five UK and Ireland trials (maximumn = 608). The average cost per person of the IY intervention was £2414. The probability that the IY intervention is considered cost-effective is 99% at a willingness to pay of £145 per 1-point improvement on the ECBI-I. Estimated longer-term savings over 20 years range from £1000 to £8400 per child, probably offsetting the cost of the intervention.

Limitations

Limitations include a focus on one parenting programme; the need to make assumptions in harmonising data; and the fact that data addressed equalities in the effectiveness of, not access to, the intervention.

Conclusions

There is no evidence that the benefits of the IY parenting intervention are reduced in disadvantaged or minority families; benefits are greater in the most distressed families, including parents who are depressed. Thus, the intervention is unlikely to widen socioeconomic inequalities in disruptive behaviour and may have effects in narrowing inequalities due to parent depression. It was as likely to be effective for older as for younger children. It has wider benefits for ADHD and parenting and is likely to be considered to be cost-effective. Researchers/funders should encourage data sharing to test equity and other moderator questions for other interventions; further research is needed on enhancing equality of access to interventions.

Funding

The National Institute for Health Research Public Health Research programme.

Maternal Monitoring Knowledge Change and Adolescent Externalizing Behaviors in Low-Income African American and Latino Families

Drawing on a sample of 318 African American and 354 Latino urban, low-income families, we identify maternal monitoring knowledge trajectories and examine which trajectory predicts fewer late-adolescent externalizing problems and which family and neighborhood factors predict trajectories with positive implications for late-adolescent externalizing behaviors. The majority of adolescents in both groups perceived long-term high levels of maternal monitoring knowledge throughout adolescence-stably high for the African American sample and high for the Latino sample. Long-term high levels of knowledge predicted fewer general late-adolescent externalizing problems for both groups and fewer late-adolescent delinquent behaviors for the African American sample. Family routine and mother-adolescent trust predicted long-term high levels of knowledge for both groups. For the African American sample, family routine and neighborhood cohesion predicted stably high levels of knowledge via the mediation of mother-adolescent trust. We discuss implications for improving positive adolescent development and family environments for both groups.

Conceptualizing Culturally Infused Engagement and Its Measurement for Ethnic Minority and Immigrant Children and Families

Despite the central role culture plays in racial and ethnic disparities in mental health among ethnic minority and immigrant children and families, existing measures of engagement in mental health services have failed to integrate culturally specific factors that shape these families' engagement with mental health services. To illustrate this gap, the authors systematically review 119 existing instruments that measure the multi-dimensional and developmental process of engagement for ethnic minority and immigrant children and families. The review is anchored in a new integrated conceptualization of engagement, the culturally infused engagement model. The review assesses culturally relevant cognitive, attitudinal, and behavioral mechanisms of engagement from the stages of problem recognition and help seeking to treatment participation that can help illuminate the gaps. Existing measures examined four central domains pertinent to the process of engagement for ethnic minority and immigrant children and families: (a) expressions of mental distress and illness, (b) causal explanations of mental distress and illness, (c) beliefs about mental distress and illness, and (d) beliefs and experiences of seeking help. The findings highlight the variety of tools that are used to measure behavioral and attitudinal dimensions of engagement, showing the limitations of their application for ethnic minority and immigrant children and families. The review proposes directions for promising research methodologies to help intervention scientists and clinicians improve engagement and service delivery and reduce disparities among ethnic minority and immigrant children and families at large, and recommends practical applications for training, program planning, and policymaking.

Computer Informed and Flexible Family-Based Treatment for Adolescents: A Randomized Clinical Trial for at-Risk Racial/Ethnic Minority Adolescents

Family interventions have been shown to be effective for adolescents with behavior problems. Current literature supports both adaptive treatments and technology-assisted interventions as highly promising innovations for treating at-risk adolescents. The purpose of this investigation was to develop and test the efficacy of a computer-assisted version of an established office-based multicomponent family therapy. Eighty Hispanic and Black Non-Hispanic adolescents and their families participated in the study and were randomized to either Immediate Computer-Assisted CIFFTA or Delayed Computer-Assisted CIFFTA. Significant between-groups effects were found from baseline to posttreatment showing the superiority of the Immediate CA CIFFTA condition on both the Conduct Disorder (B = -5.17, SE = 1.73, p < .01, CI [-8.55, -1.79]) and Socialized Aggression (B = -2.04, SE = .83, p < .05, CI [-3.67, -.41]) subscales of the Revised Behavior Problem Checklist, on the Youth Self Report Externalizing scale (B = -4.22, SE = 1.40, p < .01, CI [-6.95, -1.48]), and on both the parent (B = 1.34, SE = .50, p < .01, CI [.36, 2.32]) and adolescent (B = 1.31, SE = .46, p < .01, CI [.41, 2.21]) reports of the Family Environment Scale’s family cohesion subscale. Baseline to 6-weeks posttreatment (T1-T3) analyses showed that these significant within-subjects effects were sustained for the treatment group. Results highlight that adolescent behavior problems can be significantly impacted by a computer-assisted intervention that replaces psychoeducational face-to-face meetings with computer-delivered modules.

Measurement Invariance and Convergent Validity of Anger and Sadness Self-Regulation Among Youth From Six Cultural Groups

The present study examined measurement invariance and convergent validity of a novel vignette-based measure of emotion-specific self-regulation that simultaneously assesses attributional bias, emotion-regulation, and self-efficacy beliefs about emotion regulation. Participants included 541 youth-mother dyads from three countries (Italy, the United States, and Colombia) and six ethnic/cultural groups. Participants were 12.62 years old ( SD = 0.69). In response to vignettes involving ambiguous peer interactions, children reported their hostile/depressive attribution bias, self-efficacy beliefs about anger and sadness regulation, and anger/sadness regulation strategies (i.e., dysregulated expression and rumination). Across the six cultural groups, anger and sadness self-regulation subscales had full metric and partial scalar invariance for a one-factor model, with some exceptions. We found support for both a four- and three-factor oblique model (dysregulated expression and rumination loaded on a second-order factor) for both anger and sadness. Anger subscales were related to externalizing problems, while sadness subscales were related to internalizing symptoms.

Gestational age and chronic 'body-mind' health problems in childhood: dose-response association and risk factors

Understanding the developmental course of all health issues associated with preterm birth is important from an individual, clinical and public health point-of-view. Both the number of preterm births and proportion of survivors have increased steadily in recent years. The UK Millennium Cohort Study (n = 18,818) was used to examine the association of gestational age with maternal ratings of general health and behavior problems at ages 5 and 11 years using binary and multinomial logistic regression analyses. The association between mothers' ratings of general health and behavior problems was relatively weak at each time point. Children rated as being in poor general health remained constant over time (4.0 % at age 5, 3.8 % at age 11), but children rated as having behavioral problems increased by almost 100 % (5.6 % at 5; 10.5 % at 11). A gradient of increasing risk with decreasing gestational age was observed for a composite health measure (general health problems and/or behavior problems) at age 5, amplified at age 11 and was strongest for those with chronic problems (poor health at both age 5 and age 11). This association was found to be compounded by child sex, maternal characteristics at birth (education, employment, marital status) and duration of breast feeding. Integrated support to at-risk families initiated during, or soon after pregnancy, may prevent chronic problems and might potentially reduce long term health costs for both the individual and health services.

A Behavioral Process Model of Familism

Familismo, or familism, an important Latino cultural construct associated with youth adjustment, describes the importance of family regarding support, comfort, and services. Increased research on familism among Latino families in the past decade has called for a theoretical process model of familism that can guide research on familism, family processes, and youth development. In this article, we propose the behavioral process model of familism (BPMF), which identifies proximal mechanisms through which familism is expected to promote youth psychological adjustment. Specifically, we propose that parenting behaviors (e.g., monitoring, discipline strategies) are a mechanism by which parent familism relates to youth familism and psychological adjustment both directly and via their familism-consistent behaviors. We hypothesize direct and mediated pathways in the BPMF and consider how sociodemographic variables modify the described processes.

The Culturally-Enhanced Videofeedback Engagement (CEVE) Framework: Qualitative findings in families of children with disruptive behavior problems

While cultural competence has been promoted as a way to reduce mental health disparities among ethnic minority populations, there remains a gap between theory and practice. This study examined the use of the Culturally Enhanced Videofeedback Engagement (CEVE) intervention as a clinical tool to facilitate culturally anchored shared understanding to foster treatment engagement among ethnic minority families with children with disruptive behavior disorders (DBDs) participating in a family clinic. In-depth qualitative analysis of individual interviews compared parents' experiences of the therapy process among 9 intervention families and 10 families participating in treatment as usual. Thematic analysis of semistructured interviews with parents revealed that for families in the intervention group, clinician cultural and clinical competence and the therapeutic relationship were important characteristics of the intervention condition that enhanced parents' experience of treatment.

Spanking of young children: do immigrant and U.S.-born Hispanic parents differ?

Building on prior research showing fewer parenting risk behaviors and lower levels of harsh punishment among less acculturated Hispanic parents, we tested the hypothesis that foreign-born (FB; immigrant) Hispanic parents use less spanking toward children at 3 years and 5 years of age than U.S.-born Hispanic parents. We also examined whether other indicators of acculturation-endorsement of traditional gender norms and religiosity-showed any direct or indirect effects in explaining the hypothesized association. Path model analyses were conducted with a sample of Hispanic mothers (n = 1,089) and fathers (n = 650). Cross-sectional and time lagged path models controlling for a wide range of psychosocial and demographic confounds indicated that, when compared with U.S.-born Hispanic parents, FB Hispanic mothers and fathers used less spanking toward their young children. In cross-sectional analysis only, mothers' greater endorsement of traditional gender norms had small protective effects on spanking. Although fathers' endorsement of traditional gender norms was not a significant direct predictor of spanking, there was a significant indirect effect of nativity status on spanking mediated by endorsement of traditional gender norms. Religiosity showed no relation to spanking for either mothers or fathers. Immigrant status may be an important protective factor that is associated with lower levels of parenting aggression among Hispanic mothers and fathers living in the United States.

Prevalence and correlates of substance use among trans female youth ages 16-24 years in the San Francisco Bay Area

BACKGROUND

Substance use is highly prevalent among transgender (trans*) females and has been associated with negative health outcomes, including HIV infection. Little is known about psychosocial risk factors that may influence the onset of substance use among trans*female youth, which can contribute to health disparities during adulthood.

METHODS

We conducted a secondary data analysis of a study on HIV risk and resilience among trans*female youth (N=292). Prevalence of substance use was assessed and multivariable logistic regression models were used to examine the relationship between posttraumatic stress disorder (PTSD), psychological distress, gender-related discrimination, parental drug or alcohol problems (PDAP) and multiple substance use outcomes.

RESULTS

Most (69%) of the trans*female youth reported recent drug use. In multivariable analyses, those with PTSD had increased odds of drug use [AOR=1.94 (95% CI=1.09-3.44)]. Those who experienced gender-related discrimination had increased odds of drug use [AOR=2.28 (95% CI=1.17-4.44)], drug use concurrent with sex [AOR=2.35 (95% CI=1.11-4.98)] and use of multiple drugs [AOR=3.24 (95% CI=1.52-6.88)]. Those with psychological distress had increased odds of using multiple heavy drugs [AOR=2.27 (95% CI=1.01-5.12)]. Those with PDAP had increased odds of drugs use [AOR=2.62 (95% CI=1.43-4.82)], drug use concurrent with sex [AOR=2.01 (95% CI, 1.15-3.51)] and use of multiple drugs [AOR=2.10 (95% CI=1.22-3.62)].

CONCLUSIONS

Substance use is highly prevalent among trans*female youth and was significantly associated with psychosocial risk factors. In order to effectively address substance use among trans*female youth, efforts must address coping related to gender-based discrimination and trauma. Furthermore, structural level interventions aiming to reduce stigma and gender-identity discrimination might also be effective.

Changes in Ethnic Identity and Competence in Middle Adolescents

Purpose: Evidence suggests that the construct of ethnic identity (EI) in adolescents changes over time and is related to factors including social connectedness, social competence, coping, and self-worth. Transitional changes of EI in middle adolescence have not been studied. Method: This analysis, part of a longitudinal study of health behaviors, explored how EI changes from the first year of high school to the last, and it examined relationships among EI, social connectedness, indicators of social competence, coping, and self-worth in 602 youth (49% Hispanic, 59% female). Results: EI was significantly related to social connectedness, social competence, coping, and self-worth as adolescents entered and prepared to exit high school. EI increased significantly over time for both genders and for Hispanics more so than for non-Hispanics. Discussion: Findings support and extend the conceptual framework and previous research. Socialization with one’s ethnic group is associated with developing competence and self-worth. EI development continues throughout high school. Conclusion: Findings extend our understanding of the salience of EI in adolescents in transition throughout high school. Implications: Strengthening EI may contribute to adolescents’ feelings of self-worth, skills in coping, and competence within an ethnically diverse society. Nurses might plan interventions to strengthen EI throughout adolescence.

Family check-up effects across diverse ethnic groups: reducing early-adolescence antisocial behavior by reducing family conflict

Multicultural responsiveness and adaptation have been a recent area of emphasis in prevention and intervention science. The changing demographics of the United States demand the development of intervention strategies that are acceptable and effective for diverse cultural and ethnic groups. The Family Check-Up (FCU) was developed to be an intervention framework that is flexible and adaptive to diverse cultural groups (Dishion & Stormshak, 2007 ). We empirically evaluated the extent to which the intervention is effective for improving youth adjustment and parent-child interactions for diverse cultural groups. A sample of 1,193 families was drawn from 2 large-scale randomized prevention trials conducted in diverse urban middle schools. We formulated 3 groups on the basis of youth self-identification of ethnicity (European American, African American, Hispanic) and examined group differences in the hypothesized mediating effect of family conflict (FC) on later antisocial behavior (ASB). Path analysis revealed that youths in the intervention condition reported significantly less ASB over a 2-year period (Grades 6-8). Moreover, youth-reported reductions in FC at 12 months were an intervening effect. Ethnicity did not moderate this relationship. Consistent with one of the primary tenets of coercion theory, participation in the FCU acts on ASB through FC across diverse ethnic groups, lending support to the multicultural competence of the model. Limitations of this study are discussed, along with areas for future research.

Coercive family process and early-onset conduct problems from age 2 to school entry

The emergence and persistence of conduct problems (CPs) during early childhood is a robust predictor of behavior problems in school and of future maladaptation. In this study we examined the reciprocal influences between observed coercive interactions between children and caregivers, oppositional and aggressive behavior, and growth in parent report of early childhood (ages 2-5) and school-age CPs (ages 7.5 and 8.5). Participants were drawn from the Early Steps multisite randomized prevention trial that includes an ethnically diverse sample of male and female children and their families (N = 731). A parallel-process growth model combining latent trajectory and cross-lagged approaches revealed the amplifying effect of observed coercive caregiver-child interactions on children's noncompliance, whereas child oppositional and aggressive behaviors did not consistently predict increased coercion. The slope and initial levels of child oppositional and aggressive behaviors and the stability of caregiver-child coercion were predictive of teacher-reported oppositional behavior at school age. Families assigned to the Family Check-Up condition had significantly steeper declines in child oppositional and aggressive behavior and moderate reductions in oppositional behavior in school and in coercion at age 3. Results were not moderated by child gender, race/ethnicity, or assignment to the intervention condition. The implications of these findings are discussed with respect to understanding the early development of CPs and to designing optimal strategies for reducing problem behavior in early childhood with families most in need.

"It's like big mama's house": examining extended family influences on the dietary behaviors of African American children

The family environment plays an important role in influencing children's dietary behaviors. Traditionally, African American extended family members play a key role in child socialization. We examine the role of extended families in how children are socialized to adopt dietary norms. We conducted in-depth, semi-structured interviews with 24 individuals across eight family units to elicit information regarding the influences of culture and families on children's dietary behaviors. Findings suggest that families teach children to value activities that combine quality time and enjoying food together; adults are inconsistent in how they teach children to adopt desired dietary behaviors. This work has implications for improving family-based interventions for African American children through promoting healthful behaviors that are also respectful of family dietary traditions, improving communication between adults and children, and leveraging family members as attitudinal and behavioral referents.

The protective role of ethnic identity for urban adolescent males facing multiple stressors

Having a connection to one's ethnic heritage is considered a protective factor in the face of discrimination; however, it is unclear whether the protective effects are persistent across multiple stressors. Furthermore, the dimensions of ethnic identity that reflect group pride/connection (affirmation) and exploration of the meaning of group membership (achievement) may operate differently in the face of stress. The present study examined the moderating role of ethnic identity affirmation and achievement on concurrent and longitudinal relationships between exposure to stress (discrimination, family hardship, exposure to violence) and antisocial behavior in a sample of 256 Black and Latino male youth (70% Black) living in low-income urban neighborhoods. Using regression analysis, concurrent associations were examined at age 18, and longitudinal associations were tested 18 months later. We found that, among youth experiencing discrimination, high levels of achievement and low levels of affirmation predicted greater aggressive behavior and delinquency. Low affirmation also predicted more criminal offending in the face of discrimination. The two dimensions operated similarly in the context of family stress, in which case high levels of affirmation and achievement predicted lower levels of antisocial behavior. The findings suggest a differential role of the two dimensions of ethnic identity with respect to discrimination; furthermore, the coping skills that may be promoted as youth make meaning of their ethnic group membership may serve as cultural assets in the face of family stress.

Peer Associations and Coping: The Mediating Role of Ethnic Identity for Urban, African American Adolescents

This study sought to examine the relationship between coping strategies and prosocial and deviant peer associations for urban, African American adolescents. In addition, the study analyzed the mediating role of ethnic identity for coping strategies and peer associations. Results of the African American models were then compared with models for European American adolescents. Results indicated that African American and European American adolescents who reported using distraction coping strategies were more likely to associate with prosocial peers, and those who reported using self-destruction strategies were less likely to associate with prosocial peers. Adolescents who reported using distraction coping strategies were less likely to associate with deviant peers, and adolescents who reported using self-destruction strategies were more likely to associate with deviant peers. Ethnic identity mediated the relationship between coping and prosocial peer association for African American adolescents. Limitations of the study and future research directions are also presented.

Indirect Effects of the Family Check-Up on School-Age Academic Achievement Through Improvements in Parenting in Early Childhood

This project examined the hypothesis that the impact of the Family Check-Up on parent use of positive behavior support would indirectly improve academic achievement scores at school age. The study included a sample of 731 high-risk families recruited from Women, Infant, and Children Supplemental Nutrition Program settings in 3 geographically distinct areas. The results demonstrated that changes in positive parenting between the child ages of 2 and 3 were associated with higher scores on children's school-age academic achievement, as measured by the Woodcock-Johnson III (W-J) Academic Skills composite. Moreover, structural equation modeling revealed that random assignment to the intervention was associated with higher levels of children's academic achievement at age 5 and age 7.5 indirectly, through greater increases in parents' use of positive behavior support in intervention families than in control families. Results are discussed with respect to the potential of a brief parenting intervention for improving parenting practices that promote academic achievement up to 5 years later. The results have promising implications for efforts to promote child adaptation in the school environment.

Effectiveness of an individual school-based intervention for children with aggressive behaviour: a randomized controlled trial

BACKGROUND

For elementary school-children with aggressive behaviour problems, there is a strong need for effective preventive interventions to interrupt the developmental trajectory towards more serious behaviour problems.

AIM

The aim of this RCT-study was to evaluate a school-based individual tailor-made intervention (Stay Cool Kids), designed to reduce aggressive behaviour in selected children by enhancing cognitive behavioural skills.

METHOD

The sample consisted of 48 schools, with 264 fourth-grade children selected by their teachers because of elevated levels of externalizing behaviour (TRF T-score>60), randomly assigned to the intervention or no-intervention control condition.

RESULTS

The intervention was found to be effective in reducing reactive and proactive aggressive behaviour as reported by children, mothers, fathers or teachers, with effect sizes ranging from .11 to .32. Clinically relevant changes in teacher-rated externalizing behaviour were found: the intervention reduced behaviour problems to (sub) clinical or normative levels for significantly more children than the control condition. Some aspects of problems in social cognitive functioning were reduced and children showed more positive self-perception. Ethnic background and gender moderated intervention effects on child and teacher reported aggression and child response generation.

CONCLUSIONS

The results of this study demonstrate the effectiveness on outcome behaviour and child cognitions of an individual tailor-made intervention across informants under real-world conditions.

Differences in agency? How adolescents from 18 countries perceive and cope with their futures

This study investigated how N = 5,126 adolescents (mean age of 15 years) from 18 countries perceive and cope with future- and school-related stress. The adolescents completed the Problem Questionnaire (PQ), which assesses stress, and the Coping Across Situations Questionnaire (CASQ), which assesses three coping styles (reflection/support-seeking, emotional outlet, and withdrawal/denial). Across countries, adolescents reported considerably higher levels of future-related stress than school-related stress. The adolescents actively coped with stressors in both domains and seldom relied on emotional outlet or withdrawal/denial. A clustering of the countries according to socioeconomic criteria and geographical proximity demonstrated that adolescents from the continental group of countries showed low stress and high coping. Adolescents in the east/Asia group showed medium stress and low coping and those in the south group showed high stress and low coping. Developmental context was more strongly associated with stress perception and coping, style than age or gender, a finding relevant for prevention approaches aiming to endorse positive orientation to the future and improve coping competence.

Competent youth in a "disorderly world": findings from an eighteen-nation study

Future- and school-related stressors are salient for adolescents from different regions of the world, and they cope with these stressors competently.

Family Functioning and Externalizing Behaviour among Low-income Children: Self-regulation as a Mediator

The purpose of this study was to examine self-regulation as a mediator of the relation between family functioning and externalizing behaviour in 731 low-income children (M age = 41 months) across three time points. Specifically, this study focused on whether chaos in the home and positive behaviour support were indirectly related to externalizing problems through their influence on inhibitory control. The primary findings were as follows: (a) chaos in the home at age 3 years was indirectly related to externalizing behaviour at age 5.5 years through children's inhibitory control at age 4 years, and (b) positive behaviour support at age 3 years was indirectly related to externalizing behaviour at age 5.5 years through inhibitory control at age 4 years. Implications of these findings and directions for future research are discussed.

Experimentally Evaluating the Impact of a School-Based African-Centered Emancipatory Intervention on the Ethnic Identity of African American Adolescents

Ethnic identity, the extent to which one defines one’s self as a member of a particular ethnic group, has been found to be an important predictor of African American adolescents’ psychological and behavioral well-being. This study experimentally examined the effects of a school-based emancipatory intervention on the ethnic identity of African American adolescents. Using a promising education framework drawn from elements of East African Ujamaa philosophy and practice, the intervention was provided to a randomly selected group of 32 eighth graders in a predominately African American inner-city mainstream public school and then compared to a randomly selected group of 33 eighth graders in a regularly scheduled life skills class from the same population. Contrary to expectations, growth trajectory modeling indicated that participants’ ethnic identity significantly decreased throughout the intervention compared to youth in the control group. Intervention and evaluation challenges are discussed as are implications for future practice and research.

The relationship between internalizing and externalizing symptoms and cultural resilience factors in Indigenous Sami youth from Arctic Norway

OBJECTIVES

To examine whether enculturation factors, like cultural activities, ethnic pride and native language competence, are related to decreased internalizing and externalizing symptoms in Indigenous Sami youth from Arctic Norway. The impact of self-efficacy on the relationship between enculturation factors and mental health problems was also examined.

STUDY DESIGN

Population-based, cross-sectional questionnaire study.

METHODS

The Norwegian Arctic Adolescent Health Study was conducted among 10th graders in junior high schools in north Norway during 2003-2005. The study sample consisted of 450 Indigenous Sami youth, aged 15-16 years. Internalizing symptoms were measured with the Hopkins Symptom Check List-10 (HSCL-10), while externalizing symptoms were measured by two subscales of the Strengths and Difficulties Questionnaire (SDQ).

RESULTS

For boys, self-efficacy and participation in cultural activities were associated with decreased internalizing symptoms. Additionally, self-efficacy interacted with Sami language competence and cultural activities: when self-efficacy increased, these enculturation factors were related to symptom reduction. For girls, self-efficacy had an independent effect on internalizing symptoms and also strengthened the relationship between participation in cultural activities and reduced externalizing symptoms. Sami language competence was related to the reduction of both internalizing and externalizing symptoms in girls.

CONCLUSIONS

In the present study, several enculturation factors as well as self-efficacy were identified as potential protective factors against mental health problems. In order to develop theoretical models that explain the mechanisms between cultural resilience and mental health, there is a need for both qualitative studies and longitudinal studies.

Person-related protective and vulnerability factors of psychopathology symptoms in non-clinical adolescents

Psychopathology in youths is thought to originate from a dynamic interplay of a variety of protective and vulnerability factors. In this study, a large multi-ethnic sample of non-clinical adolescents (N = 376) completed questionnaires for measuring a wide range of person-related protective and vulnerability factors as well as psychopathology symptoms, in order to explore (a) the relations among various protective and vulnerability factors, and (b) the unique contributions of these protective and vulnerability factors to different types of psychological problems. Results indicated that the overlap among protective and vulnerability factors was quite modest. Further, it was found that factors clustered in theoretically meaningful components reflecting protection, vulnerability, and more specific aspects of coping and social support. Finally, data indicated that each type of psychopathology symptoms was associated with a typical set of protective and vulnerability factors. Although these results should be interpreted with caution because of the cross-sectional nature of the study, they may nevertheless guide future research exploring multifactorial models of psychopathology in youths.

Do Maltreated Children who Remain at Home Function Better than Those who Are Placed?

The majority of children in the child welfare system remain with their maltreating parents, yet little is known about their level of functioning and whether they are in need of mental health intervention. The purpose of this study was to evaluate the mental health functioning of an ethnically diverse sample of 302 maltreated children and 151 non maltreated children ages 9-12 to see if there were differences between those who remained at home, those placed in kin care, non-relative foster care or a comparison group of children who were not maltreated. Children were evaluated on multiple measures of mental health functioning, both self report and caregiver report. Results showed that the maltreated children did not differ by placement type but did score significantly higher than the comparison children on many measures. There were substantial numbers of maltreated children scoring in the clinical range of measures in all placement types with over 60% of those remaining with birth parents being seen as functioning at a level that indicated a need for mental health intervention. While fewer comparison children had scores indicating a need for mental health care, the numbers were higher than noted in national studies. Implications of the findings are presented.

Self-reported internalization symptoms and family factors in indigenous Sami and non-Sami adolescents in North Norway

Through differences in family socialization between indigenous and non-indigenous youth, there may be cultural differences in the impact of family factors on mental health outcome. Using structural equation modelling, this population-based study explored the relationship between symptoms of anxiety and depression and family factors in indigenous Sami and non-Sami boys and girls in North Norway. The findings show that family income was to a lesser degree related to internalization symptoms for Sami youth than non-Sami youth. For all groups except for Sami girls, family conflict and moving was associated with increasing symptoms. Sami boys differed from the other three groups with regard to the relationship between family connectedness and symptom level. These interaction effects were discussed in light of traditional Sami values and gender socialization. The present study has indicated that in the family socialization context, culture may be related to internalization symptoms in youth.

A longitudinal analysis of parenting practices, couple satisfaction, and child behavior problems

This longitudinal study examined the relationship between couple relationship satisfaction, parenting practices, parent depression, and child problem behaviors. The study participants (n = 148) were part of a larger experimental study that examined the effectiveness of a brief family-centered intervention, the Family Check-Up model. Regression analysis results indicated that our proposed model accounted for 38% of the variance in child problem behavior at Time 2, with child problem behavior and couple relationship satisfaction at child age 2 years each accounting for a significant portion of the variance in child problem behavior at age 3. Couple relationship satisfaction directly predicted child behavior problems over time. Clinical and research implications are discussed.

Racial/ethnic differences in correlates of prescription drug misuse among young adults

This study examined psychosocial correlates of prescription drug misuse over time among young adults. Data from a nationally representative U.S. sample consisting of 4882 cases were analyzed. Multivariate logistic regression analyses revealed that being younger, having less education, as well as alcohol use; marijuana use, inhalant use, and delinquent behavior during adolescence were associated with prescription drug misuse. In Whites, prescription drug misuse was related to age, alcohol use, marijuana use and delinquent behavior. Among Hispanic young adults inhalant use, delinquent behavior and maternal warmth were associated with greater prescription drug use, while marijuana use was predictive of lower prescription drug misuse. Religious attendance was associated with lower prescription drug misuse among Black young adults. These findings suggest that there are unique racial/ethnic profiles for substance use risk behaviors in adolescence. Further investigations should examine culturally specific dimensions culturally specific dimensions that may account for racial/ethnic differences in prescription drug misuse.

An adaptive approach to family-centered intervention in schools: linking intervention engagement to academic outcomes in middle and high school

This study examined the impact of an adaptive approach to family intervention in public schools on academic outcomes from age 11 to 17. Students were randomly assigned to the three-session Family Check-Up (FCU), which is designed to motivate change in parenting practices by using an assessment-driven approach and strengths-based feedback. All services were voluntary, and approximately 25% of the families engaged in the FCU. Compared with matched controls, adolescents whose parents received the FCU maintained a satisfactory GPA into high school, and intervention engagement was associated with improved attendance. The highest-risk families were the most likely to engage in the family-centered intervention, suggesting the efficacy of integrating supportive services to families in the context of other schoolwide approaches to promote the success and achievement of vulnerable students.

The timing of alcohol use and sexual initiation among a sample of Black, Hispanic, and White adolescents

The goals of this study were to examine the relationship between age at first drink and age at first sex among an emergency department sample of Black, Hispanic, and White adolescents (N = 1,1110) and to assess two sexual behavior-related consequences of underage drinking. The authors used multivariable linear regression to analyze data from a self-reported survey. Age at first sex decreased linearly with decreasing age at first drink (p < .001) for all adolescents in the sample. In analyses stratified by race, significant positive trends between age at first drink and age at first sex were observed for all race and ethnic subgroups, although the relationship between age at first drink and age at first sex was not as strong for Black males and females as their White counterparts, respectively. Compared to White males, Black males were less likely to report having had sex without using a condom or birth control after drinking in the past month and during their lifetimes.

Relationships of Social Context and Identity to Problem Behavior among High-Risk Hispanic Adolescents

The present study was designed to examine the extent to which (a) family and school functioning and (b) personal and ethnic identity is associated with conduct problems, drug use, and sexual risk taking in a sample of 227 high-risk Hispanic adolescents. Adolescents participated in the study with their primary parents, who were mostly mothers. Adolescents completed measures of family and school functioning, personal and ethnic identity, conduct problems, and drug use. Parents completed measures of family functioning and adolescent conduct problems. Results indicated that school functioning and personal identity confusion were related to alcohol use, illicit drug use, and sexual risk taking indirectly through adolescent reports of conduct problems. Adolescent reports of family functioning were related to alcohol use, illicit drug use, and sexual risk taking through school functioning and conduct problems. Results are discussed in terms of the problem behavior syndrome and in terms of the finding of relative independence of contextual and identity variables vis-à-vis conduct problems, substance use, and sexual risk taking.

Parent-child acculturation patterns and substance use among Hispanic adolescents: a longitudinal analysis

Acculturation discrepancy theory predicts that conflicting cultural preferences between adolescents and their parents will increase the adolescents' risk for behavior problems such as substance use. This study evaluated this hypothesis in a sample of 1683 Hispanic students in Southern California who completed surveys in 9th and 10th grade. Measures included the students' own cultural orientations and their perceptions of their parents' preference for their cultural orientations ("Perceived Parental Cultural Expectations"--PPCE). Hispanic PPCE in 9th grade was a risk factor for lifetime, but not past-month, cigarette, alcohol, and marijuana use in 10th grade. The adolescents' own Hispanic orientation in 9th grade was protective against lifetime and past-month smoking and marijuana use and lifetime alcohol use in 10th grade. The effects of the acculturation variables did not vary according to generation in the U.S. Change in acculturation between 9th and 10th grade was statistically significant but small in magnitude. Increases in parent-child Hispanic acculturation discrepancy (i.e., the difference between the adolescents' own cultural orientations and their PPCE, with adolescents perceiving that their parents wanted them to be more Hispanic oriented than they actually were) from 9th to 10th grade were associated with an increased risk of substance use. Family-based interventions for acculturating Hispanic families may be useful in decreasing the likelihood of substance use among Hispanic adolescents.