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Zhen-Duan J, Alvarez K, Zhang L, Cruz-Gonzalez M, Kuo J, Falgas-Bagué I, Bird H, Canino G, Duarte CS, Alegría M. Parental psychopathology and posttraumatic stress in Puerto Ricans: the role of childhood adversity and parenting practices. J Child Psychol Psychiatry 2024; 65:742-752. [PMID: 37850715 PMCID: PMC11024057 DOI: 10.1111/jcpp.13902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/04/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND Parental psychopathology is associated with their children's posttraumatic stress symptoms (PTSS). However, the mechanisms through which this occurs remain unclear. We hypothesized that exposure to childhood adversities is the mechanism linking parental psychopathology to child PTSS and that parenting practices moderated these associations. METHODS Participants (N = 1,402) with an average age of 24.03 years old (SD = 2.20), were all Puerto Ricans (50% Male and 50% Female) from the Boricua Youth Study, which is a four-wave longitudinal study spanning almost 20 years, following individuals from childhood (ages 5-13 at Wave 1) to young adulthood. Measured variables include parental psychopathology at Wave 1, childhood adversities and parenting practices at Waves 2-3, and PTSS at Wave 4. A traditional mediation model estimated the association between parental psychopathology and child PTSS via childhood adversities. A moderated mediation model was used to examine whether parenting practices moderated this mediation model. RESULTS Results showed that the total effect of parental psychopathology at Wave 1 on PTSS at Wave 4 was fully mediated by childhood adversities at Waves 2-3 (direct effect b = 1.72, 95% CI = [-0.09, 3.83]; indirect effect b = 0.40, 95% CI = [0.15, 0.81]). In addition, the magnitude of this pathway varied by levels of parenting practices (i.e. parental monitoring and parent-child relationship quality). Specifically, the indirect effect of additional adversities in the psychopathology-PTSS link was stronger with higher levels of parental monitoring but weaker with higher parent-child relationship quality scores. CONCLUSIONS Intergenerational continuity of psychopathology may be mitigated through the prevention of additional childhood adversities via upstream interventions, emphasizing providing parents with mental health needs with parenting tools. Family-based interventions focused on providing families with the tools to improve parent-child relationships may reduce the negative impact of childhood adversities on mental health across the life course.
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Affiliation(s)
- Jenny Zhen-Duan
- Disparities Research Unit, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Kiara Alvarez
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Lulu Zhang
- Disparities Research Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Mario Cruz-Gonzalez
- Disparities Research Unit, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Josephine Kuo
- Disparities Research Unit, Massachusetts General Hospital, Boston, MA, USA
- Department of Community Health, Tufts University, Medford, MA, USA
| | - Irene Falgas-Bagué
- Disparities Research Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Hector Bird
- Department of Psychiatry, Columbia University – New York State Psychiatric Institute, New York, NY, USA
| | - Glorisa Canino
- Department of Pediatrics, University of Puerto Rico School of Medicine, San Juan, PR, USA
| | - Cristiane S. Duarte
- Department of Psychiatry, Columbia University – New York State Psychiatric Institute, New York, NY, USA
| | - Margarita Alegría
- Disparities Research Unit, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
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Kreniske P, Morrison C, Spencer BH, Levine A, Liotta L, Fisher PW, Nguyen N, Robbins RN, Dolezal C, Kluisza L, Wiznia A, Abrams EJ, Mellins CA. HIV and suicide risk across adolescence and young adulthood: an examination of socio-demographic, contextual and psychosocial risk factors for attempted suicide in a longitudinal cohort of ageing adolescents affected by HIV living in the New York City Area. J Int AIDS Soc 2022; 25 Suppl 4:e25984. [PMID: 36176026 PMCID: PMC9522633 DOI: 10.1002/jia2.25984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 08/01/2022] [Indexed: 12/22/2022] Open
Abstract
Introduction As children become adolescents and young adults (AYA), their risk for attempting suicide increases dramatically, with chronic health conditions an important risk factor. This study examined correlates of suicidality across development in AYA living with perinatally acquired HIV (AYALPHIV) and those perinatally HIV‐exposed but uninfected (AYAPHEU). Methods Data come from an ongoing longitudinal New York City‐based study (N = 339) with AYALPHIV and AYAPHEU interviewed every 12–18 months from 2003 to 2019 (mean enrolment age = 12 years; current mean age = 27 years). The Diagnostic Interview Schedule for Children (adolescent or young adult version) assessed psychiatric disorders and first‐reported suicide attempt. Generalized estimating equations were used to examine associations between first‐reported suicide attempt and socio‐demographic, contextual and psychosocial correlates measured concurrently across six timepoints. Results At enrolment, 51% of participants were female, 72% heterosexual, 60% Black and 50% Latinx. Attempted suicide was significantly higher among AYALPHIV (27%, CI 21–33%) compared to AYAPHEU (16%, CI 10–22%), with an OR of 1.74 (CI 1.04–2.92) in a model adjusting for age. For AYALPHIV, anxiety (OR 2.66, CI 1.46–4.85), mood (OR 3.62, CI 1.49–8.81) and behaviour disorders (OR 5.05, CI 2.15–11.87) and past‐year arrest (OR 3.05, CI 1.26–7.4), negative life events (OR 1.27, CI 1.11–1.46), city stress (OR 2.28, CI 1.46–3.57), pregnancy (OR 2.28, CI 1.08–4.81) and HIV stigma (OR 2.46, CI 1.27–4.75) were associated with increased odds of attempted suicide, while identifying as heterosexual (OR 0.27, CI 0.14–0.52), higher personal (OR 0.45, CI 0.26–0.80) and family self‐concept (OR 0.36, CI 0.22–0.57) were protective. Interactions by HIV status and age were found: substance use was more strongly associated with attempted suicide among AYAPHEU than AYALPHIV, while negative life events and higher religiosity were more strongly associated with increased odds of attempted suicide among AYA ≥ 19 versus ≤ 18 years. Conclusions AYALPHIV compared to AYAPHEU faced unique risks for attempted suicide as they age into adulthood, with the highest risk among AYALPHIV experiencing HIV stigma or pregnancy and the highest risk among AYAPHEU with substance use. Assessing for suicide risk and correlates with attention to ageing can inform preventive interventions tailored to meet AYALPHIV and AYAPHEU needs.
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Affiliation(s)
- Philip Kreniske
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Corey Morrison
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Bailey Holmes Spencer
- Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City, New York, USA
| | - Alina Levine
- Mental Health Data Science, Research Foundation for Mental Hygiene, New York City, New York, USA
| | - Lucy Liotta
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Prudence W Fisher
- Child and Adolescent Psychiatry, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Nadia Nguyen
- The Aaron Diamond AIDS Research Center, New York City, New York, USA
| | - Reuben N Robbins
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Curtis Dolezal
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Luke Kluisza
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Andrew Wiznia
- Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Elaine J Abrams
- ICAP at Columbia University, Mailman School of Public Health and Vagelos College of Physicians & Surgeons, Columbia University, New York City, New York, USA
| | - Claude A Mellins
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
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Duarte CS, Canino GJ, Wall M, Ramos-Olazagasti M, Elkington KS, Bird H, Choi CJ, Adams C, Klotz J, Carliner H, Wainberg ML, Alegria M. Development, Psychopathology, and Ethnicity II: Psychiatric Disorders Among Young Adults. J Am Acad Child Adolesc Psychiatry 2021; 60:579-592. [PMID: 32171633 PMCID: PMC7945985 DOI: 10.1016/j.jaac.2020.02.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 02/07/2020] [Accepted: 03/04/2020] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To estimate the prevalence of psychiatric disorders and their continuity since childhood among young adults from the same ethnic group living in 2 low-income contexts. METHOD Young adults (N = 2,004; ages 15-29) were followed (82.8% retention) as part of the Boricua Youth Study, a study of Puerto Rican youths recruited at ages 5-13 in the South Bronx (SBx), New York, and Puerto Rico (PR). We estimated prevalence (lifetime; past year) of major depressive (MDD), mania, hypomania, generalized anxiety (GAD), tobacco dependence, and any other substance use disorders (SUD). RESULTS The prevalence of every disorder was higher among young women from the SBx compared with those from PR (eg, 9.2% versus 4.1% past-year SUD; 14% versus 6.8% for MDD/GAD). Among SBx young men, tobacco dependence and illicit SUD were elevated. Across both contexts, men had higher adjusted odds of illicit SUD than women, while women had higher GAD than men. MDD did not differ by gender. Young adulthood disorders (except for alcohol use disorder and GAD) followed childhood disorders. For example, childhood externalizing disorders preceded both MDD (young men and women) and illicit SUD (young women only). CONCLUSION Young women raised in a context where adversities like ethnic discrimination concentrate are at high risk for psychiatric disorders. In certain high-poverty contexts, young men may present with MDD as often as women. Interventions to prevent psychiatric disorders may need to address gender-specific processes and childhood disorders. However, SUD prevention among young men may need to address other factors.
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Affiliation(s)
- Cristiane S. Duarte
- Columbia University, New York, NY,New York State Psychiatric Institute, Columbia University Medical Center, New York, New York
| | - Glorisa J. Canino
- Behavioral Sciences Research Institute, University of Puerto Rico School of Medicine, San Juan
| | - Melanie Wall
- Columbia University, New York, NY,New York State Psychiatric Institute, Columbia University Medical Center, New York, New York
| | | | - Katherine S. Elkington
- Columbia University, New York, NY,New York State Psychiatric Institute, Columbia University Medical Center, New York, New York
| | | | | | | | | | - Hannah Carliner
- Columbia University, New York, NY,New York State Psychiatric Institute, Columbia University Medical Center, New York, New York
| | - Milton L. Wainberg
- Columbia University, New York, NY,New York State Psychiatric Institute, Columbia University Medical Center, New York, New York
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Duarte CS, Canino GJ, Alegria M, Ramos-Olazagasti MA, Vila D, Miranda P, Ramjattan V, Alvarez K, Musa GJ, Elkington K, Wall M, Lapatin S, Bird H. Developmental Psychopathology and Ethnicity I: The Young Adulthood Assessment of the Boricua Youth Study. J Am Acad Child Adolesc Psychiatry 2021; 60:398-409. [PMID: 32171634 PMCID: PMC9044282 DOI: 10.1016/j.jaac.2020.02.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 02/07/2020] [Accepted: 03/04/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Developmental psychopathology processes pertinent to underserved ethnically diverse youths may not always coincide with those relevant to youths from nondisadvantaged groups. This article reports on the young adulthood assessment (fourth wave; April 2013 to August 2017) of the Boricua Youth Study, which includes 2 population-based samples of children of Puerto Rican background (N = 2,491) aged 5-13 years (recruited in 2000), in the South Bronx, New York, and San Juan, Puerto Rico. METHOD Study procedures included intensive participant tracking and in-person interviews of young adults and, when possible, their parents. Study participation rates, measures, and weights are described. RESULTS At Boricua Youth Study wave 4 (on average 11.3 years since last wave of participation), we reassessed 2,004 young adults (mean age = 22.9 years, range = 15-29 years; 51% women; retention rate adjusted for ineligibility = 82.7%) and available parents (n = 1,180). Nonparticipation was due to inability to locate/contact participants (8.6%); refusal (4.7%); and ineligible status (2.8%) owing to cognitive impairment, incarceration, or death. Among participants originally from Puerto Rico, 91% stayed in Puerto Rico during young adulthood. Of participants from the South Bronx, 52.4% remained in the area (85.8% within 100 miles). Most study measures had good internal consistency (Cronbach α ≥ .70). CONCLUSION Our results support the viability of retaining a population-based cohort of children from the same ethnic group across 2 contexts during a life stage when individuals are likely to move. Longitudinal samples that are generalizable to underserved populations can elucidate developmental processes of relevance for curtailing the risk of psychopathology in disadvantaged contexts.
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Affiliation(s)
- Cristiane S Duarte
- New York State Psychiatric Institute, Columbia University Medical Center, New York.
| | - Glorisa J Canino
- Behavioral Sciences Research Institute, University of Puerto Rico School of Medicine, San Juan
| | | | | | - Doryliz Vila
- Behavioral Sciences Research Institute, University of Puerto Rico School of Medicine, San Juan
| | - Patricia Miranda
- New York State Psychiatric Institute, Columbia University Medical Center, New York
| | - Vijah Ramjattan
- New York State Psychiatric Institute, Columbia University Medical Center, New York
| | - Kiara Alvarez
- Massachusetts General Hospital, Harvard Medical School, Boston
| | - George J Musa
- New York State Psychiatric Institute, Columbia University Medical Center, New York
| | - Katherine Elkington
- New York State Psychiatric Institute, Columbia University Medical Center, New York
| | - Melanie Wall
- New York State Psychiatric Institute, Columbia University Medical Center, New York
| | - Sheri Lapatin
- Massachusetts General Hospital, Harvard Medical School, Boston
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Duarte CS, Klotz J, Elkington K, Shrout PE, Canino G, Eisenberg R, Ortin A, Henriquez-Castillo M, Corbeil T, Bird H. Severity and Frequency of Antisocial Behaviors: Late Adolescence/Young Adulthood Antisocial Behavior Index. JOURNAL OF CHILD AND FAMILY STUDIES 2020; 29:1200-1211. [PMID: 33343180 PMCID: PMC7747833 DOI: 10.1007/s10826-019-01661-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVES An Antisocial Behavior index (ASB-I) for children (ages 5 to 15) was previously developed by obtaining clinician ratings of the seriousness or severity of various behaviors with the goal of improving assessment of antisocial behaviors (ASB) longitudinally. We extend the instrument for use in late adolescence/young adulthood, as socially unacceptable conduct manifests differently across developmental stages. As in the original study, this extension (the ASB-I YA) is based on independent ratings of ASB seriousness/severity during late adolescence/young adulthood (16 to 28 years) made by nine experienced clinicians. METHODS The items rated were drawn from the Oppositional Defiant Disorder and Conduct Disorder schedules of the NIMH Diagnostic Interview Schedule for Children (DISC-IV) and the Elliott Delinquency scales, plus new or modified items developmentally appropriate for late adolescence/young adulthood. Specific ratings were based on the developmental stage and reported frequency of the behaviors. The study also describes the distribution of ASB-I YA scores in the Boricua Youth Study. RESULTS Reliability was substantial for the average ratings of each subscale and for the total score [ICC(3,9): .88 to .95]. Certain items were rated as more severe when occurring in late adolescence/young adulthood compared to childhood/early adolescence (e.g., hitting someone on purpose); however, most ratings were similar across developmental periods. Most importantly, raters reliably and consistently rated the items describing ASB in young adulthood, allowing the computation of the ASB-I YA score. CONCLUSIONS Together with the ASB-I, the ASB-I YA can further advance the study of ASB progression from childhood into young adulthood.
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Affiliation(s)
- Cristiane S Duarte
- New York State Psychiatric Institute, Columbia University, 1051 Riverside Drive, Unit# 43, New York, NY, USA
| | - Jaimie Klotz
- New York State Psychiatric Institute, New York, NY
| | | | | | | | | | - Ana Ortin
- City University of New York - Hunter College, New York, NY
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