An Intersectional-Contextual Approach to Racial Trauma Exposure Risk and Coping Among Black Youth

An Exploration of Racial Differences Among Male Youth Adjudicated for Sexual Offenses

In 2019, the male adjudicated youth (AY) population in correctional facilities was 33% White and 67% minority. Yet, the distribution among male AY charged with sexual offenses (AYSOs) was 55% White and 45% minority, highlighting the lack of disproportionate minority contact within the AYSO population. Little research on AYSOs has focused explicitly on exploring racial differences within this population. Using secondary data from 720 AY 11-18 years of age, the goal of this exploratory study was to identify differences in length of detention, presence of clinical syndromes, attachment patterns, and childhood trauma experiences among a sample of AYSOs and AYs by race category. Although few racial differences were identified among AYSOs, study results overwhelmingly highlighted differences between AYSOs and AYs.

Sexual Violence in Later Life: A Widespread and Growing Yet Hidden Public Health Issue

Sexual violence in later life and related trauma have been identified as a growing yet preventable public health crises, which disproportionately impact women. Research is limited and is continuing to emerge in this area, along with implications for addressing healthcare disparities, primarily among older women. In this paper, the prevalence of sexual violence in later life will be explored, along with survivor characteristics as they relate to structural inequality and health disparities. Consequences of sexual violence in later life will be explored as well, with implications for healthcare workers, focused on pressing needs for research, practice, policy and education at individual, relational, organizational and societal levels.

Feasibility and acceptability of a virtual mindfulness intervention for Black adults with PTSD and depression: Randomized controlled trial

Mindfulness-based cognitive therapy (MBCT) offers promise as a group-based intervention to alleviate posttraumatic stress disorder (PTSD) and depression symptoms in traumatized Black adults. Given the high level of barriers that exist for low-income Black adults, virtual delivery of MBCT may be helpful. This pilot randomized controlled trial assessed feasibility and acceptability of an adapted 8-week virtual MBCT group intervention for Black adults screening positive for PTSD and depression. Forty-six participants (89.3% women) recruited from an urban safety net hospital were randomized to MBCT or waitlist control (WLC). Overall feasibility was fair (70%); however, completion rates were higher for WLC than MBCT (90% vs. 54%). Group acceptability was high across quantitative and qualitative measures for study completers. Perceived barriers to psychological treatment were high (>9). While showing potential via improved coping skills and positive health changes, this intervention's success hinges on mitigating engagement barriers for future delivery; additional studies are warranted.

Psychology's Contributions to Anti-Blackness in the United States Within Psychological Research, Criminal Justice, and Mental Health

The mass incarceration of Black people in the United States is gaining attention as a public-health crisis with extreme mental-health implications. Although it is well documented that historical efforts to oppress and control Black people in the United States helped shape definitions of mental illness and crime, many psychologists are unaware of the ways the field has contributed to the conception and perpetuation of anti-Blackness and, consequently, the mass incarceration of Black people. In this article, we draw from existing theory and empirical evidence to demonstrate historical and contemporary examples of psychology's oppression of Black people through research and clinical practices and consider how this history directly contradicts the American Psychological Association's ethics code. First, we outline how anti-Blackness informed the history of psychological diagnoses and research. Next, we discuss how contemporary systems of forensic practice and police involvement in mental-health-crisis response maintain historical harm. Specific recommendations highlight strategies for interrupting the criminalization of Blackness and offer example steps psychologists can take to redefine psychology's relationship with justice. We conclude by calling on psychologists to recognize their unique power and responsibility to interrupt the criminalization and pathologizing of Blackness as researchers and mental-health providers.

Impacts of intergenerational substance use and trauma among black women involved in the criminal justice system: A longitudinal analysis

INTRODUCTION

Intergenerational substance use and trauma disproportionately impact racialized women. Yet, how these factors impact outcomes in women involved in the criminal justice system is understudied.

METHODS

Using data from 443 participants in the Black Women in a Study of Epidemics, we assessed the impact of intergenerational substance use and trauma on participant drug use and open Child Protective Services (CPS) cases over 18 months. In repeated-measures logistic regression, intergenerational substance and trauma were independent variables, while participants' drug use at each follow-up and any open CPS case (s) served as separate dependent variables. Models were adjusted for criminal justice involvement, age, marital status, education, childhood guardian, number of children, and prior year homelessness.

RESULTS

On average, participants were aged 35 years, 64 % had never married, and 44 % were raised by both parents. Two-thirds of women (67 %) reported intergenerational substance use (≥1 parent and/or grandparent with alcohol/drug problems), while only 13 % reported intergenerational trauma. Each increase in the number of parents/grandparents with drug/alcohol problems was associated with 30 % increased odds of participants' drug use (aOR 1.30, 95 % CI: 1.07,1.57) and 40 % increased odds of having an open CPS case (aOR 1.40, 95 % CI: 1.11, 1.78). The association of intergenerational trauma and CPS cases was attenuated with sociodemographic/contextualizing factors.

CONCLUSIONS

Intergenerational substance use and trauma are associated with negative outcomes. Our findings highlight the need for substance use treatment to address the pervasive generational effects of substance use and trauma faced by racialized women in the criminal justice system.

The Restorative Integral Support (RIS) Model: Community-Based Integration of Trauma-Informed Approaches to Advance Equity and Resilience for Boys and Men of Color

Mental health and health promotion research and practice have consistently revealed the social and structural inequities that boys and men of color (BMoC) face. Moreover, scholarship highlights the importance of gender, especially the concepts of masculinity and manhood, in understanding inequities that are experienced. Providers and community leaders are finding culturally relevant ways to foster healing and restoration while addressing racial trauma and the adverse community environments tied to adverse childhood experiences (ACEs). This article introduces the restorative integral support (RIS) model to promote connectivity through networks and to acknowledge the contextual differences BMoC experience when suffering from trauma and adversities. RIS is a framework used to address adversities and trauma while increasing societal awareness and advancing equity. This community-based, multidimensional approach is offered to enhance individual, agency, community, and policymaking leadership, raising awareness of mental health concerns and trauma while offering a flexible guide to developing safe spaces and support for recovery from ACEs and trauma. This article offers an in-depth appreciation of the real-life contexts within which BMoC overcome histories of adversity and trauma, demonstrating how the RIS model is applied to advance structural transformation while fostering community resilience.

Adherence and Self-management Interventions among Systemically Marginalized and Underserved Youth with Asthma

Objective

Asthma disproportionately impacts youth who have been systemically marginalized and underserved, henceforth termed underserved for brevity. Disparities are driven by systemic and structural racism and social determinants of health. We aimed to synthesize findings from interventions delivered among youth who have been underserved, highlight effective intervention strategies, and provide recommendations to promote health equity. To demonstrate, we also present a case example of clinical application.

Methods

We conducted a systematic literature search of randomized trials among youth (≤18 years old) who are often underserved, delivered in clinical, community, or home-based settings with medication adherence and/or self-management behaviors as an intervention outcome. We used descriptive statistics to synthesize study characteristics and outcomes.

Results

Twenty four articles, representing 21 unique interventions, met inclusion criteria. Forty-six percent reported significant improvements in adherence or self-management for the intervention group. Self-management interventions focused on symptom recognition and monitoring demonstrated the greatest percentage of significant intervention findings (71.4%); controller medication adherence interventions demonstrated the fewest (33.3%).

Conclusions

Interventions are not consistently effective for youth who have been underserved. Findings suggest that pediatric psychologists can help patients from underserved backgrounds by bolstering symptom recognition and monitoring skills, providing self-management skill education, and problem-solving ways to reduce triggers through individually tailored, multicomponent approaches. Pediatric psychologists should simultaneously strive to consider and address systemic, structural, and social determinants of asthma disparities in their work.

Dismantling systems of racism and oppression during adolescence: An agenda for anti-racist research

In reflecting on the collection of work in the recent Journal of Research on Adolescence special series and what it means for research to dismantle systems of racism and oppression, we call for adolescent development researchers to embrace anti-racist research. We describe a set of strategies for conceptualizing, conducting, and disseminating research with adolescents using an anti-racist lens. These strategies flow from tenets of anti-racist research that include recognizing racism as systemic and being critically self-reflective on power and privilege, committed to doing no harm to adolescents, action-oriented, and community-centered. Despite obstacles to anti-racist research in academic and public ecosystems, anti-racist research is essential if we are interested in equity in adolescent' development and the well-being of all adolescents.

Culturally Responsive Telepsychology & mHealth Interventions for Racial-Ethnic Minoritized Youth: Research Gaps and Future Directions

Telepsychology and mHealth (TPmH) services for youth and their families have become increasingly prevalent in recent years. However, significant limitations in theory, research, and policy introduce questions about the effectiveness of such interventions, particularly for racial-ethnic minoritized youth and their families, who already contend with inequities in mental health treatment access and outcomes. Although TPmH have the potential to reduce barriers to mental health services in ways that may benefit racial-ethnic minoritized youth and their families, the mental health field must first grapple with limitations in culturally responsive TPmH work to avoid perpetuating existing mental health inequities. As such, this article begins by briefly reviewing extant literature on (1) TPmH for youth, (2) culturally adapted or culturally responsive evidence-based interventions for racial-ethnic minoritized youth and families, and (3) the intersection of TPmH and culturally responsive interventions. Informed by the gaps identified by this review, we provide recommendations for future directions in culturally responsive TPmH for racial-ethnic minoritized youth and families. These recommendations have been organized into four overarching categories: (1) conceptual and theoretical recommendations, (2) research priorities, (3) practice and policy recommendations, and (4) engagement and access recommendations. These recommendations offer novel ideas for researchers, clinicians, funding agencies, policy-makers, and other key stakeholders and are intended to facilitate equity in TPmH for racial-ethnic minoritized youth and their families.

Evolving Our Understanding: Housing Instability as an ACE for Young Children

We investigated the conceptualization and impact of adverse childhood experiences (ACEs) in a sample of 231 children ages 3-5 living in poverty and experiencing homelessness, focusing specifically on caregiver well-being and housing instability. Data was collected using the Neurodevelopmental Ecological Screening Tool (NEST), which screens for developmental risk and resilience across three domains (neurodevelopmental, caregiver, and environment). We used structural equation modelling (SEM) to test the association between domains and ACE scores and assessed the impact on neurodevelopmental constructs. Fifty-five percent of the sample had high ACE scores (> 3), which were associated with lower attention, social skills, and emotional regulation. ACEs were strongly associated with 0.17 standard deviation units of higher levels of caregiver distress (p < .001), which was also associated with 0.26 standard deviation units of lower levels of child neurodevelopmental functioning (p = .001). For each unit increase in housing instability, there was a three-fourths increase in ACE (0.78 ACE at p = .004); four or more moves were associated with the worst neurodevelopmental outcomes (53% of the sample). We must use an ecological, developmental lens to understand how early adversity impacts children, at what age, and in what context. Housing stability plays a critical role in developmental well-being and should be accounted for in conceptualizations of child ACE scales. Caregiver and child relationships are reciprocal, and so the impacts of ACEs are also bidirectional. Our policies and practices at individual, community, and systemic levels should account for these dynamics to improve child well-being.

Shifting the discourse on disability: Moving to an inclusive, intersectional focus

Individuals with disabilities comprise one of the largest marginalized groups in the United States and experience systemic barriers in health care. In Westernized communities, disability has historically been conceptualized via the medical model, which considers disability an individual-level deficit in need of correction. Although other models of disability (e.g., social model) have been developed to address the medical model's ableist shortcomings, these fail to consistently acknowledge intersectionality. Specifically, these models fail to consider that (a) a disabled individual may hold other marginalized or oppressed identities and (b) these intersecting oppressions may exacerbate health inequities. Intersectionality, which originates from Black feminist literature, describes the ways that systems of power and oppression (e.g., racism, sexism) interact to form an individual's unique experience. To date, the intersection of disability and other marginalized identities has been neglected in psychology and related fields, leaving little guidance for how scholars, clinicians, and other stakeholders can address disability via an intersectional lens. The present article discusses how a disability-affirmative, intersectional approach can serve as a strategy for challenging and reforming oppressive systems across the field of psychology. We assert that, ultimately, this approach has the potential to optimize and expand access to equitable, inclusive mental health care, and we propose actionable steps psychologists can take in research, practice, training, and policy in pursuit of this aim. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Dismantling Systems and Improving Contexts to Support the Development of BIPOC Youth

The issue's collection of 17 papers apply a wide range of developmental, contextual, intersectional, and critical perspectives (and their combinations) to promote understanding on how oppressive systems intersect and overlap in detrimental ways for BIPOC youth development. Innovative conceptual models and a variety of methodological techniques advance our understanding of the lived experiences of BIPOC youth who interact daily in contexts such as neighborhoods and educational settings in which racism and anti-immigrant sentiment pervades. Together, the papers in this issue examine the systemic forces at the root of experiences of oppression and advance the field toward improving short and long-term developmental outcomes for BIPOC adolescents.