Binge Drinking Disparities by Grade, Race and Ethnicity, Sexual Orientation, and Gender Identity

BACKGROUND AND OBJECTIVES

Binge drinking disparities between sexual and gender minority (SGM) students and their heterosexual, cisgender peers are well-established. Data limitations have precluded understandings of whether the onset and progression of these disparities differ by grade. Additionally, little is known about whether and how SGM-related binge drinking varies across groups of students coincidingly defined by sexual orientation or gender identity (SOGI), race, and ethnicity. In the current study, we used a large, statewide sample of secondary school students in California to describe the prevalence of binge drinking among subgroups of adolescents at the intersections of grade, race and ethnicity, and SOGI.

METHODS

Data were from the 2017-2019 cycle of the California Healthy Kids Survey, one of the largest statewide cross-sectional surveys of secondary school students in the United States (n = 925 744). We described the grade-specific prevalence rates of past 30-day binge drinking by (1) grade level, (2) race and ethnicity, and (3) SOGI. Predicted probabilities estimated adjusted percentages of students' binge drinking by subgroups.

RESULTS

SGM-related binge drinking differences were present early in secondary school. Several subgroups of SGM adolescents with minoritized racial and ethnic identities reported higher binge drinking rates relative to their same-grade, white, non-SGM peers.

CONCLUSIONS

Prevention and intervention programs must consider developmentally- and culturally-informed strategies to most effectively promote health among minoritized students.

COVID-19 Anti-Chinese Discrimination, Current Pandemic Stress, And Adolescents' Mental Health

The current study investigated adolescents' experiences of COVID-19 anti-Chinese discrimination (i.e., vicariously witnessed, directly experienced), the consequences for mental health, and the moderating role of general pandemic stress. During Summer 2020, 106 adolescents (43% Latino/a/x, 19% Asian American, 13% Black/African American, 26% biracial/multiracial/other; 58% female) participated in a 14-day daily diary study. Path analyses revealed that more experiences of vicarious COVID-19 anti-Chinese discrimination were associated with greater anxious mood, depressed mood, and mental health stress, while direct COVID-19 anti-Chinese discrimination was unrelated to mental health outcomes. The interaction between vicarious COVID-19 anti-Chinese discrimination and general COVID-19 stress was significant for depressed mood; simple slope analyses showed that for adolescents reporting high levels of COVID-19 stress, more frequent experiences of vicarious COVID-19 anti-Chinese discrimination were associated with greater severity in depressed mood, but this link was nonsignificant for those reporting low levels of general pandemic stress. Findings from the current study underscore the pernicious effects of vicarious COVID-19 anti-Chinese discrimination on the mental health of minoritized youth beyond solely Asian Americans. Additionally, the results evince the need for future pandemic-response efforts to craft public health messaging that avoids the racialization of disease and subsequent stigmatization of ethnic-minority communities.

Multiple marginalization, discrimination, and disordered eating among youth aged 10-11

OBJECTIVE

Although rates of weight discrimination are on-par with racial, ethnic, and gender discrimination, comparatively less work has examined impacts of weight-based discrimination in youth, including on disordered eating. Knowing whether experiences of weight-based discrimination, including in youth with multiply-marginalized identities, are associated with disordered eating could identify vulnerable youth and inform intervention efforts.

METHOD

Youth (N = 11,875) ages 10-11 were recruited through the Adolescent Brain Cognitive Development (ABCD) study. Logistic regressions using cross-sectional data examined discrimination experiences (weight, perceived sexual orientation, race/ethnicity, national origin) and disordered eating (binge-eating, vomiting, weight-gain fear, weight self-worth). Models included race/ethnicity, age, sex, parental income, and degree of elevated weight. Raked poststratification weights were used.

RESULTS

Rates of weight-based discrimination (6.2%) were similar to rates of race/ethnicity (4.4%) and sexual orientation discrimination (4.5%). Weight-based discrimination was associated with more disordered eating. Youth reporting multiple experiences of discrimination had significantly increased disordered eating compared to youth who did not report discrimination.

DISCUSSION

Weight-based discrimination is common in youth and associated with disordered eating. Youth with elevated weight are more likely to be multiply marginalized and experience disordered eating. These findings suggest discrimination, including weight-based discrimination, is a critical intervention target to prevent and treat eating disorders.

PUBLIC SIGNIFICANCE

Experiences of discrimination contribute to poorer health; however, weight-based discrimination is relatively understudied. Data from a large sample of youth ages 10-11 showed that youth with elevated weight reported experiencing multiple types of discrimination, and multiply-marginalized youth had increased odds of disordered eating with each additional type of discrimination. Together, this suggests that weight-based discrimination is a critical target to prevent and treat eating disorders, especially in multiply-marginalized youth.

Creating an Equitable System of Care for Minoritized Youth and Addressing Systemic and Structural Barriers

We provide an overview of the systems of care and the barriers faced by minoritized youth. We discuss ways to address barriers by forging alliances, improving communication with cultural humility, and a nonjudgmental approach. We underscore the importance of a holistic evaluation of minoritized children while leveraging their resilience to create a comprehensive and multipronged plan of action.

Factors That Contribute to the Mental Health of Black Youth during COVID-19 Pandemic

BACKGROUND

The mental health of Black youth during the COVID-19 pandemic is potentially influenced by various systemic factors, including racism, socioeconomic disparities, and access to culturally sensitive mental health support. Understanding these influences is essential for developing effective interventions to mitigate mental health disparities.

METHODS

Our project used a community-based participatory (CBP) research design with an intersectional theoretical perspective. An advisory committee consisting of fourteen Black youth supported all aspects of our project. The research team consisted of experienced Black researchers who also trained six Black youths as research assistants and co-researchers. The co-researchers conducted individual interviews, contributed to data analysis, and mobilized knowledge. Participants were recruited through the advisory committee members and networks of Black youth co-researchers and sent an email invitation to Black community organizations. Forty-eight Black identified were interviewed between the ages of 16 and 30 in Canada. The data was analyzed thematically. We kept a reflexive note throughout all aspects of the project.

RESULTS

Participants reported significant challenges with online schooling, including a lack of support and access to resources. Lockdowns exacerbated stress, particularly for those living in toxic living/home environments. Financial burdens, such as food insecurity and precarious employment, were prevalent and exacerbated mental health challenges. Additionally, experiences of anti-Black racism and police brutality during the pandemic heightened stress and anxiety among participants.

CONCLUSIONS

The findings underscore the complex interplay of systemic factors in shaping the mental health of Black youth during the COVID-19 pandemic. Addressing these disparities requires targeted interventions that address structural inequities and provide culturally competent support to mitigate the impact on mental well-being.

Perceived Racial Discrimination, Psychological Distress, and Suicidal Behavior in Adolescence: Secondary Analysis of Cross-Sectional Data from a Statewide Youth Survey

Developmental, clinical, and epidemiological research have demonstrated the salience of perceived racial discrimination (PRD) as a contributor to negative mental health outcomes in adolescence. This article summarizes secondary analyses of cross-sectional data from a large-scale youth survey within a predominantly rural state, to estimate the prevalence and strength of the association between PRD and serious psychological distress (SPD), suicidal ideation, and prior suicidal attempts. Data from 93,812 students enrolled in 6th, 8th, 10th, or 12th grade within 129 school districts across Kentucky were examined, to determine prevalence rates for subgroups within the cohort. Logistic regression analyses assessed the differences and established comparative strength of the association among these variables for racial/ethnic subgroups. PRD was self-reported at high rates across several demographic subgroups and was most evident among Black (24.5%) and Asian (22.1%) students. Multiracial students experienced the highest rates of both SPD and suicidality (ideation and prior attempt). Both for the entire cohort and for each racial/ethnic subgroup, PRD was significantly associated with an increased likelihood of negative mental health outcomes, although the strength of these associations varied across the subgroups and developmental levels. The implications for early intervention and prevention are discussed.

Emergence and evolution of developmental resilience science over half a century

This reflection on the history and future of developmental resilience science (DRS) highlights its co-emergence with developmental psychopathology (DP), as well as the roles of this journal and its founding editor, Dante Cicchetti, in the evolution of these intertwined domains of scholarship. A remarkable constellation of scholars at the University of Minnesota shaped the course of both conceptual frameworks and their dissemination. I describe fundamental assumptions common to DP and DRS frameworks that reflect their common roots and the pervasive influence of systems theory on developmental science. I describe four waves of DRS and key principles of DRS at the present time. In conclusion, I consider the possibility that a fifth wave of DRS is emerging with a focus on understanding patterns of multisystem, multilevel processes of resilience and their implications for interventions in the context of interacting, interdependent, and complex adaptive systems. I close this commentary with questions for future research and a hopeful outlook on the future of human resilience.

Potentially Traumatic Events, Socioemotional and Adaptive Functioning: Associations with Self-Regulatory Skills in a Community Sample of Primarily Black and Latinx 3-5-year-olds

Early childhood is a heightened risk period for exposure to potentially traumatic events (PTEs) and a critical period for the development of foundational self-regulatory competencies that have potential cascading effects on future socioemotional functioning. This cross-sectional study examined associations between PTE exposure and socioemotional and adaptive functioning, and self-regulatory skills, in a community-based sample of 280 primarily Black and Latinx 3-5-year-olds. Results supported direct relations between PTE exposure and socioemotional and adaptive functioning. Attentional regulation was associated with PTEs and internalizing behaviors, externalizing behaviors, and adaptive behaviors. There was also a significant association of emotional regulation on the relationship between PTEs and internalizing and externalizing behaviors, but not adaptive functioning. Findings have implications for early intervention and educational and public policy, including the importance of scaffolding the development of self-regulatory skills among preschoolers with high PTE exposure.

Risk behaviors and well-being among Egyptian and Roma adolescents in Albania during the COVID-19 pandemic: Vulnerability and resilience in a positive youth development perspective

Introduction

Egyptian and Roma communities represent two of the most deprived and stigmatized ethnic minorities in Albania. However, research investigating vulnerability and well-being in youth from these communities is scant. Even less is known among Egyptian and Roma adolescents who dropped-out of school. Within a Positive Youth Development framework, we investigated among Egyptian and Roma adolescents: (1) risk behaviors, well-being, and developmental assets (personal and contextual); (2) associations of developmental assets with risk behaviors and well-being; (3) specificities by ethnicity, gender, and education.

Methods

A total of 201 Egyptian and Roma adolescents (Mage = 16.63, SDage = 1.80; 47% girls; 53% school dropouts) completed a series of questionnaires in a community setting in August 2020 (first wave of the COVID-19 pandemic).

Results

Binomial, Poisson and linear regression models indicated that Egyptian and Roma adolescents reported similar and high levels of risk behaviors, with boys reporting overall more risk behaviors than girls. Low level of well-being and of personal and contextual assets were reported. Girls reported higher family assets, positive values and social competencies than boys. The situation of adolescents attending school was overall not better than that of youth who had dropped out. Higher positive identity was associated with higher well-being.

Discussion

Intervention and prevention efforts are urgently needed to support minority adolescents' development during and in the aftermath of the pandemic. They should address the structural factors which limit the availability of personal and contextual resources in minority youth's lives. Interventions aimed at building safer neighborhoods and providing safe access to schools for minority youth should be a priority and are essential to prevent the widening of inequalities during and after this health emergency.

Racial Discrimination in Late Adolescence and Mental Health Outcomes Among Participants in the Panel Study of Income Dynamics

PURPOSE

To assess whether racial discrimination experienced at ages 18-21 years is associated with psychological distress and well-being, and investigate potential moderators of this relationship.

METHODS

We used panel data collected from 2005 to 2017 from 661 participants in the Transition into Adulthood Supplement of the Panel Study of Income Dynamics. The Everyday Discrimination Scale measured racial discrimination. The Kessler six and Mental Health Continuum Short Form assessed psychological distress and well-being, respectively. Generalized linear mixed modeling was used to model outcomes and test potential moderating variables.

RESULTS

Approximately 25% of participants experienced high levels of racial discrimination. In analyses of panel data, these participants had significantly worse psychological distress (odds ratio = 6.04, 95% confidence interval: 3.41, 8.67) and lower levels of emotional well-being (odds ratio = 4.61, 95% confidence interval: 1.87, 7.36) compared to those who did not. Race and ethnicity moderated the relationship.

DISCUSSION

Exposure to racial discrimination in late adolescence was associated with worse mental health outcomes. This study has important implications for interventions addressing the need for mental health support that is critical for adolescents who experience racial discrimination.

Intergenerational risk and resilience pathways from discrimination and acculturative stress to infant mental health

Preconception and prenatal stress impact fetal and infant development, and women of color are disproportionately exposed to sociocultural stressors like discrimination and acculturative stress. However, few studies examine links between mothers' exposure to these stressors and offspring mental health, or possible mitigating factors. Using linear regression, we tested associations between prenatally assessed maternal acculturative stress and discrimination on infant negative emotionality among 113 Latinx/Hispanic, Asian American, Black, and Multiethnic mothers and their children. Additionally, we tested interactions between stressors and potential pre- and postnatal resilience-promoting factors: community cohesion, social support, communalism, and parenting self-efficacy. Discrimination and acculturative stress were related to more infant negative emotionality at approximately 12 months old (M = 12.6, SD = .75). In contrast, maternal report of parenting self-efficacy when infants were 6 months old was related to lower levels of infant negative emotionality. Further, higher levels of parenting self-efficacy mitigated the relation between acculturative stress and negative emotionality. Preconception and prenatal exposure to sociocultural stress may be a risk factor for poor offspring mental health. Maternal and child health researchers, policymakers, and practitioners should prioritize further understanding these relations, reducing exposure to sociocultural stressors, and promoting resilience.

Advancing research on early autism through an integrated risk and resilience perspective

To date, a deficit-oriented approach dominates autism spectrum disorder (ASD) research, including studies of infant siblings of children with ASD at high risk (HR) for the disabilities associated with this disorder. Despite scientific advances regarding early ASD-related risk, there remains little systematic investigation of positive development, limiting the scope of research and quite possibly a deeper understanding of pathways toward and away from ASD-related impairments. In this paper, we argue that integrating a resilience framework into early ASD research has the potential to enhance knowledge on prodromal course, phenotypic heterogeneity, and developmental processes of risk and adaptation. We delineate a developmental systems resilience framework with particular reference to HR infants. To illustrate the utility of a resilience perspective, we consider the "female protective effect" and other evidence of adaptation in the face of ASD-related risk. We suggest that a resilience framework invites focal questions about the nature, timing, levels, interactions, and mechanisms by which positive adaptation occurs in relation to risk and developmental pathways toward and away from ASD-related difficulties. We conclude with recommendations for future research, including more focus on adaptive development and multisystem processes, pathways away from disorder, and reconsideration of extant evidence within an integrated risk-and-resilience framework.

An integrated review of social information processing as a mechanism in the association between maltreatment and depression among youth of color

BACKGROUND

Child maltreatment is a potent risk factor for depression across the life course, with maltreatment and depression demonstrated to disproportionately impact youth of color. Despite evidence for mechanisms (e.g., social information processing; SIP) accounting for the effects of maltreatment on youth broadly, pathways of risk for depression among maltreated youth of color specifically remain largely under-investigated.

OBJECTIVE

In an effort to address this gap in the literature, the present review synthesizes available research regarding SIP as a mechanism underlying the impact of maltreatment on the development of depression in general, and among youth of color specifically.

PARTICIPANTS & SETTING

A review of literature was conducted on English language articles published between 1989 and 2022 involving maltreatment, depression, social information processing, and/or youth of color.

METHODS

An electronic database search using terms "Maltreatment," "Depression," "Social Information Processing," "Social Cognition," and "Youth of Color" identified relevant literature.

RESULTS

Synthesis of literature supports SIP as a salient mechanism in the effect of maltreatment on depressive symptomatology for youth broadly, identifying the need for additional empirical work explicitly assessing this pathway among youth of color.

CONCLUSION

In addition to support for SIP as a risk pathway for youth broadly, this review highlights associated processes that can lend support to SIP as a meaningful mechanism of risk for youth of color. Additionally, this review addresses the deficit-based approach through which research and intervention tools evaluate youth of color experiencing maltreatment and depression, proposing alternative approaches towards prevention and intervention efforts with this marginalized population.

A Closer Look: Examination of Suicide Risk Screening Results and Outcomes for Minoritized Youth in Subspecialty Pediatrics

OBJECTIVE

To describe a sample of minoritized youth who screened positive for suicide risk within medical subspecialty pediatrics, compared to non-minoritized youth and describe the screening outcomes of these youth.

METHODS

This retrospective chart review from October 2018 to April 2021 used electronic medical record data from an academic pediatric medical subspecialty clinic that screens universally for suicide risk for all patients ages 9 and up. Chart reviews were conducted for 237 minoritized youth (operationalized as identifying as non-White or Hispanic/Latinx, identifying as a gender minority, and having a preferred language other than English) who screened positive for suicide risk. Descriptive statistics include need for escalation to an emergency room, connection to mental health care, receival of a mental health referral, and attendance at follow-up visits.

RESULTS

Minoritized youth were more likely to screen positive and report a history of suicide attempt when compared to non-minoritized peers. Youth identifying as gender expansive had significant elevation in suicide risk. The majority of youth in this sample were already connected to mental health care, with youth preferring a language other than English being the least likely to be connected.

CONCLUSIONS

Findings indicate heightened suicide risk for minoritized youth, with gender expansive youth having particularly elevated suicide risk. A need to support youth with a preferred language other than English in getting connected to mental health care was also revealed.

A Resistance Framework for Racially Minoritized Youth Behaviors During the Transition to Adulthood

The transition from adolescence to adulthood is a challenging time marked by rapid changes in relational connections, housing status, and academic or work trajectories. We emphasize how structural inequality shapes racially minoritized youth behaviors and center the potential for resistance, arguing that a resistance lens allows us to deepen our understanding of the transition to adulthood for racially minoritized youth. Throughout the paper, we include research on how racially minoritized youth experience marginalizing institutional structures concurrently across multiple systems and their resulting behaviors. We end with the clinical and research implications of a resistance framework to illuminate resistance-informed responses such as rethinking risk and creating spaces for youth-led self-making, youth-adult partnerships to scaffold transitions, and cultivating youth activism.

The Invisibility of Power: A Cultural Ecology of Development in the Contemporary United States

This article highlights the invisible power those in racial and gendered privilege continue to hold in the contemporary United States and the harmful psychological effects of this power on both those it oppresses and, importantly, those who wield it. A lack of empathy and an inability for compassion arise in individuals holding sociopolitical and cultural power, and we highlight how this psychological condition is qualifiable as psychosis and question why it has not been discussed as such in the literature until now. We also, however, bring attention to the invisible psychological power that marginalized populations in the United States hold, invisible because it has been left largely unrecognized by mainstream cultural forces. By centering the ways American cultural minorities successfully navigate multiply oppressive structural systems, we conclude with a reflection on how intersectional feminism can offer a philosophical lens through which to mitigate the unhealthy developmental outcomes and effects of White heteronormative male power.

Mechanisms of Mental-Health Disparities Among Minoritized Groups: How Well Are the Top Journals in Clinical Psychology Representing This Work?

We have known for decades that mental health disparities exist among minoritized groups, including race, ethnicity, sexual identities, gender identity and expression, ability, and others. Theories and frameworks that incorporate stressors unique to the experiences of minoritized groups, such as the biopsychosocial model of racism (Clark et al, 1999) and minority stress model (Meyer, 2003), offer testable mechanisms that may help explain, in part, mental health disparities. However, research addressing mechanisms of these disparities is still scarce and is not well represented in our top clinical psychology journals. This review critically examines the extent to which top tier clinical psychology journals publish work examining mechanisms of mental health disparities among minoritized populations. We find very few studies have been published in top clinical psychology journals that address mechanisms of mental health disparities. We examine potential reasons for this and discuss recommendations for future research.

Long-term effects of a community-based positive youth development program for Black youth: health, education, and financial well-being in adulthood

BACKGROUND

Childhood poverty is known to be associated with poor health. For youth living in extreme poverty, community-based programs focused on youth development are one strategy to improve health and well-being outcomes. However, very few evaluations of the long-term effectiveness of youth development programs have been conducted. The aim of this study was to assess the long-term effectiveness of a positive youth development program (PYD), serving a segregated housing project with a history of community violence, to improve the health, education, and financial well-being of its alumni.

METHODS

A quasi-experimental causal comparative study design was used to study the effectiveness of the Cabrini-Green Youth Program (CGYP). CGYP alumni (mean: 16.8 +/- 7.4 years after program participation) were surveyed. For comparison, participants from the same housing project who were eligible to participate in the CGYP but did not, were identified.

RESULTS

In total, 246/417 (59%) eligible alumni were located. 221 alumni were available to be interviewed; 191/221 (86%) completed the interview survey along with 143 in the comparison group. Both groups self-identified as being Black, African American, and of Other race. Alumni were younger (34.6 vs. 38.1 years, p < .001), less likely to be female (62% vs. 74%, p =.03), and more likely to have been abused as a child (26% vs. 11%, p = .001). The majority in both groups reported to be in good to excellent health (83% of alumni vs. 74% of comparison group). After adjusting for comparison group differences, alumni were more likely to have completed college, 24% vs. 12% (adjusted odds ratio (aOR) 2.47, 95% CI, 1.25-4.86), and to end up with some money at the end of the month, 35% vs. 19% (aOR 2.16, 95% CI, 1.17, 3.97).

CONCLUSIONS

Participation in a PYD program starting at a young age may be associated with reduced poverty in adulthood, possibly aided by higher educational attainment and resultant increased income. PYD may be an effective strategy to supplement evidenced-based poverty reducing policies. This study of a voluntary, community-based PYD program is unique in its up to 33-year follow-up and an outcome assessment that measures more than knowledge change.

The Role of Parents in Reducing Academic, Health, and Behavioral Problems for Native American, African American, and Latinx Adolescents

OBJECTIVE

The aim of the study was to determine how parental modeling of thoughtful behavior and the home physical environment may reduce the number of developmental problems exhibited by Native American, African American, and Latinx adolescents.

METHOD

Demographic and home environmental data were collected from 54 Native American, 131 African American, and 159 Latinx families living in 4 states as part of a home visit. Parents and adolescents were administered surveys that captured adolescent health, social skills, problem behavior, self-efficacy beliefs, vocabulary attainment, and school grades. Scores from the surveys were combined to construct both an adolescent problems index and a household risk index. For each of the 3 racial/ethnic groups examined, the adolescent problems index was regressed on parental modeling and encouragement of mature behavior, the home physical environment, and the household risk index.

RESULTS

Modeling and encouragement of mature behavior was a significant bivariate predictor of overall problems in all 3 groups of adolescents-albeit the overall regression model was nonsignificant for Native Americans. By contrast, the other 2 predictors were nonsignificant in regression models for all 3 groups.

CONCLUSION

Native American, African American, and Latinx adolescents often face a multitude of risks, including poverty and discrimination. As a consequence, adolescents from these 3 racial/ethnic groups frequently display problems pertaining to health, competence, and adaptive behavior. The results from this study suggest that adolescents from such demographic groups are less likely to manifest developmental problems if their parents model mature behavior and encourage the adolescent to act in thoughtful ways.

Multidimensional conceptualization of identity and psychopathology: Assessing mental health disparities from an intersectional and dimensional framework

Black, Indigenous, and People of Color (BIPOC) currently constitute 40% of the US population and will become the majority by 2045. Current mental health systems have not sufficiently accounted for disparities, inequities, and social determinants impacting BIPOC lives. We outline several advances that could improve mental health disparities research. Research on BIPOC requires mental health assessment accurately capturing multiple facets of one's identity, taking into account the complexities of multifaceted historical oppression. Assessing (personality) psychopathology in a dimensional and hierarchical manner could provide greater insight into mental health disparities between diverse identity individuals. We encourage studying moderators that are protective assets for BIPOC-such as resiliency and community factors-as opposed to deficit-dominant, category-based, and majority-dominant assessments.

A Qualitative Study of Stress and Coping to Inform the LEADS Health Promotion Trial for African American Adolescents with Overweight and Obesity

The purpose of this study was to conduct in-depth individual interviews with 30 African American adolescents with overweight and obesity and their families (caregiver/adolescent dyads) to gain a better understanding of how to integrate stress and coping essential elements into an existing family-based health promotion program for weight loss. Interview data from 30 African American adolescents with overweight and obesity (Mage = 15.30 ± 2.18; MBMI%-ile = 96.7 ± 3.90) were transcribed and coded for themes using inductive and deductive approaches by two independent coders. Inter-rater reliability was acceptable (r = 0.70–0.80) and discrepancies were resolved to 100% agreement. The themes were guided by the Relapse Prevention Model, which focuses on assessing barriers of overall coping capacity in high stress situations that may undermine health behavior change (physical activity, diet, weight loss). Prominent themes included feeling stressed primarily in response to relationship conflicts within the family and among peers, school responsibilities, and negative emotions (anxiety, depression, anger). A mix of themes emerged related to coping strategies ranging from cognitive reframing and distraction to avoidant coping. Recommendations for future programs include addressing sources of stress and providing supportive resources, as well as embracing broader systems such as neighborhoods and communities. Implications for future intervention studies are discussed.

Childhood Trauma and Psychological Distress: A Serial Mediation Model among Chinese Adolescents

The consequence of childhood trauma may last for a long time. The purpose of the present study was to examine the effect of childhood trauma on general distress among Chinese adolescents and explore the potential mediating roles of social support and family functioning in the childhood trauma-general distress linkage. A total of 2139 valid questionnaires were collected from two high schools in southeast China. Participants were asked to complete the questionnaires measuring childhood trauma, social support, family functioning, and general distress. Pathway analysis was conducted by using SPSS AMOS 24.0 and PROCESS Macro for SPSS 3.5. Results showed that childhood trauma was positively associated with general distress among Chinese adolescents. Social support and family functioning independently and serially mediated the linkage of childhood trauma and general distress. These findings confirmed and complemented the ecological system theory of human development and the multisystem developmental framework for resilience. Furthermore, these findings indicated that the mental and emotional problems of adolescents who had childhood trauma were not merely issues of adolescents themselves, but concerns of the whole system and environment.

Pain and QOL in Pediatric Sickle Cell Disease: Buffering by Resilience Processes

OBJECTIVE

Sickle cell disease (SCD) is a group of inherited blood disorders. The central feature of this chronic condition is pain. Several identified risk factors exacerbate the impact of pain on quality of life (QOL) in SCD; however, there are relatively fewer investigations of strengths-based resilience variables that might buffer the influence of pain on living with SCD. The purpose of this study was to examine strength-based resilience processes in youth with SCD and their parents. Grounded in an ecological resilience-risk model, we evaluated whether adolescent and parent protective factors (pain acceptance, mindfulness, and psychological flexibility) moderated the relation between adolescent-reported pain burden and QOL.

METHODS

Ninety-three 12- to 18-year-old adolescents with SCD and their parents participated. Adolescents completed assessments of pain characteristics, pain acceptance, mindfulness, and QOL. Parents completed instruments measuring demographic and disease variables and parent psychological flexibility.

RESULTS

Pain variables were associated with protective factors in predicted directions. Adolescent acceptance and mindfulness were positively correlated with QOL. Parent psychological flexibility and adolescent QOL were not related. After controlling for demographic, pain, and disease variables, moderation analyses indicated that adolescent pain acceptance buffered the relation between SCD pain burden and QOL. Moderation analyses were not significant for adolescent mindfulness or parent psychological flexibility.

CONCLUSIONS

Results suggest that strengths-based factors may play an important role for adolescents' QOL within the context of SCD pain. Interventions that enhance teenagers' ability to accept pain might be particularly useful to improve QOL in adolescents living with SCD pain.

Resilience in Development and Psychopathology: Multisystem Perspectives

Resilience science in psychology and related fields emerged from clinical research on risk for psychopathology in the 1970s and matured over the ensuing decades with advances in theory, methods, and knowledge. Definitions and models of resilience shifted to reflect the expanding influence of developmental systems theory and the growing need to integrate knowledge about resilience across levels and disciplines to address multisystem threats. Resilience is defined for scalability and integrative purposes as the capacity of a dynamic system to adapt successfully through multisystem processes to challenges that threaten system function, survival, or development. Striking alignment of resilience factors observed in human systems, ranging from individuals to communities, suggests the possibility of networked, multisystem protective factors that work in concert. Evidence suggests that there may be resilience factors that provide transdiagnostic protection against the effects of adverse childhood experiences on risk for psychopathology. Multisystem studies of resilience offer promising directions for future research and its applications to promote mental health and positive development in children and youth at risk for psychopathology.