Review of stress inoculation training with children and adolescents. Issues and recommendations

Behavioral and neural processes in counterconditioning: Past and future directions

Counterconditioning refers both to the technique and putative process by which behavior is modified through a new association with a stimulus of an opposite valence. Similar to extinction, counterconditioning is considered a form of inhibition that interferes with the expression of the originally learned response without erasing it. But whereas interest in extinction continues to rise, counterconditioning has received far less attention. Here, we provide an in-depth review of counterconditioning research and detail whether counterconditioning is any more effective than extinction at preventing relapse of the originally learned behavior. We consider the clinical implications of counterconditioning, describe recent neurobiological and neuroimaging research in this area, and consider future avenues in need of further investigation.

Understanding resilience

Resilience is the ability to adapt successfully in the face of stress and adversity. Stressful life events, trauma, and chronic adversity can have a substantial impact on brain function and structure, and can result in the development of posttraumatic stress disorder (PTSD), depression and other psychiatric disorders. However, most individuals do not develop such illnesses after experiencing stressful life events, and are thus thought to be resilient. Resilience as successful adaptation relies on effective responses to environmental challenges and ultimate resistance to the deleterious effects of stress, therefore a greater understanding of the factors that promote such effects is of great relevance. This review focuses on recent findings regarding genetic, epigenetic, developmental, psychosocial, and neurochemical factors that are considered essential contributors to the development of resilience. Neural circuits and pathways involved in mediating resilience are also discussed. The growing understanding of resilience factors will hopefully lead to the development of new pharmacological and psychological interventions for enhancing resilience and mitigating the untoward consequences.

Process evaluation of a community-based mental health promotion intervention for refugee children

Public health interventions are complex in nature and composed of multiple components. Evaluation of process and impact is necessary to build evidence of effectiveness. Process evaluation involves monitoring extent of implementation and comparison against the program plan. This article describes the process evaluation of the 'Qaderoon' (We are Capable) intervention; a community-based mental health promotion intervention for children living in a Palestinian refugee camp of Beirut, Lebanon. The manuscript describes the context of Palestinian refugees in Lebanon, the intervention, the process evaluation plan and results. The process evaluation was guided by the literature and by a Community Youth Committee. Findings indicated that attendance was 54 and 38% for summer and fall sessions, respectively. Session objectives and activities were commonly achieved. Over 78.4% of activities were reported to be implemented fully as planned. Over 90% of the children indicated high satisfaction with the sessions. Contextual facilitators and challenges to implementing the intervention are discussed. The most challenging were maintaining attendance and the actual implementation of the process evaluation plan. Findings from process evaluation will strengthen interpretation of impact evaluation results.

Developing a logic model for youth mental health: participatory research with a refugee community in Beirut

Although logic models are now touted as an important component of health promotion planning, implementation and evaluation, there are few published manuscripts that describe the process of logic model development, and fewer which do so with community involvement, despite the increasing emphasis on participatory research. This paper describes a process leading to the development of a logic model for a youth mental health promotion intervention using a participatory approach in a Palestinian refugee camp in Beirut, Lebanon. First, a needs assessment, including quantitative and qualitative data collection was carried out with children, parents and teachers. The second phase was identification of a priority health issue and analysis of determinants. The final phase in the construction of the logic model involved development of an intervention. The process was iterative and resulted in a more grounded depiction of the pathways of influence informed by evidence. Constructing a logic model with community input ensured that the intervention was more relevant to community needs, feasible for implementation and more likely to be sustainable.

Perceived stress, coping, and adjustment in adolescents

PURPOSE

To investigate age and gender effects on perceived interpersonal stress, coping with interpersonal stressors, and psychological adjustment among early and middle adolescents. Furthermore, the associations of perceived stress and coping with adjustment were examined.

METHODS

The sample included 286 Austrian adolescents aged 10 to 14 years who attended the fifth to seventh grade. Self-report data on perceived stress, coping, as well as emotional and behavioral problems, were assessed.

RESULTS

Fifth graders scored lower on maladaptive coping strategies and externalizing problems and reported more adaptive coping strategies than sixth and seventh graders. Compared with boys, girls evaluated a higher amount of perceived interpersonal stress and used more social support. Additionally, girls scored higher on maladaptive coping strategies and emotional distress and scored lower on distraction than boys. Problem-focused and emotion-focused coping were negatively related to emotional and behavioral problems, whereas perceived stress and maladaptive coping was positively associated with adjustment problems. These relations were stronger in female than in male adolescents.

CONCLUSIONS

Evaluating multidimensional coping patterns is supported. Particularly, implementation of primary preventive programs during late childhood is suggested.