Reducing Stress and Preventing Anxiety in African American Adolescents: A Culturally- Grounded Approach

Reducing suicidal ideation in African American adolescents: A randomized controlled clinical trial

OBJECTIVE

Suicide rates among African American adolescents have increased exponentially in recent years. The socioecological stressors that can increase suicide risk for African American adolescents, in conjunction with unique suicide risk manifestations within this group, require culturally sensitive preventive interventions. This study examines the efficacy of the Adapted-Coping With Stress course (A-CWS), a culturally tailored preventive intervention, to reduce suicidal ideation in African American adolescents, utilizing a randomized controlled design.

METHOD

Participants included 410 ninth-grade students in a large Midwestern city; most students identified as Black/African American. Participants were randomly assigned to either the A-CWS intervention or standard care control condition. All participants were assessed at baseline, immediately postintervention, and 6 and 12 months postintervention.

RESULTS

Treatment effects were examined using latent growth models comparing suicidal ideation trajectories in control and intervention conditions. Analyses were conducted using both intention-to-treat and treatment-as-received samples (i.e., intervention condition participants who attended at least 80% of sessions). In both intention-to-treat and treatment-as-received analyses, there was a significant treatment effect: Individuals in the A-CWS intervention condition with higher baseline ideation evidenced a superior reduction in suicidal ideation over the course of the study, relative to their counterparts in the standard care control condition.

CONCLUSION

Findings indicate that the A-CWS preventive intervention is efficacious in reducing suicidal ideation among African American adolescents with higher levels of baseline suicidal ideation and that effects sustain over time, with the strongest effect evidenced 12 months postintervention. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

B. W, Carlo G, Gonzales NA, Knight GP. U.S. Mexican-origin young adults' mental health relative to interpersonal stressor transitions from childhood to adolescence

OBJECTIVES

This study sought to describe latent transitions in developmentally and culturally salient interpersonal stressors from late childhood to late adolescence and examine whether different transition patterns predicted early adult mental health problems.

METHOD

Data from four waves (Grades 5, 7, 10, 12) of a study of 749 U.S. Mexican-origin youth were used for a latent transition analysis (LTA) of family, peer, and community stressors; distal outcomes of externalizing and internalizing problems were measured 5 years after Grade 12. Latent class analysis (LCA) and LTA were conducted for investigating underlying subgroups of interpersonal stress at each wave and transitions between subtypes over waves.

RESULTS

For the LCA, two latent classes emerged at all four waves, representing low and high interpersonal stress. The LTA model with two classes at all waves was conducted with good fit. Six prominent transition classes emerged and related to young adult internalizing and externalizing problems. Transition class related to young adult internalizing and externalizing problems, such that youth who consistently had exposure to interpersonal stress or who had transitions from low to high exposure had more internalizing and externalizing problems.

CONCLUSIONS

Findings are discussed relative to the developmental salience of these transitions and opportunities to intervene during adolescence to mitigate later mental health problems. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Adaptation of the Coping With Stress Course for Black Adolescents in Low-Income Communities: Examples of Surface Structure and Deep Structure Cultural Adaptations

Black adolescents in low-income communities are at increased risk of developing mental health problems due to the impact of cumulative poverty-related stressors and racial discrimination, yet Black youth have relatively low rates of mental health service utilization, resulting in significant unmet need. The Coping With Stress (CWS) Course is an evidence-based, cognitive behavioral intervention that has been shown to reduce the incidence of anxiety, mood, and conduct problems among predominantly White samples, as well as Asian and Latinx youth. In the past 25 years since the CWS Course was introduced, Black adolescents have either been severely underrepresented or conspicuously absent from program evaluation research on the CWS Course, with few exceptions. The purpose of this article is threefold: (1) to justify the need for cultural adaptations to the CWS Course for Black adolescents from low-income communities, (2) to describe the scientific basis for the specific surface structure and deep structure modifications made to the culturally adapted version of the CWS Course, known as Resilient In spite of Stressful Events or RISE, and (3) to illustrate the deep structure adaptations with a vignette drawn from implementation of the RISE program with Black adolescents in a low-income, urban community.

Protective factors for suicidal ideation among Black adolescents indirectly exposed to community violence

OBJECTIVE

Community violence exposure has been identified as a risk factor for Black youth suicide ideation. However, little is known about factors that protect community violence exposed youth against suicide ideation. The current study examined associations between knowledge of family member and peers' community violence exposure and Black youth's subsequent suicidal ideation, and investigated self-worth and social support as protective factors.

METHOD

Participants were a community sample of Black youth (N = 447, 47.4% female; Mage = 11.77, SD = 0.35) who reported about community violence exposure, self-worth, social support, and suicide ideation in grades 6 and 7.

RESULTS

Regression analyses revealed that grade 6 knowledge of family member and peers' community violence exposure was associated with increases in suicide ideation assessed in grade 7. Self-worth attenuated the association between knowledge of others' community violence exposure and suicide ideation for male adolescents. For female adolescents, social support attenuated the association between knowledge of others' community violence and suicide ideation.

CONCLUSIONS

Findings highlight the consequential impact of knowledge about community violence for Black youth's suicidal ideation. Enhancing protective factors for Black youth is an important target for intervening with exposure to violence and reducing suicide ideation.

Expanding Collective Efficacy Theory to Reduce Violence Among African American Adolescents

Community violence is a complex phenomenon, and many theories have been put forth to explain the causes of community violence and disparities in community violence across neighborhoods. One notable theory, collective efficacy theory (CET), posits that collective efficacy (i.e., a neighborhood's social cohesion and informal social control) mediates the association between concentrated disadvantage and community violence. As CET theorizes an inverse feedback loop between collective efficacy and community violence, collective efficacy could mitigate the link between neighborhood disadvantage and community violence. The current study examines the reciprocal association between collective efficacy and community violence exposure using data from 604 low-resourced, urban African American ninth-grade students from a large Midwestern city. Data were collected at 6-month intervals over 2 years. Significant cross-sectional associations were found between each of the collective efficacy constructs (social cohesion and informal social control) and community violence exposure, although no significant longitudinal cross-lagged associations were found. There were positive cross-sectional associations between (a) collective efficacy and community violence exposure and (b) informal social control and community violence exposure; however, the association between social cohesion and community violence exposure was negative. Associations between overall collective efficacy, as well as its subscales, and community violence exposure were consistent with hypothesized directions for social cohesion, but not for collective efficacy or informal social control. Findings support the use of collective efficacy as two constructs, rather than a single construct as proposed by Sampson et al. Implications for expanding original assumptions of CET are discussed.

African American adolescent suicidal ideation and behavior: The role of racism and prevention

Suicide is one of the most devastating, yet preventable, health disparities for African American adolescents. African American adolescent suicidal ideation and behavior may have different manifestations and risk factors relative to those of adolescents from other ethnic backgrounds that impact prevention efforts. For example, in addition to more common manifestations of suicidal ideation and behavior, African American youth may engage in violent or high-risk behaviors, use more lethal means, or report ideation at lower depression levels. The Adapted-Coping with Stress Course (A-CWS), an adaptation of Gregory Clarke and colleagues' Coping with Stress Course, was developed to address the cultural nuances of African American adolescents. The A-CWS is a 15-session cognitive-behavioral, group-based preventive intervention that aims to enhance adaptive coping skills and reduce suicidal ideation, by incorporating strategies that counter stressors associated with systemic racism that burden African American adolescents. This study evaluated the feasibility and acceptability of the A-CWS intervention, using a sample of predominantly African American ninth-grade students. Results indicated that the adolescents were very favorable and receptive to the A-CWS intervention and that the intervention could be conducted feasibly. The A-CWS intervention serves as a model to advance culturally-grounded, evidence-based preventive intervention, for an underserved sector of adolescents.

Psychometric properties of the Escala de Autoeficacia para la Depresión en Adolescentes (EADA) among Latino youth with type 1 diabetes

Type 1 Diabetes (T1D) adolescents have higher depression rates than controls. Self-efficacy has been proposed as a mediator of therapeutic changes. Few scales assess emotional self-efficacy in adolescents. None have been validated with T1D youth. We examined the psychometric properties of the Escala de Autoeficacia para la Depresión en Adolescentes (EADA) with 51 T1D youth (aged 12-17 years), enrolled in a depression treatment study. Adolescents and one parent each completed several measures. Youth completed the EADA. We used alpha coefficient to estimate its internal consistency and Pearson correlation to assess its concurrent and construct validity. We found an internal consistency of 0.93 for the EADA total score, with alpha values ranging from 0.71 to 0.85 for its subscales. EADA scores significantly (p ≤ 0.05) diverged from self-reports of depression, hopelessness/helplessness, suicidal ideation, self-esteem/guilt problems, depression-related cognitive alterations, hypoglycemic symptoms, and problems in quality of life. Its scores converged with youth's life satisfaction, self-efficacy for diabetes, self-care behaviors, and perceptions about the quality of group therapy climate and family social support. Our findings document EADA's reliability and validity when used with T1D youth and extend the supporting evidence on its psychometric properties to a clinical sample of Latino adolescents.