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Alvis L, Kibble CDM, Douglas RD, Giang C, Johns T, Oosterhoff B, Kaplow JB. Exploring Intersections Between Trauma and Discrimination in Youth of Color Seeking Mental Health Services. J Am Acad Child Adolesc Psychiatry 2025:S0890-8567(25)00017-6. [PMID: 39842632 DOI: 10.1016/j.jaac.2024.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 09/30/2024] [Accepted: 01/13/2025] [Indexed: 01/24/2025]
Abstract
OBJECTIVE The purpose of this study is to explore the intersection between trauma and discrimination among Black and Latino/a/x youth seeking treatment. Specifically, we examine the following: (1) the frequency of various everyday discrimination experiences, averaged across the sample and disaggregated by demographic characteristics; (2) unique associations between exposure to potentially traumatic events (PTEs) and everyday discrimination experiences; and (3) unique associations between everyday discrimination experiences and specific posttraumatic stress symptoms while accounting for demographic characteristics and PTEs. METHOD Participants were 573 Black (54.8%) and non-Black Latino/a/x youth (10-18 years of age, 55.8% female, 25.7% first- or second-generation immigrant) who were treatment seeking and had exposure at least one traumatic event. RESULTS Two-thirds of trauma-exposed youth reported having experienced discrimination, with the most common experience being treated as not smart (46%), followed by being treated with less courtesy or respect (40%). Rates of discrimination varied by intersecting demographic characteristics in nuanced ways. Among 11 PTEs, exposure to a natural disaster, experiencing community violence, and witnessing community violence were each positively associated with overall everyday discrimination scores and specific discriminatory encounters. Everyday discrimination experiences were positively associated with posttraumatic stress symptoms after accounting for demographic characteristics and exposure to PTEs. CONCLUSION Findings provide important context for understanding experiences of everyday discrimination in Black and Latino/a/x youth seeking mental health services for trauma. Findings further highlight variability in the types of discrimination youth with different intersecting identities experience, the high rates of co-occurrence between discrimination and other traumatic events, and unique associations between specific discrimination experiences and posttraumatic stress reactions. DIVERSITY & INCLUSION STATEMENT We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. We worked to ensure sex and gender balance in the recruitment of human participants. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. One or more of the authors of this paper self-identifies as living with a disability. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work. One or more of the authors of this paper received support from a program designed to increase minority representation in science.
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Oosterhoff B, Alvis L, Steinberg AM, Pynoos RS, Kaplow JB. Validation of the four-item very brief University of California at Los Angeles Posttraumatic Stress Disorder Reaction Index screening tool for children and adolescents. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2024; 16:1338-1346. [PMID: 37650801 DOI: 10.1037/tra0001580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
OBJECTIVE Experiencing traumatic events places children and adolescents at risk for developing posttraumatic stress disorder (PTSD), often leading to adverse mental health consequences. Although well-validated measures of PTSD are available, very brief screening tools are needed to assess PTSD when resources are limited. This study was conducted to develop and validate the four-item University of California at Los Angeles (UCLA) PTSD Reaction Index for DSM-5-Very Brief Form (RI-5-VBF) to be used in settings requiring rapid and efficient screening. METHOD Item response theory (IRT) models were used to derive RI-5-VBF scores from the UCLA PTSD Reaction Index for DSM-5 and assess its internal consistency using a sample of 1,785 youth (Mage = 12.32 years, SD = 2.78) seeking support at an academic medical center clinic or bereavement center. Receiver operating characteristic (ROC) analyses and diagnostic efficiency statistics were used to assess discriminant groups validity and screening utility of the RI-5-VBF scores. Differential item functioning (DIF) analyses were used to examine possible bias across age, gender, race, ethnicity, and clinical setting versus bereavement center setting. RESULTS IRT models identified four items with the highest discrimination within each PTSD subscale. The RI-5-VBF scores exhibited acceptable internal consistency (α = .74). ROC analyses indicated that an RI-5-VBF score of 9 maximized sensitivity and specificity. DIF analyses did not find evidence of bias across age, gender, race, ethnicity, or clinical versus bereavement center settings. CONCLUSION These findings provide support for the reliability and validity of the RI-5-VBF. Findings highlight the utility of the RI-5-VBF as a brief screening measure for PTSD in children and adolescents. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Alvis L, Oosterhoff B, Hoppe R, Giang C, Kaplow JB. Measurement invariance of the Grief Facilitation Inventory with respect to youth gender, race, ethnicity, and age. DEATH STUDIES 2024:1-6. [PMID: 38768059 DOI: 10.1080/07481187.2024.2355482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
The Grief Facilitation Inventory (GFI) assesses caregiver grief facilitation behaviors among bereaved youth. Initial analyses supported the GFI's reliability and validity. The purpose of this study was to evaluate measurement invariance of the GFI across gender, race/ethnicity, and age. Participants were 558 clinic-referred youth aged 7-18 (58.8% female; 43.6% Latino(a), 24.9% White, 14.9% Black, 16.6% Multiracial). Multigroup confirmatory factor analyses provided evidence of measurement invariance for ongoing connection, caregiver grief expression, and existential continuity and support-but not grief inhibition/avoidance-across subgroups. Results suggest that ongoing connection, caregiver grief expression, and existential continuity and support are measuring similar constructs, to a similar degree, across demographics, thereby supporting generalizability and clinical utility of these subscales. The grief inhibition/avoidance subscale should be used with caution and interpreted in the context of low reliability for Black, Latino(a), and younger youth, with further research needed to improve conceptualization and measurement of this subscale.
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Giang C, Alvis L, Oosterhoff B, Kaplow JB. Protective Factors in the Context of Childhood Bereavement: Youth Gratitude, Future Orientation, and Purpose in Life. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228241246919. [PMID: 38621174 DOI: 10.1177/00302228241246919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
The objective of the study was to examine potential associations between positive youth development constructs (gratitude, future orientation, purpose in life) and psychological functioning (posttraumatic stress symptoms, depressive symptoms, maladaptive grief reactions) among bereaved youth and test whether these associations vary by age. A diverse sample of 197 clinic-referred bereaved youth (56.2% female; M = 12.36, SD = 3.18; 36.1% Hispanic, 23.7% White, 20.1% Black, 11.9% Multiracial, and 8.2% another race/ethnicity) completed self-report measures of psychological functioning and positive youth development constructs. Linear regression models indicated that gratitude and purpose were associated with lower posttraumatic stress and depressive symptoms among bereaved youth. Future orientation was associated with higher posttraumatic stress symptoms. Results were consistent across age. If replicated longitudinally, gratitude and purpose may be important protective factors against negative mental health outcomes in the aftermath of losing a loved one.
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Alvis L, Zhang N, Sandler IN, Kaplow JB. Developmental Manifestations of Grief in Children and Adolescents: Caregivers as Key Grief Facilitators. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:447-457. [PMID: 35106114 PMCID: PMC8794619 DOI: 10.1007/s40653-021-00435-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/22/2021] [Indexed: 05/26/2023]
Abstract
The death of a loved one represents one of the most distressing and potentially traumatic life events in childhood and adolescence. Grief reactions in youth are influenced by ongoing developmental processes and manifest differently depending on the child's age and developmental stage. These grief-related processes unfold within youths' caregiving context, as children and adolescents rely heavily on the adults in their environment to navigate and cope with the death of a loved one. Despite the field's increasing recognition of the potential for maladaptive grief reactions to impede functioning over time, few longitudinal research studies on childhood grief currently exist. In this article, we will (a) provide a brief overview of the childhood bereavement literature; (b) review the new DSM-5 and ICD-11 Prolonged Grief Disorder diagnostic criteria through a developmentally-informed lens; (c) describe how grief reactions manifest in children and adolescents of different ages through the lenses of multidimensional grief theory and relational developmental systems theory; (d) highlight key moderating factors that may influence grief in youth, and (e) discuss a primary moderating factor, the caregiving environment, and the potential mechanisms through which caregivers influence children's grief.
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Dodd CG, Kassing F, Alvis LM, Hill RM, Kaplow JB. Prevalence and correlates of externalizing behaviors among youth seeking treatment following trauma exposure. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2023; 15:S20-S28. [PMID: 35201834 DOI: 10.1037/tra0001219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
OBJECTIVE Trauma-exposed youth often experience impairing externalizing problems (EXTs), yet the relationship between EXTs, trauma exposure, and posttraumatic stress symptoms (PTSS) are not well understood. To examine the extent of their co-occurrence, we report the rates and correlates of youth EXTs relative to clinically elevated PTSS in a sample of youth referred to a trauma and grief specialty clinic. METHOD Self- and caregiver-report measures were obtained from 260 youth ages 7-19 years (M = 11.92, SD = 3.21; 53.5% female) during a pretreatment assessment. The sample was divided into 4 groups according to the youths' PTSS and EXT score elevations, and these groups were then compared according to rates of youth depressive symptoms, youth suicidal ideation, and caregiver strain. RESULTS The 4 groups were comorbid PTSS and EXTs (18%); EXTs-only group (36%); PTSS-only group (13%), and subclinical symptom group (34%). The comorbid PTSS and EXTs group had the highest scores on all other child and caregiver symptom measures. Compared to the subclinical group, youth in the PTSS-only group had increased depressive symptoms and suicidal ideation, whereas youth in the EXTs-only group had elevated levels of caregiver strain. CONCLUSION Co-occurring PTSS and EXTs is a common presentation among trauma-exposed youth referred to treatment. These youth are also likely to suffer from other problems of clinical concern, including suicidal ideation, and their problems are associated with caregiver distress. More research is needed to examine unique risk and resiliency factors related to the development of youth EXTs in response to trauma exposure. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Alvis L, Douglas RD, Oosterhoff B, Gaylord-Harden NK, Kaplow JB. Identity-based bullying and mental health among Black and Latino youth: The moderating role of emotional suppression. J Trauma Stress 2023; 36:409-420. [PMID: 36989065 DOI: 10.1002/jts.22927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 12/05/2022] [Accepted: 01/11/2023] [Indexed: 03/30/2023]
Abstract
The current study examined the prevalence of identity-based bullying, the unique links between identity-based bullying and mental health (i.e., depressive and posttraumatic stress symptoms [PTSS]), and emotional suppression as a potential moderator of these links. Participants were 899 clinic-referred Black and Latino youth aged 7-18 years (M = 13.37 years, SD = 2.75, 60.8% female). Regression analyses indicated youth who experienced identity-based bullying victimization reported worse depressive symptoms and PTSS, controlling for co-occurring trauma exposure and demographic characteristics. We did not find evidence that emotional suppression moderated these associations. The findings highlight the potentially traumatic nature of identity-based bullying victimization in treatment-seeking Black and Latino youth and speak to the need for identity-based bullying risk screening.
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Hill RM, Oosterhoff B, King CA, Kaplow JB. Open trial of a brief,
web‐assisted
behavioural intervention to reduce thwarted belongingness and suicidal ideation among adolescents: The Supporting Grieving Teens intervention. COUNSELLING & PSYCHOTHERAPY RESEARCH 2022. [DOI: 10.1002/capr.12582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Douglas RD, Alvis LM, Rooney EE, Busby DR, Kaplow JB. Racial, ethnic, and neighborhood income disparities in childhood posttraumatic stress and grief: Exploring indirect effects through trauma exposure and bereavement. J Trauma Stress 2021; 34:929-942. [PMID: 34643296 DOI: 10.1002/jts.22732] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 06/28/2021] [Accepted: 07/01/2021] [Indexed: 11/09/2022]
Abstract
Previous findings suggest that experiences with systems of oppression that disproportionately affect individuals based on race and neighborhood residency (e.g., systemic racism, neighborhood income disadvantage [NID]) can be associated with higher odds of developing psychological problems following traumatic events. Although race/ethnicity and NID residency are often associated, they are separate concepts that play unique roles in mental health outcomes among youth. Residents of Black, Latinx, and income-disadvantaged communities also have an increased risk of exposure to polyvictimization and the loss of multiple loved ones. Studies have not carefully delineated the potential relations between race/ethnicity and NID residency, polyvictimization, accumulated losses, and trauma and grief outcomes in youth. We examined mediation models to investigate whether polyvictimization, the loss of multiple loved ones, and exposure to violent death were potential mechanisms through which race/ethnicity and NID would predict trauma and grief outcomes in youth. Participants (N = 429) included Black (19.9%), Latinx (36.0%), and White (27.3%) children and adolescents who were assessed through a routine baseline assessment at a trauma and grief outpatient clinic. Black youth reported significantly elevated posttraumatic stress and maladaptive grief symptoms through higher polyvictimization and violent death exposure relative to White youth, βs = .06-.12, ps <.001. Latinx identity and NID were positively and directly associated with specific domains of maladaptive grief reactions, βs = .10-.17, ps < .001. If replicated longitudinally, these findings suggest that polyvictimization and violent death exposure may be mechanisms through which Black youth develop more severe traumatic stress and grief reactions.
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Hill RM, Gushanas KL, Alvis L, Dodd CG, Kurian S, Saxena J, Saxena K, Kaplow JB, Rufino K, Williams L. Geospatial identification of high youth suicide risk areas via electronic health records: Avenues for research and prevention efforts. Suicide Life Threat Behav 2021; 51:255-262. [PMID: 33876482 DOI: 10.1111/sltb.12701] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE As suicide risk screening becomes more common in healthcare settings, geospatial coding of behavioral health data may offer a means for identifying areas of elevated suicide risk for use in public health prevention efforts. The present study demonstrates an analytic approach for using universal suicide risk screening data to identify areas of elevated suicide risk. METHOD Data were drawn from standard suicide risk screens recorded in electronic health records of a large pediatric emergency department. A total of 12,400 suicide risk screening responses were recorded, among youth aged 11-19 years (mean = 14.60, SD = 2.16; 57.2% girls, 47.8% Hispanic/Latinx, 72.1% White). A total of 86 unique ZIP codes had at least 50 completed screens, representing 9139 respondents. RESULTS Rates of positive screens ranged from 6.17% to 31.03% (mean = 18.33, SD = 5.14) for any suicide-related behavior and from 0.0% to 19.61% (mean = 9.14, SD = 3.43) for suicide attempt. Rates of positive screens approximated a normal distribution. CONCLUSIONS Results demonstrated several areas with elevated rates of positive suicide risk screens, within the hospital catchment area. The proposed method capitalizes on large-scale screening data, provides an estimate of areas of relative increased risk, and may be used to inform public health responses to suicide prevention.
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Kaplow JB, Wamser‐Nanney R, Layne CM, Burnside A, King C, Liang L, Steinberg A, Briggs E, Suarez L, Pynoos R. Identifying Bereavement‐Related Markers of Mental and Behavioral Health Problems Among Clinic‐Referred Adolescents. PSYCHIATRIC RESEARCH AND CLINICAL PRACTICE 2020; 3:88-96. [PMID: 36101665 PMCID: PMC9175856 DOI: 10.1176/appi.prcp.20190021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 09/13/2020] [Accepted: 10/28/2020] [Indexed: 11/30/2022] Open
Abstract
Objective This study examined bereavement‐related risk markers (number of deaths, cause of death, and relationship to deceased) of mental and behavioral health problems (suicidal thoughts or behaviors, self‐injury, depression, posttraumatic stress, and substance use) in a national sample of clinic‐referred bereaved adolescents. Method Participants included 1281 bereaved youth aged 12–21 years (M=15, SD=1.8; 62.1% female), from the National Child Traumatic Stress Network Core Data Set. Results Generalized linear mixed‐effects regression models controlling for demographics and other traumas revealed that youth bereaved by multiple deaths had higher posttraumatic stress scores than youth bereaved by a single death (Estimated difference ±SE=3.36 ± 1.11, p=0.003). Youth bereaved by suicide were more likely to report experiencing suicidal thoughts or behaviors (AOR=1.68, p=0.049) and alcohol use (AOR=2.33, p<0.001) than youth bereaved by natural causes. Youth bereaved by homicide were at greater risk for substance use than youth bereaved by natural death (AOR=1.76, p=0.02). Compared to parentally bereaved youth, youth who lost a peer were more likely to use alcohol (AOR=2.32, p=0.02) or other substances (AOR=2.41, p=0.01); in contrast, parentally bereaved youth were more likely to experience depression compared to those who experienced the death of an adult relative or unrelated adult (range of AOR: 0.40 to 0.64, p‐values<0.05). Conclusion These bereavement‐related contextual factors can serve as early markers of mental and behavioral health problems among bereaved youth.
Few studies have examined bereavement‐related risk markers of mental and behavioral health problems among treatment‐seeking adolescents. Number of prior traumas, number of prior losses, experiencing a death due to suicide or homicide, and experiencing the death of a parent (as opposed to another relative or friend) were each associated with higher levels of mental and behavioral health problems among bereaved adolescents. Findings have implications for early identification of bereaved youth who may be in need of intervention.
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Hill RM, Mellick W, Alvis L, Dodd CG, Do C, Buitron V, Sharp C, Pettit JW, Kaplow JB. Performance of the interpersonal needs questionnaire in adolescent clinical samples: Confirmatory factor analyses and evaluation of measurement invariance. Suicide Life Threat Behav 2020; 50:1214-1222. [PMID: 33078464 DOI: 10.1111/sltb.12714] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 06/02/2020] [Accepted: 06/17/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study evaluated the factor structure, internal consistency reliability, construct and criterion validity, and measurement invariance of the Interpersonal Needs Questionnaire (INQ) among adolescents. METHOD Participants (N = 539) included three distinct samples of youth drawn from two outpatient psychology clinics and an inpatient psychiatric unit. The combined sample was 63.3% female and had a mean age of 14.95 years (SD = 1.31 years). All participants completed the INQ as well as measures of depressive symptoms and suicide ideation. RESULTS Confirmatory factor analyses indicated that the removal of three items from the thwarted belongingness subscale of the INQ was needed to achieve acceptable model fit. The resulting combined 12-item scale demonstrated good factor structure, internal consistency reliability, construct validity, and criterion validity. The modified 12-item INQ also demonstrated scalar invariance across subgroups defined by sex, race, and age. CONCLUSIONS Findings support the use of this reduced 12-item version of the INQ among adolescents. Youth may have difficulty accurately responding to changes in item valence; thus, future research with youth should consider using a 12-item version of the INQ that avoids valence changes within subscales.
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Alvis LM, Dodd CG, Oosterhoff B, Hill RM, Rolon-Arroyo B, Logsdon T, Layne CM, Kaplow JB. Caregiver behaviors and childhood maladaptive grief: Initial validation of the Grief Facilitation Inventory. DEATH STUDIES 2020; 46:1307-1315. [PMID: 33180687 DOI: 10.1080/07481187.2020.1841849] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The Grief Facilitation Inventory (GFI) is a newly-developed measure of caregiver behaviors theorized to facilitate or hinder children's adaptive grief reactions. We examine its factor structure, reliability, and validity. An exploratory factor analysis identified four factors: Ongoing Connection, Existential Continuity/Support, Caregiver Grief Expression, and Grief Inhibition/Avoidance. Both child- and caregiver-report versions had adequate-to-good internal consistency. The child-report GFI showed evidence of criterion-referenced validity via significant correlations with measures of child maladaptive grief and other psychological symptoms. Results provide preliminary evidence of the reliability, validity, and clinical utility of the GFI as a measure of caregiver grief-facilitation behaviors.
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Hill RM, Dodd C, Oosterhoff B, Layne CM, Pynoos RS, Staine MB, Kaplow JB. Measurement Invariance of the Persistent Complex Bereavement Disorder Checklist With Respect to Youth Gender, Race, Ethnicity, and Age. J Trauma Stress 2020; 33:850-856. [PMID: 32686226 DOI: 10.1002/jts.22560] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 04/20/2020] [Accepted: 04/20/2020] [Indexed: 11/09/2022]
Abstract
The Persistent Complex Bereavement Disorder (PCBD) Checklist was constructed to facilitate the developmentally sensitive assessment of proposed PCBD criteria in bereaved children and adolescents 8-18 years of age. Initial analyses of the PCBD Checklist provided support for the hypothesized two-factor model. The purpose of the present study was to evaluate the measurement invariance of the PCBD Checklist with respect to gender (boys and girls), race/ethnicity (White, Black, and Hispanic youth), and age (school age, preadolescent, and adolescent youth). Participants were 594 youth (50.4% female) aged 7-18 years (M = 11.91, SD = 2.80) who were evaluated as part of standard care at a community-based grief support center. Youth self-identified as Hispanic (n = 184, 30.8%), non-Hispanic white (n = 179, 30.0%), and African American/Black (n = 136, 22.8%). A series of stepwise, multigroup confirmatory factor analyses provided evidence in support of the PCBD Checklist's measurement invariance for all three groups concerning configural invariance, metric invariance, and scalar invariance. These results suggest that PCBD Checklist Criterion B and C scores are measuring similar latent variables, to a similar degree, across gender, race/ethnicity, and age. Establishing the cross-group equivalence of the PCBD Checklist is an important endorsement of its generalizability and clinical utility in that it can be administered to diverse populations with confidence that it is measuring proposed PCBC diagnostic criteria similarly across subgroups.
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Dodd CG, Hill RM, Alvis LM, Rooney EE, Layne CM, Logsdon T, Sandler IN, Kaplow JB. Initial Validation and Measurement Invariance of the Active Inhibition Scale Among Traumatized and Grieving Youth. J Trauma Stress 2020; 33:843-849. [PMID: 32516471 DOI: 10.1002/jts.22529] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 12/16/2019] [Accepted: 01/07/2020] [Indexed: 01/08/2023]
Abstract
The Active Inhibition Scale (AIS; Ayers, Sandler, & Twohey, 1998) is an 11-item, self-report measure of emotional suppression among children and adolescents. Previous research with the AIS has linked emotional suppression to several clinically significant outcomes, such as posttraumatic stress symptoms (PTSS) and suicide, among trauma-exposed and bereaved youth; however, there are no published evaluations of its psychometric properties. We examined the factor structure and criterion validity of the AIS in two samples. Sample 1 included youth (M = 12.22 years, SD = 2.96, range: 6-18 years; 55.4% female) referred to an outpatient psychology clinic specializing in childhood trauma and grief. Sample 2 included youth (M = 13.18 years, SD = 2.58, range: 8-18 years; 61.8% female) referred to a community grief counseling center. Confirmatory factor analytic results supported a one-factor solution, Cronbach's α = .94. Additionally, AIS scores correlated positively with PTSS, depression, and maladaptive grief, rs = .43-.64. Evidence of factorial invariance was found across gender, race/ethnicity, and age group. Emotional suppression scores were higher among girls compared to boys, Black and Hispanic youth compared to White youth, and older compared to younger age groups. The magnitude of correlations between AIS and symptom measure scores was comparable across groups. These results support the reliability and criterion validity of the AIS with diverse youth populations and underscore the role that emotional suppression may play in explaining group differences in mental health symptoms.
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Moscardini EH, Hill RM, Dodd CG, Do C, Kaplow JB, Tucker RP. Suicide Safety Planning: Clinician Training, Comfort, and Safety Plan Utilization. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186444. [PMID: 32899637 PMCID: PMC7559434 DOI: 10.3390/ijerph17186444] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/19/2020] [Accepted: 09/02/2020] [Indexed: 11/16/2022]
Abstract
Extant literature has demonstrated that suicide safety planning is an efficacious intervention for reducing patient risk for suicide-related behaviors. However, little is known about factors that may impact the effectiveness of the intervention, such as provider training and comfort, use of specific safety plan elements, circumstances under which providers choose to use safety planning, and personal factors which influence a provider’s decision to use safety planning. Participants were (N = 119) safety plan providers who responded to an anonymous web-based survey. Results indicated that most providers had received training in safety planning and were comfortable with the intervention. Providers reported that skills such as identifying warning signs and means safety strategies were routinely used. Providers who reported exposure to suicide were more likely to complete safety plans with patients regardless of risk factors. In addition, almost 70% of providers indicated a need for further training. These data provide important considerations for safety plan implementation and training.
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Kassing F, Alvis L, Hill RM, Kaplow JB. A Person-Centered Approach to Examining Polytraumatization Among Traumatized and Bereaved Youth. JOURNAL OF LOSS & TRAUMA 2020. [DOI: 10.1080/15325024.2020.1783105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Oosterhoff B, Wray-Lake L, Palmer CA, Kaplow JB. Historical Trends in Concerns About Social Issues Across Four Decades Among U.S. Adolescents. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2020; 30 Suppl 2:485-498. [PMID: 30908819 DOI: 10.1111/jora.12493] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
This study examined adolescents' concerns about social issues and how these concerns have changed over historical time. Separate cohorts of U.S. high school seniors (N = 110,953; 51.1% female) reported their worries about four social issues (crime/violence, economic problems, hunger/poverty, race relations) every year from 1976 to 2015. Youth were most concerned with crime/violence, followed by economic problems, hunger/poverty, and race relations. Adolescents' social concerns varied by demographic characteristics and cohort, paralleling specific historical events and appearing responsive to the political challenges of the time. Initiatives seeking to engage youth within the political process may benefit from providing opportunities for teens to participate in civic activities aimed to address these issues.
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Kaplow JB, Rolon-Arroyo B, Layne CM, Rooney E, Oosterhoff B, Hill R, Steinberg AM, Lotterman J, Gallagher KAS, Pynoos RS. Validation of the UCLA PTSD Reaction Index for DSM-5: A Developmentally Informed Assessment Tool for Youth. J Am Acad Child Adolesc Psychiatry 2020; 59:186-194. [PMID: 30953734 DOI: 10.1016/j.jaac.2018.10.019] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/16/2018] [Accepted: 01/23/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To describe the test construction procedure and evaluate the internal consistency, criterion-referenced validity, and diagnostic accuracy of the Child/Adolescent Self-Report Version of the UCLA PTSD Reaction Index for DSM-5 (RI-5) across 2 independent samples. METHOD Study 1 examined the clarity, developmental appropriateness, acceptability of individual RI-5 items, and internal consistency and criterion-referenced validity of the full test. The study 1 sample included 486 youth recruited from 2 major US cities who completed the RI-5 and a measure of depression. Study 2 evaluated the reliability and diagnostic accuracy of the RI-5 in 41 treatment-seeking youth who completed the RI-5 and a "gold standard" structured diagnostic interview, the Clinician-Administered PTSD Scale for DSM-5-Child/Adolescent Version. RESULTS RI-5 total scale scores showed excellent internal consistency in the 2 samples. Study 1 provided evidence of criterion-referenced validity, in that total scale scores correlated positively with depressive symptoms. Study 2 provided evidence of diagnostic accuracy (including discriminant-groups validity). RI-5 total scores discriminated youth with from youth without PTSD as benchmarked against the structured diagnostic interview. Further, receiver operating characteristic analyses using a total score of 35 provided excellent diagnostic classification accuracy (area under the curve 0.94). CONCLUSION The developmental appropriateness and diagnostic accuracy of the RI-5 support its utility for clinical assessment, case conceptualization, and treatment planning in different child-serving systems, including schools, juvenile justice, child welfare, and mental health.
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Roley-Roberts ME, Hill RM, Layne CM, Goldenthal H, Kaplow JB. Cause of Caregiver Death and Surviving Caregiver Coping Style Predict Thwarted Belongingness in Bereaved Youth. Arch Suicide Res 2019; 23:455-470. [PMID: 29791306 DOI: 10.1080/13811118.2018.1470949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Both bereavement and thwarted belongingness serve as risk markers for youth suicide-related behaviors. This study examined candidate predictors of thwarted belongingness among bereaved youth, including caregiver cause of death and surviving caregiver coping style. A group of 43 caregiver-bereaved families (58 children aged 7-13-years-old) participated in a longitudinal study investigating associations between hypothesized bereavement-related contextual factors and youth thwarted belongingness. Cause of caregiver deaths included anticipated deaths preceded by illness (37%; n = 16), sudden natural deaths (25.6%; n = 11), accidental deaths (20.9%; n = 9), death by suicide (9.3%; n = 4), and death from drug overdose (7.0%; n = 3). Children's thwarted belongingness was significantly higher among youth bereaved by suicide compared to youth bereaved by sudden natural death, accident, and anticipated death by illness. Surviving caregivers' use of behavioral disengagement and positive reinterpretation and growth as coping strategies at Time 1 predicted lower thwarted belongingness in children at Time 2. Implications for risk screening and assessment of suicide risk among bereaved youth are discussed.
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Rooney EE, Hill RM, Oosterhoff B, Kaplow JB. Violent victimization and perpetration as distinct risk factors for adolescent suicide attempts. CHILDRENS HEALTH CARE 2019. [DOI: 10.1080/02739615.2019.1630280] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Rooney EE, Oosterhoff B, Kaplow JB. Associations between dimensions of religiousness and psychosocial functioning among bereaved youth. DEATH STUDIES 2019; 44:440-449. [PMID: 30907248 DOI: 10.1080/07481187.2019.1578304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Using a sample of recently bereaved youth (N = 2,425; Mage = 15.31, SD = 1.50), this study examined associations between dimensions of religiousness and current functioning. Youth reported on their religious service attendance, religious coping, and the importance of religious beliefs and substance use, academic achievement, depressive symptoms, and self-esteem. Greater religious service attendance was associated with lower substance use and the greater importance of religious beliefs was associated with lower substance use and greater self-esteem. Greater religious coping was associated with greater academic achievement. Findings suggest distinct dimensions of religiousness may have differential implications for adolescent functioning after experiencing loss.
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Hill RM, Kaplow JB, Oosterhoff B, Layne CM. Understanding grief reactions, thwarted belongingness, and suicide ideation in bereaved adolescents: Toward a unifying theory. J Clin Psychol 2019; 75:780-793. [DOI: 10.1002/jclp.22731] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 10/23/2018] [Accepted: 11/04/2018] [Indexed: 11/11/2022]
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Hulsey EG, Hill RM, Layne CM, Gaffney DA, Kaplow JB. Calculating the incidence rate of sibling bereavement among children and adolescents across the United States: A proposed method. DEATH STUDIES 2018; 44:303-311. [PMID: 30513272 DOI: 10.1080/07481187.2018.1541946] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 09/04/2018] [Accepted: 09/26/2018] [Indexed: 06/09/2023]
Abstract
This study proposes a method for calculating the annual incidence rate of sibling bereavement among US youth using national epidemiological data. The proposed model combines data on family household size with national death statistics to calculate the number of siblings affected by the death of a child annually. From 2012 to 2015, an average of 61,389 children per year experienced the death of a sibling, resulting in an estimate of 0.0832% of children bereaved by the death of a sibling annually. Data indicate a need for greater awareness and dialog concerning the frequency with which children experience the death of a sibling.
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Oosterhoff B, Kaplow JB, Layne CM. Links between bereavement due to sudden death and academic functioning: Results from a nationally representative sample of adolescents. SCHOOL PSYCHOLOGY QUARTERLY 2018; 33:372-380. [DOI: 10.1037/spq0000254] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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