This paper is designed to provide a broad-view perspective on at least some of the implications of the Affordable Care Act for children's behavioral health. Historical trends in behavioral health have tended to isolate both consumers of services (including children, youth and families) and practitioners from the larger world of healthcare, with decidedly mixed results. This paper uses the concept of path dependence to highlight the multiple challenges facing child behavioral health as it moves forward. The paper builds its recommendations on the 4 pillars of sustainable change: politics, practice, economics, and science. In a changing health care environment, behavioral health has to transform. The paper concludes with some observations on the kinds of transformative change required to move in new directions. (PsycINFO Database Record
{"title":"Can behavioral health drive its own reformation? The challenges of shifting direction.","authors":"John A. Morris","doi":"10.1037/ort0000067","DOIUrl":"https://doi.org/10.1037/ort0000067","url":null,"abstract":"This paper is designed to provide a broad-view perspective on at least some of the implications of the Affordable Care Act for children's behavioral health. Historical trends in behavioral health have tended to isolate both consumers of services (including children, youth and families) and practitioners from the larger world of healthcare, with decidedly mixed results. This paper uses the concept of path dependence to highlight the multiple challenges facing child behavioral health as it moves forward. The paper builds its recommendations on the 4 pillars of sustainable change: politics, practice, economics, and science. In a changing health care environment, behavioral health has to transform. The paper concludes with some observations on the kinds of transformative change required to move in new directions. (PsycINFO Database Record","PeriodicalId":409666,"journal":{"name":"The American journal of orthopsychiatry","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114742697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The mental, emotional and behavioral health problems of high-risk youth and youth living in high-risk communities are not inevitable and can be prevented. A shift from the nation's focus on treating disease and illness after it occurs to a concentrated effort on preventing the root causes of these problems is needed. Prevention science suggests a comprehensive multitiered approach that provides evidence-based prevention supports for children and youth at each developmental stage and across multiple social contexts is likely to result in the greatest health impact and return on investment. However, actually implementing this approach at a neighborhood level has remained a challenge and an ongoing research gap especially in high-risk communities. This article describes a process and provides a case study example for implementing a comprehensive, multitiered approach in a high-risk community. This includes assessing and prioritizing the specific needs of individuals and communities; selecting evidence-based programs based upon assessed needs; and creating a continuum of programs to improve the health and well-being of youth across developmental age spans, social contexts, and levels of risk. Operational details and challenges for organizing and implementing this comprehensive approach are also described. We estimate that the collective impact of a multitiered evidence-based approach, implemented with fidelity, could conservatively result in a 30 to 40% reduction in problem behaviors. (PsycINFO Database Record
{"title":"Building an evidence-based multitiered system of supports for high-risk youth and communities.","authors":"Beverly Kingston, Sharon F. Mihalic, E. Sigel","doi":"10.1037/ort0000110","DOIUrl":"https://doi.org/10.1037/ort0000110","url":null,"abstract":"The mental, emotional and behavioral health problems of high-risk youth and youth living in high-risk communities are not inevitable and can be prevented. A shift from the nation's focus on treating disease and illness after it occurs to a concentrated effort on preventing the root causes of these problems is needed. Prevention science suggests a comprehensive multitiered approach that provides evidence-based prevention supports for children and youth at each developmental stage and across multiple social contexts is likely to result in the greatest health impact and return on investment. However, actually implementing this approach at a neighborhood level has remained a challenge and an ongoing research gap especially in high-risk communities. This article describes a process and provides a case study example for implementing a comprehensive, multitiered approach in a high-risk community. This includes assessing and prioritizing the specific needs of individuals and communities; selecting evidence-based programs based upon assessed needs; and creating a continuum of programs to improve the health and well-being of youth across developmental age spans, social contexts, and levels of risk. Operational details and challenges for organizing and implementing this comprehensive approach are also described. We estimate that the collective impact of a multitiered evidence-based approach, implemented with fidelity, could conservatively result in a 30 to 40% reduction in problem behaviors. (PsycINFO Database Record","PeriodicalId":409666,"journal":{"name":"The American journal of orthopsychiatry","volume":"27 16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122358240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
There is clear evidence that ensuring safe, stimulating, and nurturing caregiving environments for young children may be one of the most impactful health promotion strategies available, with lifelong and intergenerational benefits. Supports and interventions in the early years of life may in fact be the most effective way to improve school performance, increase high school graduation rates, job performance, and adult productivity. A public health approach to early childhood well-being, as opposed to the needs of children being addressed in multiple siloes, may be a more effective strategy that will lead to smarter investments and increasing financial commitments. Louisiana is used as a case study, with examples of strategies organized by the 3 core functions of public health. (PsycINFO Database Record
{"title":"Using public health strategies to shape early childhood policy.","authors":"G. Nagle, Lindsay R Usry","doi":"10.1037/ort0000088","DOIUrl":"https://doi.org/10.1037/ort0000088","url":null,"abstract":"There is clear evidence that ensuring safe, stimulating, and nurturing caregiving environments for young children may be one of the most impactful health promotion strategies available, with lifelong and intergenerational benefits. Supports and interventions in the early years of life may in fact be the most effective way to improve school performance, increase high school graduation rates, job performance, and adult productivity. A public health approach to early childhood well-being, as opposed to the needs of children being addressed in multiple siloes, may be a more effective strategy that will lead to smarter investments and increasing financial commitments. Louisiana is used as a case study, with examples of strategies organized by the 3 core functions of public health. (PsycINFO Database Record","PeriodicalId":409666,"journal":{"name":"The American journal of orthopsychiatry","volume":"90 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124623229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study is an examination of the reliability and validity of the Beck Anxiety Inventory (BAI; Beck, Epstein, Brown, & Steer, 1988) in a sample of NPIs (N = 529). Validity was assessed by comparing BAI scores among 3 different diagnostic categories in a clinical sample (anxiety disorder, mood disorder, and comorbid anxiety/mood disorder diagnostic groups) and a community sample of participants with no self-reported mental health diagnoses. The BAI was also compared with depression, quality of life, and anxiety measures to assess validity. Support toward the validity of the BAI was demonstrated through high correlations with similar measures of anxiety, as well as higher scores among the clinical samples compared to the control sample. The BAI also demonstrated strong internal consistency (α = .95). An exploratory factor analysis indicated the presence of 3 factors: (a) fear, (b) cardiorespiratory, and (c) body instability symptoms. The BAI was unable to accurately differentiate between mood disorder and anxiety disorder groups. Results of this study indicate that the BAI may be a useful instrument in the assessment of anxiety with NPIs; however, the BAI is potentially unsuited to differentiating between mood disorders and anxiety disorders with this population. (PsycINFO Database Record
{"title":"Assessment of anxiety among Northern Plains Indians.","authors":"J. Gray, J. Mccullagh, T. Petros","doi":"10.1037/ort0000103","DOIUrl":"https://doi.org/10.1037/ort0000103","url":null,"abstract":"This study is an examination of the reliability and validity of the Beck Anxiety Inventory (BAI; Beck, Epstein, Brown, & Steer, 1988) in a sample of NPIs (N = 529). Validity was assessed by comparing BAI scores among 3 different diagnostic categories in a clinical sample (anxiety disorder, mood disorder, and comorbid anxiety/mood disorder diagnostic groups) and a community sample of participants with no self-reported mental health diagnoses. The BAI was also compared with depression, quality of life, and anxiety measures to assess validity. Support toward the validity of the BAI was demonstrated through high correlations with similar measures of anxiety, as well as higher scores among the clinical samples compared to the control sample. The BAI also demonstrated strong internal consistency (α = .95). An exploratory factor analysis indicated the presence of 3 factors: (a) fear, (b) cardiorespiratory, and (c) body instability symptoms. The BAI was unable to accurately differentiate between mood disorder and anxiety disorder groups. Results of this study indicate that the BAI may be a useful instrument in the assessment of anxiety with NPIs; however, the BAI is potentially unsuited to differentiating between mood disorders and anxiety disorders with this population. (PsycINFO Database Record","PeriodicalId":409666,"journal":{"name":"The American journal of orthopsychiatry","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121548181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Patty Leijten, Maartje A. J. Raaijmakers, B. Orobio de Castro, W. Matthys
Ethnic minority families in Europe are underrepresented in mental health care-a profound problem for clinicians and policymakers. One reason for their underrepresentation seems that, on average, ethnic minority families tend to perceive externalizing and internalizing child behavior as less problematic. There is concern that this difference in problem perception might limit intervention effectiveness. We tested the extent to which ethnic differences in problem perception exist when ethnic minority families engage in mental health service and whether lower levels of problem perception diminish parenting intervention effects to reduce disruptive child behavior. Our sample included 136 mothers of 3- to 8-year-olds (35% female) from the 3 largest ethnic groups in the Netherlands (43% Dutch; 35% Moroccan; 22% Turkish). Mothers reported on their child's externalizing and internalizing behavior and their perception of this behavior as problematic. They were then randomly assigned to the Incredible Years parenting intervention or a wait list control condition. We contrasted maternal reports of problem perception to teacher reports of the same children. Moroccan and Turkish mothers, compared with Dutch mothers, perceived similar levels of child behavior problems as less problematic, and as causing less impairment and burden. Teacher problem perception did not vary across children from different ethnic groups. Importantly, maternal problem perception did not affect parenting intervention effectiveness to reduce disruptive child behavior. Our findings suggest that ethnic differences in problem perception exist once families engage in treatment, but that lower levels of problem perception do not diminish treatment effects. (PsycINFO Database Record
{"title":"Ethnic differences in problem perception: Immigrant mothers in a parenting intervention to reduce disruptive child behavior.","authors":"Patty Leijten, Maartje A. J. Raaijmakers, B. Orobio de Castro, W. Matthys","doi":"10.1037/ort0000142","DOIUrl":"https://doi.org/10.1037/ort0000142","url":null,"abstract":"Ethnic minority families in Europe are underrepresented in mental health care-a profound problem for clinicians and policymakers. One reason for their underrepresentation seems that, on average, ethnic minority families tend to perceive externalizing and internalizing child behavior as less problematic. There is concern that this difference in problem perception might limit intervention effectiveness. We tested the extent to which ethnic differences in problem perception exist when ethnic minority families engage in mental health service and whether lower levels of problem perception diminish parenting intervention effects to reduce disruptive child behavior. Our sample included 136 mothers of 3- to 8-year-olds (35% female) from the 3 largest ethnic groups in the Netherlands (43% Dutch; 35% Moroccan; 22% Turkish). Mothers reported on their child's externalizing and internalizing behavior and their perception of this behavior as problematic. They were then randomly assigned to the Incredible Years parenting intervention or a wait list control condition. We contrasted maternal reports of problem perception to teacher reports of the same children. Moroccan and Turkish mothers, compared with Dutch mothers, perceived similar levels of child behavior problems as less problematic, and as causing less impairment and burden. Teacher problem perception did not vary across children from different ethnic groups. Importantly, maternal problem perception did not affect parenting intervention effectiveness to reduce disruptive child behavior. Our findings suggest that ethnic differences in problem perception exist once families engage in treatment, but that lower levels of problem perception do not diminish treatment effects. (PsycINFO Database Record","PeriodicalId":409666,"journal":{"name":"The American journal of orthopsychiatry","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116326855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Todd I. Herrenkohl, Hyunzee Jung, J. B. Klika, W. Mason, E. Brown, R. Leeb, R. C. Herrenkohl
A number of cross-sectional and a few longitudinal studies have shown a developmental relationship between child abuse and adult physical and mental health. Published findings also suggest that social support can lessen the risk of adverse outcomes for some abused children. However, few studies have investigated whether social support mediates or moderates the relationship between child abuse and adult physical and mental health. Structural equation modeling was used to examine data on these topics from a longitudinal study of more than 30 years. While a latent construct of physical and emotional child abuse did not predict adult health outcomes directly, child abuse did predict outcomes indirectly through social support. A test of variable moderation for child abuse and social support was nonsignificant. Results suggest that social support may help explain the association between child abuse and health outcomes at midlife. Implications of the findings for prevention and treatment are discussed. (PsycINFO Database Record
{"title":"Mediating and moderating effects of social support in the study of child abuse and adult physical and mental health.","authors":"Todd I. Herrenkohl, Hyunzee Jung, J. B. Klika, W. Mason, E. Brown, R. Leeb, R. C. Herrenkohl","doi":"10.1037/ort0000136","DOIUrl":"https://doi.org/10.1037/ort0000136","url":null,"abstract":"A number of cross-sectional and a few longitudinal studies have shown a developmental relationship between child abuse and adult physical and mental health. Published findings also suggest that social support can lessen the risk of adverse outcomes for some abused children. However, few studies have investigated whether social support mediates or moderates the relationship between child abuse and adult physical and mental health. Structural equation modeling was used to examine data on these topics from a longitudinal study of more than 30 years. While a latent construct of physical and emotional child abuse did not predict adult health outcomes directly, child abuse did predict outcomes indirectly through social support. A test of variable moderation for child abuse and social support was nonsignificant. Results suggest that social support may help explain the association between child abuse and health outcomes at midlife. Implications of the findings for prevention and treatment are discussed. (PsycINFO Database Record","PeriodicalId":409666,"journal":{"name":"The American journal of orthopsychiatry","volume":"259 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122748388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Concentrated disadvantage in urban communities places young Black men at disproportionate risk for exposure to violence and trauma. Homicide, a health disparity, positions Black males vulnerable to premature violent death and traumatic loss, particularly when peers are murdered. Posttraumatic stress disorder (PTSD) has been demonstrated as a health consequence for middle-income and White homicide survivors; however, understandings of traumatic stress among young Black men situated in contexts of chronic violence exposure remains limited. Guided by phenomenological variant of ecological systems theory (PVEST), the current study used in-depth qualitative interviews (average length: 90 min) to examine the presence and expression of traumatic stress symptoms among 37 young Black men (18-24) in Baltimore who experienced the homicide death of a loved one. Participants were recruited over 18 months through fieldwork at a large organization that serves Baltimore youth and young adults. Confidential participant interviews were audio recorded, transcribed verbatim, coded, and analyzed in ATLAS.ti. Pseudonyms were assigned to all participants. More than 70% of participants reported experiencing 2 or more Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V)-defined posttraumatic stress symptoms. Hypervigilance was most frequently experienced and expressed as being on point. Findings identify the prevalence of traumatic stress symptoms among young Black men in urban contexts; identify contextually specific expressions of traumatic stress; and, present implications for the mental health and clinical treatment of Black males living in environments where no "post" exists. (PsycINFO Database Record
{"title":"Posttraumatic stress symptoms in context: Examining trauma responses to violent exposures and homicide death among Black males in urban neighborhoods.","authors":"Jocelyn R. Smith, D. Patton","doi":"10.1037/ort0000101","DOIUrl":"https://doi.org/10.1037/ort0000101","url":null,"abstract":"Concentrated disadvantage in urban communities places young Black men at disproportionate risk for exposure to violence and trauma. Homicide, a health disparity, positions Black males vulnerable to premature violent death and traumatic loss, particularly when peers are murdered. Posttraumatic stress disorder (PTSD) has been demonstrated as a health consequence for middle-income and White homicide survivors; however, understandings of traumatic stress among young Black men situated in contexts of chronic violence exposure remains limited. Guided by phenomenological variant of ecological systems theory (PVEST), the current study used in-depth qualitative interviews (average length: 90 min) to examine the presence and expression of traumatic stress symptoms among 37 young Black men (18-24) in Baltimore who experienced the homicide death of a loved one. Participants were recruited over 18 months through fieldwork at a large organization that serves Baltimore youth and young adults. Confidential participant interviews were audio recorded, transcribed verbatim, coded, and analyzed in ATLAS.ti. Pseudonyms were assigned to all participants. More than 70% of participants reported experiencing 2 or more Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V)-defined posttraumatic stress symptoms. Hypervigilance was most frequently experienced and expressed as being on point. Findings identify the prevalence of traumatic stress symptoms among young Black men in urban contexts; identify contextually specific expressions of traumatic stress; and, present implications for the mental health and clinical treatment of Black males living in environments where no \"post\" exists. (PsycINFO Database Record","PeriodicalId":409666,"journal":{"name":"The American journal of orthopsychiatry","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126422645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pratyusha Tummala-Narra, Anita A. Deshpande, Jasleen Kaur
Despite the significant growth in the South Asian population in the United States over the past 2 decades, the experiences of South Asian adolescents have remained largely invisible. Guided by a socioecological perspective (American Psychological Association, 2012; García Coll & Marks, 2012), this study examined South Asian adolescents' experiences of acculturative stress and approaches to coping with this stress across home and school contexts. A semistructured interview was completed by 16 participants (9 girls, 7 boys; ages 14-18 years) from different South Asian backgrounds, attending an urban public high school in the Northeastern part of the United States. Conventional content analysis was used to analyze the interview data, and revealed 4 broad categories or domains related to participants' experiences as young South Asians in the U.S. These domains include the following: (a) Connection to family, community, and heritage; (b) Challenges to acculturation; (c) Stress accompanying the navigation across cultural contexts; and (d) Coping and resilience. Participants' narratives reflect acculturative stress experienced in home and school contexts which can inhibit psychological well-being and bicultural identity development. The findings have important implications for culturally informed research, intervention, and policy. (PsycINFO Database Record
{"title":"South Asian adolescents' experiences of acculturative stress and coping.","authors":"Pratyusha Tummala-Narra, Anita A. Deshpande, Jasleen Kaur","doi":"10.1037/ort0000147","DOIUrl":"https://doi.org/10.1037/ort0000147","url":null,"abstract":"Despite the significant growth in the South Asian population in the United States over the past 2 decades, the experiences of South Asian adolescents have remained largely invisible. Guided by a socioecological perspective (American Psychological Association, 2012; García Coll & Marks, 2012), this study examined South Asian adolescents' experiences of acculturative stress and approaches to coping with this stress across home and school contexts. A semistructured interview was completed by 16 participants (9 girls, 7 boys; ages 14-18 years) from different South Asian backgrounds, attending an urban public high school in the Northeastern part of the United States. Conventional content analysis was used to analyze the interview data, and revealed 4 broad categories or domains related to participants' experiences as young South Asians in the U.S. These domains include the following: (a) Connection to family, community, and heritage; (b) Challenges to acculturation; (c) Stress accompanying the navigation across cultural contexts; and (d) Coping and resilience. Participants' narratives reflect acculturative stress experienced in home and school contexts which can inhibit psychological well-being and bicultural identity development. The findings have important implications for culturally informed research, intervention, and policy. (PsycINFO Database Record","PeriodicalId":409666,"journal":{"name":"The American journal of orthopsychiatry","volume":"75 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130385594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Refugees commonly experience traumatic events that threaten the self and close others, suggesting the possibility that they may experience overlapping symptoms of posttraumatic stress disorder (PTSD) and separation anxiety disorder (SAD). We examine this possibility among West Papua refugees (n = 230) displaced to Port Moresby, Papua New Guinea. We also examine associations between the combined PTSD-SAD construct and indices of past trauma exposure, ongoing adversity, and the psychosocial disruptions caused by mass conflict and displacement. We applied culturally adapted interview modules to assess symptoms of PTSD, SAD, traumatic events (TEs), ongoing adversity, and 5 psychosocial dimensions. Latent class analysis identified a PTSD class (23%), a posttraumatic (PT) SAD class (22%), and a low-symptom class (55%). Compared with the low-symptom class, both the PTSD and PT-SAD classes endorsed higher levels of exposure to all domains of TEs (conflict-related trauma, witnessing murder, childhood related adversities, traumatic losses, and health stress) and ongoing adversity (access to health care, displacement/separation, safety in the community, and access to basic needs), but the 2 comorbid groups did not differ on these indices. The PT-SAD class alone scored higher than the low-symptom reference class in relation to disruptions to the psychosocial domains (safety/security, bonds/network, access to justice, roles/identities, existential meaning) and higher than the PTSD class on safety/security, justice and roles/identities. Our findings suggest that the PT-SAD pattern may represent a response to the most severe forms of psychosocial disruptions of mass conflict among refugees. A focus on separation anxiety may enhance psychotherapies designed to treat PTSD in refugees. (PsycINFO Database Record
{"title":"Associations of adult separation anxiety disorder with conflict-related trauma, ongoing adversity, and the psychosocial disruptions of mass conflict among West Papuan refugees.","authors":"A. Tay, S. Rees, Moses Kareth, D. Silove","doi":"10.1037/ort0000126","DOIUrl":"https://doi.org/10.1037/ort0000126","url":null,"abstract":"Refugees commonly experience traumatic events that threaten the self and close others, suggesting the possibility that they may experience overlapping symptoms of posttraumatic stress disorder (PTSD) and separation anxiety disorder (SAD). We examine this possibility among West Papua refugees (n = 230) displaced to Port Moresby, Papua New Guinea. We also examine associations between the combined PTSD-SAD construct and indices of past trauma exposure, ongoing adversity, and the psychosocial disruptions caused by mass conflict and displacement. We applied culturally adapted interview modules to assess symptoms of PTSD, SAD, traumatic events (TEs), ongoing adversity, and 5 psychosocial dimensions. Latent class analysis identified a PTSD class (23%), a posttraumatic (PT) SAD class (22%), and a low-symptom class (55%). Compared with the low-symptom class, both the PTSD and PT-SAD classes endorsed higher levels of exposure to all domains of TEs (conflict-related trauma, witnessing murder, childhood related adversities, traumatic losses, and health stress) and ongoing adversity (access to health care, displacement/separation, safety in the community, and access to basic needs), but the 2 comorbid groups did not differ on these indices. The PT-SAD class alone scored higher than the low-symptom reference class in relation to disruptions to the psychosocial domains (safety/security, bonds/network, access to justice, roles/identities, existential meaning) and higher than the PTSD class on safety/security, justice and roles/identities. Our findings suggest that the PT-SAD pattern may represent a response to the most severe forms of psychosocial disruptions of mass conflict among refugees. A focus on separation anxiety may enhance psychotherapies designed to treat PTSD in refugees. (PsycINFO Database Record","PeriodicalId":409666,"journal":{"name":"The American journal of orthopsychiatry","volume":"152 3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131186865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study examines the risk and protective factors for gang involvement among subgroups of youth (i.e., current or former gang members, youth who resisted gang membership, and non-gang-involved youth) using the social-ecological framework. Middle and high school students (N = 17,366) from school districts in a large Midwestern county participated. Results indicated that males were more likely than females to be involved in gangs. For the individual context, our findings indicate that racial and ethnic minorities, females, and youth with depression/suicidal ideation are likely to be at risk for gang involvement. For the family context, we found that having gang-involved family members and family dysfunction are related to youth gang involvement. For the peer context, peers' alcohol and drug use and bullying were significantly associated with gang involvement. For the school context, as our results demonstrate, youth who perceived fair treatment from teachers and other adults in school and those with a sense of belonging in school are more likely to avoid gang membership. For the neighborhood context, we found that presence of adult support in the neighborhood and perceived neighborhood safety are negatively associated with gang membership. Findings suggest that gang prevention efforts need to target multiple ecologies that surround and influence youth. (PsycINFO Database Record
{"title":"Are the risk and protective factors similar for gang-involved, pressured-to-join, and non-gang-involved youth? A social-ecological analysis.","authors":"Gabriel J. Merrin, J. Hong, D. Espelage","doi":"10.1037/ort0000094","DOIUrl":"https://doi.org/10.1037/ort0000094","url":null,"abstract":"This study examines the risk and protective factors for gang involvement among subgroups of youth (i.e., current or former gang members, youth who resisted gang membership, and non-gang-involved youth) using the social-ecological framework. Middle and high school students (N = 17,366) from school districts in a large Midwestern county participated. Results indicated that males were more likely than females to be involved in gangs. For the individual context, our findings indicate that racial and ethnic minorities, females, and youth with depression/suicidal ideation are likely to be at risk for gang involvement. For the family context, we found that having gang-involved family members and family dysfunction are related to youth gang involvement. For the peer context, peers' alcohol and drug use and bullying were significantly associated with gang involvement. For the school context, as our results demonstrate, youth who perceived fair treatment from teachers and other adults in school and those with a sense of belonging in school are more likely to avoid gang membership. For the neighborhood context, we found that presence of adult support in the neighborhood and perceived neighborhood safety are negatively associated with gang membership. Findings suggest that gang prevention efforts need to target multiple ecologies that surround and influence youth. (PsycINFO Database Record","PeriodicalId":409666,"journal":{"name":"The American journal of orthopsychiatry","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125931619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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