LONGITUDINAL FOLLOW-UP OF FAMILY BEREAVEMENT PROGRAM. Irwin Sandler1, Tim Ayers1, 1Arizona State University, Tempe, AZ United States
This presentation will present findings from a six-year follow-up of the Family Bereavement Program (FBP), a randomized trial of a preventive intervention with parentally-bereaved children. Parental death, one of the most traumatic stressors of childhood, occurs to approximately 3.5% of the population during childhood or adolescence. Death of a parent is associated primarily with internalizing problems during childhood, and with increased vulnerability for depression in adulthood (Ayers et al., 2003). Reviews of the intervention literature indicate that there have been few randomized trials of interventions for this population, with the FBP being the only randomized trial of a preventive intervention designed for a general community sample of parentally bereaved children. The FBP was designed based on a small theory approach in which the program was specifically designed to change processes which have been found to be related to mental health problems in this population, including improving parental warmth and discipline, strengthening active coping and coping efficacy, reducing inhibition of emotional expression, decreasing parental distress and reducing children´s exposure to family stressors. Participants consisted of 244 children ages 8-16, who had experienced the death of their parent between 4 and 30 months prior to entering the program. Participants were randomly assigned to receive the FBP or a literature comparison condition (LC). The FBP consisted of an 11 session multi-component program consisting of support and skill building groups for surviving caregivers and children/adolescents. Outcome analysis up to 11-months following the program indicated that the program indicated significant program effects to improve multiple mediators including parenting, coping, emotional expression and exposure to family stressors. Growth curve modeling of trajectories of mental health outcomes indicated significant program effects to reduce internalizing and externalizing problems of girls as rated by both caregivers and children. However, no program effects on mental health problems were found for boys. Ninety percent of the children were re-interviewed six years later, when the children were between ages 14 and 22. The results will be presented in terms of the effects of the program on both mediating variables and mental health outcomes over this six year period.
DEVELOPING AND TESTING MOTIVATIONAL PARENT MANAGEMENT TRAINING: THE OSLC-LINCOLN COUNTY HEALTHY FAMILY PROJECT. Lew Bank1, Suzi Gonzales2, Carl Reddick2, Gary Weeber1, Anne Swinehart2, 1Oregon Social Learning Center, Eugene, OR United States; 2Lincoln County Community Corrections, Newport, OR United States
Offenders are rarely targeted for help with parenting strategies, yet require a large portion of community resources at the school, human resources and public safety levels. This community-scientist collaboration team, Lincoln County Community Corrections (LCCC) and Oregon Social Learning Center (OSLC), was initiated with the purpose of bringing parent management training (PMT) to the community corrections population. Findings from 86 randomly selected intake records from 2000-2002 indicated 23% were women, 93% had substance use problems, 33% reported children living in their home, and 29% reported regular weekly contact with their children. Using a cognitive behavioral framework including self-instructional training, self-control and problem solving strategies, and correcting criminal thinking errors, motivational PMT (MPMT) addresses specific criminogenic risk factors, such as antisocial attitudes and deviant peer associations, substance use, poor family relationships, criminal role models, poor self-control, and inadequate self-management skills. The 12-session MPMT curriculum is comprised of motivational enhancement techniques and a cognitive restructuring-reality therapy approach combined with parent management training strategies that focus on children´s success at school and with appropriate peers. Participants are provided with notebooks and materials that illustrate the session objectives and provide examples for home practice. Home visitation by MPMT facilitators allow participants to review their progress as they gradually consolidate skills and face the daily challenges of raising children. In addition, we will report results of qualitative analyses performed with data from each of three focus groups conducted with class completers of three separate pilot MPMT groups.
PREVENTION OF DEPRESSION AMONG ETHNIC MINORITY YOUTH. Belinda Sims1, Sharon Lambert2, Cheryl Boyce1, 1National Institutes of Health, Bethesda, MD United States; 2George Washington University, Washington, DC United States
Child and adolescent depression are associated with multiple psychosocial and behavioral problems, mental health disorders, and adverse outcomes; as a result, there has been increased interest in the development of preventive interventions to address youth depression. However, relatively little research has examined interventions to prevent depression among ethnically diverse youth. This is concerning given high rates of depressive symptoms and associated behaviors, such as suicide, among ethnically diverse youth. For example, while suicide rates have historically been lower among African American and Latino youth than Caucasian youth, suicide attempts are increasing among African American youth (CDC, 1998; Price, Dake, & Kucharewski, 2001), and Latino adolescents are more likely to have a suicide plan and attempt suicide than African American and Caucasian counterparts (CDC, 1999).
Prior research examining the effect of prevention programs targeting depression among minority youth have yielded mixed results, suggesting that program effectiveness may vary according to youth ethnic background and contextual factors associated with ethnic minority status. This highlights the need to a) identify risk factors for depression across different ethnic minority groups in order to identify appropriate targets for intervention, b) understand the longitudinal course of depressive symptoms among different ethnic minority groups, and c) develop culturally relevant methods for intervening with ethnic minority youth. Given increased rates of depression among low income populations, and because poor individuals are overrepresented among African Americans and Latinos, the roles of socioeconomic status and social context also are important to address in understanding risk for depression and the effectiveness of preventive interventions targeting depression in these groups.
The papers in this symposium discuss the development and evaluation of preventive interventions targeting depression and suicidal behavior among ethnically diverse children and adolescents. We will present results from a randomized control trial to evaluate a cognitive-behavioral intervention modified for use with low income African American and Latino children. Next, we will discuss the effects of a school-based universal intervention targeting early learning and aggressive/disruptive behavior on depressed mood among predominantly low income and African American children. Finally, we will present a suicide prevention program for African American adolescents based in the Black Church. Implications for the development and implementation of culturally appropriate preventive interventions for depression will be discussed, with attention to the issues of social class and context.
PREVENTING DEPRESSION AMONG ETHNICALLY DIVERSE YOUTH BY TARGETING EARLY LEARNING AND AGGRESSION. Sharon Lambert1, Nicholas S. Ialongo2, 1George Washington University, Washington, DC United States; 2Johns Hopkins University, Baltimore, MD United States
There are few longitudinal evaluations of preventive interventions targeting early antecedents of depression. Fewer still examine preventing depression among low income, ethnically diverse samples. This study examined the impact of two universal preventive interventions on depressed mood among a predominantly African American sample, and whether their impact was mediated through effects on the proximal targets of aggressive/disruptive behavior and readiness to learn. A Classroom-Centered Intervention targeted aggressive/disruptive behavior and academic readiness by improving parents´ and teachers´ disciplinary practices; the Family-School Partnership Intervention targeted aggressive/disruptive behavior and academic readiness by enhancing family-school communication and parenting practices. It was hypothesized that children who successfully refrain from aggressive/disruptive behavior and children who show improvements in academic readiness would be more likely to be reinforced and less likely to be punished by parents and teachers. Consequently, these children would be less likely to experience decrements in psychological well-being, such as depressed mood or depressive disorders.
A total of 678 children (86.8% African American, 53% male, 63.4% receiving free or reduced lunch) and families representative of the entering first graders in 9 Baltimore City public elementary schools was available for participation. Depressed mood and the hypothesized mediators were measured at 4 time points in grades 1-3. Mediated effects of the intervention were examined using latent growth curve modeling.
Both interventions decreased girls´ aggressive/disruptive behavior, but neither significantly decreased girls´ depressed mood. The Classroom-Centered Intervention significantly improved boys´ academic readiness and decreased boys´ depressed mood. Tests for mediation revealed that the effect of the Classroom Centered Intervention on boys´ depressed mood was mediated through academic readiness.
Results provide support for continued examination of psychological well-being within randomized, universal prevention trials. The findings also have implications for interventions targeting depressive symptoms among low income, African American youth. The limited research available on prevention of depression among ethnically diverse youth suggests that interventions targeting depression directly may not result in decreases in depressed mood among African American youth (Cardemil, Reivich, & Seligman, 2002). In contrast, this study suggests that one means of reducing depressed mood among African American youth is to target behaviors which are antecedent to depressive symptoms. Further implications for prevention of depression among African American youth will be discussed.
PREVENTING DEPRESSIVE SYMPTOMS IN LOW-INCOME, MINORITY CHILDREN. Esteban Cardemil1, Karen Reivich2, 1Clark University, Worcester, MA United States; 2University of Pennsylvania, Philadelphia, PA United States
Given both the high rates of depression in children and adolescents and the subsequent negative life consequences that often result from depression (Lewinsohn, Rohde, Klein, & Seeley, 1999; Petersen et al., 1993), researchers have begun the process of developing interventions that can prevent the onset of depression in children and adolescents (e.g., Clarke et al., 1995; 2001; Gillham, Reivich, Jaycox, & Seligman, 1995). Not surprisingly, the majority of this prevention research has focused on Caucasian, middle-class children, as developing interventions for low-income, racial/ethnic minority populations can be difficult, particularly given the underutilization of mental health services by both low-income and minority clients (U.S. Department of Health and Human Services, 2001). And yet, there is reason to believe that properly designed and implemented depression prevention programs can engage participants who might not otherwise seek mental health services (Cardemil, 2002). Thus, prevention programs may be able to offer benefits to low-income minority clients who might not otherwise take advantage of formal mental health services.
We believe that low-income, minority children represent a population that could potentially reap large benefits from depression prevention programs. And so, building on the emerging success of depression prevention programs in general, and with minority adults in particular (Muñoz et al., 1995), we modified the Penn Resiliency Program (PRP), a cognitive-based depression prevention program that our lab had previously designed and evaluated with middle-class, suburban children (Jaycox, Reivich, Gillham, & Seligman, 1994; Gillham, et al., 1995). We then used a randomized, controlled trial to evaluate the modified PRP with a sample of 168 low-income Latino and African American 5th and 6th grade children (Cardemil, Reivich, & Seligman, 2002; Cardemil, Reivich, James, & Seligman, 2004).
Results indicate that the PRP produced clearly positive results with the Latino children up to two years after the conclusion of the program, as the Latino children randomized to the PRP condition reported fewer depressive symptoms than the children who were randomized to the no-intervention control condition. The second major finding was that the success of PRP did not extend to the African American children. While the African American prevention children did report fewer depressive symptoms over the course of the two years, the control children reported a similar improvement. Implications for future basic and intervention research with minority children are discussed.
SUICIDE PREVENTION PROGRAMS IN BLACK CHURCHES. Sherry Molock1, 1George Washington University, Washington, DC United States
Suicide is currently the third leading cause of death for African American youth. Yet few suicide prevention programs are specifically tailored toward African American youth. Community-based interventions need to be anchored in culturally relevant contexts because research suggests that African Americans are underrepresented in outpatient mental health treatment. Research clearly indicates that health beliefs and help-seeking behaviors are important factors in the utilization of mental health services. However, traditional help-seeking models typically ignore the role of culture. Other models emphasize the influence of the sociocultural context but focus less on the influence of personal and interpersonal contexts on help-seeking (Cauce et al., 2002). While little work has been done on how sociocultural contexts influence help-seeking behaviors, research suggests that African Americans prefer informal sources of help, although they will utilize and report satisfaction with professional mental health services. African Americans are also more likely to seek help from clergy for mental health concerns, report greater satisfaction with the services provided by clergy, and are less likely to seek help from mental health professionals once they have seen clergy.
This paper will discuss a suicide prevention model that is contextualized in the African American church. The model assumes that the health of individuals, their families, and communities is situated in a wider context, that includes not only culture but personal and interpersonal contexts as well. The model proposes that a successful suicide prevention program for at-risk youth in a Black Church context must attempt to change help-seeking behaviors at three levels: church community, family, and at-risk youth. It is anticipated that a suicide prevention program would be an ideal location for prevention efforts because: religion and spirituality are central components of African American culture; African Americans attend church and practice private devotional behaviors at a higher rate than other ethnic groups; the Black Church is strategically positioned to shape perceived social norms about mental health and help-seeking behaviors; and Black Churches already provide a number of social programs for their members and to the larger community. Potential barriers to implementing the program and ways to overcome these barriers will be discussed. Preliminary data from qualitative studies will be presented to demonstrate the readiness of African American churches to develop suicide prevention programs.
CONCURRENT 5, ETIOLOGY, Organized symposia
GIRLS AND THE JUVENILE JUSTICE SYSTEM: EXAMINING MENTAL HEALTH, EDUCATION, AND TREATMENT
Chair: Paula Smith
GIRLS AND THE JUVENILE JUSTICE SYSTEM: EXAMINING MENTAL HEALTH, EDUCATION, AND TREATMENT. Paula Smith1, Christiana Russell2, Leslie Leve3, Patricia Chamberlain3, Shari Miller-Johnson4, 1University of Utah, Salt Lake City, UT United States; 2Ohio State University, Columbus, OH United States; 3Oregon Social Learning Center, Eugene, OR United States; 4Duke University, Durham, NC United States
These presentations will highlight findings from three separate projects on female juvenile offenders. These presentations present inter-related findings which focus specifically on the mental health and educational needs of female juvenile offenders along with findings from a current intervention.
The first presentation will highlight a study aimed at developing of a gendered understanding of mental health problems as a risk factor for female juvenile offenders. The qualitative study presents the voices of girls as they discuss the complexity of the relationship between mental health problems, attempts at self-medication using drugs and alcohol and the sequelae of arrest and/or incarceration.
The second presentation will highlight findings from a study of examining how poverty and gender are significant predictors of educational risk, which in turn affects the likelihood of the female youth´s involvement in future crime, which decreases the chances of a successful transition to adulthood. This study uses data from The Global Risk Assessment Device, an assessment tool used to measure the education risk of court-involved female youth.
The third presentation will highlight results from an intervention with female juvenile offenders, the Multidimensional Treatment Foster Care (MTFC). An examination of the 12-month outcomes suggests that, overall, MTFC was more effective than group care in reducing delinquency, deviant peer associations, and internalizing symptoms in girls: MTFC girls had significantly fewer days in locked settings; caregivers reported that MTFC girls were significantly less involved in delinquency; MTFC girls showed a trend towards fewer official arrests; MTFC girls had fewer delinquent peer associations; and MTFC girls had lower levels of anxiety at the 12-month assessment. Implications for reducing and preventing girls´ delinquency and for the dissemination of the program to community settings will be discussed.
The discussant will provide a summary of interwoven themes, common elements across the studies and facilitate a discussion of the risk and protective factors for female juvenile offenders, as well as intervention strategies that appear to be promising in reducing recidivism among this population.
DRUG USE AMONG FEMALE JUVENILE OFFENDERS: SELF-MEDICATION FOR MENTAL HEALTH ISSUES. Paula Smith1, 1University of Utah, Salt Lake City, UT United States
Over the past decade, there has been a rapid and substantial rise in the numbers of girls involved with the juvenile justice system. While still a smaller percentage of overall juvenile offenders, girls now represent the fastest growing segment of the juvenile justice population and a growing proportion of them are 15 and under (Snyder, 2003). Girls have increased more or decreased less than boys in all major offense categories, and the most marked rise in arrest rates for girls is drug abuse violations, increasing 201% from 1992-2001 (Crime in the U.S., 2003).
Substance use among these youth has typically been described as a concurrent part of their participation in risky and delinquent behavior (Bloom, 2003). Using the self-medication hypothesis, this presentation will present data from a qualitative study of female juvenile offenders which offers an alternative view suggesting that substance use for female juvenile offenders may serve as self-medication for mental health problems. The presentation will highlight statistics of mental health problems and drug related arrests among female offenders and connect it to abuse and neglect statistics for girls and women at a national and local level.
The current study is aimed at developing of a gendered understanding of mental health problems as a risk factor for female juvenile offenders by presenting the voices of girls as they discuss the complexity of the relationship between mental health problems, attempts at self-medication using drugs and alcohol and the sequelae of arrest and/or incarceration. These data are part of a larger interview study of 30 participants in the custody of or under the supervision of Utah´s Department of Youth Corrections. The sample ranged in age from 14 to 19, with n=17 (57%) White; n=9 (30%) Latina; n=2 African-American; 1 Polynesian and 1 participant who was not sure of her racial/ethnic make-up. The presentation will conclude with recommendations for both prevention and intervention for female juvenile offenders.
EDUCATIONAL RISK IN THE LIVES OF COURT INVOLVED FEMALES. Christiana Russell1, 1Ohio State University, Columbus, OH United States
There has been a dramatic increase in the number of female youth offenders. In 1999, 27% of an estimated 2.5 million juvenile arrests were female adolescents (Snyder, 2000). The causes of crime for females delinquency has been linked to poor education, low socioeconomic status, drug use, and physical and sexual abuse (Kataoka et al., 2001). Correlates of delinquency and educational issues have been well documented and many studies have generated evidence regarding the significant relationship between educational factors and delinquent behavior. Delinquent youth are significantly less likely to experience academic success and, in turn, are significantly more likely to drop out of school altogether (Smith, 2000).
This present study reports on data from The Global Risk Assessment Device used to measure the education risk of court-involved female youth. This study examined how poverty and gender were significant predictors of educational risk, which in turn affects the likelihood of the female youth´s involvement in future crime and decreases the chances of a successful transition to adulthood. The present study that demonstrates the importance of considering socioeconomic status and gender issues as they are related to educational risk with court involved female adolescents. The data indicated that while socioeconomic status and education risk were significantly related, at the same time the impact of gender played an important role in determining the nature of this relationship.
More specifically, the fact that females who came from working class families scored at higher risk than females coming from both the most economically advantaged and disadvantaged classes indicates that having “working poor” parents is a risk factor for females. Why are the adolescent females from “working poor” families at higher risk than the poorest female adolescents? One assumption is that these female youth come from single parent households that are often marked by a lack of parental monitoring (Jenkins, 1995). Many of these single mothers do not have the vocational skills or the educational attainment to obtain well-paying clerical jobs; instead they are relegated to less-skilled jobs that often operate around the clock and thus make extreme demands on the parents. This usually means that these mothers, and fathers to a lesser extent, have to work various shifts that cannot accommodate the needs of their family.
Findings from the present study have relevance for prevention and intervention as they underscore the importance of examining the intersection of class and gender. In addition, information gleaned from this study may have practical application in enabling the courts to better serve at-risk female adolescents.