CONCURRENT 10, MIDDLE CHILDHOOD, WELL-BEING, EMERGING OPPORTUNITES IN PREVENTION RESEARCH, Poster Forum
PREVENTION AND INTERVENTION FOR ADOLESCENT DEPRESSION, RISK AND PROTECTIVE FACTORS FOR PACIFIC ISLANDER YOUTH, PERSONALITY VULNERABILITY TO DEPRESSION
Chair: Judith Stein
FRIENDS: PREVENTION AND EARLY INTERVENTION PROGRAM FOR ANXIETY AND DEPRESSION. Julia Gallegos1, 1University of Texas at Austin, Austin, TX United States
Children and youth are now more likely to develop mental illness than 20 years ago (Barrett, Webster & Turner, 2003). Anxiety is a general response that may be out of proportion to environmental threats and tend to be associated with worrying about future or past difficulties rather than an immediate situation. Anxiety difficulties can be manifested in different forms (e.g. panic attacks and social phobia) and are the major psychological risk factor for depression (Barrett, Webster & Turner, 2000). Based on the 1998 U.S. census, 19 million of American adults are affected by anxiety disorders every year. According to Barrett, Webster, and Turner (2003), it is estimated that 1 in 5 children will experience a significant degree of impairment as a result of anxiety. Anxiety symptoms are risk factors for high rates of absenteeism and mental distress, thus impairing children´s learning, and too often manifest in later adolescence and adulthood as more severe anxiety disorders, substance abuse, and self-damaging behaviors among others (ibid). Therefore, to prevent these life-long consequences and high economic costs, early intervention and/ or prevention of anxiety is crucial.
The FRIENDS program, developed by Barrett, Webster, and Turner (2000), was created to assist children and youth, at an appropriate developmental level, to build emotional resilience by learning skills and techniques to cope and manage anxiety. The FRIENDS program is a community-oriented cognitive behavioral intervention, grounded in cognitive-behavioral therapy, and it is implemented through peer learning model and experiential learning. Several interventions have been conducted using the FRIENDS program in various settings: as a universal school-based intervention for the prevention of anxiety symptoms (e.g. Barrett & Turner, 2001), as an intervention for students at risk (e.g.Barrett, Shortt, Fox & Wescombe, 2001), and as an intervention for children and adolescents with one or more anxiety disorders (e.g. Shortt, Barrett & Fox, 2001).
The aim of this presentation is first, to provide an overview of the importance of early intervention and prevention of anxiety disorders and secondly, analyze the effectiveness of FRIENDS program. Finally, suggestions for increasing the effectiveness of FRIENDS will be presented.
RISK AND PROTECTIVE FACTORS FOR PACIFIC ISLANDER YOUTH. Robin Davis1, 1University of Utah, Salt Lake City, UT United States
There is a dearth of research on risk and protective factors for substance abuse, violence, and overall delinquency for Pacific Islander youth. Current research on this population is confounded for two reasons: (1) Pacific Islander youth are aggregated within the Asian/Pacific Islander (API) ethnic category, and (2), Existing research on Pacific Islander youth has identified conflicting findings regarding substance abuse and delinquency problems. Pacific Islander youth are overrepresented in the juvenile justice system nationally. Given the dynamics of overrepresentation of Pacific Islander youth coupled with scant and contradictory existing research, it is evident that further research is needed on Pacific Islander youth.
This quantitative, exploratory study utilized the Prevention Needs Assessment Survey that was administered to over 30,000 youth in Utah in 2003. The study examined the risk and protective factors for 571 Pacific Islander youth living in the state of Utah and provided profiles for factors that place youth at higher risk for or protection from, substance abuse, violence, and overall delinquency.
This study identified several critical findings. First, Pacific Islander youth reported an increased frequency of substance abuse, and risk for future substance abuse as compared to other youth in Utah, and across samples of Hispanic and White youth. Second, Pacific Islander youth reported higher levels of violent behavior and risk for violence in the future. Third, Pacific Islander youth reported significantly higher rates of overall antisocial behavior and particularly high levels of gang involvement and depression. Both of these issues are critically important in identifying both prevention and intervention services needed for Pacific Islander youth.
Pacific Islander youth reported to be less protected that Hispanic and White youth. In the community, family, and school domains, Pacific Islanders reported significantly lower levels of opportunities for prosocial involvement and similarly lower levels of rewards for involvement than the State norm.
DEPRESSION: A CASE OF MISDIRECTED AGGRESSION?. Suzanne Haddad1, Jenae Neiderhiser1, Erica Spotts2, 1George Washington University, Washington, DC United States; 2George Washington University and Karolinska Institute, Washington, DC United States
This study is an effort to examine how different forms of aggression – self-directed and externally directed – are related to depressive symptomatology. The sample consists of twin parents participating in two studies of twin families in Sweden. These studies are companion studies with 450 twin mothers, 650 twin fathers, their spouses and one adolescent child of each twin. Depressive mood, as measured by the Center for Epidemiologic Studies – Depression Scale (CES-D), will be associated with three subscales of aggression, as measured by the Karolinska Scales of Personality (KSP). Based, in part, on Freud´s (1917) conceptualization of depression as aggression directed towards the self, it is hypothesized that the subscales of inhibited aggression and indirect aggression would be highly correlated to total depressive mood, whereas direct aggression would not. Preliminary findings support this hypothesis. Additional analysis will examine these associations by gender and multiple regression analyses will further test the hypothesis that individuals often unconsciously inhibit or completely repress their negative feelings to avoid the perceived negative consequences of expressing aggression outward. This process results in internalized hostility and depressive symptoms. The final component of the study will examine genetic and environmental contributions to associations among depression and the types of aggression. Findings that support this hypothesis could enhance our clinical and theoretical understanding of the psychological mechanisms of depression and provide insight into its prevention.
MECHANISMS LINKING PERSONALITY VULNERABILITY TO DEPRESSION: FINDINGS AND IMPLICATIONS FOR PREVENTION. Jongil Yuh1, Jenae Neiderhiser1, David Reiss1, 1George Washington University, Washington, DC United States
The literature clarifies that certain features of personality characteristics are important risk factors for depression and depressive symptoms; these studies raise questions about underlying mechanisms. To what extent do personality characteristics make individuals more vulnerable to depression? Do the same genetic and environmental influences account for the association? Does the mechanism work equally in adolescents and adults? The goal of this study was to identify underlying genetic and environmental mechanisms on relationships between personality characteristics and depressive symptoms during adolescence, young adulthood, and middle adulthood, using two complimentary genetically informative samples. This integrated study could shed light on expanding our knowledge of depressive symptoms and on developing preventive interventions by identifying specific risk factors and their mechanisms.
This study assessed depressive symptoms and personality characteristics including optimism, temperament, and character in the longitudinal female sub-sample from two different waves of the Nonshared Environment in Adolescent Development project (NEAD; N=343 and N=170), as well as adult twin women pairs in the Twin Moms project (TM; N=326). Optimism was assessed by the Life Orientation Test (Scheier & Carver, 1985) for the NEAD sample during adolescence and the Ladder of Life (Wiklund et al, 1992) for the TM sample. The Temperament and Character Inventory (Cloninger et al, 1993) was used to assess dimensions of temperament and characters in wave 3 of the NEAD sample and in the TM sample. Depressive symptoms for the NEAD at the first wave were assessed by multiple measures and multiple raters including observer ratings (Child Depression Inventory: Kovacs, 1985; Behavior Problems Index: Zill, 1985; Behavior Events Inventory: Hetherington & Clingempeel, 1992). The Center for Epidemiological Studies-Depression scale (Radloff, 1977) was used to assess the severity of depressive symptoms for the wave 3 assessment of the NEAD sample and for the TM sample. Phenotypic correlations, intraclass correlations, and maximum-likelihood model fitting were used.
The results suggest that a dynamic process with genetic and environmental influences plays important and differing roles in the association at different ages. Genetic influences accounted for a moderate to substantial percentage of the association between personality vulnerability and depressive symptoms, emphasizing the mechanisms that transform genetically influenced risk into overt psychopathology as a target of preventive intervention. Nonshared environmental influences in the association tended to increase in adulthood, suggesting the importance of specific social context (e.g., marriage) in adulthood.
ASSESSMENT OF SCHOOL BONDING IN ELEMENTARY SCHOOL STUDENTS. Samuel Maddox1, 1University of South Carolina, Columbia, SC United States
The purpose of this study is to examine the relationship between school bonding and behavioral and academic outcomes in elementary school students. School bonding refers to the connections that youth have with their school and aspects of academic life. School bonding is an important concept in prevention because it has been linked to various developmental and adjustment outcomes including substance use, delinquency, antisocial behavior, anxiety, and academic performance. In addition, research suggests that school bonding is a potentially malleable target for intervention. Therefore, a detailed understanding of this construct can provide practitioners with additional tools necessary to prevent the development of the negative outcomes mentioned above. Unfortunately there are two major problems with school bonding research 1) Little attention is paid to the conceptualization and measurement of school bonding and 2) Most school bonding research is conducted with adolescents. This study attempts to address these problems by designing a measure of school bonding and examining its relationship to outcomes in 3-5 grade students. The School bonding Assessment Measure (SAM) has four dimensions: attachment to school, attachment to personnel, school commitment, and school involvement. Attachment to school refers to feelings about the school and the degree to which the students care about it. Attachment to personnel refers to the interpersonal connection experienced by students as reflected in their respect, regard, and admiration for the educators, staff, and administration. School commitment refers to personal investment in school activities and the priority school holds for youth. Finally, school involvement refers to the students´ participation in school activities and their experiences regarding this participation. These four dimensions will be compared to various behavioral and academic outcomes such as conduct problems, anxiety, depression, attitudes toward delinquency and substance use, frustration tolerance, discipline referrals, social competence, grades, and school attendance. Moderating effects of demographic variables and neighborhood characteristics will also be examined. Discussion will include comparisons between the current study and significant relationships found in other studies on school bonding and the implications they have for future research and intervention.
THE STATUS OF MENTAL HEALTH AMONG APPALACHIAN TEEN SMOKERS. Angela Lacey-Mccracken1, Geri Dino1, Kimberly Horn1, 1West Virginia University, Morgantown, WV United States
Learning Objective: Attendees will be able to describe how mental health issues affect smoking among rural youth. Abstract: Although rural youth are more at risk for smoking than their non-rural counterparts there is little research about cessation efforts specifically geared toward this population and the effect that mental health has on cessation development, implementation, and outcomes. Methods: A total of 20 schools (n = 258 youth) participated in this 5-year study: 10 from West Virginia and 10 from North Carolina. Five schools from each state were selected to receive the American Lung Association´s Not-On-Tobacco teen smoking cessation program which was administered in same-gender groups, one hour a week for 10 weeks. These schools were matched according to demographic variables with 5 other schools who received a brief intervention (i.e., 10-15 minutes of advice to quit smoking and distribution of pamphlets). Surveys were administered pre-and post-program to collect information about smoking rates and mental health. Afterward, 7 focus groups of 4 different types were conducted in same-gender groups to explore findings in depth. These included: (1) parents, (2) smokers who participated in N-O-T, (3) smokers who did not participate in N-O-T, and (4) teens who did not report smoking. Questions for the focus groups were developed based on the findings from the quantitative portion of the research. Results: Regarding depression, 26.8% of participants scored in the pathological range. 34.1% scored in the pathological range for anxiety. Additionally, 25.6% of participants reported suicidal ideation “often” or “almost always.” In support, focus group results revealed that most teens acknowledge that their lives are very stressful and that it is difficult to find ways to cope with the stressors, especially in a rural area where transportation and lack of resources are often issues. Conclusion: Mental health may be an important function to consider when administering cessation services to Appalachian youth. Cessation services for these youth may benefit from enhancing social and coping skills.
IMPLEMENTING A SCHOOL-BASED “EMOTIONAL HEALTH CHECK-UP”. Ann Vander Stoep1, Elizabeth McCauley1, 1University of Washington, Seattle, WA United States
Reducing the occurrence of depression and other emotional and behavioral problems among children and adolescents is a key objective of Healthy People 2010. In the U.S. today, 1 in 5 children is affected by a significant emotional health problem. These problems are commonly associated with poor school performance and impaired social and vocational functioning. Fortunately, early detection and intervention can enable children to get back on a healthy developmental path.
Depression and anxiety are good targets for screening. They manifest through early signs that can be detected with self-report questionnaires that are brief, accurate, and easy to administer. Without a specific screening effort, they go undetected. Schools provide a good site for emotional health screening and preventive interventions because of access to large groups of underserved young people, preference of adolescents to seek health care at school, cost-effective delivery of services, and credibility for parents.
Probably the most compelling argument for providing emotional health screening in the school setting is the high toll that emotional health conditions take on children´s school success. According to the CDC, “young people who are hungry, ill, depressed, or injured are less likely to learn. School health programs can be an effective means of improving educational achievement” (Healthy Youth, 2003).
For the past four years, the University of Washington Developmental Pathways Program (DPP) has conducted universal, school-based emotional health screening of sixth graders making the transition from elementary to middle school. DPP deploys a team of child mental health professionals to meet one-on-one with students who screen high to assess the child´s level of distress, functional status, and supportive resources. With the child´s permission, the DPP professional communicates with the parent/guardian and school counselor and offers assistance in making appropriate connections to the school counselor, tutors, after school programs, or community mental health agencies as needed.
While other school-based mental health initiatives focus on the goals of diagnosing mental illness or preventing suicide, the goal of the DPP Emotional Health Check-up is to ease the adjustment to middle school and help children get on track for academic success.
In this presentation, we will discuss program implementaion including laying groundwork in schools and inviting parents and students to participate. We will describe how screening and clinical evaluations are carried out and how recommendations are communicated. Finally, we will present information about who participates, what emotional health problems are detected, and what kinds of support students need.
RELATION OF DEPRESSION TO OBESITY FROM ADOLESCENCE TO ADULTHOOD: IMPLICATIONS FOR PREVENTION. Guneet Kaur1, Chih-Ping Chou1, Mary Ann Pentz1, 1University of Southern California, Alhambra, CA United States
The present study examines the longitudinal relationship between adolescent depression, adult depression and adult obesity. The main hypothesis posited in this study is that adolescent depression increases the risk for adult obesity while controlling for adult depression. Few longitudinal studies exist that have evaluated a causal relationship between adolescent depression and adult obesity. However, none of the studies analyzing this relationship between adolescent depression and adult obesity control for adult depression, extracurricular physical activities and drug use. This study utilizes data from a longitudinal tracking study that is part of a drug prevention trial, Project STAR (78% white, 20% African-American, 2% Other, 51% female; 64% low SES, N=2544). Items measuring depression (derived from the Hopkins Symptom Checklist) have been tracked among the subjects since 1989-90 (Grade 11-12) and weight/obesity items are being currently collected (2003-2005). To test our main hypothesis that depression in adolescence is associated with an increased risk for obesity in adulthood, regression analyses are being performed with adolescent and adult depression as the predictors and adult obesity as the outcome. Potential covariates include gender, participation in extracurricular physical activities, drug use and subjective rating of health. Significance of the long-term relation between depression and obesity would suggest that prevention efforts aimed at promoting mental health or preventing depression might also work to prevent obesity.
12:00 PM – 1:30 PM
LUNCH (ON YOUR OWN)
12:00 PM – 1:30 PM
ECPN LUNCHEON (REGISTRATION REQUIRED)
Chairs: Celene Domitrovich and David Wyrick
Dr. Melissa Stigler: Findings from Project MYTRI: Testing theory as it relates to preventing tobacco use among youth in India
Project MYTRI is a group-randomized trial designed to prevent the onset and reduce the prevalence of tobacco use among two cohorts of students (6th-8th and 8th-10th grade) in thirty-two private and government schools in Delhi and Chennai, India (n ~ 12,000).
Using analyses of data collected in the last year (2004- developed in the West to other populations, settings, and contexts in the East – like India – will be discussed.
Deaths due to tobacco are expected to rise dramatically in many developing nations of the world in the next two decades. During this time, India will experience the highest rate of increase among all regions in the world – the proportion of all deaths related to tobacco will rise from 1.4% (in 1990) to 13.3% (in 2020), according to the World Health Organization. Tobacco is consumed in a variety of forms throughout India. Currently, other forms of tobacco (e.g., gutkha, bidis) are more prevalent than cigarette smoking. Cigarette smoking is starting to increase, especially in urban India, as income rises and a more Western lifestyle is embraced. As in other parts of the world, tobacco use often begins during adolescence and early adulthood in India. Comparatively little is known, however, about which factors may influence the onset of tobacco use in this population, or which intervention strategies may be most appropriate and effective at preventing it.05), during administration of the baseline student survey and implementation of the first year of intervention materials, this presentation will explore the conceptual theory and action theory used to guide the development of the intervention model for Project MYTRI. Conceptual theory connects potential mediators (e.g., knowledge, skills, social norms) to outcomes of interest (e.g., tobacco use) – while action theory links program components (e.g., mass media, skills training) to the potential mediators (e.g., knowledge, skills, social norms). Implications in regards to the relevance, transfer, and adaptation of theories Dr. Antonio Morgan-Lopez: A Medley on Mediation: (Simulation Work on and) Recent Advances in Study Designs and Estimation Methods
There has been considerable progress in the last two decades in the understanding and the application of theory in the etiology and prevention of negative health outcomes. These advances in substantive theories of health behavior have occurred in parallel (and arguably in symbiosis) with advances in quantitative methods, particularly in the statistical modeling of mediation effects. A medley of three studies will be presented that serve as illustrations of very recent (and forthcoming) advances in the area of mediation analysis. Each of these studies varies on several dimensions including: (a) study design (i.e., cross-sectional, "semi"-longitudinal, longitudinal), (b) confidence interval estimation method, (c) research context (i.e., etiological, intervention) and (d) specialized mediation context (mediation with three paths, mediation with "baseline by treatment" interactions, mediation contrasts across groups). Each study will be presented in the context of how the links in the theory of a program can be (a) formed from etiological contexts or (b) tested in intervention contexts.
1:30 PM – 3:00 PM
CONCURRENT SESSIONS, 1 - 10
CONCURRENT 1, EFFECTIVENESS TRIALS, Roundtable
YOUTH WITH MULTIPLE PROBLEM BEHAVIORS: WHAT HAVE WE LEARNED ABOUT THEM, HOW SUCCESSFUL HAVE WE BEEN IN INTERVENING WITH THEM, AND WHERE TO GO FROM HERE?.