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From Early to Late Adolescence: American Indian Youths' Behavioral Trajectories and Their Major Influences
Abstract
This article identifies behavioral trajectories of American Indian adolescents and examines their predictors.
A total of 401 urban and reservation American Indian adolescents were interviewed yearly from 2001 to 2004 (with 341 youths, or 85%, retained to 2004, and 385 completing at least two interviews). The Youth Self-Report total problem score is used to model behavior change trajectories, with psychological (addictions and mental health) and environmental (family, peer, community, and services) variables as independent variables. Analyses were based on PROC TRAJ, an SAS macro.
Five trajectory groups were found. Youths who started with a Youth Self-Report score less than the clinical cutoff were low stable (n = 142) or low improving (n = 175). Youths with initial scores over the cutoff were very high chronic (n = 5), high improving (n = 30), or high chronic (n = 33). High improvers scored close to the low improving group by 2004. At baseline, the high improving group was more likely than the high chronic group to be from the reservation (odds ratio 5.94), have greater family satisfaction (1.14), and have fewer school problems (0.84). Over time, the high improving group had substance use and depression drop, family satisfaction increase, fewer parents with mental health or addictions problems, fewer peers using substances, and a decrease in neighborhood problems and stressors.
A significant majority (more than 82%) of the youths exhibited relatively low levels of problem behaviors over all 4 years, and 42% of those with clinically significant problems improved over time.
... Substance use Substance use was associated with poorer mental health in 8/9 (88.9%) studies [30,36,40,46,51,[62][63][64]. Substance use was consistently associated with externalising and global measures of poor mental health (5/5 studies) [36,40,51,62,63], but was less consistently associated with depressive symptoms (4/8 studies) [30,46,63,64]. ...
... Substance use Substance use was associated with poorer mental health in 8/9 (88.9%) studies [30,36,40,46,51,[62][63][64]. Substance use was consistently associated with externalising and global measures of poor mental health (5/5 studies) [36,40,51,62,63], but was less consistently associated with depressive symptoms (4/8 studies) [30,46,63,64]. ...
... Internalising All studies (7/7) that measured internalising symptoms found a positive association between this domain and other negative mental health outcomes [30,40,44,45,51,62,64]. Internalising symptoms were associated with symptoms of externalising symptoms in 3/3 studies [40,51,64], with global measures of poor mental health in 2/2 studies [45,62], with other internalising symptoms in 2/2 studies [30,64], and were negatively associated with positive mental health in one study [44]. ...
Background
Indigenous children living in high income countries have a consistently high prevalence of mental health problems. We aimed to identify psychosocial risk and protective factors for mental health in this setting.
Methods
A systematic review of studies published between 1996 and 2016 that quantitatively evaluated the association between psychosocial variables and mental health among Indigenous children living in high income countries was conducted. Psychosocial variables were grouped into commonly occurring domains. Individual studies were judged to provide evidence for an association between a domain and either good mental health, poor mental health, or a negligible or inconsistent association. The overall quality of evidence across all studies for each domain was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) guidelines.
Results
Forty-seven papers were eligible (mainland US 30 [64%], Canada 8 [17%], Australia 7 [15%], Hawaii 4 [9%]), including 58,218 participants aged 4–20 years. Most papers were cross-sectional (39, 83%) and measured negative mental health outcomes (41, 87%). Children’s negative cohesion with their families and the presence of adverse events appeared the most reliable predictors of increased negative mental health outcomes. Children’s substance use, experiences of discrimination, comorbid internalising symptoms, and negative parental behaviour also provided evidence of associations with negative mental health outcomes. Positive family and peer relationships, high self-esteem and optimism were associated with increased positive mental health outcomes.
Conclusions
Quantitative research investigating Indigenous children’s mental health is largely cross-sectional and focused upon negative outcomes. Indigenous children living in high income countries share many of the same risk and protective factors associated with mental health. The evidence linking children’s familial environment, psychological traits, substance use and experiences of discrimination with mental health outcomes highlights key targets for more concerted efforts to develop initiatives to improve the mental health of Indigenous children.
Electronic supplementary material
The online version of this article (doi:10.1186/s12939-017-0652-5) contains supplementary material, which is available to authorized users.
... This finding may suggest that American Indian children who are more likely to experience social stigmatization and discrimination and are in the greatest need of outside supports may be able to effectively communicate this to others. The literature suggests that American Indians are not utilizing mental health resources and are faring poorly in regards to mental health functioning (Novins et al. 1999;Stiffman et al. 2007) and are continuing to struggle with how to effectively handle emotional states. However, this study may indicate that American Indians may not be repressing their anxiety and thus may be finding other outlets (e.g., cultural avenues) to cope with emotional distress. ...
There may be significant differences in coping styles across ethnicities. Previous research has suggested disparities in the number of individuals who utilize repressive adaptive coping style among cultural groups. Repressive adaptive style is a coping mechanism in which individuals report low distress levels while they actually experience high levels of stress. Developing an enhanced understanding of the prevalence of the utilization of repressive adaptive style in different ethnic groups is important for informing intervention techniques to better account for the cultural influences on mental health. The present study investigated the utilization of repressive adaptive style across American Indian (n = 31), African American (n = 53), and European American (n = 48) children in the Midwest. The age range of the children was 10 to 13 years and 50.8% were male. Dependent measures included the Children’s Social Desirability Scale and the State-Trait Anxiety Inventory for Children. Results indicated significant differences in reports of anxiety between ethnic groups. Additionally, it was discovered that African American and European American children utilized repressive adaptive style more than American Indian children, albeit not significantly. Because of the high rates of suicide and emotional distress believed to be experienced by American Indian children this result is interesting. Continued research investigating protective factors, such as high levels of cultural identity and connectedness, is warranted. © 2017 Springer Science+Business Media, LLC, part of Springer Nature
... To take into account the uncertainty of class trajectory assignment, the posterior classification probabilities of class membership were used as weights. This means that the data of women who were assigned to a class trajectory with high certainty were given more weight than the data of women who were assigned with less certainty (same procedure as in Henselmans et al. 2010, Stiffman et al. 2007). First, univariate multinominal logistic regressions were used to investigate associations between demographic (age, education, children before treatment), diagnostic (duration and cause of infertility) and treatment variables (live-birth after 1 st and last cycle and compliance behaviour) and class trajectory membership. ...
STUDY QUESTION
Do patients present different adjustment trajectories during and after IVF treatment?
SUMMARY ANSWER
Most women show resilient trajectories during and after IVF treatment but 37% show temporary or chronic maladjustment during IVF and 10% are maladjusted 11–17 years after treatment.
WHAT IS KNOWN ALREADY
Research on patient psychosocial adjustment during treatment has contributed to identifying the most distressful stages of IVF treatment and profiling patients at risk for emotional maladjustment at these specific stages. This knowledge is currently driving the deliverance of psychosocial care at fertility clinics by tailoring it to patients' risk profiles and specific treatment stages. However, current care does not take into consideration how individuals adjust across the entire treatment pathway. This can be assessed by profiling individual adjustment trajectories.
STUDY DESIGN, SIZE, DURATION
A longitudinal cohort study with five assessment moments that combines data from two different studies, the STRESSIVF and OMEGA projects. Participants enrolled in the STRESSIVF study (started IVF in 1998–2000) were assessed before and after the first IVF treatment cycle and 6 months and 2.5 years after the last IVF cycle. A subset participated in the OMEGA project (started IVF in 1995–2000) and reported on their mental health 11–17 years after treatment.
PARTICIPANTS/MATERIALS, SETTING, METHODS
Three hundred and forty-eight women participated in the STRESSIVF project and 108 of these in the OMEGA. Anxiety was measured with the State and Trait Anxiety Inventory, depression with the Beck Depression Inventory and mental health with the Mental Health Inventory. Latent class growth mixed modelling was carried out to identify distinct anxiety and depression trajectories over the four STRESSIVF study assessment moments. Multinominal logistic regressions were conducted to investigate predictors of trajectory membership, and stepwise linear regressions were performed to investigate if adjustment trajectories predicted mental health 11–17 years after IVF treatment.
MAIN RESULTS AND THE ROLE OF CHANCE
A total of 67 and 86% of women showed normal levels of anxiety and depression, respectively, throughout treatment (resilient trajectories), 24 and 33% experienced anxiety and depression only during treatment (recovery trajectories), 4.6 and 4.9% experienced anxiety and depression only after treatment (delayed trajectories), and 4.3% showed chronic anxiety (chronic trajectory, not identified for depression). Non-resilient trajectories were associated with unsuccessful treatment, marital dissatisfaction, lack of social support and negative infertility cognitions. One in 10 women had a delayed or chronic trajectory and these trajectories predicted serious mental health impairment 11–17 years after treatment.
LIMITATIONS, REASONS FOR CAUTION
The study only focuses on women. In the OMEGA project adjustment was assessed using a mental health measure. Although we could investigate how trajectories predicted mental health, it would have been preferable to map anxiety and depression trajectories up to 11–17 years after treatment. Missing analysis showed selective dropout from the study but this was accounted for by using mixed models and imputation procedures. Finally, data on other life stressors were not collected; therefore any contribution from these events cannot be assessed.
WIDER IMPLICATIONS OF THE FINDINGS
Fertility health-care providers have been called upon considering their responsibility in supporting patients in the aftermath of treatment. Results show it is possible to profile different groups of at-risk women at the start of the treatment and tailor psychosocial support to risk profile to promote health adjustment during treatment and thereafter.
STUDY FUNDING/COMPETING INTEREST(S)
This study was supported by a grant from the Dutch Cancer Society (2006-3631) and the Praeventiefonds (28-3012). No competing interests exist.
... Also using semi-parametric mixture models to discern internally homogeneous latent class trajectory groups of antisocial behavior trajectories (Nagin, 1999(Nagin, , 2005 , Stiffman, Alexander-Eitzman, Silmere, Osborne, and Brown ( 2007 ) analyzed a total behavior problem index among a prospective sample of American Indian youth (average age of 15 at Wave I of four wave study) that included internalizing problems (e.g., depression) as well as externalizing problems (e.g., delinquency, aggression). Stiffman et al. ( 2007 ) found a fi ve group model fi t the data. They then analyzed predictors differentiating membership in the high chronic group from the high level improver group, also known as desisters in life course criminology. ...
This chapter reviews recent research on neighborhood influences on children’s and adolescents’ antisocial behavior. Building on reviews in this area, we focus on recent developments pertaining to life course criminology. We have five main aims in this chapter. First, we engage General Strain Theory along with stress process perspectives to further theorize neighborhood structural and processual influences both in the short-term and dynamically over time. Second, we examine findings from cross-sectional research on neighborhood structure and process influences on a range of antisocial behaviors in both childhood and adolescence, considering direct and indirect links as well as moderating factors. Third, we use a life course criminology framework to examine antisocial behavior trajectories in the context of neighborhood residence. Studies in this area include results of both semi-parametric mixture models as well as hierarchical linear growth models of antisocial behavior trajectories. Fourth, we examine emerging research on neighborhood dynamics. Fifth, we consider research on the timing of neighborhood influences. We conclude with a summary of major findings and suggestions for future research on neighborhood influences on young people in life course criminology.
... In many communities, high rates of a variety of mental health problems have been identified among FN, Native American, and American Indian youth, including but not limited to depression and low self-esteem (P. B. Jackson & Lassiter, 2001;Twenge & Crocker, 2002), suicide and suicide-related behaviors (Alcántara & Gone, 2007;Chandler & LaLonde, 1998;Kirmayer, 1994;LaFromboise, Medoff, Lee, & Harris, 2007), antisocial behavior and panic disorder (Stiffman, Alexander-Eitzman, Silmere, Osborne, & Brown, 2007), and substance abuse and conduct disorders (Hawkins, Cummins, & Marlatt, 2004;Whitbeck, Yu, Johnson, Hoyt, & Walls, 2008). Some of the poor mental health concerns experienced by many FN youth may be further exacerbated by difficulties associated with ongoing forms of systemic acculturation (i.e., the extent to which individuals are influenced, assimilated, or adopted into cultures other than their own), leading to diminished mental health outcomes (LaFromboise, Albright, & Harris, 2010). ...
Despite a growing recognition of cultural connectedness as an important protective factor for First Nations (FN) peoples' health, there remains a clear need for a conceptual model that organizes, explains, and leads to an understanding of the resiliency mechanisms underlying this concept for FN youth. The current study involved the development of the Cultural Connectedness Scale (CCS) to identify a new scale of cultural connectedness. A sample of 319 FN, Métis, and Inuit youths enrolled in Grades 8-12 from reserve and urban areas in Saskatchewan and Southwestern Ontario, Canada, participated in the current study. A combination of rational expert judgments and empirical data were used to refine the pool of items to a set that is a representative sample of the indicators of the cultural connectedness construct. Exploratory factor analysis (EFA) was used to examine the latent structure of the cultural connectedness items, and a confirmatory factor analysis was used to test the fit of a more parsimonious version of the final EFA model. The resulting 29-item inventory consisted of 3 dimensions: identity, traditions, and spirituality. Criterion validity was demonstrated with cultural connectedness dimensions correlating well with other youth well-being indicators. The conceptualization and operationalization of the cultural connectedness has a number of potential applications both for research and prevention. This study provides an orienting framework that guides measurement of cultural connectedness that researchers need to further explore the role of culture in enhancing resiliency and well-being among FN youth in Canada. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
... Studies show that children and youths entering foster care are highly vulnerable to a variety of problems, including disproportionate rates of mental health and related psychosocial and adjustment problems (Landsverk & Garland, 1999;Rubin, Downes, O'Reilly, Mckonnen, Luan, & Localio, 2008). Although child welfare systems have long been described as gateways to mental health services (Halfon, Berkowitz, & Klee, 1992;Leslie, Hurlburt, James, Landsverk & Zhang, 2005), the relationship between child mental health and child welfare cannot be easily separated from the relationship between poverty and psychopathology (Costello, Compton, Keeler & Angold, 2003;Stiffman, Alexander-Eitzman, Silmere, Osbourne & Brown, 2007). Attempts to unpack these relationships are confounded by the relationship between race, class, and gender, making it virtually impossible to consider the impact of each of these factors from the larger spatial and socio-political structures that produce them. ...
... To take into account the uncertainty of group assignment when examining possible predictors, we used the posterior group membership probabilities as weights. That is, the data of women who were assigned to a group with high certainty were given more weight than the data of women who were assigned to a group with less certainty (same procedure as Stiffman et al., 2007). First, the relation between group membership and the categorical characteristics were explored with chisquare tests. ...
The flexible goal adjustment (FLEX) and tenacious goal pursuit (TEN) scales are used regularly in aging research. The current study examined their validity in a sample of 517 women (30-75 years) in multiple ways. Overall, the findings show that the scales do not clearly distinguish between FLEX and TEN. The direction in which the items were formulated was just as important as what was being measured. Moreover, face validity of the inversely phrased items in particular appeared to be weak. On the basis of these findings, the authors recommend a revision of the concept definitions as well as of the items.
... American Indians must cope with poverty, violence, and cultural trauma (a term encompassing the legacy of forced relocation and acculturation, societal prejudice, and systematic genocide), which create chronic stress and heighten the risk of mental illness (Hawkins & Blume, 2002). American Indian adolescents have high rates of a variety of mental health problems, including anti-social behavior and panic disorder (Stiffman, Alexander-Eitzman, Silmere, Osborne, & Brown, 2007). Indicators of psychological difficulty such as depression and low self-esteem are particularly prevalent among this population (Jackson & Lassiter, 2001;Twenge & Crocker, 2002). ...
Despite a number of investigations into the protective effects of ethnic and cultural identity among a variety of diverse populations, there have been relatively few studies that examine the relationship between this identity and American Indian mental health. This brief report investigates the associations between ethnic/cultural identification and feelings of hopelessness among American Indian adolescents. Data were drawn from middle-school respondents on a reservation community at 2 time points 14 months apart. Although White cultural identification was significantly and negatively correlated with hopelessness at 14 months, Indian cultural identification was not associated with hopelessness at either time point. These results are discussed with attention to the developmental stage of our respondents and to the possibility of social dynamics relevant to this particular reservation community.
... New statistical methods, including group-based trajectory models (GBTM), provide the ability to identify adherence sub-groups, including those with the poorest adherence (e.g., highest risk). These methods have been successfully applied to other areas and populations, including criminology (Jennings & Piquero, 2008), dental caries (Broadbent, Thomson, & Poulton, 2008), American Indian youth (Stiffman, Alexander-Eitzman, Silmere, Osborne, & Brown, 2007), and most recently dyspnea symptoms in marine transportation workers (Arrandale, Koehoorn, Macnab, & Kennedy, 2009); however, it has not been used in pediatric psychology research, which was the central goal of the current study. ...
Although cross-sectional studies have demonstrated poor adherence to airway clearance therapy (ACT) for patients with cystic fibrosis (CF), no studies have identified longitudinal patterns of adherence. The objective was to characterize and identify predictors of ACT adherence trajectories for individuals with CF.
Secondary data analyses were conducted for a randomized clinical trial examining differences in three ACTs. Participants (n = 153; M = 14.3 years, 55% male, 86% Caucasian, baseline FEV(1)% predicted: M = 86.7)/primary caregivers completed Daily Phone Diaries, an empirically supported adherence measure, every 4 months.
Group-based trajectory modeling revealed the best-fitting solution was a three-group model: low-adherence (14%), medium-adherence (49%), and high-adherence (37%) groups. ACT type was the only significant predictor of adherence trajectories.
Three trajectories of adherence to ACT for patients with CF were found. With the identification of trajectories, adherence interventions can be targeted for the subgroup at highest risk in order to prevent poor health outcomes.
... To take into account the uncertainty of group assignment when examining possible predictors, we used the posterior group membership probabilities as weights. That is, the data of women who were assigned to a group with high certainty were given more weight than the data of women who were assigned to a group with less certainty (same procedure as Stiffman, Alexander-Eitzman, Silmere, Osborne, & Brovin, 2007). First, we explored the relation between group membership and the categorical characteristics with chi-square tests. ...
In this article, we aim to (a) identify distinct trajectories of psychological distress in the first year after a breast cancer diagnosis in women treated with adjuvant therapy and (b) explore possible predictors of these trajectories, that is, demographic, medical, and personal characteristics.
The 171 patients were assessed after diagnosis, after surgery, after adjuvant treatment, in the reentry phase, and in the (short-term) survivorship phase (2 and 6 months after the end of treatment, respectively).
Psychological distress was assessed with the 12-item General Health Questionnaire.
There were four trajectories of distress: a group that experienced no distress (36.3%), a group that experienced distress only in the active treatment phase (33.3%), a group that experienced distress in the reentry and survivorship phase (15.2%), and a group that experienced chronic distress (15.2%). Personality and physical complaints resulting from adjuvant treatment could distinguish the distress trajectories. Mastery was the only unique predictor.
Most patients were not distressed in response to breast cancer or only temporarily so. Yet, a minority of patients became or remained distressed after the end of treatment.
... To take into account the uncertainty of group assignment when examining possible predictors, we used the posterior group membership probabilities as weights. That is, the data of women who were assigned to a group with high certainty were given more weight than the data of women who were assigned to a group with less certainty (same procedure as Stiffman et al., 2007). First, the relation between group membership and the categorical characteristics were explored with chisquare tests. ...
This prospective study examines the cognitive and behavioural mediators of the relation between personal control and the initial response to a breast cancer diagnosis as well as subsequent psychological adjustment. A total of 143 patients participated immediately after diagnosis (T1), after surgery (T2) and 2 months after the end of treatment (T3), of whom 92 also completed a questionnaire pre-diagnosis (T0). The buffering effect of personal control on psychological distress shortly after diagnosis was mediated by cancer-specific cognitions, i.e. threat appraisal and coping self-efficacy. Moreover, a strong sense of personal control predicted lower levels of anxiety 2 months after the end of treatment, but was unrelated to distress at T3. The adaptive effect on anxiety was mediated by threat appraisal and active engagement in social life after surgery, but not by active patient participation or coping self-efficacy. These results confirm and explain the adaptive effect of control. Apparently, women with a low sense of control appraise cancer and their personal coping skills more negatively, which makes them vulnerable to distress in response to diagnosis. Furthermore, women with a strong sense of control might regulate anxiety by remaining engaged in social life.
... We have evidence that when a child or adolescent's environment is improved, some mental health problems decline (Costello et al. 2003; McKay 2005; Stiffman et al. 2007); and • There is evidence that even the most resilient of children will succumb to a chronically stressful environment (Vanderbilt-Adriance and Shaw 2006). ...
The Child-Adolescent Mental Health Services (CAMHS) system confronts clinically complex youth with high rates of behavior problems, diverse mental health disorders, substance abuse, criminal behavior, and other "at risk" behaviors (e.g. school truancy, family conflict, etc.). Because of the complexity of the youth, the system has serious difficulties helping them to successfully overcome the myriad of problems they confront. This group proposes that a public health approach would help solve many of the inadequacies of the current system.
... To take into account the uncertainty of group assignment when examining possible predictors, we used the posterior group membership probabilities as weights. That is, the data of women who were assigned to a group with high certainty were given more weight than the data of women who were assigned to a group with less certainty (same procedure as Stiffman et al., 2007). First, the relation between group membership and the categorical characteristics were explored with chisquare tests. ...
De diagnose borstkanker en de daaropvolgende behandelingen kunnen negatieve emoties zoals angst en somberheid teweegbrengen. Kennis over het verloop in dergelijke klachten en over factoren die de kans op psychische problemen vergroten, geeft richting aan de psychosociale zorg voor borstkankerpatiënten. Dit proefschrift beschrijft de resultaten van een onderzoek waarin vrouwen werden gevolgd gedurende de verschillende fases in het eerste jaar na de diagnose. Het onderzoek richtte zich op individuele verschillen in het verloop van psychische klachten, op verschillen tussen negatieve emoties en op de voorspellende rol van waargenomen controle. Hoewel vrouwen opvallend veerkrachtig bleken, doorliep niet iedereen het traject na diagnose zonder problemen. Vooral kort na diagnose werden angst en algemene psychische klachten gerapporteerd; depressieve symptomen waren niet veelvoorkomend. Veel vrouwen hadden weinig klachten of herstelden zich na de afronding van de behandeling, terwijl een kleine groep pas na de behandeling of in elke fase problemen ondervond. Vrouwen met een sterk gevoel van controle over het leven rapporteerden relatief weinig psychische klachten. Zij dachten positief over de situatie en de eigen vaardigheden om met de ziekte om te gaan en zij bleven betrokken bij hun sociale leven. Vooral vrouwen met een stressbestendige persoonlijkheid hadden het gevoel zelf invloed te hebben op de genezing van de ziekte. Zelfs na teleurstellend nieuws resulteerde een geloof in de eigen invloed niet in psychische problemen. Naast deze centrale bevindingen rapporteert het proefschrift over de invloed van wachttijden op het emotioneel welbevinden en over de validiteit van een vragenlijst gericht op de persoonlijk stijl in de omgang met problemen.
... Similarly when substances are used to enhance one's self-image (e.g., Bradizza, Reifman, & Barnes, 1999; Windle & Windle, 2006), it occurs primarily among adolescents who keep company with substance using peers. Although previous research has found family functioning, selfimage , and peer substance use behaviors to be associated with adolescent substance use (e.g., Kokkevi et al., 2007; Stiffman, Alexander- Eitzman et al., 2007; Taylor, Lloyd, & Warheit, 2005), no known studies have examined the role that peer substance use plays in the link between negative self-image and substance use. Such research would lead to a more comprehensive understanding of the complex relationships among contextual and individual factors leading to adolescent substance use. ...
This cross-sectional self-report study examined (1) whether family functioning (Family Functioning in Adolescence Questionnaire, FFAQ) and self-image (Piers-Harris Children's Self-Concept Scale) have independent associations with smoking and alcohol use and (2) whether self-image mediates the relationship between family functioning, smoking, and alcohol use among 1,598 Hispanic males and females in grades 7 through 12 in Los Angeles County, California, in 2001. The findings supported the main effects and, to some degree, the mediational effects that were hypothesized. Limitations and implications for this study are discussed, and directions for future research are suggested. This study was funded by the California Tobacco Related Disease Research Program.
... To take into account the uncertainty of group assignment when examining possible predictors, we used the posterior group membership probabilities as weights. That is, the data of women who were assigned to a group with high certainty were given more weight than the data of women who were assigned to a group with less certainty (same procedure as Stiffman et al., 2007). First, the relation between group membership and the categorical characteristics were explored with chisquare tests. ...
This longitudinal study aims to gain more insight in both the changes in personal control due to a breast cancer diagnosis, as well as in the stress-buffering effect of personal control.
Personal control and distress were assessed in breast cancer patients not treated with chemotherapy (n=47), breast cancer patients treated with chemotherapy (n=32) and in healthy women (n=58) at 3, 9 and 15 months after diagnosis.
Results indicate that personal control was affected only in patients treated with chemotherapy, particularly right after the completion of treatment. Furthermore, the cross-sectional and longitudinal results provide modest support for the stress-buffering potential of control.
The findings and future directions of research on the role of personal control in the adjustment to cancer will be discussed.
Purpose
This study reports the impact of an entrepreneurship education intervention designed and evaluated specifically for its impact on substance use, suicide and violence-related outcomes among Native American adolescents.
Methods
This randomized controlled trial included N = 394 Native Americans ages 13–16. Participants were randomly assigned 2:1 (n = 267:127) to the Arrowhead Business Group intervention versus a control condition. Logistic mixed effects regression models examined within group and between group differences in trajectory from baseline to 24 months follow-up.
Results
Fewer intervention vs. control participants used marijuana at 6-, 12- and 24-months post-intervention (19.6% vs. 28.0%, p = 0.032; 20.4% vs. 31.8%, p = 0.01; and 24.1% vs. 31.4%, p = 0.047). All violence-related measures (suicide attempts, carrying a weapon, missing school because felt unsafe, fighting, and fighting at school) statistically significantly declined between baseline and 24 months for both groups. Positive between group differences favoring intervention participants were observed at 6-months for missing school because felt unsafe, and at 24-months for fighting at school. While alcohol use increased for both groups over time, control participants experienced a two-fold higher increase in binge alcohol use than intervention participants (control: 7.1–16.7% vs. intervention: 8.1–13.0%).
Conclusions
This is the first report in the US literature of a youth entrepreneurship intervention designed and evaluated to promote behavioral and mental health outcomes. It shows promise for reducing substance abuse and violence toward self and others, the largest health disparities for Native American youth.
The Declaration on the Rights of Indigenous Peoples was adopted by the UN General Assembly on Thursday, 13 September 2007, by a majority of 144 states in favor, with 4 votes against and 11 abstentions. During the Durban Review Conference in April 2009, 182 states from all regions of the world reached consensus on an outcome document in which they “Welcome[d] the adoption of the UN Declaration on the Rights of Indigenous Peoples, which has a positive impact on the protection of victims and, in this context, urge[d] states to take all necessary measures to implement the rights of indigenous peoples in accordance with international human rights instruments without discrimination…” (UN Office of the High Commissioner for Human Rights, Outcome Document of the Durban Review Conference, 24 April 2009, para. 73).
Several decades of research demonstrate a link between neighborhood residence and human development throughout the life course. This chapter goes beyond enumerating studies that have found such connections between neighborhoods and development; we focus on synthesizing findings from methodologically rigorous research to lay a foundation of what we know about how and why neighborhoods matter for children during the first two decades of life. We begin the chapter with an overview of the history and context of neighborhood research, with special attention to the intersections of research and policy. We next turn our attention to defining the neighborhood context for children. By addressing issues of theory and measurement in neighborhood research, we provide a framework for the third section on approaches to studying neighborhood influences on children's development. The fourth section presents a review of the current state of research in the field, integrating multiple aspects of the neighborhood context and synergies with related contexts and individual characteristics. The fifth section then considers the neighborhood as a unit of intervention. Finally, we offer a dynamic framework for the study of neighborhoods and child development before presenting our conclusions.
Poverty. Lack of social support. Limited access to education. High risk for health problems. Indigenous communities face an inordinate number of hardships. But when children have special needs, these problems multiply exponentially, making existing difficulties considerably worse. School-Parent Collaborations in Indigenous Communities: Providing Services for Children with Disabilities begins with an in-depth overview of indigenous experience and psychology, and situates disabilities within the contexts of indigenous communities and education services. The pilot study at the core of the book, conducted among the Bedouins of southern Israel, shows this knowledge in action as special education personnel engage parents in interventions for their children. Going beyond facile concepts of cultural sensitivity, the model recasts professionals as cultural mediators between school and family. This practice-oriented information has the potential to improve not only the well-being of children and families, but of the greater community as well. Featured in the coverage: Unique characteristics of indigenous communities and children with disabilities. Psychological models of reactions to disability. Benefits of multidisciplinary teams. Factors affecting collaboration between indigenous parents of children with disabilities and school professionals. Core principles of indigenously attuned collaboration. An extended case study on collaboration between parents of children with disabilities and school professionals in a Bedouin community. School-Parent Collaborations in Indigenous Communities is a breakthrough resource for researchers, graduate students, and professionals working with special needs children in child and school psychology, international and comparative education, social work, cross-cultural psychology, public health, and educational psychology. © Springer Science+Business Media New York 2014. All rights are reserved.
This chapter discusses the tension between human subject considerations, basic ethics, cultural approaches to the research process, and researchers' need for objective data. It outlines potential conflicts and presents examples of how these issues have been managed by other research projects. It lists principles for applying cultural and ethical issues, including involving stakeholders, accepting stakeholder's needs and concerns, taking risks to be responsive and assure community benefits, and recognizing community concerns about publications. Suggestions are made for responding to information about child abuse, mental health needs, and suicidality without compromising the research.
Although most American Indian students are educated in the public school system, there is limited literature regarding (a) how general and special educators can effectively meet the unique educational needs of these students or (b) what strategies educators can use while working with their families. Additionally, there are limited resources available regarding how American Indians view special education, disability issues, and the relationship between school and family. The worldview of American Indians differs from mainstream America, which has led to the overrepresentation of American Indian students in special education programs. This article provides culturally responsive research-based practices to help foster school and family relationships and improve the educational outcomes of American Indian students.
The effects of enculturation, self-esteem, subjective well-being, and social support on resilience among urban American Indian (AI) adolescents from a South Central region of the U.S. were explored. Of the 196 participants, 114 (58.2%) were female and 82 (41.8%) were male (ages 14-18 years). Thirty-three percent of the variance in resilience was accounted for by enculturation, self-esteem, and social support, while 34% of the variance in resilience was contributed by enculturation, subjective well-being, and social support. However, social support from friends remained the strongest predictor.
The smoking patterns of youth remain unknown after they have received smoking cessation counseling. This study aims to examine the quitting trajectories of Chinese youth smokers after they have received quitline services and to examine factors to predict their quitting trajectories.
A total of 402 Chinese youth smokers (aged 12-25 years) called a quitline and participated in telephone follow-ups at 1 week, 1 month, and 3 and 6 months after initial telephone counseling. Finite mixture modeling was employed to examine the quitting trajectories by the SAS Proc Traj group-based modeling procedure. Hierarchical multinomial logistic regression was used to compare the baseline intention to quit smoking, prosmoking attitudes, social influences, self-efficacy to quit, smoking profile, quitting history, and demographic characteristics among the trajectory groups.
Three distinct quitting trajectory groups were identified: quitters, reducers, and persistent smokers. Both quitters and reducers dramatically reduced the level of their cigarette consumption immediately after initial counseling. Youth smokers who were intended to quit at baseline, perceived confidence to quit, and perceived importance of quitting were more likely to have successfully quit smoking at six-month follow-up. Those who had prosmoking attitudes were less likely to quit smoking. Conclusion: The findings reveal the profiles of youth smokers who can quit successfully and can guide the development of better and relevant interventions based on the psychosocial characteristics of youth smokers. Short-term goals such as an abrupt quit attempt or immediately reducing cigarette consumption by half may be the key to help youth smokers quit successfully.
This paper presents a retrospective study to classify patients into subtypes of the treatment according to baseline and longitudinally observed values considering heterogenity in migraine prognosis. In the classical prospective clinical studies, participants are classified with respect to baseline status and followed within a certain time period. However, latent growth mixture model is the most suitable method, which considers the population heterogenity and is not affected drop-outs if they are missing at random. Hence, we planned this comprehensive study to identify prognostic factors in migraine.
The study data have been based on a 10-year computer-based follow-up data of Mersin University Headache Outpatient Department. The developmental trajectories within subgroups were described for the severity, frequency, and duration of headache separately and the probabilities of each subgroup were estimated by using latent growth mixture models. SAS PROC TRAJ procedures, semiparametric and group-based mixture modeling approach, were applied to define the developmental trajectories.
While the three-group model for the severity (mild, moderate, severe) and frequency (low, medium, high) of headache appeared to be appropriate, the four-group model for the duration (low, medium, high, extremely high) was more suitable. The severity of headache increased in the patients with nausea, vomiting, photophobia and phonophobia. The frequency of headache was especially related with increasing age and unilateral pain. Nausea and photophobia were also related with headache duration.
Nausea, vomiting and photophobia were the most significant factors to identify developmental trajectories. The remission time was not the same for the severity, frequency, and duration of headache.
The role of neighborhood and school environments in adolescent development has been explored over the years, yet few have examined these relationships with an American Indian sample. The purpose of this study was to explore the role of American Indian adolescents' sense of safety in their neighborhood and school environments and how this relates to their experience of depressive symptoms and alcohol/marijuana use. The data were drawn from a southwestern state's dataset containing survey results of adolescent well-being. Responses from a total of 148 American Indian 8th, 10th, and 12th grade students were analyzed. The findings indicated that neighborhood safety, especially the presence of crime and drug sales, was the strongest predictor of depressive symptoms and alcohol/marijuana use. Implications for future research and work with this population are discussed.
Poor mental health among American Indian adolescents has been a matter of significant concern for the past two decades. This study extends the literature on acculturation within this population by investigating the relationship between hopelessness, levels of acculturation, and residence among American Indian adolescents. Utilizing data drawn from 438 adolescents across 67 American Indian tribes, our analyses show that American Indian adolescents who have bicultural competence (i.e., those who are adept in both Indian and White cultures) have significantly less hopelessness than do those with adeptness in only one culture or in neither culture. Our findings also show a significant difference by residence, with American Indians who live on reservations indicating less hopelessness than those living in urban or rural/nonreservation areas. Analysis of interaction effects suggests that the beneficial effect of adeptness in White culture is particularly true for American Indians living in urban areas.
The current study sought to identify classes of growth trajectories of adolescent alcohol use and to examine the predictors and outcomes associated with the classes. Alcohol use was assessed from Grades 7 to 12 in a school-based sample. Latent growth mixture modeling was used, and results indicated 5 discrete longitudinal drinking patterns. The 2 most common drinking patterns included occasional very light drinking from Grades 7 to 12 and moderate escalation in both quantity and frequency of alcohol use. One group drank infrequently but at high levels throughout the study period. Another group exhibited rapid escalation in both quantity and frequency. The final group started at high levels of frequency and quantity in Grade 7 and showed rapid de-escalation in frequency. Emotional distress and risk taking distinguished the classes, and all classes, particularly rapid escalators, showed elevated levels of alcohol-related problems relative to occasional very light drinkers.
We examined individual mental health problems (depression, conduct disorder, and substance abuse) and social environment (family, peer, and neighborhood) factors associated with the sexual risk behaviors of male and female adolescents. Interviews with 778 adolescents, aged 14 to 18, showed that both mental health problems and social environment were related to adolescents' involvement in sexual risk behaviors. Conduct disorder symptoms, substance abuse or dependence symptoms, and the interaction between peer misbehavior and neighborhood problems were significantly associated with risky sexual behaviors. Peer misbehavior was a particularly strong factor related to sexual risk behaviors for youths who lived in neighborhoods with multiple problems. The only gender differences were found in age, with older males more likely to report engaging in high risk sexual behaviors. This study suggests the utility of multidimensional intervention strategies to deal with various adolescent problem behaviors, including risky sexual behaviors, within the context of their social environment.
This article introduces a new SAS procedure written by the authors that analyzes longitudinal data (developmental trajectories) by fitting a mixture model. The TRAJ procedure fits semiparametric (discrete) mixtures of censored normal, Poisson, zero-inflated Poisson, and Bernoulli distributions to longitudinal data. Applications to psychometric scale data, offense counts, and a dichotomous prevalence measure in violence research are illustrated. In addition, the use of the Bayesian information criterion to address the problem of model selection, including the estimation of the number of components in the mixture, is demonstrated.
The psychometric characteristics of the Center for Epidemiologic Studies Depression Scale (CES–D) were investigated with American Indian boarding school students (
N = 188; Grades 9–12). The CES–D showed good internal consistency (α = .82). Its dimensional structure was different from that described for adults, both Indian and non-Indian. Of the Indian students, 58% were classified as depressed, using the standard cutoff score of 16 or more, consistent with past studies of this age group. Alternative scoring methods were considered, based on persistence of symptoms as well as derived Diagnostic and Statistical Manual of Mental Disorders (DSM-III) and Research Diagnostic Criteria algorithms. Major gender differences were observed in the prevalence of reported symptoms as well as patterns of endorsement for certain CES–D items. The CES–D should be used with caution with American Indian adolescents, given the observed variation in its dimensional structure and uncertainty regarding appropriate cutoff scores. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
A developmental trajectory describes the course of a behavior over age or time. A group-based method for identifying distinctive groups of individual trajectories within the population and for profiling the characteristics of group members is demonstrated. Such clusters might include groups of "increasers," "decreasers," and "no changers." Suitably defined probability distributions are used to handle 3 data types—count, binary, and psychometric scale data. Four capabilities are demonstrated: (a) the capability to identify rather than assume distinctive groups of trajectories, (b) the capability to estimate the proportion of the population following each such trajectory group, (c) the capability to relate group membership probability to individual characteristics and circumstances, and (d) the capability to use the group membership probabilities for various other purposes such as creating profiles of group members. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Using longitudinal data from a sample of 236 young adults and their romantic partners, we tested a life-course model that integrates social control and peer influence arguments with the idea of assortative mating. For both males and females, adolescent delinquency and affiliation with deviant peers predicted having an antisocial romantic partner as a young adult. Involvement with an antisocial romantic partner, in turn, had both a direct effect on crime as well as indirect influence through adult peer affiliations. For females, quality of the romantic relationship also predicted crime. The analyses revealed several moderating influences in addition to these mediating effects. For females, a conventional romantic partner, strong job attachment, and conventional adult friends all served to moderate the chances that a woman with a delinquent history would graduate to adult crime. In contrast, only conventional adult friends served this function for males.
This study uses structural equation models to describe how objective neighborhood, perceived neighborhood, and environmental support predict mental health; 792 adolescents responded to highly structured interviews. The effect of objective environment on mental health was mediated through its influence on perceived neighborhood. Environmental support mitigated negative perceptions of environment and the effect of perceived environment on mental health, while exposure to violence augmented the negative effect of perceived environment.
We illustrate the addictions and mental health service use of American Indian adolescents. Interviews concerning mental health need and service configurations with 401 Southwestern American Indian (AI) youth used questions from the Diagnostic Interview Schedule (DIS) and the Service Assessment for Children and Adolescents (SACA). Seventy-nine percent had mental health or addiction problems, with half meeting criteria for at least one diagnosis. One in 4 youth met criteria for drug dependence'abuse or conduct disorder, 1 in 5 for depression, and 1 in 8 for alcohol dependence'abuse. Most youth were helped by a combination of providers. Youth meeting more diagnostic criteria were increasingly likely to use service configurations with adults, nonspecialist professionals, and specialists, respectively. Regardless of disorder, youth were least likely to use configurations with traditional healers or specialists and there was little difference in rates of use between the two. The lack of services from specialist providers was potentially offset by use of an extensive range of informal adults, nonspecialist professionals, and peers. Since informal helpers, peers, and nonspecialist providers, but not specialists, are providing the bulk of services they must be given support and skills so they can function effectively.
The study of desistance from crime is hampered by definitional, measurement, and theoretical incoherence. A unifying framework can distinguish termination of offending from the process of desistance. Termination is the point when criminal activity stops and desistance is the underlying causal process. A small number of factors are sturdy correlates of desistance (e.g., good marriages, stable work, transformation of identity, and aging). The processes of desistance from crime and other forms of problem behavior appear to be similar. Several theoretical frameworks can be employed to explain the process of desistance, including maturation and aging, developmental, life-course, rational choice, and social learning theories. A life-course perspective provides the most compelling framework, and it can be used to identify institutional sources of desistance and the dynamic social processes inherent in stopping crime. Sociology
This article explores how personal and environmental variables influence change in human immunodeficiency virus (HIV)-related risk behaviors between adolescence and young adulthood. Repeated interviews with 602 youths from 10 cities across the United States provide the data. These interviews first occurred in 1984-1985 and 1985-1986 when the youths were adolescents and were repeated again in 1989-1990 and 1991-1992 when they were all young adults. A longitudinal multivariate analysis shows that 31% of the variance in HIV risk behaviors by inner-city young adults is predicted by a combination of adolescent risk behaviors, personal variables (suicidality, substance misuse, antisocial behavior), environmental variables (history of child abuse, poor relations with parents, stressful events, peer misbehavior, number of AIDS prevention messages), and interactions between variables (number of neighborhood murders with child abuse, number of neighborhood murders with substance misuse, and unemployment rates with antisocial behavior).
We have analysed data from a longitudinal representative study to explore aggregate and individual level changes in alcohol use from late adolescence to early adulthood. The sample, which consisted of 2000 Norwegians, was assessed at ages 19-22, 21-24 and 25-28 years. Only a bare majority of the respondents reduced their alcohol intake during the course of the study, whereas a substantial proportion showed an increase. The initial drinking level in individuals whose consumption declined was quite high, and the opposite was true for those who increased their consumption. The findings seemed to reflect true changes, implying that they only could be attributed to measurement errors to a limited extent. The stability in absolute alcohol intake was rather low, especially at the very high consumption levels. However, the respondents clearly tended to maintain their relative drinking position over time. Furthermore, the very high consumers were actually somewhat more apt than others to hold their position relative to the group. In contrast to previous research, these results thus suggest that there is a substantial stability in alcohol use over time. This in turn underscores the importance of implementing preventive programmes targeted towards factors that promote heavy drinking in adolescents.
This study examined prevalence of psychiatric disorders, social and family risk factors for disorders, and met and unmet needs for mental health care among Appalachian youth.
All 9-, 11-, and 13-year-old American Indian children in an 11-county area of the southern Appalachians were recruited, together with a representative sample of the surrounding population of White children.
Three-month prevalences of psychiatric disorders were similar (American Indian, 16.7%; White, 19.2%). Substance use was more common in American Indian children (9.0% vs 3.8% in White children), as was comorbidity of substance use and psychiatric disorder (2.5% vs 0.9%). American Indian poverty, family adversity (e.g., parental unemployment, welfare dependency), and family deviance (parental violence, substance abuse, and crime) rates were higher, but the rate of family mental illness, excluding substance abuse, was lower. Child psychiatric disorder and mental health service use were associated with family mental illness in both ethnic groups but were associated with poverty and family deviance only in White children. Despite lower financial barriers, American Indian children used fewer mental health services.
This study suggests that poverty and crime play different roles in different communities in the etiology of child psychiatric disorder.
Objective: The purpose of this study was to investigate longitudinal trajectories of heavy drinking for males and females from adolescence to young adulthood, across the age span of 16-25 years, and to identify prospective predictors of the trajectory groups identified. Method: This study used semiparametric group-based mixture modeling to derive adolescent to young adult longitudinal trajectories of heavy drinking separately for 760 participants (430 females and 330 males) who have been participating in a long-term prospective study of risk factors for the development of heavy drinking and alcohol disorders. Results: Four trajectory groups were identified for males and five for females; the trajectories indicated both continuity and change in heavy drinking across time for the trajectory groups identified. Major common prospective predictors for the high and very high heavy drinking trajectory groups supported the influences of values and beliefs (e.g., religious commitment), stressful life events and substance use. Additional predictors for males included lower academic functioning and task orientation, and for females, more frequent sexual behavior and general deviance. Conclusions: In this predominantly white, middle-class sample, we identified groups of frequent, heavy drinking teens during the middle-adolescent years. Our findings suggest that the frequency of heavy drinking behavior will further increase for some teens into their young adult years. The potential adverse consequences of heavy drinking among adolescents and young adults suggests that multitargeted, gender-specific, early interventions with these high-risk teens is important.
Objective.
—To assess risk behaviors, health problems, worries and concerns, and resiliency-promoting factors among American Indian—Alaska Native adolescents.Design.
—Survey.Setting.
—Nonurban schools from eight Indian Health Service areas.Participants.
—A total of 13454 seventh- through 12th-grade American Indian— Alaska Native youths.Main Outcome Measures.
—A revised version of the Adolescent Health Survey, a comprehensive, anonymous, self-report questionnaire with 162 items addressing 10 dimensions of health.Results.
—Poor physical health was reported by 2% of the study sample and was significantly correlated with social risk factors of physical and/or sexual abuse, suicide attempts, substance abuse, poor school performance, and nutritional inadequacies. Injury risk behaviors included never wearing seatbelts (44%), drinking and driving (37.9% of driving 10th through 12th graders), and riding with a driver who had been drinking (21.8%). Physical and sexual abuse prevalence was 10% and 13%, respectively, with 23.9% of females reporting physical abuse and 21.6% of females reporting sexual abuse by the 12th grade. Almost 6% of the entire sample endorsed signs of severe emotional distress. Eleven percent of the teens surveyed knew someone who had killed himself or herself, and 17% had attempted suicide themselves. Sixty-five percent of males and 56.8% of females reported having had intercourse by the 12th grade. Weekly or more frequent alcohol use rose from 8.2% of seventh graders to 14.1% by the 12th grade; for males, the survey noted an increase in regular alcohol use of 3% to 5% a year to 27.3% by the 12th grade. For each variable measured, rates are much higher for American Indian adolescents than those for rural white Minnesota youth, except for age at first intercourse and alcohol use.Conclusions.
—American Indian—Alaska Native adolescents reported high rates of health-compromising behaviors and risk factors related to unintentional injury, substance use, poor self-assessed health status, emotional distress, and suicide. Interventions must be culturally sensitive, acknowledge the heterogeneity of Indian populations, be grounded in cultural traditions that promote health, and be developed with full participation of the involved communities.(JAMA. 1992;267:1637-1644)
This paper presents the results of a two year follow-up of a community sample of boys who initially were in grades one, four, or seven (labeled the youngest, middle, and oldest samples, respectively). Initiation in offending was most marked for the youngest sample, escalation in the seriousness of offending was prominent for the middle and oldest samples, while de-escalation was most prevalent in the oldest sample. The strength of association between the initial and later seriousness of offending appeared to increase with age. We classified offenders according to their pattern of seriousness of offending over time (called a dynamic classification of offenders). Many variables correlated with this measure, showing a covariation with both increases and decreases in the seriousness of offending over time. We noted major shifts in the correlates of offense seriousness between the three age samples--physical aggression and social withdrawal decreasing in strength, while school problem behaviors, peer deviance, and boys' positive attitude to deviancy increased in magnitude. Several factors were associated with the early initiation of offending (before age twelve), including social withdrawal and depression, positive attitude to problem behavior, association with deviant peers, and family problems. In contrast, the later onset of offending (between ages thirteen and fourteen), among other factors, was associated with low school motivation. Correlates of escalation were found for the two older samples but not for the youngest sample, and were particularly prominent in the area of school functioning, disruptive behaviors, positive attitude to deviant behavior, and some aspects of family functioning. Several variables were associated with desistance in offending, including low social withdrawal, low disruptive behavior, and positive motivational and attitudinal factors. The correlates of initiation were distinct from the processes explaining escalation, but were similar to the correlates of desistance. Finally, the paper discusses the relevance of the findings for preventive interventions.
This article demonstrates a multivariate latent growth curve methodology (LGM) for analyzing longitudinal adolescent substance use data. Hypotheses concerning the form of growth in substance use, individual differences in the common trajectory over time, and covariates influencing growth were tested. Significant linear increases existed for alcohol, cigarette, and marijuana use. Second‐order multivariate extensions of LGM indicated that associations among the individual differences parameters of the various substances could be adequately modeled by a higher order substance use construct. Family status, parent‐child conflict, peer encouragement for substance use, parent substance use, and age significantly influenced initial levels of use. Peer encouragement, change in peer encouragement, change in parent‐child conflict, age, and gender significantly influenced development of use. These findings support the influence of families and peers on the development of adolescent substance use and demonstrate the utility of multivariate extensions of LGM in the analysis of longitudinal data.
We analyze month-to-month variations in offending and life circumstances of convicted felons to understand change in criminal behavior. We extend previous applications of social control theory by considering whether local life circumstances that strengthen or weaken social bonds influence offending over relatively short periods of time. We seek to determine whether formal and informal mechanisms of social control affect the likelihood of committing nine major felonies. We employ a hierarchical linear model that provides a within-individual analysis as we explore factors that determine the pattern of offending. The results suggest that meaningful short-term change in involvement in crime is strongly related to variation in local life circumstances.
One of the few facts agreed on in criminology is the age distribution of crime. This fact has been used to criticize social theories of crime causation, to provide the foundation for other theories, to justify recent emphases on career criminals, and to support claims of superiority for longitudinal designs in criminological research. In the present paper, we argue that the age distribution of crime is sufficiently invariant over a broad range of social conditions that these uses of the age distribution are not justified by available evidence.
This article reviews questions about different categories of criminal careers, summarizes Poisson latent class regression models, describes procedures for evaluating the optimal number of latent classes, and applies this methodology to data from male cohorts taken from the cities of London, Philadelphia, and Racine. Four latent classes of offending careers is an appropriate number for the London cohort, but five classes can be justified for the Philadelphia data. In the case of the Racine cohorts, five classes may be detected for the 1942 and 1955 cohorts but only four for the 1949 cohort. Despite the varying numbers of latent offending classes, there clearly is a small number of typical age patterns.
Compared predictors of participation in offending, of early (aged 10–23 yrs) vs later (aged 14–20 yrs) initiation of offending, and of persistence vs desistance of offending in adulthood (aged 21–32 yrs). Periodic interviews were conducted with 411 males, beginning in 1961. Early involvement in antisocial behavior was the strongest predictor of convictions. The strongest predictors of early conviction (EC) were low parental involvement (LPI), troublesomeness, authoritarian parents, poor psychomotor skills, and noncriminal parents. Interactions with antisocial others (AOs) were not positively related to EC. LPI, low commitment to school, and low verbal IQ (all measured before adolescence) were predictive of persistence in offending in Ss aged 21–32 yrs. Ss who initiated delinquent behaviors early appeared less influenced by AOs than those who did so in mid-adolescence. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The Columbia Impairment Scale (CIS) is a 13-item scale that can be administered by a lay interviewer to provide a global measure of impairment. The 13 items tap 4 major areas of functioning: interpersonal relations, broad psychopathological domains, functioning in job or schoolwork, and use of leisure time. Items are scored on a spectrum ranging from 0 "no problem" to 4 "a very big problem." The CIS was administered to 182 children (aged 9–17 yrs) during the pilot phase of a multisite methodological study. The CIS score obtained through the parent's interview appears to provide a useful global measure of impairment. Initial findings from this pilot sample show high internal consistency, excellent test–retest reliability, and good validity when correlated with a clinician's score on the Children's Global Assessment Scale and with other measures indicative of impairment. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
We explore a model that examines how personal and environmental variables explain violent behavior by adolescents. Repeated interviews with youths from 1984–1992 from 10 cities across the United States provided the data. These interviews first occurred with 2,787 youths when they were adolescents (1984–85 and 1986–87) and the interviews were repeated on a subsample of 602 youths when they were young adults (1989–90 and 1991–92). Longitudinal multivariate analyses showed that almost a third of the variance in adolescent violent behaviors was predicted by a combination of personal variables (gender, substance misuse) and environmental variables (history of child abuse, stressful events, traumatic events, and city rates of unemployment). Further, almost a third of the variance in change in violent behaviors from year to year was predicted by prior violent behavior and a combination of personal variables (gender, suicidality, and substance misuse) and environmental variables (stressful events).
Using a person-centered developmental approach, we explored how 319 American Indian youth moved to various aspects of HIV risk/protection from adolescence to young adulthood. With two waves of data spanning seven years, we examined multifinality (looking prospectively) and equifinality (looking retrospectively) to identify both normative and less common combinations of risk/protective configurations. These analyses highlighted that a preventive intervention that does not take into account the diversity of risk/protection may be ineffective in addressing the needs of a significant number of young people. Editors’ Strategic Implications: This paper provides examples of several strategies that show promise. The authors applied a developmental, personcentered approach—informed by systems theory—to a longitudinal study of HIV risk in a large sample of Northern Plains American Indian youth/young adults. The
This paper explores the relationship between changes in HIV risk behaviors and physical and sexual abuse. A stratified random sampling procedure selected 602 youths from a sample of 2,787 patients seen consecutively at public health clinics in 10 cities. Face-to-face structured interviews conducted since 1984-85 provide a history of change in risk behavior from adolescence to young adulthood. Univariate and bivariate analyses assessed differences in demographic and number and type of risk behaviors between those experiencing single or multiple types of abuse and those with no abuse history at all. The results show that a history of physical abuse, sexual abuse, or rape is related to engaging in a variety of HIV risk behaviors and to a continuation or increase in the total number of these behaviors between adolescence and young adulthood. This information might help practitioners to both prevent initial involvement in HIV risk behaviors and to prevent continuation of behaviors as youths move into young adulthood.
The Cambridge Study in Delinquent Development is a prospective longitudinal survey of 411 London males followed up from age eight onwards. This paper investigates the official crime rates of these males between the fourteenth birthday and an interview at a median age of 18 years 7 months, according to whether they were at school, in full-time employment, or unemployed. Crime rates were higher during periods of unemployment than during periods of employment . This was particularly true for offences involving material gain, at the younger ages (15–16), for the most delinquent-prone youths, and for youths with lower status jobs. However, there was little difference between crime rates just before leaving school and just afterwards in full-time employment.
This research uses data from the National Longitudinal Survey of Youth (NLSY) to describe and model developmental trajectories across middle childhood. Our sample consists of approximately 1,000 children of NLSY women who were age 6-7 in either 1986 or 1988. Assessments of PIAT math and reading scores and the mother-reported Behavior Problem Index in 1986, 1988, 1990 and 1992 provide data for middle-child trajectories of children age 6-7 in 1986. Assessments in 1988, 1990, 1992 and 1994 provide data for children age 6-7 in 1988. We use the raw-score form of these data to estimate LISREL-based models of the autoregressive structure of these data. As with other samples, average math and reading achievement trajectories are parabolic for NLSY children, with scores increasing at a decreasing rate over this period. Average behavior-problem scores are basically flat. Behind these average shapes is extreme diversity in level, and in some cases, slopes of, individual trajectories, and a pronounced tendency for above average changes between two assessments to be followed by opposed-signed changes in the subsequent period. Estimates from our structural models showed great heterogeneity in the average level of achievement and behavior for all three outcomes and heterogeneous slopes for reading scores as well. Boys but not girls were found to have heterogeneous slopes for math and behavior problems, while girls but not boys showed a significantly higher degree of persistence if shocked off of their long run trajectories.
This paper discusses treatment implications of comorbid psychopathology in the context of American Indian and Alaska Native culture and in the context of the Indian Health Service's Mental Health and Alcohol and Substance Abuse Program Branches. Treatment of comorbidity in this population is a particularly difficult problem due to numerous barriers to treatment and a poorly defined treatment system. As in other clinical populations, these patients are high utilizers of the limited treatment services available, but may not receive the type of treatment they need. After describing the extent of comorbidity in this population, we present an historical perspective of mental illness that provides an Indian's view of why we are where we are today in treating these problems. Next, we discuss Western and traditional treatment implications for comorbidity among adults and adolescents. Finally, we suggest directions for future research in this area.
One hundred American Indian patients with a Psychoactive Substance Use Disorder (PSUD) were studied with special reference to associated psychiatric disorders. This clinical sample was divided into three groups: PSUD only, PSUD plus an Organic Mental Disorder (OMD), and PSUD plus any other psychiatric disorder. OMD diagnoses included primarily Delirium Tremens and Alcoholic Hallucinosis; cases of Alcohol Amnestic Disorder, Alcohol Dementia, and trauma-induced OMD were also encountered. Other psychiatric disorders included primarily Major Depression and Anxiety Disorder, with smaller numbers of Schizophrenia, Conduct, Sexual, and other Disorders. Demographic and clinical characteristics were compared among these three groups. Those with PSUD+OMD tended to be older, male, and have more DSM-III Axis 3 disorders (American Psychiatric Association 1980) as compared to other patients; those with PSUD+other diagnoses tended to be single and younger. Education and occupational status were not related to the three diagnostic groups. The data were also subjected to MANOVA analysis. Even when corrected for sex, types of substance being abused, Axis 3 health status, and other factors, the three diagnostic groups still bore a significant relationship to age. Those with PSUD+Other psychiatric diagnoses besides OMD tended to be youngest. Those with PSUD-only were intermediate by age, while those with PSUD+OMD tended to be the oldest.
To assess risk behaviors, health problems, worries and concerns, and resiliency-promoting factors among American Indian-Alaska Native adolescents.
Survey.
Nonurban schools from eight Indian Health Service areas.
A total of 13,454 seventh- through 12th-grade American Indian-Alaska Native youths.
revised version of the Adolescent Health Survey, a comprehensive, anonymous, self-report questionnaire with 162 items addressing 10 dimensions of health.
Poor physical health was reported by 2% of the study sample and was significantly correlated with social risk factors of physical and/or sexual abuse, suicide attempts, substance abuse, poor school performance, and nutritional inadequacies. Injury risk behaviors included never wearing seatbelts (44%), drinking and driving (37.9% of driving 10th through 12th graders), and riding with a driver who had been drinking (21.8%). Physical and sexual abuse prevalence was 10% and 13%, respectively, with 23.9% of females reporting physical abuse and 21.6% of females reporting sexual abuse by the 12th grade. Almost 6% of the entire sample endorsed signs of severe emotional distress. Eleven percent of the teens surveyed knew someone who had killed himself or herself, and 17% had attempted suicide themselves. Sixty-five percent of males and 56.8% of females reported having had intercourse by the 12th grade. Weekly or more frequent alcohol use rose from 8.2% of seventh graders to 14.1% by the 12th grade; for males, the survey noted an increase in regular alcohol use of 3% to 5% a year to 27.3% by the 12th grade. For each variable measured, rates are much higher for American Indian adolescents than those for rural white Minnesota youth, except for age at first intercourse and alcohol use.
American Indian-Alaska Native adolescents reported high rates of health-compromising behaviors and risk factors related to unintentional injury, substance use, poor self-assessed health status, emotional distress, and suicide. Interventions must be culturally sensitive, acknowledge the heterogeneity of Indian populations, be grounded in cultural traditions that promote health, and be developed with full participation of the involved communities.
This paper explores the extent of change in acquired immunodeficiency syndrome (AIDS) risk level and in the numbers of AIDS-related risk behaviors in 602 inner-city adolescents as they enter young adulthood. Youths' risk level for human immunodeficiency virus (HIV) infection during adolescence was categorized as high (engaging in prostitution, male homosexual or bisexual activity, or injectable drug use or having ulcerative sexually transmitted diseases), moderate (having six or more sex partners in a 1-year period or nonulcerative sexually transmitted diseases), or low (none of the above). Although a proportion at high or moderate risk during adolescence did move to lower risk levels by young adulthood, the overall risk level stayed fairly stable: 45% were at high or moderate risk levels during adolescence, and 35% were at those levels by young adulthood. Then change in the total number of risk behaviors engaged in by the youths was examined. Knowledge about AIDS or HIV infection and its prevention was not associated with any change in risk behavior, nor were the number of sources of information about the epidemic, acquaintance with those who are infected, estimates of personal risk, or exposure to HIV-test counseling. In fact, youths whose risk behaviors increased the most were more likely to know someone who had died of AIDS and to estimate their own risk as high. Most youths reported that they did not use condoms regularly, disliked them, and had little confidence in their protective ability. Changes in preventive strategies and further research on the causes of behavior change are needed.
A theory of cultural identification is presented indicating that identification with different cultures is orthogonal. Instead of cultures being placed at opposite ends of a continuum, cultural identification dimensions are independent of each other, and increasing identification with one culture does not require decreasing identification with another. Studies of Native-American and Mexican-American youth show that: (1) identification with Anglo (White American) culture is related to having Anglo friends and to family acceptance of an Anglo marriage, (2) identification with either the minority or the majority culture is a source of personal and social strength, and (3) this greater strength, however, does not translate automatically into less drug use, because drug use is related to how much the culture that the person identifies with approves or disapproves of drugs.
This paper examines the extent of physical and sexual abuse among runaway youths and the association of that abuse with behavior, mental health, life events, and parental mental health. Of 291 youths who sought shelter at homes for runaway youths, almost half (141) reported a history of physical or sexual abuse. The results emphasize the need that these abused youths and their parents have for mental health services: One in five of the nonabused youths and one in three of the abused youths endorsed parental descriptions reflective of antisocial personality and/or drug problems, and runaways who were abused had a mean level of behavior problems in the clinically significant area. Multivariate analyses demonstrate that the simple existence of physical or sexual abuse impacts on self-esteem and overall behavior problems regardless of other family problems.
The Diagnostic Interview for Children and Adolescents (DICA) is a structured interview for school-age children, patterned after the National Institute of Mental Health Diagnostic Interview Schedule (DIS) and based on the DSM-III criteria. An inter-interview reliability study of the child version (DICA-C) was determined by interviewing 27 psychiatric inpatients, 7 to 17 years of age. Using the kappa statistic for multiple major diagnostic categories, the results demonstrated high reliability. A comparison of the DICA-C diagnoses with the hospital discharge diagnoses for validation of the DICA-C showed that in 81.5% of the cases, the clinicians were in agreement with the DICA-C diagnoses. The DICA-C resulted in more diagnoses per child compared with the hospital discharge diagnoses. The results are discussed in view of the different methods of evaluation. Parent-child agreement based on the DICA-C and DICA-P interview in 84 outpatients. 7 to 17 years of age, and their mothers showed a good to moderate agreement in most DSM-III diagnostic categories. Taken together, these data suggest that the DICA-C is a reliable and valid instrument for either clinical or research purposes.
To investigate the 4-year course of behavioral and emotional problems from adolescence into young adulthood in a general population sample.
The population consisted of 364 individuals, aged 15 to 18 years at the beginning of the study. Subjects filled out the Youth Self-Report at the first time of assessment. At follow-up, 2 and 4 years later, subjects aged 19 or older completed the Young Adult Self-Report, which was derived from the Youth Self-Report.
Almost 40% of the adolescents who were classified as deviant initially were still deviant 4 years later. There was no significant difference in the continuity of internalizing problems versus externalizing problems in this sample.
All types of problems tended to persist to a similar degree. This holds also for problems that are often regarded as typical childhood problems, such as attention problems and hyperactivity. Because adolescent problems are likely to continue, we need more knowledge on the efficacy of interventions.
This study examined the patterns and correlates of alcohol use in a Native American boarding school. Specifically, stressful life events, social support and emotional distress were associated with quantity as well as frequency of alcohol use in this population. A sample of 188 students (52% female) in grades 9-12 attending a boarding school in the midwest were administered self-report measures of these above constructs as part of a larger battery. Family support, and to some degree stressful life events and emotional distress, correlated significantly with alcohol use. The implications of these findings for Native American adolescents in general, and in a boarding school population specifically, are discussed. The need for longitudinal research to explore further the temporal sequence of depression, stressful life events and social support in relation to alcohol use is addressed.
Although the religious and spiritual dimensions of life are among the most important cultural factors structuring human experience, behavior, and illness patterns, mainstream psychiatry has tended either to ignore or pathologize the religious and spiritual issues that clients bring into treatment. To redress this lack of sensitivity, the authors of this article propose a new diagnostic category to the DSM-IV Task Force entitled "Religious or Spiritual Problem" (V62.61). It is hoped that the acceptance of this category will increase the accuracy of diagnostic assessments, reduce iatrogenic harm from misdiagnosis, and increase mental health professionals' respect for individual beliefs and values.
This study examines factors potentially associated with the receipt of alcohol treatment services among a large sample of American Indian adolescents.
Data for this study were drawn from the Voices of Indian Teens project, a 5-year, longitudinal project involving school-based survey data collection at 10 primarily American Indian schools. In November 1992 a total of 2,077 American Indian youths in grades 9 through 12 completed self-report surveys. Of these, 1,681 had a complete set of data for these analyses. Three logistic regression models were developed to predict the probability of (1) receipt of treatment, (2) treatment recommendation, and (3) receipt of treatment among those teenagers who received a treatment recommendation.
The probability of an individual receiving treatment was 15 times greater if treatment was recommended. Treatment recommendation mediated the relationship of several measures of psychological distress and alcohol use, abuse, and dependence with actual treatment.
Recommendation for treatment is strongly associated with receiving treatment. Community education about the risks, signs, symptoms, need, and mechanisms for obtaining treatment of alcohol abuse among youths might help alcohol-abusing individuals receive the help they need.
To delineate the degree to which various levels of problematic alcohol use are associated with psychiatric disorders in adolescents.
The lifetime occurrence of psychiatric disorders was examined in a community sample of 1,507 older adolescents (aged 14 through 18 years) who were categorized according to their alcohol use (i.e., abstainers, experimenters, social drinkers, problem drinkers, and abuse/dependence group).
Increased alcohol use was associated with the increased lifetime occurrence of depressive disorders, disruptive behavior disorders, drug use disorders, and daily tobacco use. There was a trend for increased alcohol use in girls to be associated with anxiety disorders. More than 80% of adolescents with alcohol abuse/dependence had some other form of psychopathology. Alcohol disorders, in general, followed rather than preceded the onset of other psychiatric disorders. Comorbidity was associated with an earlier age of alcohol disorder onset and with greater likelihood of mental health treatment utilization.
Rates of psychiatric comorbidity with problematic alcohol use in adolescents are striking and represent an important therapeutic challenge.
The Youth Self-report was administered to 50 institutionalized delinquents between the ages of 14 and 16 years and readministered after 7 days to estimate test-retest reliability; r=.97.
The objective of this pilot study was to determine how Dakotan/Lakotan parents view the Conners Parent Rating Scale (CPRS) and Child Behavior Checklist (CBCL).
Using a focus group methodology, four discussion groups were held in different sites across South Dakota where the CPRS and CBCL were in clinical use.
Only two questions on each form were incomprehensible to these Dakotan/Lakotan parents. Other questions were hard to answer because certain questions contained implicit dominant cultural values that did not take into account Dakotan/Lakotan cultural values or traditions, or the questions were hard to answer because Dakotan/Lakotan believed their responses could or would be misunderstood by members of the dominant culture who did not understand Dakotan/Lakotan style or customs.
The CPRS and CBCL were generally acceptable to Dakotan/Lakotan parents. Clinicians could make several statements to Native parents that would improve cultural acceptability.
The progression of substance use and the patterns of comorbidity of substance use and psychiatric disorders are explored prospectively in young adolescents enrolled in the Great Smoky Mountains Study. This study is an epidemiologic study of white and American Indian youths living in rural Southern Appalachia. Results from this study indicate that alcohol use without permission predicts subsequent use of illicit drugs and regular tobacco use. Use of tobacco was not associated with either later alcohol or drug use. Patterns of comorbidity showed strong cross-sectional relationships between substance use and behavioral disorders, but not emotional disorders. Use of alcohol was also associated with psychiatric diagnosis at a later interview. There were some differences between white and American Indian youths in the pattern of comorbidity of tobacco use and psychiatric disorder and the relationship between prior psychiatric disorder and later alcohol use. These findings suggest that alcohol use without permission may be an important marker for youths who are at risk for illicit drug use and/or psychiatric diagnoses.
This article presents data on the prevalence of psychiatric disorders among American Indian adolescents, using DSM-III-R criteria.
To generate current prevalence data using a structured diagnostic instrument, the Diagnostic Interview Schedule for Children, Version 2.1C (DISC-2.1C).
Youths from a Northern Plains tribe who had participated in an earlier study comprised the sample. At reinterview, respondents were between 14 and 16 years of age, when Indian adolescents are thought to be at particularly high risk for manifesting emotional disorders. One hundred nine of the original sample of 251 were still in schools on the reservation. Trained indigenous lay interviewers administered the DISC-2.1C to respondents in a private setting within the school.
The findings indicate that rates of some psychiatric problems (e.g., disruptive behavior disorders, substance-related disorders, and their comorbidity) are high among these high school students.
These data, as well as national statistics, suggest that, compared with non-Indian populations, a greater percentage of Northern Plains adolescents manifest significant psychiatric symptoms which warrant treatment.
The publication of DSM-IV is notable for the improved coverage of cultural issues in the diagnosis of mental disorders. In particular, Appendix I of DSM-IV includes an "Outline for Cultural Formulation" (Outline) which assists the clinician in evaluating the impact of an individual's cultural context on diagnosis and treatment. However, the capacity of the Outline to facilitate the development of comprehensive cultural formulations for children and adolescents has not been established. In this article the use of the Outline with American Indian children is reviewed critically.
Based on the Outline, cultural case formulations for four American Indian children were developed and their comprehensiveness was assessed.
Applied to the case material, the Outline provided a clear template for the development of cultural formulations. Nonetheless, several gaps in the material required by the Outline were identified, particularly in the areas concerning cultural identity and cultural elements of the therapeutic relationship.
Clinicians working with children should recognize the strengths as well as the limitations of the Outline and expand their cultural descriptions accordingly. Several additions to the text of the Outline that will facilitate the development of comprehensive cultural formulations specific to children and adolescents are proposed.