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Showing papers in "American Journal of Orthopsychiatry in 2011"


Journal ArticleDOI
TL;DR: Because resilience occurs even when risk factors are plentiful, greater emphasis needs to be placed on the role social and physical ecologies play in positive developmental outcomes when individuals encounter significant amounts of stress.
Abstract: More than two decades after E. E. Werner and R. S. Smith (1982), N. Garmezy (1983), and M. Rutter (1987) published their research on protective mechanisms and processes that are most likely to foster resilience, ambiguity continues regarding how to define and operationalize positive development under adversity. This article argues that, because resilience occurs even when risk factors are plentiful, greater emphasis needs to be placed on the role social and physical ecologies play in positive developmental outcomes when individuals encounter significant amounts of stress. Four principles are presented as the basis for an ecological interpretation of the resilience construct: decentrality, complexity, atypicality, and cultural relativity. These 4 principles, and the research upon which they are based, inform a definition of resilience that emphasizes the environmental antecedents of positive growth. This framework can guide future theory development, research, and the design of interventions that promote well-being among populations who experience environments that inhibit resilience-promoting processes.

1,097 citations


Journal ArticleDOI
TL;DR: The frequency of depression was similar for men and women and thought of suicide was higher for men than women, and "Days of exercise per week" was inversely associated with screening positive for depression.
Abstract: Depression and suicide are of increasing concern on college campuses. This article presents data from the College Health Intervention Projects on the frequency of depression and suicide ideation among 1,622 college students who accessed primary care services in 4 university clinics in the Midwest, Northwest, and Canada. Students completed the Beck Depression Inventory and other measures related to exercise patterns, alcohol use, sensation seeking, and violence. The frequency of depression was similar for men (25%) and women (26%). Thought of suicide was higher for men (13%) than women (10%). Tobacco use, emotional abuse, and unwanted sexual encounters were all associated with screening positive for depression. "Days of exercise per week" was inversely associated with screening positive for depression. Because the majority of students access campus-based student health centers, medical providers can serve a key role in early identification and intervention. With every 4th student reporting symptoms of depression and every 10th student having suicidal thoughts, such interventions are needed.

242 citations


Journal ArticleDOI
TL;DR: A 4-part definition of peer interveners is presented here with a consideration of the dimensions of their involvement in health promotion and a 2-step process is proposed as a means of conceptualizing peer interventions to promote health.
Abstract: Peers have intervened to promote health since ancient times, yet few attempts have been made to describe theoretically their role and their interventions. After a brief overview of the history and variety of peer-based health interventions, a 4-part definition of peer interveners is presented here with a consideration of the dimensions of their involvement in health promotion. Then, a 2-step process is proposed as a means of conceptualizing peer interventions to promote health. Step 1 involves establishing a theoretical framework for the intervention’s main focus (i.e., education, social support, social norms, self-efficacy, and patient advocacy), and Step 2 involves identifying a theory that justifies the use of peers and might explain their impact. As examples, the following might be referred to: theoretical perspectives from the mutual support group and self-help literature, social cognitive and social learning theories, the social support literature, social comparison theory, social network approaches, and empowerment models.

188 citations


Journal ArticleDOI
TL;DR: Regression analyses indicated that both neighborhood disorder and community cohesion are related to PTSD symptoms after controlling for trauma exposure, and Community cohesion was found to be a partial mediator of the relationship between neighborhood Disorder and PTSD symptoms.
Abstract: Studies have established a link between contextual factors, such as neighborhood and community environments, and psychopathology. Although these factors have been shown to affect the expression of symptoms of depression and other disorders, little evidence exists of a link between contextual factors and posttraumatic stress disorder (PTSD). The current study tested the relationships among perceived neighborhood disorder (a measure of self-reported perceptions of the physical environment), community cohesion (a measure of perceived social ties), and self-reported PTSD symptoms while controlling for previous trauma exposure in a low-income, urban, African American population. Regression analyses indicated that both neighborhood disorder and community cohesion are related to PTSD symptoms after controlling for trauma exposure. Community cohesion, however, was found to be a partial mediator of the relationship between neighborhood disorder and PTSD symptoms.

128 citations


Journal ArticleDOI
TL;DR: Inclusive altruism born of suffering is examined, which is directed toward members of disadvantaged outgroups, and it is found that prosocial attitudes toward tsunami victims were highest among those who had suffered in a similar way (from natural disasters).
Abstract: This article reports the results of 2 studies examining altruism born of suffering (E. Staub & J. R. Vollhardt, 2008). More specifically, we examined inclusive altruism born of suffering, which is directed toward members of disadvantaged outgroups. Drawing on and integrating clinical and social psychological theories, we hypothesized that individuals who had suffered from adverse life events would be more likely to help the outgroups in need than those who had not suffered. This was demonstrated for helpers who had experienced various forms of suffering (interpersonal and group-based harm, natural disasters) and for 2 distinct types of prosocial behavior and attitudes (long-term volunteering and disaster aid) benefiting outgroups within society and from other countries. We also found that prosocial attitudes toward tsunami victims were highest among those who had suffered in a similar way (from natural disasters). Additionally, we examined the underlying social psychological processes and found that empathy and reduced ingroup bias (but not personal distress) mediated the effect (Study 2). Implications for social justice and an empowering view of victims as potential helpers in society are discussed.

119 citations


Journal ArticleDOI
TL;DR: Investigation of the relationship between various types of social support and suicide among African American adolescents indicated that increased family support and peer support are associated with decreased suicidality, andpeer support and community connectedness moderated the relationshipBetween depressive symptoms and suicIDality.
Abstract: Rates of suicide are increasing among African American adolescents and pose a significant public health concern. One area that has received little attention is the relationship between various types of social support and suicide, and the extent to which support moderates the relationship between depressive symptoms and suicidality. A total of 212 African American adolescents completed in-school surveys on three types of social support: family support, peer support, and community connectedness. The survey also addressed depressive symptoms and suicidality, as measured by reasons for living, a cognitive measure of suicide risk. Hierarchical multiple regression analyses were used to examine direct and moderating relationships between types of social support and suicidality. The results indicated that increased family support and peer support are associated with decreased suicidality, and peer support and community connectedness moderated the relationship between depressive symptoms and suicidality. Over a third of the variability in reasons for living was predicted by family support, peer support, and community connectedness. Implications for research and preventative interventions for African American adolescents are discussed.

115 citations


Journal ArticleDOI
TL;DR: The findings indicate that intervention in social-cognitive mechanisms is important to reduce aggressive behavior in adolescents who have been exposed to violence.
Abstract: The purpose of this study was to determine whether exposure to violence (EV) in several contexts predicts aggressive behavior through social information processing (SIP) in adolescents. Six hundred and fifty adolescents between the ages of 12 and 17 participated in a 3-wave longitudinal study. The participants completed measures of proactive and reactive aggression at all waves, SIP measures at Time 1 and Time 2, and violence exposure at Time 1. It was expected that SIP would mediate the predictive relationship between EV and aggressive behavior. We found that total Time 1 EV predicted Time 3 reactive aggression. The influence of EV on proactive aggression was direct. Slight differences emerged, however, for victimization and witnessing violence. Witnessing was associated with reactive aggression via both hostile attribution and response selection, whereas victimization predicted reactive aggression via hostile attribution only. Results also suggested that the types of exposure that are most relevant for the development of aggressive behavior are community and school violence. Finally, male adolescents experienced more EV than female adolescents in all contexts except in the home. The findings indicate that intervention in social-cognitive mechanisms is important to reduce aggressive behavior in adolescents who have been exposed to violence.

100 citations


Journal ArticleDOI
TL;DR: It is found that discrimination was associated with greater odds of SPD, regardless of attribution, and racial group identification buffered the negative effect of moderate levels of both racially and nonracially attributed discrimination.
Abstract: There is increasing evidence that experiencing discrimination may contribute to poor mental health among Black Americans. However, few studies have distinguished between discrimination attributed to race versus other forms of discrimination or have compared differences in their psychological implications. Using nationally representative data on 5,191 Black Americans in the National Survey of American Life (NSAL; 2001–2003), this study examined serious psychological distress (SPD) in relation to discrimination attributed to racial versus nonracial causes and also investigated whether racial group identification may be a buffer. We found that discrimination was associated with greater odds of SPD, regardless of attribution. Racial attributions were associated with higher odds of SPD compared with attributions to nonracial causes for each level of discrimination. High racial group identification buffered the negative effect of moderate levels of both racially and nonracially attributed discrimination. Our results provide evidence for the negative influence of discrimination on SPD among Black Americans and indicate that high racial group identification may somewhat mitigate their negative mental health effects. Our study suggests that discrimination and racial group identification should be addressed to protect against psychological distress among Black Americans.

99 citations


Journal ArticleDOI
TL;DR: This study explores pregnancy and motherhood in unaccompanied homeless young women over a period of 3 years and finds that almost half (46.4%) of sexually active young women who are homeless had been pregnant at baseline.
Abstract: Pregnancy rates among young women who are homeless are significantly higher than rates among housed young women in the United States (J. M. Greene & C. L. Ringwalt, 1998). Yet, little research has addressed mental health or risk and resilience among young mothers who are homeless. Based on a sample from the Midwest Longitudinal Study of Homeless Adolescents, this study explores pregnancy and motherhood in unaccompanied homeless young women over a period of 3 years. The data are supplemented by in-depth interviews with a subset of young women. Results show that almost half (46.4%) of sexually active young women who are homeless (n=222, M age = 17.2) had been pregnant at baseline. Among those who stated they had children between Waves 2 and 13 (n=90), only half reported caring for their children consistently over time, and one fifth reported never seeing their children. Of the participants with children in their care at the last interview (Wave 13), almost one third met criteria for lifetime major depressive episode, lifetime posttraumatic stress disorder, and lifetime drug abuse, and half met criteria for lifetime antisocial personality disorder. Twelve-month diagnoses are also reported. The impacts of homelessness on maternal and child outcomes are discussed.

88 citations


Journal ArticleDOI
TL;DR: Study findings supported religious socialization and problem-oriented explanations indicating that persons who are heavily invested in religious pursuits and organizations are more likely than their counterparts to use ministerial assistance.
Abstract: This study examined use of ministers for assistance with a serious personal problem within a nationally representative sample of African Americans (National Survey of American Life-2001-2003). Different perspectives on the use of ministers-social stratification, religious socialization, and problem-oriented approach-were proposed and tested using logistic regression analyses with demographic, religious involvement, and problem type factors as predictors. Study findings supported religious socialization and problem-oriented explanations indicating that persons who are heavily invested in religious pursuits and organizations (i.e., women, frequent attenders) are more likely than their counterparts to use ministerial assistance. Contrary to expectations from the social stratification perspective, positive income and education effects indicated that higher status individuals were more likely to report use of ministers. Finally, problems involving bereavement are especially suited for assistance from ministers owing to their inherent nature (e.g., questions of ultimate meaning) and the extensive array of ministerial support and church resources that are available to address the issue.

83 citations


Journal ArticleDOI
TL;DR: The results revealed that ethnic identity exploration was associated with increased psychological distress within the context of discrimination in work, academic, and public settings, and ethnic identity commitment served as a buffer between covert discrimination and mental health.
Abstract: This study sought to examine the moderating effect of ethnic identity exploration and ethnic identity commitment on the various types of discrimination and psychological distress within a sample of Latino adults (N = 397). The results revealed that ethnic identity exploration was associated with increased psychological distress within the context of discrimination in work, academic, and public settings. Ethnic identity commitment, on the other hand, served as a buffer between covert discrimination and mental health. These findings highlight the circumstances in which ethnic identity functioned as a protective and as a risk factor in the psychological distress of Latinos. The implications are discussed within a stress and coping framework and outline directions for future research.

Journal ArticleDOI
TL;DR: Identification of the environmental and demographic factors associated with survival behaviors suggests that there may be value in combining harm-reduction strategies with efforts to reduce the transience of homeless young adults.
Abstract: This study assessed the prevalence and correlates of behaviors used by homeless young people to survive on the streets. Survival behaviors include prostitution, selling blood or plasma, dealing drugs, stealing, and panhandling. One hundred ninety-six homeless young adults from 4 metropolitan areas-Los Angeles, CA (n = 50); Austin, TX (n = 50); Denver, CO (n = 50); and St. Louis, MO (n = 46)-participated in individual, semistructured, face-to-face interviews. Researchers predicted that youth transience would be related to high rates of survival behaviors. Multivariate logistic regression was used to test a model predicting relationships between survival behaviors and transience, employment, substance use, and social support. Young adults who were transient, unemployed, drug-addicted, and reliant on peers for help were more likely to use these survival behaviors. In addition, among the transient subsample, being White, more reliant on peers for help, more transient, and having been victimized were associated with high use of these survival behaviors. Identification of the environmental and demographic factors associated with survival behaviors suggests that there may be value in combining harm-reduction strategies with efforts to reduce the transience of homeless young adults.

Journal ArticleDOI
TL;DR: Older mothers were more likely to be supportive during play at age 14 months, which in turn promoted enhanced developmental outcomes at age 3, and path analyses showed that maternal age had an indirect effect on child cognitive and language abilities at age3 through effects on parenting behaviors.
Abstract: This longitudinal study examined the influence of parenting behaviors, well-being, and risk factors of low-income adolescent mothers on the cognitive and language abilities of children from infancy to age 3. Participants consisted of 1,240 mother-child dyads enrolled in the Early Head Start Research and Evaluation Project. Data were collected using structured interviews with the mothers and from videotaped mother-child interactions during play activities when children were approximately 14 months old and again at 36 months of age. Positive parenting behaviors exhibited toward the 14-month-old children predicted gains in both cognitive and language abilities more so than did maternal well-being, risk factors within the family setting, and demographic risk factors. Gains in cognitive abilities from infancy to age 3 were predicted by supportive parenting, higher family resources, and lower family conflict when children were infants. Gains in language abilities were predicted by supportive parenting, support for language and learning in the home environment, and higher family resources when children were infants. Finally, path analyses showed that maternal age had an indirect effect on child cognitive and language abilities at age 3 through effects on parenting behaviors. Older mothers were more likely to be supportive during play at age 14 months, which in turn promoted enhanced developmental outcomes at age 3. Implications for intervention and future research are discussed.

Journal ArticleDOI
TL;DR: Investigation of dynamic, longitudinal associations between depressive symptoms and marital processes suggested that different domains of marital functioning related to husbands' versus wives' symptoms, and transactional relations between marital satisfaction and depressive symptoms.
Abstract: The present study investigated dynamic, longitudinal associations between depressive symptoms and marital processes. Two hundred and ninety-six couples reported on marital satisfaction, marital conflict, and depressive symptoms annually for 3 years. Observational measures of marital conflict were also collected. Results suggested that different domains of marital functioning related to husbands' versus wives' symptoms. For husbands, transactional relations between marital satisfaction and depressive symptoms were identified: High levels of depressive symptoms predicted subsequent decreases in marital satisfaction, and decreased marital satisfaction predicted subsequent elevations in depressive symptoms over time. For wives, high levels of marital conflict predicted subsequent elevations in depressive symptoms over time. Cross-partner results indicated that husbands' depressive symptoms were also related to subsequent declines in wives' marital satisfaction. Results are discussed with regard to theoretical perspectives on the marital functioning-depression link and directions for future research are outlined.

Journal ArticleDOI
TL;DR: Community resilience activities were assessed in workplace teams that became first responders for Hurricane Katrina survivors and were characterized by: shared organizational identity, purpose, and values; mutual support and trust; role flexibility; active problem solving; self-reflection; shared leadership; and skill building.
Abstract: Community resilience activities were assessed in workplace teams that became first responders for Hurricane Katrina survivors. Community resilience was assessed by a survey, focus groups, and key informant interviews. On the survey, 90 first responders ranked their team's disaster response performance as high on community resilience activities. The same participants, interviewed in 11 focus groups and 3 key informant interviews, discussed how their teams engaged in community resilience activities to strengthen their ability to deliver services. Specifically, their resilient behaviors were characterized by: shared organizational identity, purpose, and values; mutual support and trust; role flexibility; active problem solving; self-reflection; shared leadership; and skill building. The implications for research, policy, practice, and education of professionals are discussed.

Journal ArticleDOI
TL;DR: The ways in which everyday settings such as neighborhoods and the schools that exist within them can foster support for human rights can be examined, focusing on the everyday experiences and neighborhood niches for the development of participatory human rights.
Abstract: The last 6 decades of empirical research on civic engagement among young people living in democracies and of the recognition of international human rights have seen the achievement of many milestones. This article focuses on some connections between these 2 areas and examines the ways in which everyday settings such as neighborhoods and the schools that exist within them can foster support for human rights (especially the practice of participatory rights) among adolescents. Secondary analysis of the International Association for the Evaluation of Educational Achievement Civic Education (CIVED) Study (data collected in 1999 from nationally representative samples of 14-year-olds in 28 countries) is presented. A cluster analysis of 12 attitudinal scales in 5 countries sharing the Western European tradition (Australia, England, Finland, Sweden, and the United States) is presented. A new conceptual model is also introduced, a modification of Super and Harkness's Developmental Niche. This model frames an analysis unpacking some findings from the CIVED Study and focusing on the everyday experiences and neighborhood niches for the development of participatory human rights. The larger message is that research on social justice attitudes among young people is a valuable form of social advocacy and action.

Journal ArticleDOI
TL;DR: Between the early 1990s and the present, more serious problems such as suicide and depression have receded in some data sets, whereas feeling overwhelmed and reporting psychosomatic complaints have continued to increase.
Abstract: Almost all of the available evidence suggests a sharp rise in anxiety, depression, and mental health issues among Western youth between the early 20th century and the early 1990s. Between the early 1990s and the present, more serious problems such as suicide and depression have receded in some data sets, whereas feeling overwhelmed and reporting psychosomatic complaints have continued to increase. Other indicators, such as anxiety, have remained at historically high levels but not continued to increase. This mixed pattern of results may be rooted in the increasing use of antidepressants and therapy and the improvement in some cultural indicators. However, the incidence of youth mental health problems remains unacceptably high.

Journal ArticleDOI
TL;DR: While racism-related stress, acculturative stress, and bicultural self-efficacy were significant predictors of mental health in the total sample analyses, the generational analyses revealed a differential predictive pattern across generational status.
Abstract: In this study, we employed structural equation modeling to test the degree to which racism-related stress, acculturative stress, and bicultural self-efficacy were predictive of mental health in a predominantly community-based sample of 367 Asian American adults. We also tested whether bicultural self-efficacy moderated the relationship between acculturative stress and mental health. Finally, we examined whether generational status moderated the impact of racial and cultural predictors of mental health by testing our model across immigrant and U.S.-born samples. Results indicated that our hypothesized structural model represented a good fit to the total sample data. While racism-related stress, acculturative stress, and bicultural self-efficacy were significant predictors of mental health in the total sample analyses, our generational analyses revealed a differential predictive pattern across generational status. Finally, we found that the buffering effect of bicultural self-efficacy on the relationship between acculturative stress and mental health was significant for U.S.-born individuals only. Implications for research and service delivery are explored.

Journal ArticleDOI
TL;DR: The results highlight the need for clinicians to consider risk for intimate partner violence in coparenting relationships when planning family-oriented intervention designed to meet the needs of fathers, mothers, and children affected by chronic drug abuse.
Abstract: Because very little is known about the coparenting relationships of drug-abusing men, this comparative study was designed to examine the lifetime prevalence and recent frequency of intimate partner violence in the coparenting relationships of 106 fathers enrolled in methadone maintenance treatment. When compared with 118 community controls, the opioid-dependent fathers reported greater prevalence of physical, sexual, and psychological aggression directed at the mother of their youngest biological child over the course of the relationship. They also reported more frequent physical, sexual, and psychological aggression directed at the mother during the previous year. Similarly, the opioid-dependent fathers reported both greater prevalence of physical and sexual aggression directed at them by the mother of their youngest child over the course of the relationship and more frequent sexual aggression directed at them over the previous year. The results highlight the need for clinicians to consider risk for intimate partner violence in coparenting relationships when planning family-oriented intervention designed to meet the needs of fathers, mothers, and children affected by chronic drug abuse.

Journal ArticleDOI
TL;DR: It is suggested that agentic personality characteristics and coping are important in decreasing and/or protecting against anxiety, in part because of how they relate to forms of coping, and the need for more research is suggested.
Abstract: Anxiety and its disorders, often present before adulthood, have high personal and societal costs for men and women. This study tested a mediation model in which 3 forms of coping mediate the relation of 3 agentic personality characteristics (i.e., traits associated with the belief that people can effectively exercise control over their lives) to lower levels of anxiety within 1 subgroup of young adults (i.e., college students). The agentic personality characteristics were (a) hardiness, (b) personal growth initiative, and (c) coping self-efficacy. The forms of dispositional coping were (a) problem-focused, (b) emotion-focused, and (c) avoidant. Results suggest that agentic personality characteristics differentially relate to forms of coping and trait anxiety. In addition, coping appears to fully mediate the relations of the personality characteristics to anxiety. The results imply that agentic personality characteristics and coping are important in decreasing and/or protecting against anxiety, in part because of how they relate to forms of coping, and suggest the need for more research.

Journal ArticleDOI
TL;DR: Findings suggest that the differential impact of type of violence exposure and its sequela based on gender should be considered when addressing low school engagement among African American youth.
Abstract: This study examines whether the relationship between violence exposure and school engagement is mediated by psychological problem behaviors and whether such relationships are gendered. Five hundred and sixty-three high school African American adolescents (ages 13-19 years) completed questionnaires that assessed two types of violence exposure (community violence and marital conflict), psychological problem behaviors (e.g., posttraumatic stress disorder symptoms, anxiety, withdrawal, and aggressive behaviors), and school engagement (i.e., student-teacher connectedness and grade point average [GPA] obtained from school records). For male adolescents, psychological problem behaviors collectively mediated the relationship between community violence exposure and student-teacher connectedness. For female adolescents, both community violence and marital conflict exposure were negatively related to both GPA and student-teacher connectedness via aggressive behavior. Findings suggest that the differential impact of type of violence exposure and its sequela based on gender should be considered when addressing low school engagement among African American youth.

Journal ArticleDOI
TL;DR: It is highlighted that an appreciation of caregivers' own consternation and information about how best to handle the (uncooperative) behavior of the patient should be taken into account in psychoeducational groups as well as in the daily work routine of professionals.
Abstract: Thirty-two problem-oriented interviews with caregivers of patients with bipolar affective disorders were analyzed using content analysis. The 722 statements of caregivers about their experiences of subjective burden because of the illness of their family members were summarized in 49 global statements and correlated by factor analysis to 10 types of burden. In particular, patients' noncompliance as well as the helplessness of the caregivers in interaction with the (changing) depressive and manic symptoms of the ill family members emerged as serious burdens on the caregivers. Whereas female caregivers suffered more from problems regarding quality of relationship with the patient, male caregivers experienced more constraints on their own autonomy, uncertainty concerning their judgment of patients' capacity, and uncertainty because of the changing symptoms of illness. The findings of this study highlight that an appreciation of caregivers' own consternation and information about how best to handle the (uncooperative) behavior of the patient should be taken into account in psychoeducational groups as well as in the daily work routine of professionals.

Journal ArticleDOI
TL;DR: An analysis of the mental health, substance abuse, juvenile justice, and criminal justice system involvement of youth who have aged out of child welfare using administrative data from a large birth cohort of individuals born between 1985 and 1994.
Abstract: Although research on youth aging out of the child welfare system has increased, there has been limited focus on how their experiences vary. In particular, there is a need to examine patterns in the involvement of these youth in other systems, which indicate constellations of challenges facing these young people as they transition out of care and into adulthood. Using administrative data from a large birth cohort of individuals born between 1985 and 1994 whose families have been involved in the child welfare system, this article presents an analysis of the mental health, substance abuse, juvenile justice, and criminal justice system involvement of youth who have aged out of child welfare. Using a 2-step cluster analysis, we identify 5 subgroups of youth. Two of these groups, accounting for almost half of the youth, have little other system involvement and have child welfare care careers of relative stability. The other 3 groups, consisting of just over half of the youth, have much more extensive other system involvement, as well as care careers marked by instability and a greater proportion of time spent in congregate care.

Journal ArticleDOI
TL;DR: Results of intent-to-treat analyses indicated that the Bringing Baby Home program was successful in promoting less competition during family play, suggesting that fathers who took the workshop prebirth were less likely to exhibit intrusiveness during mother-baby focused play than those who received it postbirth.
Abstract: The transition to parenthood brings with it challenges to a couple's relationship, which in turn are likely to negatively impact coparenting and overall family process. The focus of the current study was to examine the effects of the Bringing Baby Home psycho-educational intervention at the first postintervention follow-up for promoting positive coparenting and family process within the mother-father-baby family system. Expectant parents (N = 181) were recruited from the greater Seattle area to participate in a longitudinal random clinical trials study. Families were randomly assigned to a control, workshop, or workshop plus support group. Observational coding indexed both parent and baby contribution to family interaction during the Lausanne Triadic Play procedure. Principal components analysis was used to create summary factors describing the family play. Results of intent-to-treat analyses indicated that the Bringing Baby Home program was successful in promoting less competition during family play. There also was an effect of workshop timing, suggesting that fathers who took the workshop prebirth were less likely to exhibit intrusiveness during mother-baby focused play than those who received it postbirth. Implications for promoting the formation of positive family-level relations are discussed.

Journal ArticleDOI
TL;DR: Support was found for the hypothesis that alexithymic symptoms mediate the direct effect of poor relational health on psychological distress and the importance of assessing relational health and tailoring counseling interventions for people with low relational health.
Abstract: Relational health refers to interpersonal interactions that are growth-fostering or mutually empathic and empowering. Poor relational health increases an individual's risk for developing psychological distress. Alexithymia is the inability to recognize and express one's own internal emotional experience. In this study, the associations of relational health, psychological distress, and alexithymia were examined by surveying 197 female undergraduate psychology students. Support was found for the hypothesis that alexithymic symptoms mediate the direct effect of poor relational health on psychological distress. The importance of assessing relational health and tailoring counseling interventions for people with low relational health and alexithymic symptoms is discussed.

Journal ArticleDOI
TL;DR: Regression analyses revealed that goal-striving stress was associated with decreased psychological well-being, controlling for demographics and various psychosocial factors.
Abstract: The present study examined the relationship between goal-striving stress and well-being in a survey of 399 college-educated Black American men who were members of a Black fraternal organization. Regression analyses revealed that goal-striving stress was associated with decreased psychological well-being, controlling for demographics and various psychosocial factors. When asked to explain their failure to reach life goals, half of the men attributed setbacks to racial discrimination. The association of goal-striving stress with diminished well-being was stronger among those who did not attribute setbacks to race than among those who did. These findings suggest that even with material success, Black men face blocked opportunities that could be consequential to their well-being.

Journal ArticleDOI
TL;DR: The current article describes the adaptations to the traditional collaborative care model that were necessitated by patient characteristics and the clinic environment.
Abstract: Low-income, uninsured immigrants are burdened by poverty and a high prevalence of trauma exposure and thus are vulnerable to mental health problems. Disparities in access to mental health services highlight the importance of adapting evidence-based interventions in primary care settings that serve this population. In 2005, the Montgomery Cares Behavioral Health Program began adapting and implementing a collaborative care model for the treatment of depression and anxiety disorders in a network of primary care clinics that serve low-income, uninsured residents of Montgomery County, Maryland, the majority of whom are immigrants. In its 6th year now, the program has generated much needed knowledge about the adaptation of this evidence-based model. The current article describes the adaptations to the traditional collaborative care model that were necessitated by patient characteristics and the clinic environment.

Journal ArticleDOI
TL;DR: In South Africa, in 2008, a wave of xenophobic violence against migrants who had migrated from the north in search of asylum was reported, and 60-two people died, and 100,000 (20,000 in the Western Cape alone) were displaced as mentioned in this paper.
Abstract: In May 2008, xenophobic violence erupted in South Africa. The targets were individuals who had migrated from the north in search of asylum. Emerging first in township communities around Johannesburg, the aggression spread to other provinces. Sixty-two people died, and 100,000 (20,000 in the Western Cape alone) were displaced. As the attacks escalated across the country, thousands of migrants searched for refuge in police stations and churches. Chilling stories spread about mobs armed with axes, metal bars, and clubs. The mobs stormed from shack to shack, assaulted migrants, locked them in their homes, and set the homes on fire. The public reaction was one of shock and horror. The Los Angeles Times declared, “Migrants Burned Alive in S. Africa.” The South African president at the time, Thabo Mbeki, called for an end to “shameful and criminal attacks.” Commentators were stunned by the signs of hatred of foreigners (xenophobia) that emerged in the young South African democracy. The tragedy of the violence in South Africa was magnified by the fact that many of the victims had fled from violence and persecution in their countries of origin. Amid genocidal violations of human rights that had recently occurred in some countries in sub- Saharan Africa, the new South Africa stood as a beacon of democracy and respect for human dignity. With this openness in mind, many immigrants to South Africa sought safety and refuge from the conflicts in their homelands. More than 43,500 refugees and 227,000 asylum seekers now live in South Africa. The majority of people accorded refugee status came from Burundi, Democratic Republic of Congo, and Somalia. South Africa also hosts thousands of other migrants who remain undocumented.

Journal ArticleDOI
TL;DR: Efforts to support women's mental health should focus on known risk factors, such as gender-based violence and prior mental health problems, rather than abortion history, according to findings.
Abstract: This study examines the risk of depression, suicidal ideation, and lower self-esteem following an abortion versus a delivery, with and without adjusting for important correlates. Using the National Comorbidity Survey, we tested how first pregnancy outcome (abortion vs. delivery) related to subsequent major depression, suicidal ideation, and self-esteem. Models controlling for risk factors, such as background and economic factors, prepregnancy violence experience, and prepregnancy mental health, as well as a model with all risk factors, were examined. When no risk factors were entered in the model, women who had abortions were more likely to have subsequent depression, OR = 1.53, 95% CI [1.05-2.22], and suicidal ideation, OR = 2.02, 95% CI [1.40-2.92], but they were not more likely to have lower self-esteem, B = -.02. When all risk factors were entered, pregnancy outcome was not significantly related to later depression, OR = 0.87, 95% CI [0.54-1.37], and suicidal ideation, OR = 1.19, 95% CI [0.70-2.02]. Predictors of mental health following abortion and delivery included prepregnancy depression, suicidal ideation, and sexual violence. Policies and practices implemented in response to the claim that abortion hurts women are not supported by our findings. Efforts to support women's mental health should focus on known risk factors, such as gender-based violence and prior mental health problems, rather than abortion history. Language: en

Journal ArticleDOI
TL;DR: To retain women with histories of trauma and substance abuse in "real world" psychiatric settings, emphasis on regulating individual-level and site-related modifiable variables are crucial.
Abstract: This study aimed to identify factors that influenced retention in the National Institute on Drug Abuse-funded Women and Trauma Study, conducted within the Clinical Trials Network (CTN). Women (N=346) were recruited from and received treatment in 6 CTN-affiliated sites. Log-linear and logistic models were used to explore factors associated with retention. The mean number of treatment sessions attended was 6.8 (SD=3.9). Women with more education, higher attendance at 12-step meetings, and strong therapeutic alliance between facilitator and participant had better retention rates. Significant site differences were found; the site with the highest retention rate provided child care and had the lowest average monthly intake. To retain women with histories of trauma and substance abuse in "real world" psychiatric settings, emphasis on regulating individual-level and site-related modifiable variables are crucial.