Familias Unidas: a family-centered ecodevelopmental intervention to reduce risk for problem behavior among Hispanic adolescents

This paper describes the theoretical and empirical foundations of Familias Unidas, a multilevel, family-centered intervention designed to prevent problem behavior in Hispanic adolescents. The main theoretical tenets for the intervention model; an ecological-developmental perspective, the centrality of ethnic and cultural themes, application of empowerment principles, and a family focus are reviewed. The literature on the risk and protective factors that provided the justification for the intervention's targeted mediators and the core clinical applications that are intended to alter them are discussed. Familias Unidas engages Hispanic immigrant parents into an empowerment process in which they first build a strong parent-support network and then use the network to increase knowledge of culturally relevant parenting, strengthen parenting skills, and then apply these new skills in a series of activities designed to reduce risks frequently found in poor, urban environments. The available evidence supporting the efficacy of Familias Unidas is summarized, as are future goals and a current, second-generation application of the intervention.     

Reducing HIV risk-associated sexual behavior among african american adolescents: Testing the generality of intervention effects

This randomized controlled trial tested the effects of a theory-based culture-sensitive HIV risk-reduction intervention among 496 inner-city African American adolescents (mean age = 13 years) and examined the generality of its effects as a function of the facilitator's race and gender and the gender composition of the intervention group. Adolescents who received the HIV risk-reduction intervention expressed more favorable behavioral beliefs about condoms, greater self-efficacy, and stronger condom-use intentions postintervention than did those who received a control intervention on other health issues. Six-month follow-up data collected on 93% of the adolescents revealed that those who received the HIV risk-reduction intervention reported less HIV risk-associated sexual behavior, including unprotected coitus, than did their counterparts in the control condition. Self-reported sexual behavior and changes in self-reported behavior were unrelated to scores on a standard measure of social desirability response bias. There was strong evidence for the generality of intervention effects. Moderator analyses testing eight specific interaction hypotheses and correlational analyses indicated that the effects of the HIV risk-reduction intervention did not vary as a function of the facilitator's race or gender, participant's gender, or the gender composition of the intervention group. This research was supported in part by grants from the National Institute of Child Health and Human Development (R01-HD24921), the National Institute of Mental Health (R01-MH45668), and the Social Science and Humanities Research Council of Canada. The authors gratefully acknowledge the contributions to this research of Margaret Bleier, Daria Boccher-Lattimore, Nancy L. Moore, Tatiana Perrino, Paul Pintella, and Fran Rosenfeld and the helpful suggestions of Isabel Fernandez, Caryn Lerman, and Ann O'Leary regarding an earlier version of this article.     

Prevention of depression among Icelandic adolescents: a 12-month follow-up

This paper reports the 12-month follow-up results regarding a program designed to prevent the initial episode of depression and/or dysthymia among Icelandic adolescents. This indicated prevention program was implemented in school settings for 14–15 year-old students judged to be “at risk” for depression because of the presence of some depressive symptoms and/or a negative attributional style. We previously reported (Arnarson & Craighead, 2009) that this program, when compared to treatment-as-usual, was effective in preventing the first episode of depression and/or dysthymia at 6-months following completion of the program. Survival analyses of the 12-month follow-up data indicated that the preventive effects were sustained at the end of 1 year following the completion of the prevention program with only 2 of the prevention program participants reporting an initial episode of MDD/DYS versus 13 of the TAU participants (χ² = 5.02, p = .025). Using logistic regression, we also found that initial level of depressive symptoms significantly (p = .0330) predicted the first episode of depression and/or dysthymia among TAU subjects. The limitations of the study were noted, and future directions of research regarding prevention of depression were discussed.     

Prevention of depression among Icelandic adolescents

Major depression and dysthymia are frequent, debilitating, and chronic disorders, whose highest rate of initial onset is during the late adolescent years. The effectiveness of a program designed to prevent an initial episode of major depression or dysthymia among adolescents was investigated. Participants were 171 fourteen-year-old “at risk” Icelandic adolescents who were randomly assigned to a prevention program or a treatment-as-usual assessment only control group. They were identified as “at risk” by reporting the presence of depressive symptoms or a negative attributional style. The program was based on a developmental psychosocial model of enhancement of resilience to factors associated with the occurrence of mood disorders. The results indicated that the prevention program resulted in a significantly lower rate of major depression and dysthymia than did the control group. The study demonstrated that school personnel in the school setting can implement such prevention programs.     

Self-reported anxiety in children and adolescents: a three-year follow-up study

Anxiety may be more transient in children and adolescents than in adults. The present study involves a longitudinal design enabling the investigation of the continuity/discontinuity of self-reported anxiety in children and adolescents. A sample of 68 children was followed over 3 years. Results indicate that, on the whole, self-reported anxiety decreased over time. This was true for overall anxiety and its sub-types, with the exception of social concerns/concentration, which did not decrease over time. Consistent with past research involving normal fear, girls and younger children were found to score higher on anxiety than boys and older children did. However, those groups scoring higher at inception also demonstrated the most marked decreases over the 3-year period. In addition to the changes found over time, the data indicated continuity in anxiety such that levels of anxiety at inception were significant predictors of follow-up anxiety, although only a small amount of variance was shared. The authors concluded that adult models of anxiety cannot be applied to youth and that future research should investigate the contribution of contextual factors to the development of anxiety in children.     

Body-image and eating disturbances predict onset of depression among female adolescents: a longitudinal study

This study examined data from a 4-year school-based longitudinal study (n = 1,124), to test whether the increase in major depression that occurs among girls during adolescence may be partially explained by the body-image and eating disturbances that emerge after puberty. Elevated body dissatisfaction, dietary restraint, and bulimic symptoms at study entry predicted onset of subsequent depression among initially nondepressed youth in bivariate analyses controlling for initial depressive symptoms. Although the unique effect for body dissatisfaction was not significant in the multivariate model, this set of risk factors was able to fairly accurately foretell which girls would go on to develop major depression. Results were consistent with the assertion that the body-image- and eating-related risk factors that emerge after puberty might contribute to the elevated rates of depression for adolescent girls.     

Reducing depression in stroke survivors and their informal caregivers: A randomized clinical trial of a web-based intervention

Purpose/Objectives: To develop and test the efficacy of a Web-based intervention for alleviating depression in male stroke survivors (SSs) and their spousal caregivers (CGs) that blends both peer and professional support. Design and Methods: The research consisted of an intervention protocol evaluated by a focus group of rehabilitation professionals, a "think aloud" session conducted with female stroke CGs, and a usability test of the intervention's online features with 7 female stroke CGs. Efficacy of the final protocol was tested in a 2-group randomized clinical trial with a sample of 32 CG-SS dyads. The CGs in the intervention condition received an online group intervention. Intervention components were based on the Stress Process Model. Those CGs in a control condition received minimal support with individualized access to relevant online information. Measures of depression, as well as the secondary outcomes of mastery, self-esteem, and social support, were obtained from SSs and CGs at pretest, posttest, and 1-month later. Results: At posttest and 1 month later, CGs in the intervention condition reported significantly lower depression than CGs in the control condition with baseline depression controlled. There was no significant effect on depression among SSs. Although no significant treatment effects for either SSs or CGs were found on the secondary outcomes, posttreatment changes on some constructs were significantly correlated with change in depression. Conclusions/Implications: CGs benefit from Web-based programs that help them better understand both their emotional needs and those of the SS. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Effects of an early intervention group program for anxious and depressed adolescents: a pilot study

The Resourceful Adolescent Program is an early intervention program designed to enhance psychological resilience in adolescents with emotional problems. Eight adolescents with high anxious and/or depressive symptoms were treated with this 11-session group program. Treatment effects were examined by means of self-report questionnaires of anxiety, depression, and self-efficacy. Pre- and postintervention data showed reductions in anxiety and depression scores and a concomitant increase in adolescents' self-efficacy.     

Prenatal depression effects on early development: A review

This review of recent research on prenatal depression suggests that it is a strong predictor of postpartum depression and is more common than postpartum depression. Prenatal depression has been associated with excessive activity and growth delays in the fetus as well as prematurity, low birthweight, disorganized sleep and less responsiveness to stimulation in the neonate. Infants of depressed mothers have difficult temperament, and later in development attentional, emotional and behavioral problems have been noted during childhood and adolescence, as well as chronic illnesses in adulthood. Several variables have confounded the effects of prenatal depression including comorbid anxiety and anger as well as stressful life events. Potential mediating variables are low prenatal maternal dopamine and serotonin levels and elevated cortisol and norepinephrine. The associated intrauterine artery resistance may limit blood flow, oxygen and nutrients to the fetus. Some studies also suggest the heritability of developmental problems for the children of prenatally depressed mothers, including ADHD and antisocial behavior. Multivariate, longitudinal research is needed to disentangle these confounding and mediating variables.     

The effects of a teaching-modeling intervention on early mother-infant reciprocity

This study investigated the effects of a teaching and modeling intervention on the development of early reciprocity and maternal self-confidence between black low-income primiparous mothers and their newborn infants. The sample included 20 mothers who had an uneventful pregnancy, labor, delivery, and postpartum course. Infants were healthy, full-term, singleton, and bottle-fed. Mothers in the experimental group received a teaching session in which the investigator discussed and modeled caregiver behaviors which elicit interactive behaviors and skills of the infant. State control, response to stress, motoric processes, and interaction processes were discussed. On pretest, no significant differences were found between the control and experimental groups on any variable. At posttest, statistically significant differences were found between the two groups on assessment of the mother-infant sensitivity scale. No significant differences were found between the treatment and the control groups on the Mother's Assessment of the Behavior of her Infant (MABI) or the Self-Confidence scores.     

Facets of loneliness and depression among Chinese children and adolescents

The authors examined the relation among different facets of loneliness and depression in a sample of 6,356 Chinese children and adolescents from Grades 4-9. Loneliness and depression were closely related among the primary (Grades 4-6) and secondary (Grades 7-9) students, both boys and girls. Although the different facets of loneliness were predictive of the various facets of depression, peer-related loneliness and aloneness were more predictive of depression in both groups than was parent-related loneliness. The students in Grades 5 and 6 scored lower for loneliness but a little higher for depression than did the students in Grade 4. The students in Grades 8 and 9 scored higher than the students in Grade 7 for loneliness and depression. The primary boys scored higher than the primary girls for both loneliness and depression. Among the secondary students, there was no difference between the scores of the boys and those of the girls for loneliness, but the boys scored lower than the girls for depression.     

The effects of infant simulators on early adolescents

The researchers examined the effects of infant simulators (computerized dolls designed to simulate normal infants) on 236 eighth-grade students. As part of their health and sex education curriculum, students had to provide care--24 hours a day, over several days--to dolls that cried when they "were hungry," "needed a diaper change," or "needed attention." The dolls enabled teachers to evaluate the care given by students. Students kept daily charts and journals, and wrote essays about their experiences. One to two years later, the students were surveyed, along with 461 comparison students who did not have the infant simulator experience. The findings indicated that the doll experience had a significant impact on the students, especially the females. It helped them to learn about the challenges of infant care, and to think of the implications before engaging in sexual intercourse. The comparison group felt less knowledgeable about what it takes to care for an infant, and judged infant care as less time consuming, difficult, and expensive than did those who had the infant simulator experience.     

Correlates of attitudes toward sexual harassment among early adolescents

A survey of 458 early adolescents (87% White; 278 females and 280 males; Mage = 13) examined the interacting relationship between family environment and involvement with pop music, and attitudes toward sexual harassment, while also controlling for sex. Attitudes toward sexual harassment were assessed by an eight-item Likert-type scale constructed from common behavioral definitions of sexual harassment (reliability alpha = .89). Results indicated females held less accepting attitudes toward sexual harassment than males. Involvement with pop music was associated with acceptance of sexual harassment, especially for females. The combination of a high level of exposure to pop music videos, and being from an unsatisfactory or nonintact family, was strongly associated with acceptance of sexual harassment for females and less so for males. The findings of this study could have implications for the etiology of acceptance of other coercive behaviors among adults.

     

The effects of a mentoring program on at-risk youth

This study examined an intensive mentoring program that focuses on youth deemed at-risk for juvenile delinquency or mental illness. Mothers and teachers completed the Child Behavior Checklist, and youth completed the Hopelessness Scale for Children, the Piers-Harris Self-Concept Scale, and the Self-Report Delinquency Scale. The youth (ages 10 to 17) either participated in the mentoring program (intervention, n = 34) or remained on the waiting list (nonintervention, n = 34) for 6 months. Repeated-measures ANOVAs assessed changes from preintervention to postintervention and indicated significant improvement in problematic behaviors for the intervention group. Mentoring appeared to affect African American youth differently than Caucasian and Latino youth. There were no significant interactions involving gender. The findings of this study supported the positive influence of mentoring on at-risk youth.     

Sex differences in symptoms of depression among American children and adolescents

The Arabic Children's Depression Inventory in its English version was administered to a sample of 535 U.S. school students (11 to 18 years old). By sex, differences on total score and on 19 of 27 items (70.4%) were not statistically significant. Nevertheless, differences were significant for 8 (29.6%) items on which girls had higher mean scores. Half of the items were positive indicators of depression (I am sad, I feel lonely, I feel miserable, and I hate myself), while the other half were negative (I feel happy, Life is rosy, A lot of people like me, and I am optimistic).     

Trait effects within potential sources of variance in transient depression

An S-R Inventory of Depression was designed to assess the experience of transient states of ‘normal unhappiness’ in non-clinical subjects and was administered to 80 men and 80 women. Differences between individuals in their overall proneness to depression and in their patterns of sensitivity to various provoking situations provided the larger sources of interpretable variance for each sex. The Neuroticism dimension of personality was involved in both sources, in the latter through the potentiation of a person's generalized response to any given situation. The argument depended upon correlations between personality dimensions and the grand means and variance components derived from a separate two-way analysis of variance in the S-R inventory for each person. This is one way to explore the effects of trait-like variables within the form of ‘interactional’ approach embodied in variance component analyses.