State Hospital Reentry Among Youth with Serious Emotional Disturbance: A Longitudinal Analysis

We investigated the demographic, service history, and clinical factors associated with readmission to state operated inpatient psychiatric hospitals by children and adolescents. Using computerized administrative data records for 3,969 consecutive index admissions of individuals between the ages of 7 and 17 inclusive, we examined hospital reentry among youth receiving services at these facilities. The univariate analysis comparing youths who reentered the hospital with those who did not reenter indicated that reentry was more likely to occur among African American youths and among those who were diagnosed with psychotic disorders. Reentry occurred less frequently among youths diagnosed with depressive disorders. Reentry also occurred less frequently among youths living in areas having an organized array of community-based mental health services. Youths who reentered the hospital were significantly older and had longer prior hospitalizations than those not reentering. The proportional hazards model used in the analysis indicated several factors associated with increased likelihood of hospital reentry. African American youths and individuals diagnosed with a psychotic disorder were more likely to reenter the hospital. Younger youths and those having lengthy prior hospitalizations were at increased risk for reentering the hospital. Youths living in urban, white, higher income communities were less likely to reenter the hospital.     

Neighborhood Racial Composition,Racial Discrimination,and Depressive Symptoms in African Americans

While evidence indicates that experienced racial discrimination is associated with increased depressive symptoms for African Americans, there is little research investigating predictors of experienced racial discrimination. This paper examines neighborhood racial composition and sociodemographic factors as antecedents to experienced racial discrimination and resultant levels of depressive symptoms among African American adults. The sample included 505 socioeconomically-diverse African American adults from Baltimore, MD. Study data were obtained via self-report and geocoding of participant addresses based on 2010 census data. Study hypotheses were tested using multiple pathways within a longitudinal Structural Equation Model. Experienced racial discrimination was positively associated with age and sex such that older individuals and males experienced increased levels of racial discrimination. In addition, the percentage of White individuals residing in a neighborhood was positively associated with levels of experienced racial discrimination for African American neighborhood residents. Experienced racial discrimination was positively associated with later depressive symptoms. Neighborhood-level contextual factors such as neighborhood racial composition and individual differences in sociodemographic characteristics appear to play an important role in the experience of racial discrimination and the etiology of depression in African American adults.     

Homeless Youths and Young Adults in Los Angeles: Prevalence of Mental Health Problems and the Relationship Between Mental Health and Substance Abuse Disorders

Although understanding of the subsistence patterns, service utilization, and HIV-risk behaviors of homeless youths and young adults is increasing, relatively little is known about the epidemiology of mental health problems in this group or the relationships between mental health problems and substance use. This study measured symptoms of depression, low self-esteem, ADHD, suicidality, self-injurious behavior (SIB), and drug and alcohol use disorder in a sample of homeless youth and young adults living in Hollywood, CA. Results indicated extremely high prevalences of mental health problems, as compared with corresponding rates of mental health problems found among housed youths in previous studies. Prevalence of mental health problems differed by age and ethnicity. African Americans were at lower risk of suicidal thoughts and SIB than were those of other ethnicities. Older respondents and females were at increased risk of depressive symptoms, and younger respondents were at increased risk of SIB. Previous history of sexual abuse and/or assault was associated with increased risk of suicidality and SIB. Risk factors for drug abuse disorder included ethnicity other than African American, homelessness for 1 year or more, suicidality, SIB, depressive symptoms, and low self-esteem. Risk factors for alcohol abuse disorder included male gender, white ethnicity, homelessness for 1 year or more, suicidality, and SIB. Extremely high rates of mental health problems and substance abuse disorders in this sample suggest the need for street-based and nontraditional mental health services targeted toward these youths and young adults.     

Behavioural characteristics of offenders with mental health disorders in a South African prison population

This exploratory study profiled behavioural characteristics of a non-random sample of 91 offenders with mental illness in a South African correctional facility. The sample is directly related to diagnosed cases from the correctional psychiatrist's case load. The most prevalent mental disorders diagnosed amongst the research participants of this sample specific profile were schizophrenia (33%), major depressive (27.5%), bipolar mood (12.1%) and psychotic disorders (11%).     

Ethnicity and gender in late childhood and early adolescence: group identity and awareness of bias

The current study examined awareness of gender and ethnic bias and gender and ethnic identity in 350 African American, White/European American, and Latino/Hispanic students (Mage = 11.21 years, SD = 1.59) from the 4th, 6th, and 8th grades of diverse middle and elementary schools. The study collected (a) qualitative data to best capture the types of bias that were most salient to children and (b) daily diaries and individual measures to examine the multiple components of children's gender and ethnic identities. Results revealed ethnic, gender, and grade-level differences in awareness of ethnic and gender bias. Overall, more children were aware of gender bias than ethnic bias. This effect was most pronounced among White/European American youths. Among those in 4th grade, African American and Latino youths were more likely to be aware of ethnic bias than were White/European American youths. Analyses also examined how awareness of bias was related to gender and ethnic identity. For example, children who had a salient and important gender identity, and a devalued ethnic identity, were less likely than other children to be aware of ethnic bias.     

Anhedonia and emotional numbing in combat veterans with PTSD

We explored relationships between anhedonia and posttraumatic stress disorder (PTSD) symptom clusters, including their role in predicting psychiatric comorbidity. Our measure of anhedonia was derived from an examination of the latent structure of the Beck Depression Inventory. We found evidence for a two-factor solution, leading to anhedonia and undifferentiated, global depressive symptoms scales. In primary analyses, anhedonia had a unique positive relationship with PTSD's emotional numbing symptoms and minimal relationships with other PTSD symptoms. Upon examining the incremental validity of appetitive functioning (i.e., anhedonia, emotional numbing) over and above aversive functioning (i.e., re-experiencing, avoidance, and hyper-arousal PTSD symptoms) variables, greater emotional numbing increased the likelihood of being diagnosed with a major depressive disorder, and greater anhedonia increased the likelihood of being diagnosed with additional anxiety disorders and to a lesser extent, psychotic disorders. Results were consistent with research on the distinction of appetitive and aversive functioning, providing insight into the nature of PTSD.     

Patterns and correlates of gun ownership among nonmetropolitan and rural middle school students

Examined prevalence of gun ownership and the links among gun ownership, reasons for gun ownership, and antisocial behavior in a sample of nonmetropolitan and rural middle school students. Participants completed the Questionnaire for Students (Olweus, 1995) and included 6,263 students from 36 elementary and middle schools, of whom most were African American (range = 46%-95% per school). Reasons for gun ownership were strongly associated with rates of antisocial behavior. Youths who owned guns for sporting reasons reported rates of antisocial behavior that were only slightly higher than those reported by youths who did not own guns. Youths who owned guns to gain respect or to frighten others reported extremely high rates of antisocial behavior. These high-risk adolescent gun owners were likely to come from families of high-risk gun owners, associate with friends who were high-risk gun owners, and engage in high rates of bullying behavior. Findings suggest that effective violence prevention programs must target high-risk youths, address risk factors that go beyond individual settings, and address a comprehensive array of risk factors.     

African American and White Women’s Experience of Sexual Assault and Services for Sexual Assault

This article presents the results of a study assessing the needs and experiences of African American and White female survivors of sexual assault in the state of Maryland. Eight specific hypotheses regarding differences in the needs and experiences of African American as compared to White women receiving partial or no support through analyses of interview data drawn from 213 survivors (African American survivors, n = 133; White survivors, n = 80) were explored. No differences were reported in medical care received; however, in comparison to their White counterparts, African American women reported decreased use of sexual assault crisis centers and mental health services, and postassault help-seeking through use of sexual assault hotlines. Barriers and facilitators associated with treatment experiences differed by ethnicity. Findings are discussed in relation to future directions for research, and service and policy improvement for survivors of sexual assault.     

Clinically Significant Depressive Symptoms in African American Adolescent Females in an Urban Reproductive Health Clinic

Adolescent depression is a major public health concern. Depression and depressive symptoms are more prevalent in adolescent females and are associated with high-risk sexual behavior. Only one third of adolescents receive professional help for their depression, although about 90% visit their primary care providers on average 2–3 times per year. It is imperative that health professionals seek additional methods in the identification and treatment of depressive symptoms. This paper presents findings of the presence of clinically significant depressive symptoms in African American female adolescents receiving routine health care services within an adolescent primary care reproductive health clinic. Results revealed higher rates of depressive symptoms in this subsample of African American adolescent females when compared to the national sample, suggesting that primary care reproductive health clinics are a viable setting for the identification of depressive symptoms among low income, African American female adolescents. Psychosocial interventions and recommendations for the integration of primary care reproductive health, and behavioral health consultation services are presented.     

African American Children’s Depressive Symptoms: The Prospective Effects of Neighborhood Disorder, Stressful Life Events, and Parenting

The prospective effects of observed neighborhood disorder, stressful life events, and parents’ engagement in inductive reasoning on adolescents’ depressive symptoms were examined using data collected from 777 African American families. Multilevel analyses revealed that stressful life events experienced at age 11 predicted depressive symptoms at age 13. Furthermore, a significant interaction between neighborhood disorder and parents’ engagement in inductive reasoning was found, indicating that parental use of inductive reasoning was a protective factor for depressive symptoms particularly for youths living in highly disordered neighborhoods. The importance of examining correlates of depressive symptoms from a contextual framework, focusing on individuals, families, and neighborhood contexts, is emphasized.     

Mediators of the Daily Hassles–Suicidal Ideation Link in African American Women

Depressive symptoms and hopelessness as mediators of the daily hassles–suicidal ideation link in low‐income African American women exposed to intimate partner violence (n = 100) were investigated. As hypothesized, daily hassles, depressive symptoms, and hopelessness were each significantly and positively associated with suicidal ideation. Moreover, the relation between daily hassles and suicidal ideation was, in part, accounted for by depressive symptoms and hopelessness. This study demonstrates the importance of assessing for the presence of these risk factors when determining the likelihood that an abused African American woman will consider suicide. The findings further highlight the value of designing and implementing interventions that target the reduction in depressive symptoms and hopelessness in abused African American women exposed to daily hassles to reduce their suicide risk.     

Increasing the number of African American PhDs in the sciences and engineering: a strengths-based approach

Fifty years after Brown v. Board of Education, the percentage of African American students who receive PhDs in natural science, technology, engineering, or mathematics (STEM) fields remains disappointingly low. A multifaceted, strengths-based approach to intervention and research that holds great promise for increasing the number of African American students who achieve at the highest levels academically is described. This work began in 1988 with the development of the Meyerhoff Scholars Program for undergraduate minority STEM majors at the University of Maryland, Baltimore County (UMBC). If current PhD receipt rates of program graduates continue, UMBC will in all likelihood become the leading predominantly White baccalaureate-origin university for Black STEM PhDs in the nation. The program is described and outcome and process findings from its ongoing evaluation are highlighted. The parenting practices that helped these youths to overcome the odds and achieve at the highest levels prior to coming to college are also examined.     

Individual and Family Contributions to Depressive Symptoms in African American Children with Sickle Cell Disease

Depressive disorders in children with chronic illnesses have received little attention despite some evidence suggesting that these children experience increased psychological difficulties as a result of their medical condition. Most of the research on depressive disorders among children has been conducted primarily with Caucasian youth, limiting generalizability to ethnically diverse populations. Further, even less research exists on depressive disorders among African American children with Sickle Cell Disease (SCD) and for African American youth from lower socioeconomic status who are at greater risk for depressive disorders. This paper is an extensive review of the major studies conducted on depression and psychosocial aspects of SCD in African American children. The Transactional Stress and Coping model is provided as a conceptual framework. Following the review, clinical and research implications are provided, as well as an illustration of a psychoeducational family intervention with an African American child who has SCD and internalizing behaviors.     

Identifying and Referring Youths at Risk for Suicide Following Participation in School‐Based Gatekeeper Training

Gatekeeper training is a core strategy of the Garrett Lee Smith Memorial Suicide Prevention Act of 2004. Using data gathered from school‐based gatekeeper trainings implemented by GLS grantees, this analysis examines training and gatekeeper factors associated with (1) identification and referral patterns and (2) services at‐risk youths receive. Time spent interacting with youths was positively correlated with the number of gatekeeper identifications and knowledge about service receipt. Gatekeepers who participated in longer trainings identified proportionately more at‐risk youths than participants in shorter trainings. Most gatekeeper trainees referred the identified youths to services regardless of training type.     

Sex, race/ethnicity, and romantic attractions: multiple minority status adolescents and mental health

This study examined the association between multiple minority statuses and reports of suicidal thoughts, depression, and self-esteem among adolescents. Data from the National Longitudinal Study of Adolescent Health were used to examine mental health outcomes across racial/ethnic groups for same-sex-attracted youths and female youths. Hispanic/Latino, African American, and White female adolescents reported more suicidal thoughts, higher depression, and lower self-esteem compared with male adolescents in their racial/ethnic group. Same-sex-attracted youths did not consistently demonstrate compromised mental health across racial/ethnic groups. Follow-up analyses show that White same-sex-attracted female adolescents reported the most compromised mental health compared with other White adolescents. However, similar trends were not found for racial/ethnic minority female youths with same-sex attractions.     

Marital quality of African American and white partners in interracial couples

In light of the growing number of interracial marriages in this country, the present study set out to examine the relative strength of one's racial identity, social support, and experience of discrimination in predicting interracial marriage quality. A total of 76 interracial couples (52 African American male/White female and 24 African American female/White male) participated in the study by completing mail surveys. Results revealed that for African American partners, and to a lesser extent White partners, racial identity was the strongest predictor of marital quality. Partners who had pride in their race but were also accepting of other races and cultures experienced higher marital quality. These findings are discussed in light of the literature that suggests interracial couples often minimize the relevance of race in their relationships.     

Psychosocial factors in outcomes of heart surgery: the impact of religious involvement and depressive symptoms.

This article reports a prospective study of religiousness and recovery from heart surgery. Religiousness and other psychosocial factors were assessed in 142 patients about a week prior to surgery. Those with stronger religious beliefs subsequently had fewer complications and shorter hospital stays, the former effect mediating the latter. Attendance at religious services was unrelated to complications but predicted longer hospitalizations. Prayer was not related to recovery. Depressive symptoms were associated with longer hospital stays. Dispositional optimism, trait hostility, and social support were unrelated to outcomes. Effects of religious beliefs and attendance were stronger among women than men and were independent of biomedical and other psychosocial predictors. These findings encourage further examination of differential health effects of the various elements of religiousness.     

Social Support,Conflict, and Integration Among Women Living With HIV/AIDS1

The relationship between depressive symptoms and perceptions of available social support, social conflict, and subjective social integration were examined as part of a psychosocial study of Puerto Rican, African American, and non‐Hispanic White women living with HIV/AIDS (N= 146) in New York City. Lower levels of subjective social integration and higher levels of social conflict were associated with more depressive symptoms. Perceived availability of social support was not significantly associated with depression in comparison with these other forms of support. No evidence was found for a stress‐buffering or a stress‐amplification effect. Significant ethnic differences in levels of social integration and social conflict also were noted. Results suggest that intervention efforts should go beyond addressing support to further address the conflict and lack, of integration experienced.     

Disproportionate Diagnosis of Mental Disorders Among African American Versus European American Clients: Implications for Counseling Theory,Research, and Practice

Research generated by the professions of psychiatry and psychology reveals that African Americans are more often diagnosed with specific mental disorders (e.g., psychotic disorders) compared with European Americans. No research to date, however, has investigated whether professional counselors make differential diagnoses according to client race. This study (N = 1,648) found that counselors diagnosed African Americans with psychotic and childhood disorders at a disproportionately high rate. Implications for counseling theory and practice are discussed.     

Family Matters: The Role of Mental Health Stigma and Social Support on Depressive Symptoms and Subsequent Help Seeking Among African American Boys

African American adolescent boys underutilize mental health service due to stigma associated with depression. Gaining an increased understanding of how depressed, African American adolescent boys perceive their mental health needs and engage in help-seeking behaviors might play an essential role in efforts to improve their symptoms and access to care. Using a mixed-methods design, this study examined the influence of mental health stigma and social support on depressive symptoms among African American adolescent boys. Findings indicated the protective effects of social support in decreasing depressive symptoms, especially when participants experienced mental health stigma. Results also revealed the pivotal role of family social support over both professional and peer support for participants who struggled with depressive symptoms. The primacy of family support among the sample, combined with the frequent distrust of professionals and peer networks, would indicate that working with families may improve initial identification of depression among African American adolescent boys and decrease their barriers to care.