Family-strengthening approaches for the prevention of youth problem behaviors

Effective parenting is the most powerful way to reduce adolescent problem behaviors. Dissemination of research-based family interventions has been slow, with most practitioners still implementing ineffective programs. This article reviews 2 federal studies that involved national searches for effective family interventions targeting pre-birth to adolescence: Preventing Substance Abuse Among Children and Adolescents: Family-Centered Approaches (Center for Substance Abuse Prevention, 1998) and Strengthening America's Families (R. Alvarado, K. L. Kumpfer, K. Kendall, S. Beesley, & C. Lee-Cavaness, 2000). Results identified 3 effective prevention approaches, 13 principles of effectiveness, and 35 programs. Recommendations include increased dissemination research on training and technical assistance systems, adoption with fidelity and quality, and gender-, age-, and culturally sensitive adaptations.     

Psychosocial correlates of substance use behaviors among African American youth

Cross-sectional data were collected on substance use behaviors and potential correlates in 1,494 African American students enrolled in grades 5-12 in eight schools in a central Alabama school district. Using a risk and asset framework, self-reported recent alcohol, cigarette, and marijuana use were analyzed by identifying and measuring levels of influence, including individual, family, and school. For alcohol and marijuana use, recurrent risk factors were age, being hit by a parent, affiliation with gangs, and a tolerant attitude of peers toward drug use. For cigarette use, risk factors were peer-oriented: associations with gangs or cohorts holding lenient attitudes about substance use. For all substances, salient asset factors were academic achievement and parental monitoring. Findings suggest that efforts to reduce substance use behaviors should be directed at adolescents in terms of academic achievement and grade level as well as their social environments. For the latter, peer/family risks and family/school assets should be the foci for programs to minimize the short- and long-term consequences of these behaviors. Hence, the emphasis should be placed on modeling attitudes, preventing gang and family violence, encouraging parental supervision, and building positive teacher-student interactions.     

Ecological influences in youth crisis shelters: Effects of social density and length of stay on youth problem behaviors

For 472 consecutive days we monitored the number of youths residing in a crisis shelter for adolescents, the average length of stay for the youths residing in the shelter on each day, and the number of problem behaviors occurring within the shelter on a daily basis. We analyzed these data using a combination of time series and logistic regression techniques to fit a model that would predict the occurrence of a problem behavior on any given day. After controlling for significant time trends in the data, our results indicate that both the number of youths in the shelter and the proportion of youths who have resided in the shelter longer than 14 days are significantly associated with a problem behavior occurring on any given day. The number of youths in the shelter and the probability of a problem behavior occurring correlated significantly. However, as the proportion of youths who resided in the shelter longer than 14 days increased, the probability of a problem behavior occurring decreased.     

The integration of research and practice in the prevention of youth problem behaviors

The prevention of youth problem behaviors is increasingly guided by science. Sound epidemiological research is coming to guide preventive efforts. Valid methods of monitoring the incidence and prevalence of youth problems increasingly shape preventive practice. The identification of empirically supported prevention interventions is becoming more sophisticated, and numerous scientific organizations have begun to engage in dissemination activities. These trends will be accelerated by increased media advocacy for the use of scientific methods and findings, the development of a registry of preventive trials, achievement of consensus about the standards for identifying disseminable interventions, and increased research on the factors that influence the effective implementation of science-based practices.     

Transgender and gender non-conforming adult preparedness for aging: Concerns for aging,and familiarity with and engagement in planning behaviors

Abstract

Background: Research on transgender and gender-nonconforming (TGNC) aging is limited. To date, most of the literature about TGNC aging has focused on discrimination (particularly in healthcare), violence and abuse, caregiving and family relations, and religiosity.

Aims: The purposes of this study were to: (a) document concerns about aging among TGNC adults, including concerns that are identity-specific; (b) examine preparation for aging and end of life (i.e., familiarity and planning) among TGNC adults; and (c) examine potential differences in familiarity and planning based on gender identity.

Methods: One hundred fifty-four individuals who currently or have ever identified as TGNC completed a national online survey assessing these constructs.

Results: TGNC individuals reported many concerns about aging, both gender identity-specific and not. The most common aging concern was losing the ability to care for themselves followed by having to go into a nursing home or assisted living facility. The age preparatory behaviors individuals were most commonly aware of included: life insurance, wills, organ donation, regular medical checkups, living wills, durable power of attorney for healthcare, and trusts. Gender-nonconforming individuals had significantly more familiarity with age preparatory behaviors than trans feminine individuals, but had lower levels of planning to engage in age preparatory behaviors than both trans masculine and trans feminine individuals.

Conclusion: The current findings highlight the need for providers to address age preparatory behaviors with TGNC individuals or provide referrals to support individuals in this planning.     

Mediating effects of an indicated prevention program for reducing youth depression and suicide risk behaviors

This study explored the intervention processes of an indicated prevention program for high-risk youth. It was hypothesized that intervention effects would be influenced by the direct and mediating effects of teacher social support on both peer group support and perceived personal control. In turn, personal control was hypothesized to mediate between teacher and peer group support, contributing to reductions in depression and suicide risk behaviors. The hypotheses were tested using a three-wave, longitudinal design incorporating data from preintervention, 5-month follow-up, and 10-month follow-up assessments of 106 high-risk youth divided into three comparison groups: two experimental, one control. For the two intervention groups, there were direct and/or indirect effects of teacher and peer group support on personal control, depression, and suicide risk behaviors. The general hypothesis that personal control mediates between support resources and reductions in depression and suicide risk behaviors received partial support across the study groups.     

An analysis of the internalizing and externalizing behaviors of traumatized urban youth with and without PTSD

To test the differential validity of the posttraumatic stress disorder (PTSD) classification, 3 groups of youths (PTSD, traumatized PTSD negatives, and controls) were examined. Youth with major comorbid disorders were excluded. On the basis of an analysis of parent-derived Child Behavior Checklist (CBCL) ratings, significant variations in CBCL scores were associated with PTSD but not with exposure to exceptional stress in the absence of PTSD. The results also indicated that traumatic exposure without the development of PTSD was not associated with higher estimates of psychopathology.     

Supporting Transgender and Sex Reassignment Issues

SUMMARY

For the care provider unfamiliar with supporting transsexual and transgender persons, as well as their partners, it becomes an imperative to be able to identify this population's unique needs, transition concerns and relationship dynamics. New challenges arise as transgender clients become more prevalent within the GLBT community and contact community clinical resources. These include distinguishing between sexual orientation and the complexities of gender identity; differentiating actual transgender issues and ordinary relationship concerns; and recognizing characteristics of strong relationships versus those doomed to fail when one or both partner's needs can no longer get met.

This article reviews an abundance of stereotypes adversely affecting transgender individuals, relationships and which can taint the treatment environment. At a core level, there exists the need for care providers to recognize when having a transgender identity stops being a disorder, such as when the client is no longer gender dysphoric, and where the care provider needs to advocate the individual's right of self-determination. This includes recognizing when situational depression or anxiety and social discrimination are the actual root of ongoing individual and relationship concerns. With basic transgender knowledge, effectively supporting transgender persons and their relationships is possible for cross-specialty providers, and is recommended.     

Transgender Primary Medical Care

SUMMARY

Transgender medical care involves addressing general medical conditions and those related specifically to transgender issues. This article summarizes existing research in transgender medicine and provides guidance for family physicians and nurses in adapting standard primary care protocols relating to health maintenance, acute illness, and chronic disease management to address trans-specific clinical oncerns. Trans-specific issues in physical examination, health history, interpretation of laboratory tests, vaccination, screening, and treatment are explored, and the role of the primary care provider in caring for patients undergoing hormonal or surgical change is discussed.     

Social and Medical Transgender Case Advocacy

SUMMARY

While some clients are confident self-advocates, many transgender individuals and loved ones find it difficult to advocate for themselves and turn to a trusted clinician for assistance. This article discusses the role of the health and social service clinician in transgender case advocacy. Although the setting, circumstances, and client needs vary greatly, the overarching goal of clinical advocacy is to address the societal barriers that interfere with clients' functionality and well-being. We suggest a protocol for advocacy assessment in the clinical setting and discuss trans-specific advocacy concerns relating to financial assistance, employment, changing identification, general advocacy, and outline concerns of specific populations within the transgender community.     

The relation between perceived parent-created sport climate and competitive male youth hockey players' good and poor sport behaviors

The authors examined achievement goal orientation (J. L. Duda & J. G. Nicholls, 1992), parental influence (M. L. Babkes & M. R. Weiss, 1999), and the parent-initiated motivational climate (S. A. White, 1996, 1998) in combination to broaden understanding of competitive male youth hockey players' (N = 259) perceptions of the parent-created sport climate and its relation to their self-reported good and poor sport behaviors (GPSB). Exploratory factor analysis revealed a multidimensional measure of GPSB. Multiple regression analyses indicated that athletes' GPSB were significantly predicted by different forms of parental influence. Canonical correlations revealed a complex picture of the contributions of goal orientation and the parent-created sport climate on boys' GPSB in youth hockey. Results expand knowledge of the influence that parents have in youth sport and emphasize the importance of understanding how children's interpretations of parental beliefs and behaviors affect their choices to engage in good and poor sport behaviors.     

对变性人和变性手术应持的态度

我们必须用人道主义价值观来确立我们的态度,从而尊重变性人在完全知情条件下的理性的自主选择。必须坚持包容与和谐的价值观,从而对变性人的性别价值观予以容纳和理解。要正确认识变性人及变性手术,积极推进健康教育,预防易性癖发生。我们要通过法律、道德、文化、科学技术等综合措施帮助病人适应社会,获得健康和幸福。     

对变性人和变性手术应持的态度

我们必须用人道主义价值观来确立我们的态度,从而尊重变性人在完全知情条件下的理性的自主选择.必须坚持包容与和谐的价值观,从而对变性人的性别价值观予以容纳和理解.要正确认识变性人及变性手术,积极推进健康教育,预防易性癖发生.我们要通过法律、道德、文化、科学技术等综合措施帮助病人适应社会,获得健康和幸福.     

Using sociometric measures to predict help seeking behaviors of youth in a positive peer culture program

Sociometric measures were used to predict help seeking behaviors of youth in a residential treatment center. Seventeen female adolescents with conduct disorders were asked to choose three peers in their group who were most popular, similar, and competent. These sociometric measures were correlated with the degree to which the participants would seek help from their peers across four problem scenarios representing actual situations encountered in residential settings. A multiple linear regression analysis suggested that sociometric measures of “competence” was the best predictor of intentions to seek help across the problem scenarios. Discussion focused on the implications of using sociometric measures within a residential treatment setting.     

Virginia Prince: Transgender Pioneer

SUMMARY

This article gives an overview of the life and work of Virginia Prince. It provides a synopsis of her major publications, situates her work in the context of its time and assesses her contribution as a major pioneer of transgendering.     

Clinical Aspects of Transgender Speech Feminization and Masculinization

SUMMARY

Societal norms of speech, voice, and non-verbal communication are often strongly gendered. For transgender individuals who experience a mismatch between existing communication behaviours and felt sense of self, changes to the gendered aspects of communication can help reduce gender dysphoria, improving mental health and quality of life. While peer resources are often beneficial in changing overall appearance and presentation, speech and voice modification is best facilitated by a trans-competent speech professional. In this article we review clinical research relating to transgender speech and voice change and discuss clinical protocols for trans-specific assessment, treatment, and outcome evaluation.