The Community Child Health Network Life Stress Interview: a brief chronic stress measure for community health research

Background and Objectives: Chronic stress is implicated in many theories as a contributor to a wide range of physical and mental health problems. The current study describes the development of a chronic stress measure that was based on the UCLA Life Stress Interview (LSI) and adapted in collaboration with community partners for use in a large community health study of low-income, ethnically diverse parents of infants in the USA (Community Child Health Network [CCHN]). We describe the instrument, its purpose and adaptations, implementation, and results of a reliability study in a subsample of the larger study cohort. Design and Methods: Interviews with 272 mothers were included in the present study. Chronic stress was assessed using the CCHN LSI, an instrument designed for administration by trained community interviewers to assess four domains of chronic stress, each rated by interviewers. Results: Significant correlations ranging from small to moderate in size between chronic stress scores on this measure, other measures of stress, biomarkers of allostatic load, and mental health provide initial evidence of construct and concurrent validity. Reliability data for interviewer ratings are also provided. Conclusions: This relatively brief interview (15 minutes) is available for use and may be a valuable tool for researchers seeking to measure chronic stress reliably and validly in future studies with time constraints.     

Self‐Efficacy Among Adults in Substance Abuse Treatment: The Role of Religious Coping

In substance abuse treatment, general self‐efficacy and religiousness are factors that may support positive outcomes. The authors surveyed clients receiving substance abuse treatment (N = 121) and found that religious coping predicted general self‐efficacy scores. Clinical implications are discussed.     

I owe you: age-related similarities and differences in associative memory for gains and losses

Older adults often experience associative memory impairments but can sometimes remember important information. The current experiments investigate potential age-related similarities and differences associate memory for gains and losses. Younger and older participants were presented with faces and associated dollar amounts, which indicated how much money the person “owed” the participant, and were later given a cued recall test for the dollar amount. Experiment 1 examined face-dollar amount pairs while Experiment 2 included negative dollar amounts to examine both gains and losses. While younger adults recalled more information relative to older adults, both groups were more accurate in recalling the correct value associated with high-value faces compared to lower-value faces and remembered gist-information about the values. However, negative values (losses) did not have a strong impact on recall among older adults versus younger adults, illustrating important associative memory differences between younger and older adults.     

Child and Family Emotional Functioning: A Cross-National Examination of Families from China and the United States

Scant research has examined links between particular emotion socialization processes and child emotion functioning cross-nationally. In this study, we assessed a sample of 55 families from the United States (U.S.; 28 boys and 27 girls) and 49 families from China (27 boys and 22 girls) on family emotional expressiveness and children’s emotional experiences and regulation. Results indicated that children and families from the U.S. reported greater emotional expressiveness than their Chinese counterparts. Children from the U.S. also reported greater undercontrolled emotion than Chinese youth. Family expression of positive emotion was related to effortful emotion regulation in U.S. youth only, whereas family expression of negative emotion was associated with undercontrolled emotion for both U.S. and Chinese children. Our findings advance context-specific models of emotional development by illustrating similarities and differences in emotional functioning among U.S. and Chinese families. From a clinical perspective, the findings suggest that practitioners should consider the cultural variations of emotion communication within families when conducting both assessment and therapy.     

Review of State Medication Policies/Guidelines Regarding Psychotropic Medications in Public Schools

It is currently estimated that up to 6 million children take psychotropic medications for the treatment of mental health problems. The highest prevalence rates (50–76 %) are typically found among students with special needs, especially among those with ADHD and emotional disturbance. The Individuals with Disabilities Education Act (IDEA) and Section 504 of the Rehabilitation Act of 1973 require medications be administered by schools whenever it is deemed necessary for the child to have access to educational services. However, these requirements do not extend to all students, nor do they provide guidance regarding the safest and most efficacious manner in which psychotropic medications should be administered. The authors reviewed existing state medication policies and guidelines to assess the level of guidance currently provided to school staff. Results showed the vast majority of states (48) provided guidance related to the administration of medications to students, with slightly fewer (44) states discussing required documentation procedures. Surprisingly, only 15 states addressed monitoring students for adverse side effects of medications, and even fewer (11) states specifically discussed psychotropic medication in their policies/guidelines. The vast majority (42) of states also addressed requirements for the safe and proper storage of medications, while slightly more than half of all states (31) provided any guidance regarding training of unlicensed personnel (e.g., secretaries) who frequently administer medications to students. The authors highlight several model guidelines/policies and review recommendations for best practice.     

The Complexity of Quest in Emerging Adults’ Religiosity,Well‐Being,and Identity

The construct of quest as measured by the Quest Scale raises complexities that this study addressed with online surveys measuring religiosity, ego identity, and well‐being of graduates from two Christian colleges. Intrinsic questers (those above the scale midpoint in intrinsic and quest scores but below the extrinsic midpoint) made up over half of those high in intrinsic religiosity and did not differ in Christian orthodoxy, religious identity, religious coping, or well‐being from the pure intrinsics (those high in intrinsic religiosity). Indiscriminately pro‐religious questing individuals (those high in intrinsic and extrinsic religiosity and quest) were less religious and showed poorer coping than intrinsic questers. Quest appears to be a reasonable measure of religious orientation, improving prediction of Christian orthodoxy, religious identity, and religious coping, and was more highly correlated with ego identity exploration than with stress. In association with intrinsic religiosity quest does not appear to indicate weak religiosity or poor well‐being. Instead, intrinsic questers may pursue a distinctive developmental trajectory, a path of existential searching by which emerging adults manage the demands of contemporary culture while maintaining a mature faith.     

Group CBT for Externalizing Disorders in Urban Schools: Effect of Training Strategy on Treatment Fidelity and Child Outcomes

Public schools are an ideal setting for the delivery of mental health services to children. Unfortunately, services provided in schools, and more so in urban schools, have been found to lead to little or no significant clinical improvements. Studies with urban school children seldom report on the effects of clinician training on treatment fidelity and child outcomes. This study examines the differential effects of two levels of school-based counselor training: training workshop with basic consultation (C) vs. training workshop plus enhanced consultation (C +) on treatment fidelity and child outcomes. Fourteen school staff members (counselors) were randomly assigned to C or C +. Counselors implemented a group cognitive behavioral therapy protocol (Coping Power Program, CPP) for children with or at risk for externalizing behavior disorders. Independent coders coded each CPP session for content and process fidelity. Changes in outcomes from pre to post were assessed via a parent psychiatric interview and interviewer-rated severity of illness and global impairment. Counselors in C + delivered CPP with significantly higher levels of content and process fidelity compared to counselors in C. Both C and C + resulted in significant improvement in interviewer-rated impairment; the conditions did not differ from each other with regard to impairment. Groups did not differ with regard to pre- to- posttreatment changes in diagnostic severity level. School-based behavioral health staff in urban schools are able to implement interventions with fidelity and clinical effectiveness when provided with ongoing consultation. Enhanced consultation resulted in higher fidelity. Enhanced consultation did not result in better student outcomes compared to basic consultation. Implications for resource allocation decisions with staff training in EBP are discussed.