Proximal Outcomes Matter: A Multilevel Examination of the Processes by Which Coordinating Councils Produce Change

Communities are engaged in efforts to create a coordinated response to intimate partner violence. Though coordinating councils are commonly employed vehicles for such efforts, research provides only equivocal support regarding their effectiveness. These mixed findings may reflect methodological and conceptual challenges. Specifically, there is an over-reliance on conceptualizing council effectiveness in terms of distal outcomes (e.g., behavior change), rather than the intermediary processes by which councils affect change. A direct assessment of councils' proximal outcomes may highlight change mechanisms. To that end, this study investigates the extent to which councils impact proximal outcomes and examines the processes through which proximal outcomes are interrelated and linked to distal community change. Study findings suggest that perceived proximal outcomes do significantly predict variability in perceived distal community change across councils. Specifically, promotion of social capital and institutionalized change predict achievement of distal community change, and promotion of social capital also predicts achievement of institutionalized change.     

The Combined Influence of Monitoring and Early Puberty on Disruptive Behavior Problems in African American Girls

Journal of Child and Family Studies - Adolescent girls’ disruptive behavior problems (DBP) are associated with risk for other mental health challenges and legal system involvement. Existing...     

Council-Based Approaches to Reforming the Health Care Response to Domestic Violence: Promising Findings and Cautionary Tales

Councils are commonly formed to address social issues including intimate partner violence (IPV). Research suggests that councils may be well positioned to achieve proximal outcomes, but that their success may depend on contextual factors. The current study compared providers and health care settings at two points in time to explore the degree to which the Health Care Council achieved proximal outcomes in the health care response to IPV, including: (a) providers' reported capacity to screen for IPV, (b) providers' beliefs about IPV as a health care issue and about the IPV screening process, (c) providers' screening behaviors and (d) organizational policies and protocols to encourage screening. This study, while preliminary, provides support for council-based efforts to stimulate change in the health care response to IPV and also highlights the central role that organizational environment plays in shaping desired outcomes.     

Council-Based Approaches to Intimate Partner Violence: Evidence for Distal Change in the System Response

Communities across the United States are collaborating to create a coordinated response to intimate partner violence (IPV); ideally, this involves promoting best practices in the justice and human service systems and engaging a broad array of community sectors (e.g., human service; criminal justice; faith; business; education) to promote victim safety and batterer accountability (Pence, 1999). The current study examined the extent to which Family Violence Coordinating Councils resulted in change in the systems’ response to IPV. Specifically, we examined judicial order of protection data from 1990 to 2005 to establish whether the formation and development of councils across the state of Illinois promoted the issuance of plenary orders of protection following the initial granting of emergency orders of protection. Such a pattern would indicate implementation of a best practice in the system response to IPV. Utilizing a multilevel logistic modeling approach, we found that the introduction and development of councils was indeed related to the accessibility of plenary orders of protection. The specific ways in which councils may have influenced such an outcome and the implications of this approach for research on council effectiveness are discussed.     

Suicidality as a function of impulsivity, callous-unemotional traits, and depressive symptoms in youth

Suicidality represents one of the most important areas of risk for adolescents, with both internalizing (e.g., depression, anxiety) and externalizing-antisocial (e.g., substance use, conduct) disorders conferring risk for suicidal ideation and attempts (e.g., Bridge, Goldstein, & Brent, 2006). However, no study has attended to gender differences in relationships between suicidality and different facets of psychopathic tendencies in youth. Further, very little research has focused on disentangling the multiple manifestations of suicide risk in the same study, including behaviors (suicide attempts with intent to die, self-injurious behavior) and general suicide risk marked by suicidal ideation and plans. To better understand these relationships, we recruited 184 adolescents from the community and in treatment. As predicted, psychopathic traits and depressive symptoms in youth showed differential associations with components of suicidality. Specifically, impulsive traits uniquely contributed to suicide attempts and self-injurious behaviors, above the influence of depression. Indeed, once psychopathic tendencies were entered in the model, depressive symptoms only explained general suicide risk marked by ideation or plans but not behaviors. Further, callous-unemotional traits conferred protection from suicide attempts selectively in girls. These findings have important implications for developing integrative models that incorporate differential relationships between (a) depressed mood and (b) personality risk factors (i.e., impulsivity and callous-unemotional traits) for suicidality in youth.     

Phenomenology of delusions and hallucinations in schizophrenia by religious convictions

This study was conducted to assess the impact of religious affiliations on the phenomenology of delusions and hallucinations. Fifty-three Pakistani Muslim patients with schizophrenia were interviewed using the Present State Examination and Religiosity Index. The results indicated that the more religious patients had greater themes of grandiose ability and identity. These differences were more obvious in groups divided on the basis of practice of Islam. Similar results were obtained in the content of hallucinations. More religious patients were more likely to hear voices of paranormal agents and had visions of the same. The results of this study have strong implications for mental health professionals who, without reinforcing threatening and pathological beliefs of patients, can utilise this knowledge to create and maintain a therapeutic alliance with the patients as well as to more effectively manage the disorder.     

Comparing factor structures of adolescent psychopathology

Research on the structure of adolescent psychopathology can provide information on broad factors that underlie different forms of maladjustment in youths. Multiple studies from the literature on adult populations suggest that 2 factors, Internalizing and Externalizing, meaningfully comprise the factor structure of adult psychopathology (e.g., Krueger, 1999) and presumably represent broad vulnerability for co-occurring disorders. Though this research was partially inspired by early work with children and adolescents (e.g., Achenbach & Edelbrock, 1984), the role of substance use in these models of youth psychopathology has not been fully explored. Toward this goal, we recruited 223 youths (10-17 years of age, M = 14.2) from mental health agencies and the community. We found evidence for a 3-factor model of youth psychopathology, including Internalizing (depression, generalized anxiety), Externalizing (conduct disorder, attention deficit, oppositional defiant disorder), and Substance Use (alcohol and cannabis). The 3-factor model showed the best fit to the data relative to other factor models tested, including across subsamples of adolescents who differed on level of psychopathology (treatment vs. community samples). Implications for the structure of adolescent psychopathology, including important developmental considerations, are discussed.     

Gender Differences in the Effects of Community Violence on Mental Health Outcomes in a Sample of Low-Income Youth Receiving Psychiatric Care

Previous research suggests that community violence impacts mental health outcomes, but much of this research has not (a) distinguished between different types of community violence, (b) examined gender differences, and (c) focused on youth living in urban poverty. The current study addresses these questions. Participants were 306 youth (23 % girls) and one parent/guardian receiving outpatient psychiatric services for disruptive behavior disorders in a large urban city. Youth and parents reported on youth’s experience of different types of community violence (being a direct victim, hearing reports, and witnessing violence), and whether violence was directed toward a stranger or familiar. Outcomes included youth externalizing, internalizing, and posttraumatic stress symptoms assessed via parent and youth reports. Being a direct victim of violence accords risk for all mental health outcomes similarly for both boys and girls. However, gender differences emerged with respect to indirect violence, such that girls who hear reports of violence against people they know are at increased risk for all assessed mental health outcomes, and girls who witness violence against familiars are at increased risk for externalizing mental health symptoms in particular. There are gender differences in violence-related mental health etiology, with implications for intervention assessment and design.     

Sibling Teenage Pregnancy and Clinic-Referred Girls’ Condom Use: The Protective Role of Maternal Monitoring

Younger sisters of teenage parents have elevated rates of engaging in unprotected sex. This may result from changes in parenting behavior after a sibling becomes pregnant or impregnates a partner, and be particularly pronounced for girls seeking mental health treatment. The current study examines condom use over time in 211 African-American girls recruited from outpatient psychiatric clinics. Findings indicate that having a sibling with a teenage pregnancy history predicts less consistent condom use 2 years later. After accounting for earlier condom use and mental health problems, maternal monitoring moderates condom use such that for girls with a sibling with a pregnancy history, more vigilant maternal monitoring is associated with increased condom use, while for girls with no sibling pregnancy history, maternal monitoring is unrelated to adolescents’ condom use 2 years later. Findings suggest that targeted interventions to increase maternal monitoring of high-risk teens may be beneficial for girls with a sibling history of teenage pregnancy.