Supporting the Need for an Integrated System of Care for Youth with Co-occurring Traumatic Stress and Substance Abuse Problems

Adolescents are at high risk for violence exposure and initiation of drug use. Co-occurring substance use and trauma exposure are associated with increased risk of mental health disorders, school underachievement, and involvement with multiple systems of care. Coordination and integration of systems of care are of utmost importance for these vulnerable youth. This study delineates the negative sequelae and increased service utilization patterns of adolescents with a history of trauma, substance abuse, and co-occurring trauma and substance abuse to support the need for integrated mental health and substance abuse services for youth. Data from two national sources, the National Child Traumatic Stress Network and Center for Substance Abuse Treatment demonstrate the increased clinical severity (measured by reports of emotional and behavioral problems), dysfunction, and service utilization patterns for youth with co-occurring trauma exposure and substance abuse. We conclude with recommendations for an integrated system of care that includes trauma-informed mental health treatment and substance abuse services aimed at reducing the morbidity and relapse probability of this high-risk group.     

Physical health, positive and negative affect, and personality: A longitudinal analysis

This study used structural equation modeling to examine longitudinal relations among physical health, personality and mood in a sample of 360 college students. Research focused on the longitudinal associations among physical health and mood and their systematic relations with the Big Five personality dimensions of Extraversion and Neuroticism. Longitudinal analyses over successive 1-month intervals revealed lagged reciprocal effects between physical health and negative affect. After controlling for the effect of negative affect, physical health influenced subsequent positive affect, but positive affect did not influence subsequent physical health. Implications of these findings for subsequent research on health, personality, and emotions are discussed.     

Stress in Clinical Psychology Trainees: Current Research Status and Future Directions

The purpose of this article is to present the current status of the literature related to stress in clinical psychology trainees (CPTs), and to offer research directions for investigating stress in this population and ways to enhance self‐care in these individuals. The following conclusions emerge from the review: (1) CPTs are vulnerable to elevated stress; (2) undue stress can negatively impact CPTs' personal and professional functioning and, in turn, result in less than optimal standards of care for clients; (3) there is a dearth of studies on stress in this population and no published intervention studies; (4) incorporating self‐care strategies into clinical psychology training is recommended; and (5) “third‐wave” cognitive behaviour therapy stress management interventions have been efficacious in comparable populations. In view of the potential costs of elevated stress to trainees themselves and their clients, research on stress and stress management in this population is of a high priority. Broad research agendas are proposed for these two domains. Modifications to clinical training programmes to reduce trainee stress are required and should be evidence‐based and systematically revaluated.     

Longing,Dread and Care: Spengler’s Account of the Existential Structure of Human Experience

ABSTRACT

In The Decline of the West Spengler puts forward a type of philosophical anthropology, an account of the structures of human experiential consciousness and a method of “physiognomic” analysis, which I argue has dimensions that can be understood as akin to existential phenomenology. Humanity, for Spengler, is witness to the creative flux of “Becoming” and constructs a world of phenomena bounded by death, underpinned by the two prime feelings of dread and longing and structured by the two forms of Destiny (Time) and Direction (Space). Human existence, Spengler argues, is future-directed and open in the sense that there is a certain degree of freedom in the ways in which humanity can actualize its existential possibilities. In the course of elaborating the existential implications of this future-orientation, Spengler introduces the concept of care (Sorge), the fundamental experiential structure.     

Gender differences in subjective well-being, self-esteem and psychosocial functioning in adolescents with symptoms of anxiety and depression: findings from the Nord-Trøndelag Health Study

Derdikman‐Eiron, R., Indredavik, M. S., Bratberg, G. H., Taraldsen, G., Bakken, I. J. & Colton, M. (2011). Gender differences in subjective well‐being, self‐esteem and psychosocial functioning in adolescents with symptoms of anxiety and depression: Findings from the Nord‐Trøndelag health study. Scandinavian Journal of Psychology52, 261–267. Gender differences in the prevalence of symptoms of anxiety and depression during adolescence are well documented. However, little attention has been given to differences in subjective well‐being, self‐esteem and psychosocial functioning between boys and girls with symptoms of anxiety and depression. The aim of this study was to investigate gender differences in the associations between such symptoms and subjective well‐being, self‐esteem, school functioning and social relations in adolescents. Data were taken from a major population‐based Norwegian study, the Nord‐Trøndelag Health study (HUNT), in which 8984 (91% of all invited) adolescents, aged 13–19 years, completed an extensive self‐report questionnaire. Although prevalence rates of symptoms of anxiety and depression were higher in girls than in boys, a significant interaction between gender and symptoms of anxiety and depression was found in respect of each of the following outcome variables: subjective well‐being, self‐esteem, academic problems, frequency of meeting friends and the feeling of not having enough friends. These interactions indicate that the associations between symptoms of anxiety and depression and lower subjective well‐being and self‐esteem, more academic problems in school and lower social functioning were stronger for boys than for girls. Our findings may contribute to an earlier assessment and more efficient treatment of male adolescent anxiety and depression.     

Economic Hardship, Neighborhood Context, and Parenting: Prospective Effects on Mexican�CAmerican Adolescent��s Mental Health

This study examined family and neighborhood influences relevant to low-income status to determine how they combine to predict the parenting behaviors of Mexican-American mothers and fathers. The study also examined the role of parenting as a mediator of these contextual influences on adolescent internalizing and externalizing symptoms. Study hypotheses were examined in a diverse sample of Mexican-American families in which 750 mothers and 467 fathers reported on their own levels of parental warmth and harsh parenting. Family economic hardship, neighborhood familism values, and neighborhood risk indicators were all uniquely associated with maternal and paternal warmth, and maternal warmth mediated the effects of these contextual influences on adolescent externalizing symptoms in prospective analyses. Parents' subjective perceptions of neighborhood danger interacted with objective indicators of neighborhood disadvantage to influence maternal and paternal warmth. Neighborhood familism values had unique direct effects on adolescent externalizing symptoms in prospective analyses, after accounting for all other context and parenting effects.     

Multidimensional treatment foster care (MTFC): results from an independent replication

This study examines 24‐months post‐baseline outcomes for thirty‐five Swedish antisocial youths who received either treatment in multidimensional treatment foster care (MTFC) or treatment as usual (TAU). MTFC is a community‐based treatment programme that has been successful in treating chronic juvenile offenders in the USA. This study is the first randomized control study outside the USA. The youth treated in the MTFC programme consistently showed some statistically significant positive treatment effects compared to the youth exposed to TAU. The results suggest that MTFC might be an effective method in treating youth with severe behaviour problems in a Swedish context. The authors conclude that the programme ought to be of great interest for Swedish social services as an alternative to traditional care.     

A state level investigation of the associations among intellectual capital, religiosity and reproductive health

The current study examines the degree to which state intellectual capital, state religiosity and reproductive health form a meaningful nexus of ecological relations. Though the specific magnitude of effects vary across outcomes, results from hierarchical regression analyses were consistent with the hypothesized path model indicating that a state's intellectual capital (as indicated by average state IQ and graduation rates at various levels) has a positive overall effect on state reproductive health statistics, whereas state religiosity generally has a negative impact. Specifically, both IQ and education were positively associated with breastfeeding rates, immunization rates, and rates of mammography screening, and negatively associated with teen fertility rates and infant mortality rates. Additionally, results confirm that education rates partially mediate the influence of IQ onto religiosity, and both education and religiosity partially or fully mediate the relation between IQ and state health (depending on specific outcome measure). The current results are consistent with a growing interdisciplinary literature establishing that individual, state and national well-being is substantially related to general mental ability and its covariates.     

The Big-Five, sense of control, mental health and fear of crime as contributory factors to attitudes towards punishment

Low sense of control (SoC), mental health problems and fear of crime (FoC) have separately and previously been linked to the Big-Five personality dimensions, but no study to date has sought to integrate these constructs simultaneously in relation to overall punitiveness. These constructs were assessed in 232 participants using an online survey to examine hypothesised relations between FoC and SoC, poorer mental health, Neuroticism (N), Extraversion (E) and Conscientiousness (C), and any resultant punitiveness. Measures were highly correlated, and an exploratory factor analysis summarised these as ‘instability’ and ‘crime attitude’ dimensions. A structural equation model found that high levels of N and poor mental health, as well as low levels of C, E and SoC were related to a latent variable of ‘distress’, which fed into heightened FoC. High levels of C further influenced FoC, which subsequently had an effect on individuals’ greater punitiveness. The current study supports the previous literature regarding variables that influence FoC and attitudes to punishment, and establishes novel associations involving personality.