INTERDEPENDENCE OF STRESS PROCESSES AMONG AFRICAN AMERICAN FAMILY MEMBERS: INFLUENCE OF HIV SEROSTATUS AND A NEW INFANT

This study makes a theoretical contribution to stress process research by using a systemic approach to contextualize individual outcomes within the framework of other family members' experience. Utilizing a mixed model approach, indicators of the stress process of urban low-income HIV(+) African American recent mothers were found to affect the psychological distress and perceived adequacy of coping of multiple other family members. These relationships were found to be strongest proximal to birth and to be exacerbated by HIV infection. Social support to the mother was found to have differential effects depending on whether it was from the immediate family or outside sources. HIV infection of the recent mother was found to affect family members both through relationships of the mother's stress process and through their own coping responses.     

The impact of politeness and relationship on perceived quality of advice about a problem

Advice is a common but potentially problematic way to respond to someone who is distressed. Politeness theory (Brown & Levinson, 1987) suggests advice threatens a hearer's face and predicts that the speaker‐hearer relationship and the use of politeness strategies can mitigate face threat and enhance the effectiveness of advice messages. Students (N=384) read 1 of 16 hypothetical situations that varied in speaker power and closeness of the speaker‐hearer relationship. Students then read 1 of 48 advice messages representing different politeness strategies and rated the message for regard shown for face and for effectiveness. However, neither speaker‐hearer relationship nor politeness strategies was consistently associated with perceived threat to face or perceived advice effectiveness. We suggest revisions to politeness theory and additional factors that may affect judgments of face sensitivity and advice effectiveness.     

Cynical Hostility: A Risk Factor in HIV-1 Infection?1

The aims of this study of HIV-1 positive and HIV-1 negative gay males without disease were (a) to determine whether cynical hostility in these groups (measured by the Cook-Medley Ho scale) is associated with psychosocial deficits that potentially could influence the course of HIV infection; and (b) to examine the construct validity of the sum of three Ho subsets in this sample. Correlational analyses on the full samples, and multivariate analyses of high- and low-hostility groups (formed using Ho scale cutoffs from previous research), examined person variables (traits, coping style), environmental variables (social support, stressors), and affect. In all domains other than stressors (traits, coping styles, social support, and affect), cynical hostility was associated with psychosocial deficits, with results generally stronger for the full Ho scale than for the subset sum. Results support previous research on psychosocial deficits of the cynically hostile, extend findings to HIV-infected gay males, and enlarge our understanding of the trait and coping style correlates of cynical hostility. Implications of these findings for HIV infection are discussed.     

Motivational enhancement treatment in outpatient addiction centers: A multisite randomized trial

Background/Objectives: Motivational Enhancement Treatment in Spanish (METS) is a brief intervention aimed at resolving patient ambivalence towards behavior change that has demonstrated efficacy in substance use disorder treatment to reduce use and increase treatment engagement in different populations. In order to have evidence for its implementation in Mexico, a multi-site, randomized, two-arm, controlled clinical trial was conducted at three outpatient addiction treatment centers in the country to compare the effect of METS with Counseling as Usual (CAU). Method: One hundred and twenty patients were randomized to receive three sessions of METS (n = 54) or CAU (n = 66) during the first four weeks of treatment and were assessed during the following 12 weeks. Primary outcome measures were self-reported days of substance use and of treatment services utilization, which were tested using Generalized Estimating Equations. Results: Results associated both conditions with significant changes in substance use over, whereas there were no differences between conditions in substance use or in service utilization. Conclusions: Findings do not support the hypothesis that METS is more effective than CAU, but suggest that brief interventions at treatment initiation may improve patient outcomes.     

Association Between Socio-Ecological Risk Factor Clustering and Mental,Emotional, and Behavioral Problems in Hispanic Adolescents

Compared to non-Hispanic whites, Hispanic adolescents in the U.S. report higher rates of several mental, emotional, and behavioral problems such as substance use, sexual risk behaviors, and internalizing and externalizing problems. There is evidence of common pathways in the development of mental, emotional, and behavioral problems with certain subgroups of Hispanic adolescents being at greater risk. In the present article, we report analysis of baseline data for 959 Hispanic adolescents who participated in one of two randomized controlled trials evaluating a family-based preventive intervention. Utilizing latent class analysis, we identified subgroups of Hispanic adolescents based on socio-ecological risk and protective factors (e.g., parent–adolescent communication, parental involvement in school). Three distinct socio-ecological risk subgroups (high, medium, and low risk) were identified and exhibited significant differences from each other across a majority of socio-ecological risk and protective factors. Adolescents in higher socio-ecological risk subgroups reported greater mental, emotional, and behavioral problems across all outcomes. Individual comparisons revealed significant differences between the low socio-ecological risk group and both the medium and high socio-ecological risk group in lifetime alcohol use, smoking, and sex, as well as internalizing and externalizing problems. Implications for intervention include focusing on specific risk subgroups and targeting shared risk and protective factors rather than specific mental, emotional, and behavioral outcomes.     

The efficacy of structural ecosystems therapy with drug-abusing/dependent African American and Hispanic American adolescents.

Many family therapies for adolescent drug use include ecological interventions. The purpose of this randomized clinical trial was to establish whether ecological interventions contribute to the impact of family therapy above and beyond the contributions of family process-only interventions. A family-based ecological approach, structural ecosystems therapy (SET), was compared with family process-only condition (FAM) and community services control (CS). One hundred ninety substance-abusing or dependent African American and Hispanic adolescents were randomized to SET, FAM, or CS. Follow-up assessments were conducted at 3, 6, 12, and 18 months postrandomization. SET was significantly more efficacious than FAM and CS in reducing adolescent drug use. However, these improvements were limited to Hispanic adolescents. The study demonstrates the importance of investigating changes in adolescent drug use as a result of treatment condition across more than 1 racial/ethnic group.     

Stress processes in HIV-positive African American mothers: moderating effects of drug abuse history

This study examined the mechanism by which stressors, dissatisfaction with family, perceived control, social support, and coping were related to psychological distress in a sample of HIV-positive African American mothers. Additional analyses explored whether women who had a history of a drug abuse or dependence diagnosis differed either on levels of the study variables or the model pathways. The results indicated that HIV-positive African American mothers who had higher levels of stressors perceived their stressors as a whole to be less controllable. Coping resources, available social support and perceived control, were positively associated with active coping and negatively associated with psychological distress. Avoidant coping was the most important predictor of psychological distress. Furthermore, the effect of avoidant coping on psychological distress was stronger for mothers with a history of drug diagnosis. The implications of these findings for targeting interventions are discussed.     

The influence of negative advertising frames on political cynicism and politician accountability

This research examined the influence of negative political advertising frames on the thoughts and feelings people generate in response to campaign advertising. Preparing and conducting this investigation involved the use of a multiple‐method strategy. Content analysis identified two advertising frames (i.e., candidate theme and ad hoc issue advertisements) and two experiments separately induced political cynicism and politician accountability. Three hundred and sixty people participated in the experimental studies, in which they read and responded, using a thought‐listing technique, to candidate theme or ad hoc issue negative advertisements. Results demonstrated that participants were more likely to generate cynical comments and hold politicians accountable for the country's ills when reading candidate theme advertisements than ad hoc issue advertisements. The results indicate that this contributes to a political climate of cynicism and may function to erode the electorate's overall trust in government.     

Parent and child agreement on anxiety disorder symptoms using the DISC predictive scales

Growing recognition of the negative impact of anxiety disorders in the lives of youth has made their identification an important clinical task. Multiple perspective assessment (e.g., parents, children) is generally considered a preferred method in the assessment of anxiety disorder symptoms, although it has been generally thought that disagreement between parent and youth ratings of the child's emotions is common. This study examined parent and child reports of the child's anxiety disorder symptoms using the Diagnostic Interview Schedule for Children-Predictive Scales (DISC-PS) in a clinic-referred sample of substance using adolescents. Parents and adolescents (N = 480) who were referred for substance abuse treatment were screened for anxiety disorder symptoms using the DISC-PS at pretreatment. Results suggest similar (low) levels of agreement between the parent report and child report versions as found with other anxiety symptom and anxiety disorder measures. Findings provide data on multi-informant agreement and highlight issues in the use of the DISC-PS to identify anxiety problems in youth.     

The impact of family functioning on family racial socialization processes

This longitudinal study evaluated the relationship between family functioning and family racial socialization processes in a clinical sample of African American youth referred for drug abuse treatment. Participants were 77 African American adolescents and their parents. Results showed that participants assigned to structural ecosystems therapy experienced a greater increase in family racial socialization processes during treatment than participants assigned to the treatment as usual in community settings condition. Participants in structural ecosystems therapy also demonstrated a greater increase in family functioning than participants in community settings condition, and this improvement in family functioning mediated the relationship between treatment condition and family racial socialization processes. Research and clinical implications are discussed.