PREVENTION OF DEPRESSIVE SYMPTOMS IN SCHOOLCHILDREN:

Abstract— After teaching cognitive and social-problem-solving techniques designed to prevent depressive symptoms, we followed 69 fifth- and sixth-grade children at risk for depression for 2 years. We compared these children with 49 children in a matched no-treatment control group The prevention group re- ported fewer depressive symptoms through the 2-year follow-up, and moderate to severe symptoms were reduced by half. Surprisingly, the effects of the prevention program grew larger after the program was over. We suggest that psychological immunization against depression can occur by leaching cognitive and social skills to children as they enter puberty     

Prevalence of Child and Adolescent Exposure to Community Violence

Emerging as one of the most significant health issues facing American youth today, child and adolescent exposure to community violence has generated much interest across multiple disciplines. Most research to date has focused on documenting the prevalence of community violence and the emotional and behavioral ramifications. This paper provides an overview of the current literature regarding prevalence of youth exposure to community violence, and identifies those areas where further research is warranted. In addition to examining overall rates of community violence exposure, this paper reviews the prevalence of different types of community violence, such as weapon use, physical aggression, and crime-related events. Predictors of community violence exposure, including gender, age, race, socioeconomic status, behavior patterns, and geography, are discussed.     

All symptoms are not created equal: the prominent role of hyperarousal in the natural course of posttraumatic psychological distress

This 3-wave longitudinal study examined the natural course of posttraumatic stress disorder symptoms using data collected from young adult survivors of community violence. Three key findings emerged. 1. Mean levels of distress for each symptom cluster decreased over time, with reexperiencing decreasing most rapidly. 2. Cross-lagged panel analysis revealed that hyperarousal strongly influences, but is not generally influenced by, other symptoms clusters. 3. Trajectory analysis demonstrated that respondents for whom hyperarousal was the most pronounced baseline symptom showed lower overall symptom improvement relative to trauma exposed counterparts for whom hyperarousal was a less prominent early symptom. Implications for theory, research, and clinical practice are discussed.     

Prevention of depressive symptoms in school children

This paper describes the development and preliminary efficacy of a program designed to prevent depressive symptoms in at-risk 10–13 year-olds, and relates the findings to the current understanding of childhood depression. The treatment targets depressive symptoms and related difficulties such as conduct problems, low academic achievement, low social competence, and poor peer relations, by proactively teaching cognitive techniques. Children were identified as ‘at-risk’ based on depressive symptoms and their reports of parental conflict. Sixty-nine children participated in treatment groups and were compared to 73 children in control groups. Depressive symptoms were significantly reduced and classroom behavior was significantly improved in the treatment group as compared to controls at post-test. Six-month follow-up showed continued reduction in depressive symptoms, as well as significantly fewer externalizing conduct problems, as compared to controls. The reduction in symptoms was most pronounced in the children who were most at risk.     

Violence Exposure and PTSD: The Role of English Language Fluency in Latino Youth

Although Latinos have been a rapidly growing population in the US, little is known about how mental health symptoms may present in Latino children especially in the context of those living in poverty and exposed to violence. We explored the level of violence exposure and trauma symptoms in Latino youth and the relationship of these factors with English language fluency. During 2000–2002, 1,601, Latino students from seven middle schools participated in a school-based screening to identify students with exposure to community violence and symptoms of Posttraumatic Stress Disorder (PTSD). The students completed a self-report instrument, in either Spanish or English, that combined a modified version of the Life Events Scale and the Child PTSD Symptom Scale (CPSS). Bivariate analyses and multivariate regression models showed that youth with higher English language fluency reported greater violence exposure and PTSD symptoms than those with lower fluency. No difference was found in functioning by English language fluency. English language fluency appears to be related to violence exposure and PTSD symptoms in these Latino youth. We discuss the importance of school-based programs especially designed to serve Latino students of varying English language fluency.     

Preparing for Deployment: Examining Family- and Individual-Level Factors

Deployment can be a significant source of stress for military families. Understanding how families prepare in the face of such stress, and which families are more versus less likely to prepare, is a priority of the Department of Defense. However, there has been scant research on how families prepare for deployments and the factors associated with engagement in preparation activities. The current study is a cross-sectional examination of the proportion of households engaging in deployment preparation activities and family-level and individual-level factors that are associated with these activities in a large and representative sample of married, deployable service members and their families from all military services and components (n = 1,621). Overall, results showed that families reported high rates of engaging in preparation activities, with particularly strong engagement in financial and legal preparation tasks. Talking about deployment to prepare a spouse or child was also relatively highly endorsed but not as frequently cited compared to other logistical preparation activities. Older spouses, officers, active component families, and those with higher marital satisfaction reported greater participation in preparation activities. Families with greater socioemotional difficulties, as indexed by child emotional problems or greater depressive symptoms in the service member or spouse, as well as those with lower spouse-reported marital satisfaction, were more likely to seek professional help. Evaluating the effectiveness of programs in reaching the families that may be least likely to prepare, as well as examining the longitudinal association between deployment preparation and postdeployment family adjustment, is an important area for further inquiry.     

Depression in youth: psychosocial interventions

Witnessed over the past 20 years are major advances in knowledge regarding depression in children and adolescents. Although additional research is needed, clinicians can now turn to treatment strategies with demonstrated efficacy. In this article we review the literature on psychosocial interventions for depression in youth and offer a working model to guide the treatment of depressed youth. We begin with a brief overview of the model, followed by a review of the treatment efficacy and prevention literatures. We offer some caveats that impact the ability to move from this treatment literature to the real world of clinical practice. We conclude by considering how extant research can inform treatment decisions and highlight critical questions that need to be addressed through future research.     

Development and validation of a modified version of the Peritraumatic Dissociative Experiences Questionnaire

This article reports results from 3 studies conducted to develop and validate a modified version of the self-administered form of the Peritraumatic Dissociative Experiences Questionnaire (PDEQ; C. R. Marmar, D. S. Weiss, & T. J. Metzler, 1997). The objective was to develop an instrument suitable for use with persons from diverse ethnic and socioeconomic backgrounds. In Study 1, the original PDEQ was administered to a small sample (N = 15) recruited from among men admitted to the hospital for physical injuries stemming from exposure to community violence. Results led to modifications aimed at improving the utility of the instrument. In Study 2, the modified PDEQ was subjected to structural equation modeling and item response theory analyses to assess its psychometric properties in a larger, primarily male, sample of community violence survivors (N = 284). In Study 3, the reliability and validity of the modified instrument were further assessed in a sample of female survivors of sexual assault (N = 90). Results attest to the psychometric properties as well as the reliability and validity of the modified 8-item PDEQ.     

Fear in Adolescent Dating Relationships

The aims of this study were to assess fearful and aversive aspects of dating relationships among teens and to examine those experiences by gender. We examined both survey data and cognitive interviews with teens to understand how teens experience their dating relationships and how they interpret the meaning of the items in a fear measure modified for use with teens. We found that fearful and aversive dating situations are common in adolescent dating relationships. As teens move along the continuum from friendships to romantic involvement, both boys and girls experience the aggressive and coercive behaviors that sometimes accompany these new emotional and interpersonal situations.