Clinical and Non-Clinical Characteristics Associated with Medication Use Among Children with Serious Emotional Disturbance

Our study explores the clinical and non-clinical characteristics associated with medication use among children with serious emotional disturbance who are referred into community-based family-driven system of care settings. Using data collected as part of the Comprehensive Community Mental Health Services for Children and Their Families Program initiative, our study provides results from analyses completed on 7,009 children and adolescents with serious emotional disturbance. Using both bivariate and multivariate statistical analyses, the researchers found that females entering systems of care were less likely to have received medication in the 6-months prior to entry, as were children of African-American and Native-American heritage compared to children from non-Hispanic White heritage. Children referred from mental health, child welfare or who were self-referred were more likely to use medications than those referred from juvenile justice. Children with histories of prior inpatient, outpatient, day treatment, or school-based services were between 2 and 4 times more likely to use medications than children without such histories. Children with family histories of mental illness and those who were Medicaid recipients were also more likely to use medications. Family income was also positively related to medication use and younger children were more likely to use medications than older children. Implications of the findings are discussed.     

State Hospital Reentry Among Youth with Serious Emotional Disturbance: A Longitudinal Analysis

We investigated the demographic, service history, and clinical factors associated with readmission to state operated inpatient psychiatric hospitals by children and adolescents. Using computerized administrative data records for 3,969 consecutive index admissions of individuals between the ages of 7 and 17 inclusive, we examined hospital reentry among youth receiving services at these facilities. The univariate analysis comparing youths who reentered the hospital with those who did not reenter indicated that reentry was more likely to occur among African American youths and among those who were diagnosed with psychotic disorders. Reentry occurred less frequently among youths diagnosed with depressive disorders. Reentry also occurred less frequently among youths living in areas having an organized array of community-based mental health services. Youths who reentered the hospital were significantly older and had longer prior hospitalizations than those not reentering. The proportional hazards model used in the analysis indicated several factors associated with increased likelihood of hospital reentry. African American youths and individuals diagnosed with a psychotic disorder were more likely to reenter the hospital. Younger youths and those having lengthy prior hospitalizations were at increased risk for reentering the hospital. Youths living in urban, white, higher income communities were less likely to reenter the hospital.     

Use of cognitive question testing methodologies in participant action research: implementing the Three-Step Test-Interview Method in Indian county

This study describes the use of cognitive question testing methods to pretest a Web-based questionnaire designed to gather information from American Indian and Alaska Native (AI/AN) youth between the ages of 18 and 25. The questionnaire included items related to risk and resiliency factors as well as potentially sensitive topics of victimization and delinquency. Question testing was completed with a sample of 15 youth living in three different regions of the United States. The Three Step Test Interview Method was modified to collect information related to interface usability, cognitive response, and cultural interpretation of survey items. Data collected from the question testing process resulted in questionnaire changes that included query wording, the inclusion and exclusion of survey items based on cultural input, the reordering and rendering of survey items, and improvements in interface usability. Implications for survey research with the AI/AN youth population are discussed.     

The Social Construction of Love Through Intergenerational Processes

Love became an integral part of marriage in Western culture in the mid-1900s. Marriage began to change along with the inclusion of love, which is evidenced by changes in divorce rates. While marriages themselves change, love too may be influenced in a reciprocal process. This study was interested in identifying the association between parental relationship factors, including marital status and interparental conflict, and both the experience of and expectations for love. The sample was collected using online convenience sampling, and included (N = 207) heterosexually married participants. Hierarchical multiple regressions were conducted to determine the unique contribution of the parent marital factors on love. Higher levels of interparental conflict were associated with lower levels of love and expectations for love, while having parents who were separated was associated with higher relationship expectations. These findings can support case conceptualizations for clinical work with couples and the use of Narrative and Transgenerational therapies.     

Adult Survivors of Child Abuse: An Application of John Gottman’s Sound Marital House Theory

The purpose of this study was to examine the relationship between child abuse and dysfunctional adult relationship patterns. John Gottman’s Sound Marital House Theory describes different dysfunctional adult relationship patterns including Negative Sentiment Override (NSO), Flooding, and the Distance and Isolation Cascade. In the present study, data analysis indicated that child abuse predicts the experiencing of NSO, NSO predicts the experiencing of flooding, and flooding predicts the experiencing of the distance and isolation cascade. Analysis showed that a subscale of child abuse, negative home environment predicts NSO, flooding, and the distance and isolation cascade.     

Marriage and Family Therapy Graduate Students’ Satisfaction with Training Regarding Religion and Spirituality

Marriage and family therapists are likely to encounter religious or spiritual clients in their career and thus are encouraged to be aware of their clients’ religious and spirituality. This awareness is often fostered within graduate training programs. This study aims to examine graduate students’ incorporation of religion and spirituality in therapy and their satisfaction with the quality and amount of training programs’ adherence to religion and spirituality. A sample of 135 graduate students from American Association for Marriage and Family Therapy accredited programs completed the survey. Findings showed that graduate students with greater levels of religiosity and spirituality were more likely to perceive it important to address religion/spirituality in therapy and to perceive there is a need for religious/spiritual education. When controlling for religious and spiritual orientations, overall regression results revealed that not having a course on religion and spirituality and perceiving a need for religious/spirituality in education predicted lower satisfaction with the amount and quality of current training surrounding these dimensions. Implications demonstrate the need to address religious/spiritual concepts in the curriculum, supervision, and in marriage and family therapy training.     

Predictors of Length of Stay Among Youths Hospitalized in State Hospitals in Illinois

Using data from the Integrated Database on Children and Family Services in Illinois, we examined factors associated with the length of psychiatric hospitalization of youths in state hospitals between July 1, 1987 and June 30, 1992. Univariate analysis indicated that those diagnosed with attention deficit, psychotic, and conduct disorder experienced longer hospitalizations. In contrast, youths diagnosed with depressive disorders, drug and alcohol disorders, and adjustment disorders had shorter hospitalizations. Youths receiving services from multiple sectors of the human service delivery system experienced longer hospitalizations. Youths living in communities with state hospital linked community-based mental health services had shorter hospitalizations. Males experienced longer hospitalizations than females and African American youths experienced longer hospitalizations than White youths. Hispanic youths experienced shorter stays than either White or African American youths. The proportional hazards model indicated that being female, a history of previous admissions, multiservice use, and dangerousness were all associated with the decreased likelihood of discharge. Psychotic, attention deficit, and bipolar disorders were also associated with a decreased likelihood of hospital discharge. Youths with depressive disorders and African Americans with psychotic disorders had an increased likelihood of discharge. Increased age was also associated with the increased likelihood of discharge.