Carolyn J. Tompsett

Community violence: a meta-analysis on the effect of exposure and mental health outcomes of children and adolescents

Meta-analytic techniques were used to estimate the effects of exposure to community violence on mental health outcomes across 114 studies. Community violence had its strongest effects on posttraumatic stress disorder (PTSD) and externalizing problems and smallest impact on other internalizing symptoms. Victimization by community violence most predicted symptomatology compared to witnessing or hearing about community violence. Witnessing community violence had a greater effect than hearing about violence on externalizing problems, but both types of exposure had an equal impact on other internalizing problems. PTSD symptoms were equally predicted by victimization, witnessing, or hearing about community violence. Compared to children, adolescents reported a stronger relationship between externalizing behaviors and exposure, whereas children exhibited greater internalizing problems than did adolescents.

Psychometric properties of the Adolescent Sleep Hygiene Scale

This study evaluated the psychometric properties of the Adolescent Sleep Hygiene Scale (ASHS), a self‐report measure assessing sleep practices theoretically important for optimal sleep. Data were collected on a community sample of 514 adolescents (16–19; 17.7 ± 0.4 years; 50% female) participating in the late adolescent examination of a longitudinal study on sleep and health. Sleep hygiene and daytime sleepiness were obtained from adolescent reports, behavior from caretaker reports, and sleep‐wake estimation on weekdays from wrist actigraphy. Confirmatory factor analysis indicated the empirical and conceptually based factor structure were similar for six of the eight proposed sleep hygiene domains. Internal consistency of the revised scale (ASHSr) was α = 0.84; subscale alphas were: physiological: α = 0.60; behavioural arousal: α = 0.62; cognitive/emotional: α = 0.81; sleep environment: α = 0.61; sleep stability: α = 0.68; daytime sleep: α = 0.78. Sleep hygiene scores were associated positively with sleep duration (r = 0.16) and sleep efficiency (r = 0.12) and negatively with daytime sleepiness (r = −0.26). Results of extreme‐groups analyses comparing ASHSr scores in the lowest and highest quintile provided further evidence for concurrent validity. Correlations between sleep hygiene scores and caretaker reports of school competence, internalizing and externalizing behaviours provided support for convergent validity. These findings indicate that the ASHSr has satisfactory psychometric properties for a research instrument and is a useful research tool for assessing sleep hygiene in adolescents.

Age Differences Among Homeless Individuals: Adolescence Through Adulthood

The present study examines differences between homeless adolescents, young adults, and older adults served by homeless shelters or food programs to inform service provision. Four homeless studies using the same sampling and measurement methods were pooled to permit comparisons across age groups. Results showed that homeless adolescents demonstrated greater resilience than younger and older adults. Adolescents reported the shortest duration of homelessness, lowest number of life stressors, fewest physical symptoms, largest social networks, and fewest clinically significant mental health problems. Adolescents also received fewer alcohol and drug abuse diagnoses than younger and older adults. Younger adults reported less time homeless and fewer physical symptoms than older adults, but more life stressors. Younger adults also endorsed higher levels of hostile and paranoid psychological symptoms. Implications for service provision and policy are discussed.

Community and family violence: Indirect effects of parental monitoring on externalizing problems

This study examines the mediating role of parenting on the relationship between exposure to violence and externalizing problems. Participants include 214 at-risk urban adolescents. Structured interviews assessed exposure to community and family violence, parental monitoring and warmth, as well as substance abuse and conduct problems. Structural equation modeling provided evidence of a mediation model that fits European Americans but is less predictive for African Americans. For European Americans, findings suggest greater exposure to community violence is associated with more externalizing problems, and also indirectly effects problems by disrupting parental monitoring. Although family violence relates to less parental warmth, no association exits between warmth and externalizing problems. Unmeasured variables that contribute to racial differences may explain how violence impacts African American teens.

Grouping Youth With Similar Symptoms: A Person‐Centered Approach to Transdiagnostic Subgroups

OBJECTIVES The present study extracted symptom profiles based on parent and youth report on a broad symptom checklist. Profiles based on parent-reported symptoms were compared to those based on adolescent self-report to clarify discrepancies. METHOD The current study used archival data from 1,269 youth and parent dyads whose youth received services at a community mental health center. The mean age of the sample was 14.31 years (standard deviation = 1.98), and the youth sample was half male (50.1%) and primarily Caucasian (86.8%). Latent profile analysis was used to extract models based on parent and self-reported emotional and behavioral problems. RESULTS Results indicated that a 5-class solution was the best fitting model for youth-reported symptoms and an adequate fit for parent-reported symptoms. For 46.5% of the sample, class membership matched for both parent and youth. CONCLUSION Latent profile analysis provides an alternative method for exploring transdiagnostic subgroups within clinic-referred samples.

Prediction of restraints among youth in a psychiatric hospital: application of translational action research.

This study extends a translational action research program by applying a theoretically based measure of risk in predicting incidents of restraint among children and adolescents in a secure psychiatric hospital. Youth inpatients (N = 149, aged 5-17 years) were assessed at intake for the presence of selected individual and contextual risk factors, and their involvement in critical incidents was tracked (i.e., number of episodes in which restraint was applied) for the remainder of their hospitalization. Models including history of aggression or history of previous placements as well as combined models including several individual and contextual factors significantly predicted the likelihood of a youth becoming involved in at least one restraint. Unique predictors of restraint involvement included history of aggression against adults and history of previous psychiatric hospitalizations. None of the variables assessed predicted the extent of a youths restraint involvement. The implications of these findings are discussed with respect to future research and empirically informed practice with high-risk youth.

Travel beyond the home neighborhood for delinquent behaviors: moderation of home neighborhood influences.

Neighborhood research indicates that adolescents are at higher risk for delinquency when they reside in neighborhoods low in collective efficacy, low in perceived prosocial norms and values, and high in availability of substances and firearms. However, as adolescents develop, they are more likely to independently travel during their day-to-day activities, and the effects of their home neighborhood may be weakened as they spend time in other communities. The current study surveyed 179 adolescents involved in the juvenile justice system in a small Midwestern city on their perceptions of their home neighborhood and self-reported delinquency. While perceptions of several home neighborhood characteristics significantly predicted severity of delinquency for all respondents, neighborhood effects were significantly weaker for those adolescents who tended to engage in illegal behaviors outside their home neighborhood. These findings suggest that future research and prevention efforts should include more attention to how adolescents may be influenced by multiple neighborhoods.

Who Benefits from Community Mental Health Care? Using Latent Profile Analysis to Identify Differential Treatment Outcomes for Youth

Treatment effectiveness has been shown to vary across subgroups of youth based on characteristics such as comorbidity, problem severity, gender, and age. The current study aims to explore if subgroups of youth, identified by applying latent profile analysis to parent-reported symptoms, age, and gender, are better served by specific usual care services. Archival data from a community mental health center were utilized, including parent-reports of symptoms for 953 youth (44.4% female; ages 4–18) across multiple time-points, and services received. Latent profile analysis identified five subgroups including Low Risk, High Risk, Internalizing, Externalizing, and Delinquent/Depressed. The relationship between the intensity level of services and symptoms varied across subgroups. Specifically, high intensity services were related to a greater reduction in symptoms for the Internalizing, Externalizing, and High Risk subgroups. Implications for future developmental research and clinical applications are discussed.

Development and Validation of the Therapist Barriers to Engaging Parents (TBEP) Measure

Parent engagement is a well-documented challenge when delivering child and adolescent mental health treatments. Therapists’ internal experiences, and how they respond to parents, may create a barrier to the parent engagement process. The current study developed the 13-item Therapist Barriers to Engaging Parents measure (TBEP) to assess providers’ internal and external experiences that operate as barriers to parent engagement. The TBEP was completed by 148 child and family therapists across the United States. The TBEP demonstrated strong internal reliability (Cronbach α = .86), and was negatively correlated with counselor efficacy, and significantly positively correlated with burnout, indicating convergent validity. Incremental validity of the subscales of the TBEP was also demonstrated. The TBEP appears to be a psychometrically sound measure of the internal barriers mental health providers experience when trying to engage parents.

Sibling aggression among clinic-referred children and adolescents

Aggression against siblings has been associated with a number of negative outcomes within community samples of children and adolescents, but little is known about this phenomenon within clinical samples. The current study empirically identified subtypes of sibling aggression, assessed prevalence within a clinic-referred sample of children and adolescents, and described risk factors associated with sibling aggression. Surveys were administered as part of the intake procedures at a community mental health center serving children and adolescents. The current study analyzed reports of sibling-directed aggression and mother-to-child aggression, as well as symptom counts, from a sample of 346 matched pairs of mothers and children or adolescents. Ages of child/adolescent participants ranged from 7 to 18 (M = 12.92, SD = 2.82) and were 55.8% male. The sample was primarily Caucasian (90.2%), were lower income, and resided in a semirural midwestern county. Sibling-directed aggression was reported by 93.1% of mothers and 82.4% of children. Principal components analyses identified two subtypes of sibling aggression, mild and severe. Mother and child/adolescent reports of sibling aggression demonstrated only moderate agreement. Mother-to-child verbal aggression and corporal punishment were more predictive of sibling aggression than more severe maternal aggression, and externalizing symptoms were also associated with sibling aggression. Sibling-directed aggression is very common among clinic-referred children and adolescents and may be an important target for treatment. Using multiple reports of sibling aggression could increase the chances of detection, as would awareness of other risk factors associated with sibling aggression.