Christina F. Mondi

Adverse Childhood Experiences and Adult Well-Being in a Low-income, Urban Cohort.

OBJECTIVE: This study tests the association between adverse childhood experiences (ACEs) and multidimensional well-being in early adulthood for a low-income, urban cohort, and whether a preschool preventive intervention moderates this association. METHODS: Follow-up data were analyzed for 1202 low-income, minority participants in the Chicago Longitudinal Study, a prospective investigation of the impact of early experiences on life-course well-being. Born between 1979 and 1980 in high-poverty neighborhoods, individuals retrospectively reported ACEs from birth to adolescence, except in cases of child abuse and neglect. RESULTS: Nearly two-thirds of the study sample experienced ≥1 ACEs by age 18. After controlling for demographic factors and early intervention status, individuals reporting ACEs were significantly more likely to exhibit poor outcomes than those with no ACEs. Those with ≥4 ACEs had significantly reduced likelihood of high school graduation (odds ratio [OR] = 0.37; P < .001), increased risk for depression (OR = 3.9; P < .001), health compromising behaviors (OR = 4.5; P < .001), juvenile arrest (OR = 3.1; P < .001), and felony charges (OR = 2.8; P < .001). They were also less likely to hold skilled jobs (OR = 0.50; P = .001) and to go further in school even for adversity measured by age 5. CONCLUSIONS: ACEs consistently predicted a diverse set of adult outcomes in a high-risk, economically disadvantaged sample. Effective and widely available preventive interventions are needed to counteract the long-term consequences of ACEs.

Processes of Early Childhood Interventions to Adult Well‐Being

This article describes the contributions of cognitive-scholastic advantage, family support behavior, and school quality and support as processes through which early childhood interventions promote well-being. Evidence in support of these processes is from longitudinal cohort studies of the Child-Parent Centers and other preventive interventions beginning by age 4. Relatively large effects of participation have been documented for school readiness skills at age 5, parent involvement, K-12 achievement, remedial education, educational attainment, and crime prevention. The three processes account for up to half of the program impacts on well-being. They also help to explain the positive economic returns of many effective programs. The generalizability of these processes is supported by a sizable knowledge base, including a scale up of the Child-Parent Centers.

Scaling and Sustaining Effective Early Childhood Programs Through School–Family–University Collaboration

We describe the development, implementation, and evaluation of a comprehensive preschool to third grade prevention program for the goals of sustaining services at a large scale. The Midwest Child–Parent Center (CPC) Expansion is a multilevel collaborative school reform model designed to improve school achievement and parental involvement from ages 3 to 9. By increasing the dosage, coordination, and comprehensiveness of services, the program is expected to enhance the transition to school and promote more enduring effects on well‐being in multiple domains. We review and evaluate evidence from two longitudinal studies (Midwest CPC, 2012 to present; Chicago Longitudinal Study, 1983 to present) and four implementation examples of how the guiding principles of shared ownership, committed resources, and progress monitoring for improvement can promote effectiveness. The implementation system of partners and further expansion using “Pay for Success” financing shows the feasibility of scaling the program while continuing to improve effectiveness.

Predictors of depressive symptoms in emerging adulthood in a low-income urban cohort

This study examined predictors of depressive symptoms in emerging adulthood in a sample of 1,142 individuals (94% African American) who grew up in urban poverty. Data were drawn from a longitudinal study that followed participants from age five and included participant, parent, and teacher surveys, and administrative records. Depressive symptoms were self-reported at age 22-24 using a modified version of the Brief Symptom Inventory (BSI; Derogatis, 1975). Binary logistic regression analyses identified several significant predictors of depressive symptoms in emerging adulthood, including: sex, adverse childhood experiences (ACE) score, socio-emotional adjustment in the classroom, juvenile arrest, and on-time graduation. Significant sex differences were also detected, with the final models fitting the male sample better than the full study or female samples. Implications for future research and intervention are discussed.

Tier 3: Longitudinal Studies of Mediators, Moderators, and Multiple Social-Ecological Levels

This chapter provides a review based on the best studies focused on prevention and intervention for youth exposed to political violence and armed conflict. Prevention and intervention programs in this area have often been characterized by limitations of research design, severely limiting the interpretability of the findings with regard to program efficacy. In this chapter, we identify key elements for more cogent prevention and intervention research, including (a) the use of randomized clinical trials (RCTs), and intervention components are based on (b) well-articulated theory and (c) basic research findings regarding mediating and moderating mechanisms, and (d) the identification of intervention components at multiple levels of the social ecology. We provide and analysis of key findings, implications and strengths and limitations of the prevention and intervention research, and the extent to which extant research meet the criteria of translational research. In addition, Table 7.1 presents handy reference to a group of the best psychosocial prevention and intervention studies representing diverse geographic contexts and political conflicts, a range of independent and dependent variables, diverse youth populations, and multiple research groups. Moreover, the selected studies often included relatively large sample sizes, stronger sampling procedures, RCT designs, appropriate statistical analyses, and other evidence of methodological rigor or sophistication.

Political Violence, Armed Conflict, and Youth Adjustment: A Worldwide Perspective

This chapter introduces the extent, significance, and urgency of the worldwide problem posed by youth exposure to political violence and armed conflict, and the promise of research informed by a developmental psychopathology perspective for advancing both theoretical understanding and more effective prevention and intervention. Notably, over one billion children under the age of 18 are growing up in contexts of political violence and armed conflict worldwide. A developmental psychopathology perspective provides cogent bases for the development of well-delineated theoretical and methodological approaches for conceptual understanding of the impact of armed conflict and political violence on youth, including the consideration of developmental and social-ecological contexts, and advocacy of longitudinal research. Building on the cumulative evidence for the risk of negative outcomes in youth, a developmental psychopathology perspective provides foundations for advancing understanding of (a) causal processes, (b) understanding of the impact of the many levels of youth’s social ecologies (e.g., home and community), and (c) translational research, that is, implementation of research findings in the development of more effective evidence-based intervention programs. In this book, developmental psychopathology is developed as a valuable and cogent guiding model for future advances in scientific and applied directions.

Tier 1 Studies: Documenting the Impact on Youth

This chapter focuses on explicating the status of the literature documenting the impact of political violence and armed conflict on youth, including violence exposure, youth adjustment (e.g., PTSD and externalizing problems), and risk and resilience. Notably, youth affected by political violence and armed went largely unstudied until the twentieth century. Although methodologically limited, early studies based primarily on youth exposed to war during World War II provided important initial information about the psychological effects of exposure on youth. Since the end of the Cold War, research has introduced new and more rigorous methodologies for studying youth adjustment in diverse worldwide contexts of political violence and armed conflict, documenting the incidence, prevalence, and diverse forms of developmental outcomes experienced by youth with different demographic characteristics and exposure experiences throughout the world. We provide an extensive review of the key findings, strengths, and limitation of this extensive literature. In addition, illustrating and documenting the best studies in this literature form a worldwide perspective, and detailed information is presented on a selection of highly meritorious Tier 1 studies in Table 4.1, providing a useful and handy reference regarding the characteristics, qualities, research designs, and key findings from an illustrative and noteworthy group of studies from this extensive and important worldwide literature.

Developmental Psychopathology as a Guiding Model

This chapter articulates a developmental psychopathology perspective as a promising guiding model for significant future advancements in the study of youth affected by political violence and armed conflict. Developmental psychopathology has a goal of integrating multidisciplinary approaches to foster more informative explanatory models for normal and abnormal development, including understanding both positive and negative trajectories of development over time, risk and resilience, and advocating for translational research approaches for more effective prevention and intervention. From this perspective, the identification of a problem and its correlates—for example, the number of youth affected by political violence and armed conflict—only establishes that a problem exists, not why, how, when, and for whom the problem develops, or how the problem should be addressed. Emphasis is thus placed on uncovering the processes, including mediators and moderators, underlying the many particular developmental outcomes (e.g., PTSD, specific psychopathologies; prosocial behavior and other positive youth outcomes) and the pertinent social-ecological (e.g., family; community; school; ethnic identity; and culture) and developmental factors, with the ultimate goal of translating this knowledge base into better interventions to promote healthier outcomes in youth living in contexts of armed conflict and political violence. Translational research is advanced as a concept that provides a cutting-edge foundation for fostering cogent scientific bases for more effective prevention and intervention.

A Vision for Future Research from a Developmental Psychopathology Perspective

This book systematically brought together the multiple and valuable directions of previous studies on political violence and youth adjustment in a conceptual pyramid informed by the tenets of developmental psychopathology. Thus, a value added of this book is to bring together the multiple directions in research on political violence, armed conflict, and youth adjustment with clear recommendations for future research and practice. Consistent with a developmental psychopathology perspective, work in each tier is mutually informative and synergistic with work in other tiers; the findings across the tiers should be systematically integrated to improve this field. More generally, the principles of a developmental psychopathology perspective offer well-developed future directions for advances in the study of youth and armed conflict. Moreover, this book specifically highlights the importance of process-oriented, longitudinal research from a social-ecological perspective. In conclusion, this book provides an accessible, integrative window into the state of the art in this important complex, multidisciplinary, worldwide literature and provides many guides and recommendations for ways for this area of research to move forward.

Tier 4: Prevention and Intervention Research

The goal of this chapter was to provide a roadmap for future research, based on a developmental psychopathology perspective of youth developing in contexts of political violence. Recommendations are organized by the tiers of the pyramid and aim to guide researchers at each tier to produce more information to be used by the subsequent tier. Multiple specific suggestions are made to improve research designs, approaches to analyses, and inclusion of additional variables (e.g., assessing outcomes other than psychopathology). Future translational research programs would be strengthened by greater engagement with basic research on the impact of armed conflict on children and should consider targeting multiple levels of the social ecology. Moreover, consistent with the National Institute of Mental Health advice, prevention and intervention research holds particular (and largely untapped) promise for informing conceptual models and future basic research. We also emphasize the importance of clear, accurate, underlying theory. That is, robust theoretical models that articulate specific predictions relating to timing, and developmental change should guide study design, development, implementation, and evaluation. Without this theoretical foundation, statistical bases for adequately determining mediating and moderating processes may be inadequately articulated and/or justified.