Cristina M. López

Sex Differences and Response Styles: Subtypes of Rumination and Associations with Depressive Symptoms

In view of recent findings regarding the multifaceted nature of rumination in adults and older adolescents, the purpose of this study was to evaluate the construct of rumination as a 2-factor model (brooding and reflection) in a child and early adolescent sample as well as examine sex differences and associations between depressive symptoms and these ruminative subtypes. Participants were children in 2nd through 7th grades (N = 303). Results of a confirmatory factor analysis supported the hypothesis that subtypes of rumination (2-factor model) are present in children and provided a better fit than a unitary construct of rumination (1-factor model). As predicted, girls endorsed higher levels of brooding than boys, and brooding (not reflection) was uniquely related to depressive symptoms. Results revealed that a distinction between brooding and reflection subtypes is warranted as it can help lead to better assessment and identification of risk factors of depression.

Sex differences in relational and overt aggression in the late elementary school years

Sex differences in relational and overt aggression among 3rd (n=176), 4th (n=179), and 5th graders (n=145) from three public schools (n=500; 278 girls) were examined. Nominations of relational aggression increased over time among 4th and 5th grade girls, but not among boys or 3rd grade girls. Among 3rd graders, boys received more nominations for relational aggression than girls. By the end of the 5th grade, girls received more relational aggression nominations than boys. There was also a significant rise in nominations of overt aggression among 5th grade girls, but not among 5th grade boys or younger boys and girls. As expected, boys were more likely than girls to be nominated for overt aggression at all grade levels. The findings are helpful for explaining inconsistencies of earlier research pertaining to sex differences in relational aggression and for advancing our understanding of the causes of aggression.

Ethnic and sex differences in children's depressive symptoms.

This study examined ethnic and sex differences in childrens depressive symptoms, along with hypothesized mediators of those differences (academic achievement, peer acceptance), in a follow-up of African American (n = 179) and Euro-American (n = 462) children in Grades 3 to 5. African American boys reported more depressive symptoms than African American girls, and Euro-American boys and girls. Also, depressive symptoms of African American boys increased over time whereas depressive symptoms of the other groups decreased or remained stable. Academic and social competence deficits were associated with elevated levels of depressive symptoms across the school year, although only academic achievement scores emerged as a unique predictor of increases in depressive symptoms over time. Neither academic nor social competence mediated the Sex × ethnicity interaction in changes in childrens depressive symptoms.

Ethnicity differences in child and parental outcomes following involvement the PACE program.

This study investigated ethnic differences in the extent to which engagement (i.e., attendance and quality of participation) in the PACE (Parenting our Children to Excellence) program predicted positive child and parent outcomes. PACE is an 8-week preventive intervention aimed at parents of preschool children. The study investigated the relation of engagement to outcomes in an ethnically diverse sample of 298 African American and 280 European American parents. Overall results demonstrated that engagement in PACE significantly improved child and parent outcomes for both African American and European American participants. Some improvements were evident at post-assessment already and were maintained or became stronger at a one-year follow-up assessment, whereas others only became evident at follow-up. Specifically, results revealed that attendance in PACE significantly improved child coping competence and parenting stress for both the African American and European American samples. PACE attendance also significantly improved child behavior problems, parental satisfaction and parental efficacy for the European American sample. Findings indicate that PACE is a promising intervention for parents of African American and Caucasian preschoolers; although further research and program refinement is necessary in order to understand the mechanisms with the PACE intervention that seem to vary for African American compared to Caucasian families.

Pretreatment Intervention Increases Treatment Outcomes for Patients with Anxiety Disorders.

The current study evaluated the utility of a pretreatment intervention aimed at increasing treatment attendance. We extended past work by evaluating whether this intervention was associated with less impairment at termination. Given that patients with anxiety disorders demonstrate high rates of premature termination, we assessed whether these patients would be particularly likely to benefit. The sample included 172 patients at a community outpatient mental health clinic. Patients were assigned to the intervention condition (asked to imagine attending therapy sessions) or an information control condition. Number of sessions attended and termination Clinician Global Impressions (CGI) served as outcome variables. Contrary to prior work, the two conditions did not significantly differ on outcomes. Yet, patients with anxiety disorders in the intervention condition attended the most sessions and had least termination symptom severity. This intervention may provide a simple yet powerful method to increase treatment adherence and effectiveness for patients with anxiety disorders.

Treatment satisfaction of home-based telehealth versus in-person delivery of prolonged exposure for combat-related PTSD in veterans

Introduction Although there is growing support that evidence-based psychotherapies (EBPs) delivered in-person and through telehealth are equivalent in terms of symptom reduction for posttraumatic stress disorder (PTSD), there has been far less investigation comparing these treatment modalities in terms of patient satisfaction. The present study investigated participant satisfaction and perception of the quality of service delivery within a clinical trial comparing the delivery of an EBP, Prolonged Exposure (PE) for PTSD, through home-based telehealth and in-person services. Methods Veterans (N = 67) with PTSD were randomized to receive PE via video telehealth technology (n = 27) or via in-person delivery (n = 40). Participants completed service demographic questions, PTSD symptom assessments, and satisfaction and service delivery perception questionnaires. Results Analyses of covariance were used to investigate the influence of treatment modality on patient satisfaction and perceived quality of service delivery, while controlling for demographics and PTSD symptoms. No differences were observed on the majority of measures, with the exception of participants in the telehealth condition endorsing willingness to drive further for telehealth services as compared with participants in the in-person condition. Discussion Findings illustrate participant satisfaction and acceptance of EBPs delivered via telehealth at a level consistent with that of in-person services. Preliminary findings suggest that the experience of receiving telehealth services may be associated with increased willingness to participate in telehealth services again. Together, these findings of patient satisfaction and acceptance of telehealth services support the ongoing delivery of EBPs via telehealth as well as their future expansion.

Development and preliminary evaluation of a behavioural HIV-prevention programme for teenage girls of Latino descent in the USA

National data suggests that teenage girls of Latino descent in the USA are disproportionately affected by HIV, with the US Centers for Disease Control and Prevention reporting the rate of new infections being approximately four times higher compared to White women of comparable age . This paper highlights the need for an effective single-sex HIV-prevention programme for teenage girls of Latino descent and describes the development and preliminary evaluation of Chicas Healing, Informing, Living and Empowering (CHILE), a culturally-tailored, HIV-prevention programme exclusively for teenage girls of Latino descent that was adapted from Sisters Informing, Healing, Living and Empowering (SiHLE), an evidence-based HIV- prevention program that is culturally tailored for African American young women. Theatre testing, a pre-testing methodology to assess consumer response to a demonstration of a product, was utilised to evaluate the relevance and utility of the HIV programme as well as opportunities for the integration of cultural constructs. Future directions for the evaluation of CHILE are discussed.

Parental child abuse potential and subsequent coping competence in disadvantaged preschool children: Moderating effects of sex and ethnicity

This study evaluated the effects of abuse potential in parents on subsequent coping competence domains in their children, using a model empirically supported in a high-risk community sample by Moreland and Dumas (2007). Data from an ethnically diverse sample of 579 parents enrolled in the PACE (Parenting Our Children to Excellence) program was used to evaluate whether parental child abuse potential assessed at pre-intervention negatively contributed to child affective, achievement, and social coping competence in preschoolers one year later, and whether these associations were moderated by sex or ethnicity. Cross-sectional results indicated that parental child abuse potential was negatively related to child affective and achievement coping competence, after accounting for variance associated with child behavior problems. However, child abuse potential was not predictive of subsequent coping competence in any domain after controlling for previous levels of child coping competence. No moderating effects were found for sex and ethnicity, but results showed main effects of sex and ethnicity in cross-sectional analyses. Clinical implications and future directions are discussed.

Racial/Ethnic Differences in Trauma Exposure and Mental Health Disorders in Adolescents.

Objective: Research has cited increased prevalence of mood disorders, anxiety disorders, and exposure to interpersonal violence for Hispanics and non-Hispanic Black adolescents, as well as ethnic differences in externalizing behavior (e.g., substance use, delinquency). The current study combined these areas by examining racial/ethnic differences in mental health correlates of trauma exposure. Method: Interviews were conducted to assess polyvictimization, posttraumatic stress disorder (PTSD), major depressive disorder (MDD), substance use, and delinquency in a nationally representative sample of adolescents (N = 3,614; 15.4% non-Hispanic Black; 11.3% Hispanic; 64.9% non-Hispanic White). Results: Hispanic and non-Hispanic Black adolescents endorsed greater polyvictimization than non-Hispanic Whites; however, differences in MDD and PTSD were only significant when assessed with symptom counts. Non-Hispanic Black adolescents reported the least drug use. Non-Hispanic Black and Hispanic adolescents endorsed more delinquency than non-Hispanic White adolescents. Polyvictimization only accounted for ethnic disparities in delinquency. Conclusion: Trauma-related disparities may differ across internalizing and externalizing concerns. Subsequent research should continue to examine other factors that may contribute to racial/ethnic differences in trauma sequelae.

The emergence of co-occurring adolescent polysubstance use and depressive symptoms: A latent growth modeling approach

This study tests competing models of the relation between depression and polysubstance use over the course of adolescence. Participants included a nationwide sample of adolescents (N = 3,604), ages 12 to 17 at study Wave 1, assessed annually for 3 years. Models were tested using cohort-sequential latent growth curve modeling to determine whether depressive symptoms at baseline predicted concurrent and age-related changes in drug use, whether drug use at baseline predicted concurrent and age-related changes in depressive symptoms, and whether initial levels of depression predicted changes in substance use significantly better than vice versa. The results suggest a transactional model such that early polysubstance use promotes early depressive symptoms, which in turn convey elevated risk for increasing polysubstance use over time, which in turn conveys additional risk for future depressive symptoms, even after accounting for gender, ethnicity, and household income. In contrast, early drug use did not portend risk for future depressive symptoms. These findings suggest a complicated pattern of interrelations over time and indicate that many current models of co-occurring polysubstance use and depressive symptoms may not fully account for these associations. Instead, the results suggest a developmental cascade, in which symptoms of one disorder promote symptoms of the other across intrapersonal domains.