Hugh F. Crean

Family Processes and Problem Behaviors in Middle‐Class African American Adolescents

This study examined the joint association between mothers’ and adolescents’ ratings of parental behavioral control and adolescents’ and observers’ ratings of mother – adolescent communication with adolescent problem behaviors in a sample of 86 middle-class African American early adolescent boys and girls (age: M= 13.08 years, SD= 1.32) and their mothers. Consistent with hypotheses, greater adolescent-rated parental behavioral control and better observer-rated mother – adolescent communication were associated with lower levels of adolescent problem behavior, as examined using structural equation modeling. Furthermore, interrelationships between age and adolescent problem behavior were partially mediated by adolescents’ reports of parental behavioral control and observers’ ratings of positive mother – adolescent communication, which both decreased with adolescents’ age. Although the sample was primarily middle class, higher socioeconomic status was associated with more positive mother – adolescent communication, as rated by observers. Problem behavior was greater among boys than girls, but the hypothesized indirect effect of gender on problem behavior through associations with parenting was not observed. The findings demonstrate the utility of conceptually distinguishing between parenting and parent – adolescent relationships, and suggest that both have unique influences on middle-class African American adolescents’ problem behavior.

Social support, conflict, major life stressors, and adaptive coping strategies in Latino middle school students: An integrative model.

Structural equation modeling techniques were used to test a conceptual framework for improved understanding of the relationships involved in adolescent risk and protective factors. Specifically, the model examined the direct and indirect associations, via adaptive coping strategies, that acute life stressors and contextual support and conflict have with psychological adjustment (internalizing and externalizing symptoms) and school competencies (GPA, classroom-conduct scores, and peer ratings of social competence). Participants were 304 inner-city Latino 6th- and 7th-grade middle school students (133 boys, 171 girls). Results found both acute stressors and social conflict to be positively associated with psychological symptomatology and negatively associated with school competencies.In addition, both social support and adaptive coping strategies were negatively associated with symptomatology; social support was positively associated with school competencies. Moreover, support and conflict were associated with psychological symptomatology and school competencies indirectly, mediated by adaptive coping strategies. Adaptive coping strategies were inversely related to school competencies, an unexpected finding. Implications, limitations, and future areas of study are discussed.

Reducing sexual risk behavior in adolescent girls: results from a randomized controlled trial.

PURPOSE Teenage girls in low-income urban settings are at an elevated risk for HIV, sexually transmitted infections, and unintended pregnancies. The purpose of this study was to evaluate the efficacy of a sexual risk-reduction (SRR) intervention, supplemented with postintervention booster sessions, targeting low-income, urban, sexually active teenage girls. METHOD Randomized controlled trial in which sexually active urban adolescent girls (n = 738) recruited in a midsize northeastern U.S. city were randomized to a theory-based SRR intervention or to a structurally equivalent health promotion control group. Assessments and behavioral data were collected using audio computer-assisted self-interview at baseline, then at 3, 6, and 12 months postintervention. Both interventions included four small-group sessions and two booster sessions. RESULTS Relative to girls in the control group, girls receiving the SRR intervention were more likely to be sexually abstinent; if sexually active, they showed decreases in (a) total episodes of vaginal sex at all follow-ups, (b) number of unprotected vaginal sex acts at 3 and 12 months, and (c) total number of sex partners at 6 months. Medical record audits for girls recruited from a clinical setting (n = 322) documented a 50% reduction in positive pregnancy tests at 12 months. CONCLUSIONS Theory-based behavioral interventions tailored to adolescent girls can help to reduce sexual risk and may also reduce unintended pregnancies. Although sexually active at enrollment, many of the girls receiving the intervention were more likely to practice secondary abstinence. Continued refinement of SRR interventions for girls is needed to ensure they are feasible, appealing, and effective.

Patterns of Organized Activity Participation in Urban, Early Adolescents: Associations with Academic Achievement, Problem Behaviors, and Perceived Adult Support.

This study examines patterns of organized activity and their concurrent association with academic achievement, problem behavior, and perceived adult support in a sample of urban, early adolescent, middle school students (mean age = 13.01; N = 2,495). Cluster analyses yielded six activity profiles: an uninvolved group ( n = 775, 31.1%), a multiply involved group (n = 247, 9.9%), a sports group (n = 469, 18.8%), a church group (n = 486, 19.5%), a school and community clubs group (n = 278, 11.1%), and a community clubs and sports group (n = 240, 9.6%). These profiles are differentially associated with academic achievement, problem behavior, and adult support. While some form of organized activity is generally associated with more positive outcomes, the school and community and community and sports profiles also report the highest levels of delinquency, drug use, and school suspensions. Results support the utility of using person-centered approaches to studying youth-organized activities.

Promoting Alternative Thinking Strategies (PATHS) and Elementary School Aged Children's Aggression: Results from a Cluster Randomized Trial

This study reports on aggressive outcomes from a cluster randomized trial of the Promoting Alternative Thinking Strategies (PATHS) curriculum. Fourteen elementary schools were randomly assigned to intervention or control condition and third grade students were followed through the fifth grade. Teacher and self-reports of student aggression, conduct problems, delinquency, acting out problems, and social information processing (SIP) variables were collected. Linear change for each of the SIP variables was noted with control students demonstrating increased normative beliefs about aggression, increased aggressive social problem solving, increased hostile attribution bias, and increased aggressive interpersonal negotiation strategies over time while PATHS students remained relatively stable. Teachers reported significant curvilinear change in student aggression, conduct problems, and acting out behavior problems; all favoring PATHS students.

Risk Behaviors Among Adolescent Girls in an HIV Prevention Trial

Adolescent girls remain vulnerable to HIV and other sexually transmitted infections. Understanding their sexual and substance use behaviors is essential to designing effective interventions to reduce their risk. In this study, baseline data were analyzed from 738 adolescent girls ages 15 to 19 years in Rochester, New York. Data on sexual behavior and substance use (lifetime, past 3 months, and most recent sexual experience) were collected. Nearly one half of recent vaginal (42%) and anal (45%) sex acts were not condom protected; 39% had a prior sexually transmitted infection (STI) and 12% were currently infected with an STI. Approximately one third (31%) of girls had more than one sex partner in the past 3 months. Girls with multiple partners reported that their recent sexual experiences were more likely to involve drug and alcohol use by themselves and partners. Adolescent girls, particularly those with multiple sexual partners, continue to report high-risk sexual behaviors and need focused risk-reduction interventions.

School-based child care for children of teen parents: evaluation of an urban program designed to keep young mothers in school

Abstract This study examined the effects of the school-based Early Childhood Centers for Children of Teen Parents Program. Designed to keep young mothers in school, the program provides needed support to urban young mothers including free on-site child care for their infants and toddlers, parenting classes, and referral to other service agencies. Archived school record information was collected on teen mothers who participated in the program (n=81) and on a group of teen mothers who had applied for the program but did not receive services (n=89). Controlling for pre-service differences, participant mothers were found to have better school attendance and deemed to be at lower overall risk than were the non-participant young mothers. Significant differences were also evident in the graduation rates of these young mothers—70% of the participant mothers graduated, 28% of the non-participant young mothers graduated. Logistic regression correctly classified graduation/drop-out status in 76% of the cases. School attendance, mothers age at birth of the child, and participation/non-participation in the program were significant predictors. Percent core courses passed and average risk scores did not significantly add to prediction. Implications and future areas of study are discussed.

Meditation programs for veterans with posttraumatic stress disorder: Aggregate findings from a multi-site evaluation.

OBJECTIVE Interest in meditation to manage posttraumatic stress disorder (PTSD) symptoms is increasing. Few studies have examined the effectiveness of meditation programs offered to Veterans within Department of Veterans Affairs (VA) mental health services. The current study addresses this gap using data from a multisite VA demonstration project. METHOD Evaluation data collected at 6 VA sites (N = 391 Veterans) before and after a meditation program, and a treatment-as-usual (TAU) program, were examined here using random effects meta-analyses. Site-specific and aggregate between group effect sizes comparing meditation programs to TAU were determined for PTSD severity measured by clinical interview and self-report. Additional outcomes included experiential avoidance and mindfulness. RESULTS In aggregate, analyses showed medium effect sizes for meditation programs compared to TAU for PTSD severity (clinical interview: effect size (ES) = -0.32; self-report: ES = -0.39). Similarly sized effects of meditation programs were found for overall mindfulness (ES = 0.41) and 1 specific aspect of mindfulness, nonreactivity to inner experience (ES = .37). Additional findings suggested meditation type and program completion differences each moderated program effects. CONCLUSIONS VA-sponsored meditation programs show promise for reducing PTSD severity in Veterans receiving mental health services. Where meditation training fits within mental health services, and for whom programs will be of interest and effective, require further clarification. (PsycINFO Database Record

Meditation and yoga for posttraumatic stress disorder: A meta-analytic review of randomized controlled trials

Posttraumatic stress disorder (PTSD) is a chronic and debilitating disorder that affects the lives of 7-8% of adults in the U.S. Although several interventions demonstrate clinical effectiveness for treating PTSD, many patients continue to have residual symptoms and ask for a variety of treatment options. Complementary health approaches, such as meditation and yoga, hold promise for treating symptoms of PTSD. This meta-analysis evaluates the effect size (ES) of yoga and meditation on PTSD outcomes in adult patients. We also examined whether the intervention type, PTSD outcome measure, study population, sample size, or control condition moderated the effects of complementary approaches on PTSD outcomes. The studies included were 19 randomized control trials with data on 1173 participants. A random effects model yielded a statistically significant ES in the small to medium range (ES=-0.39, p<0.001, 95% CI [-0.57, -0.22]). There were no appreciable differences between intervention types, study population, outcome measures, or control condition. There was, however, a marginally significant higher ES for sample size≤30 (ES=-0.78, k=5). These findings suggest that meditation and yoga are promising complementary approaches in the treatment of PTSD among adults and warrant further study.

Risk Reduction Strategies used by Urban Adolescent Girls in an HIV Prevention Trial

UNLABELLED Adolescent girls throughout the globe are particularly vulnerable to HIV infection. In the U.S., sexually-active, adolescent girls in urban settings are at elevated risk for HIV. The purpose of this study was to describe a theoreticallydriven, HIV prevention intervention tailored for adolescent girls and evaluate its effectiveness in reducing sexually-risky behaviors. Sexually-active urban adolescent girls (n=738) recruited in a mid-size, northeastern U.S. city were recruited for a randomized controlled trial and participated in a theory-based, sexual risk reduction intervention or a structurallyequivalent health promotion control group. Preferred sexual risk-reduction strategies were collected using ACASI at baseline, then at 3, 6 and 12-months post-intervention. The manualized interventions included four small group sessions and two booster sessions all of which included information, motivational and behavioral skill constructs. Facilitators were trained in motivational interviewing and incorporated this technique throughout the sessions. Relative to girls in the control group, girls receiving the sexual risk-reduction intervention were more likely to increase the number of sexual-risk reduction strategies at post-intervention; however, girls in the control group also increased the number of strategies used though not at the same rate. Theory-based, HIV interventions tailored to adolescent girls can help increase sexual riskreduction behaviors and provide girls with a menu of options to employ. Due to the manualized structure of this randomized controlled trial, the intervention could be modified to meet the needs of adolescent girls throughout the world. TRIAL REGISTRATION This study is registered at ClinicalTrials.gov (NCT 00161343).