Jocelyn Smith Carter

Post-Traumatic Reactions in Adolescents: How Well Do the DSM-IV PTSD Criteria Fit the Real Life Experience of Trauma Exposed Youth?

This study examined the structure and symptom specific patterns of post traumatic distress in a sample of 1,581 adolescents who reported exposure to at least one traumatic event. Symptom reporting patterns are consistent with past literature in that females reported more symptoms than males and older youth reported more symptoms than did their younger peers. Young people reporting exposure to exclusively violent type traumas were also found to be more likely to endorse symptoms than peers exposed exclusively to non violent type traumas. Confirmatory factor analysis provided stronger support for a four-factor model of PTSD than either the DSM-IV model or an alternate model. Further examination of the four factor model revealed gender differences in factor loadings with small to moderate effect sizes for recurrent, distressing memories, flashbacks, restricted affect, difficulty remember details, detachment, limited future orientation, hypervigilance and startle symptoms. Differences in factor loadings with the four factor model were also noted between younger and older adolescents, with medium to large effect sizes on the arousal items. In contract, comparison of the factor loadings revealed only small differences between youth exposed exclusively to violent traumatic stressors and those exposed exclusively to non violent traumatic stressors, suggesting relative similarity between these two groups.

Social Competence in Children with Chronic Illness: A Meta-analytic Review

OBJECTIVE To conduct a meta-analysis of social competence in children with a chronic illness. METHODS The meta-analysis included 57 studies comparing levels of social competence in children with chronic illness to those of children without chronic illness. A random effects model was used to calculate overall effect, subgroup, and meta-regression analyses. RESULTS Overall, the meta-analysis calculated 90 unique outcomes, producing a summary standardized mean difference of d = -0.44, 95% confidence interval (95% CI) -0.52 to -0.36 indicating a medium overall effect for decrease social competence. Chronic illness, measure, and informant moderated social competence outcomes. CONCLUSIONS The impact of chronic illness on youth varied by individual child factors (e.g., gender, chronic illness type) and by measurement features such as informant and measure type. The current study demonstrates a need for further research of the assessment of social competence and has implications for the development of social skills programs for children with chronic illness.

Predictors of the first onset of a major depressive episode and changes in depressive symptoms across adolescence: Stress and negative cognitions.

This 6-year longitudinal study examined stressors (e.g., interpersonal, achievement), negative cognitions (self-worth, attributions), and their interactions in the prediction of (a) the first onset of a major depressive episode (MDE), and (b) changes in depressive symptoms in adolescents who varied in risk for depression. The sample included 240 adolescents who were first evaluated in Grade 6 (M = 11.86 years old; SD = 0.57; 54.2% female) and then again annually through Grade 12. Stressful life events and depressive diagnoses were assessed with interviews; negative cognitions and depressive symptoms were assessed with self-report questionnaires. Discrete time hazard modeling revealed a significant interaction between interpersonal stressors and negative cognitions, indicating that first onset of an MDE was predicted by high negative cognitions in the context of low interpersonal stress, and by high levels of interpersonal stressors at both high and low levels of negative cognitions. Analyses of achievement stressors indicated significant main effects of stress, negative cognitions, and risk in the prediction of an MDE, but no interactions. With regard to the prediction of depressive symptoms, multilevel modeling revealed a significant interaction between interpersonal stressors and negative cognitions such that among adolescents with more negative cognitions, higher levels of interpersonal stress predicted higher levels of depressive symptoms, whereas at low levels of negative cognitions, the relation between interpersonal stressors and depression was not significant. Risk (i.e., maternal depression history) and sex did not further moderate these interactions. Implications for intervention are discussed.

The Influence of Stressors on the Development of Psychopathology

This chapter provides a brief history of the ways in which researchers have defined, conceptualized, and measured stress and provides recommended definitions and conceptualizations of stress for use in research and practice with children and adolescents. The chapter also reviews evidence that (a) stressors contribute to psychopathology; (b) moderators influence the relation between stressors and psychopathology; (c) mediators explain the relation between stressors and psychopathology; (d) there is specificity in the relations among stressors, moderators, mediators, and psychopathology; and (e) relations among stressors, moderators, mediators, and psychopathology are reciprocal and dynamic. Finally, this chapter highlights methodological problems, particularly with stressor measurement, that have impeded progress in the field and lays out a research agenda for improving the measurement of stress.

Intervening Processes in the Relationship between Neighborhood Characteristics and Psychological Symptoms in Urban Youth.

The present study tested for mediators of the relation between neighborhood risk characteristics and internalizing and externalizing symptoms in a sample of 1,120 low-income urban adolescents. Results indicate that a composite of census tract variables predicted both internalizing and externalizing symptoms in this sample. Stressful life events and exposure to violence mediated the relation between neighborhood risk and aggression, delinquency, and somatic symptoms. Gender and age were examined as moderators of these mediational pathways. Results of moderated mediation analyses revealed that both gender and age moderated the pathways between stressors and somatic complaints and between exposure to violence and somatic complaints. Implications for intervention and areas for future research are discussed.

Family orientation, language, and anxiety among low-income Latino youth.

There is emerging evidence that Latino youth report higher levels of anxiety symptoms than children from other ethnic groups. Although often implicated, cultural variables have not been systematically evaluated to determine their relationship to anxiety symptoms in Latino youth. The present study examined family orientation values, as measured by family obligation and affiliative obedience, and their relationship to youth anxiety symptoms. The sample consisted of 133 Latino students (grades 5th through 7th) of low-income backgrounds in an urban public school setting. Structural equation models revealed that higher family orientation was associated with separation anxiety/panic (β=.32) and harm avoidance (β=.51). Models employing language proficiency and use mirrored those employing family orientation, suggesting that language fluency captures, in part, family socialization values. The results provide support for the impact of culture in the assessment and specific needs of Latino youth with anxiety problems.

Testing models of children's self-regulation within educational contexts: implications for measurement.

Young childrens self-regulation has increasingly been identified as an important predictor of their skills versus difficulties when navigating the social and academic worlds of early schooling. Recently, researchers have called for greater precision and more empirical rigor in defining what we mean when we measure, analyze, and interpret data on the role of childrens self-regulatory skills for their early learning (Cole, Martin, & Dennis, 2004; Wiebe, Espy, & Charak, 2008). To address that call, this chapter summarizes our efforts to examine self-regulation in the context of early education with a clear emphasis on the need to consider the comprehensiveness and precision of measurement of self-regulation in order to best understand its role in early learning.

Mediating Effects of Stress, Weight-Related Issues, and Depression on Suicidality in College Students

Abstract Objective: Through a holistic health lens, the current study examines the effects of weight-related issues and stress on suicidality while controlling for depressive symptoms in college students. Participants: In total, 872 undergraduate and graduate students at DePaul University completed the American College Health Association–National College Health Assessment II Web-based survey in Spring 2010. Methods: Measures of suicidality, depression, weight-related issues, and life stressors were assessed, along with gender differences. Results: Females reported experiencing more weight loss attempts and total stressors than males. Weight-related issues and stress both significantly predicted depressive symptoms in a path analysis; depressive symptoms, in turn, significantly predicted suicidality. Gender differences were found; depressive symptoms mediate the relation between stress and suicidal behavior for females but not for males. Implications: This investigation furthers previous research on suicidality in college students and suggests that all-inclusive interventions that address weight-related issues and stress may help reduce depressive symptoms, which then may reduce suicidal behavior.

The manifestation of depression in the context of urban poverty: a factor analysis of the Children's Depression Inventory in low-income urban youth.

The current study used confirmatory factor analysis (CFA) to compare the fit of 2 factor structures for the Childrens Depression Inventory (CDI) in an urban community sample of low-income youth. Results suggest that the 6-factor model developed by Craighead and colleagues (1998) was a strong fit to the pattern of symptoms reported by low-income urban youth and was a superior fit with these data than the original 5-factor model of the CDI (Kovacs, 1992). Additionally, results indicated that all 6 factors from the Craighead model contributed to the measurement of depression, including School Problems and Externalizing Problems especially for older adolescents. This pattern of findings may reflect distinct contextual influences of urban poverty on the manifestation and measurement of depression in youth.

A Prospective Comparison of Moderating Relationships among Stressors, Hopelessness, and Internalizing Symptoms in Low-Income Urban Youth with Asthma

There are many risk factors associated with the development of internalizing symptoms in low-income urban youth, and youth with asthma appear to be at greater risk for experiencing stressors in multiple domains. The purpose of the current study was to examine stressors, hopelessness, and the interaction between them, as predictors of trajectories of anxious/depressed and withdrawn symptoms over a 4-year period of adolescence. Participating in the study were 53 youth from Chicago public schools, the majority of whom identified themselves as African American or Latino. Multi-level modeling was used to examine major life events, daily hassles, exposure to violence, poverty, and hopelessness as predictors of both types of symptoms. Major life events and exposure to violence predicted anxious/depressed symptoms but not withdrawn symptoms. Hopelessness predicted both types of symptoms and further interacted with major life events to predict both anxious/depressed and withdrawn symptoms. Hopelessness also moderated the effects of daily hassles on anxious/depressed symptoms and poverty on withdrawn symptoms. Results of this study provide insight into the psychosocial risk factors associated with the experience of asthma in urban adolescents.