Kristyn Zajac

Depression and Delinquency Covariation in an Accelerated Longitudinal Sample of Adolescents

OBJECTIVES The current study tested opposing predictions stemming from the failure and acting out theories of depression-delinquency covariation. METHOD Participants included a nationwide longitudinal sample of adolescents (N = 3,604) ages 12 to 17. Competing models were tested with cohort-sequential latent growth curve modeling to determine whether depressive symptoms at age 12 (baseline) predicted concurrent and age-related changes in delinquent behavior, whether the opposite pattern was apparent (delinquency predicting depression), and whether initial levels of depression predict changes in delinquency significantly better than vice versa. RESULTS Early depressive symptoms predicted age-related changes in delinquent behavior significantly better than early delinquency predicted changes in depressive symptoms. In addition, the impact of gender on age-related changes in delinquent symptoms was mediated by gender differences in depressive symptom changes, indicating that depressive symptoms are a particularly salient risk factor for delinquent behavior in girls. CONCLUSION Early depressive symptoms represent a significant risk factor for later delinquent behavior--especially for girls--and appear to be a better predictor of later delinquency than early delinquency is of later depression. These findings provide support for the acting out theory and contradict failure theory predictions.

Prevalence and Correlates of Elder Mistreatment in South Carolina: The South Carolina Elder Mistreatment Study:

The purposes of this study were to (a) derive prevalence estimates for elder mistreatment (emotional, physical, sexual, neglectful, and financial mistreatment of older adults [age 60 +]) in a randomly selected sample of South Carolinians; (b) examine correlates (i.e., potential risk factors) of mistreatment; and (c) examine incident characteristics of mistreatment events. Random Digit Dialing (RDD) was used to derive a representative sample in terms of age and gender; computer-assisted telephone interviewing was used to standardize collection of demographic, correlate, and mistreatment data. Prevalence estimates and mistreatment correlates were obtained and subjected to logistic regression. A total of 902 participants provided data. Prevalence for mistreatment types (since age 60) were 12.9% emotional, 2.1% physical, 0.3% sexual, 5.4% potential neglect, and 6.6% financial exploitation by family member. The most consistent correlates of mistreatment across abuse types were low social support and needing assistance with daily living activities. One in 10 participants reported either emotional, physical, sexual, or neglectful mistreatment within the past year, and 2 in 10 reported mistreatment since age 60. Across categories, the most consistent correlate of mistreatment was low social support, representing an area toward which preventive intervention may be directed with significant public health implications.

Prevalence and Impact of Substance Use Among Emerging Adults with Serious Mental Health Conditions

TOPIC This critical review of the literature integrates findings across varied literatures and identifies areas for continued study on the prevalence, correlates, and impact of substance use (alcohol and illicit drugs) on social role functioning among emerging adults with serious mental health conditions. PURPOSE This population is of interest because of high comorbidity rates between substance use and serious mental health conditions and the added difficulties posed by their co-occurrence during the transition to adulthood. This critical review presents the epidemiology of substance use in emerging adults with serious mental health conditions compared to emerging adults without these conditions, as well as what is known about predictors and consequences of substance use in this population. SOURCES USED PsychINFO and PubMed along with relevant published literature. RESULTS This review summarizes what is known about the impact of these co-occurring problems on the transition of emerging adults from school and training environments to adult work roles. Though this group presents with unique challenges, few programs have been developed to address their specific needs. This paper synthesizes what is known empirically about approaches with this population, discussing those that might be useful for emerging adults with comorbid serious mental health conditions and substance use problems, particularly in supporting their educational and vocational development. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Emerging adults with co-occurring serious mental health conditions and substance use problems are underserved by current mental health systems. Recommendations focus on how to promote mental health and social role functioning through comprehensive intervention programs that provide continuity of care through the transition to adulthood.

Child Sexual Abuse Prevention Training for Childcare Professionals: An Independent Multi-Site Randomized Controlled Trial of Stewards of Children

Given the significant rates and deleterious consequences of childhood sexual abuse (CSA), identifying effective primary prevention approaches is a clear priority. There is a growing awareness that childcare professionals (e.g., teachers, childcare personnel, clergy) are in a unique position to engage in prevention efforts due to high accessibility to children and expertise in child development. However, CSA prevention programs targeting childcare professionals have received insufficient attention. The goal of this study was to conduct an independent multi-site controlled evaluation of an existing CSA prevention program, Stewards of Children, offered through both in-person and web-based formats. This study included 352 childcare professionals recruited from children’s advocacy centers across three states. Participants were randomly assigned to one of three conditions: (1) in-person training, (2) web-based training, or (3) waitlist control. Dependent variables included CSA knowledge, CSA attitudes, and self-reported CSA preventive behaviors. Results indicated that Stewards impacted knowledge, attitudes, and preventive behaviors. No differences were found between training modalities (i.e., in-person versus web-based) on knowledge and preventive behaviors. Results indicate that brief trainings for childcare professionals may impact CSA prevention efforts.

Maternal support following childhood sexual abuse: Associations with children's adjustment post-disclosure and at 9-month follow-up

Maternal support has been widely cited as an important predictor of childrens adjustment following disclosure of sexual abuse. However, few studies have examined these effects longitudinally. The current study examines the relationships between a multidimensional assessment of maternal support rated by both mothers and children and childrens adjustment in various domains (internalizing, externalizing, anger, depression, and posttraumatic stress disorder symptoms) concurrently and longitudinally. Participants were 118 mother-child dyads recruited from a Child Advocacy Center where children were determined through a forensic evaluation to be victims of sexual abuse. Child and mother ratings of maternal support and child adjustment were collected shortly after the forensic evaluation and at 9-month follow-up. Results were consistent with findings from past studies that maternal support is significantly related to childrens post-disclosure adjustment and extends these findings longitudinally. Additionally, the study sheds light on differential relations between dimensions of maternal support (Emotional Support, Blame/Doubt, Vengeful Arousal, and Skeptical Preoccupation) and child adjustment and suggests the importance of using both child and mother ratings of maternal support in future research.

Feasibility and acceptability of a child sexual abuse prevention program for childcare professionals: comparison of a web-based and in-person training.

Recent prevention research has established the efficacy of some child sexual abuse prevention programs targeting adults; however, less is known about the feasibility of implementing such programs. The current study examines the feasibility and acceptability of a child sexual abuse prevention program for child care professionals provided in two different formats: in person and Web based. The sample consisted of 188 child care professionals from a large-scale, multisite, randomized controlled trial. Findings indicate that both in-person and online training formats are feasible to implement and acceptable to professionals. When comparing formats, the in-person format was favored in terms of comfort level and likelihood of sharing information with others. These findings have significant implications for dissemination of child sexual abuse prevention programs for child care professionals.

Psychiatric Problems and Trauma Exposure in Nondetained Delinquent and Nondelinquent Adolescents

This study examined the prevalence of and associations between specific psychiatric disorders, substance use problems, and trauma exposure in a sample of delinquent and nondelinquent adolescents. A nationally representative sample of adolescents (n = 3,614; M age = 14.5 years, SD = 1.7; 51% male; 71% White, non-Hispanic, 13.3% African American, non-Hispanic, 10.7% Hispanic) was interviewed via telephone about engagement in delinquent acts and their experience of posttraumatic stress disorder, major depressive episode, substance use, interpersonal violence, and other forms of trauma exposure. Delinquent adolescents were more likely than nondelinquent adolescents to experience trauma; they were also more likely to report past-year posttraumatic stress disorder, major depressive episode, alcohol abuse, and nonexperimental drug use. After accounting for the effects of demographics and trauma exposure, delinquency was associated with increased likelihood of posttraumatic stress disorder and problematic substance use in both genders and increased likelihood of major depressive episode in girls. Findings highlight substantial overlap among delinquency, trauma exposure, posttraumatic stress disorder, and major depressive episode in adolescents and the need for interventions that address these varied clinical problems. Future work should examine the factors underlying the development of these relations over time.

Adolescent Distress in Traumatic Stress Research: Data From the National Survey of Adolescents-Replication

Small numbers of adults report distress in response to traumatic stress surveys. Less is known about adolescent research participants. We examined distress in response to a survey on traumatic stress using data from the National Survey of Adolescents-Replication, a nationally representative sample of 3,614 youth aged 12-17 years. Although 204 (5.7%) adolescents found some questions distressing, only 8 (0.2%) remained upset at the end of the interview, and 2 (<0.1%) wished to speak to a counselor. Adolescents reporting traumatic experiences or mental health problems were significantly more likely to report distress compared to those not endorsing such problems. Significantly more girls (7.5%) reported distress than boys (3.9%). Findings suggest that survey questions about trauma pose minimal risk to adolescents.

Multisystemic Therapy for Externalizing Youth

Externalizing problems are multidetermined and related to individual, family, peer, school, and community risk factors. Multisystemic therapy (MST) was originally developed to address these risk factors among youth with serious conduct problems who are at-risk for out-of-home placement. Several decades of research have established MST as an evidence-based intervention for adolescents with serious clinical problems, including serious offending, delinquency, substance abuse, and parental physical abuse and neglect. This article presents an overview of the clinical procedures and evidence base of MST for externalizing problems as well as 2 adaptations: MST for Substance Abuse and MST for Child Abuse and Neglect.

Longitudinal Examination of PTSD Symptoms and Problematic Alcohol Use as Risk Factors for Adolescent Victimization

The current study examined associations between posttraumatic stress disorder (PTSD) symptoms and future interpersonal victimization among adolescents, after accounting for the impact of early victimization exposure, gender, ethnicity, and household income. In addition, problematic alcohol use was tested as a mediator of the relation between PTSD symptoms and subsequent victimization. Participants included a national longitudinal sample of adolescents (N = 3,604) who were ages 12 to 17 at the initial assessment: 50% were male, and 67% were White, 16% African American, and 12% Hispanic. Cohort-sequential latent growth curve modeling was used to examine associations among the study variables. Baseline PTSD symptoms significantly predicted age-related increases in interpersonal victimization, even after accounting for the effects of earlier victimization experiences. In addition, alcohol problems emerged as a partial mediator of this relation, such that one fourth to one third of the effect of PTSD symptoms on future victimization was attributable to the impact of PTSD symptoms on alcohol problems (which, in turn, predicted additional victimization risk). Collectively, the full model accounted for more than half of the variance in age-related increases in interpersonal victimization among youth. Results indicate that PTSD symptoms serve as a risk factor for subsequent victimization among adolescents, over and above the risk conferred by prior victimization. This increased risk occurred both independently and through the impact of PTSD symptoms on problematic alcohol use. Based on these findings, it is hypothesized that the likelihood of repeated victimization among youth might be reduced through early detection and treatment of these clinical problems.