Linda Lewin

Social Determinants of Adolescent Depression: An Examination of Racial Differences

Conventional behavior theories that assert adolescent risk behaviors are determined by peer and parental relationships are being challenged as research begins to consider broader socioenvironmental factors. This study, using data from the Longitudinal Study for Adolescent Health (Add Health), Wave II, Public Use Data, and the Social Determinants of Adolescent Risk Behaviors (SDOARB) framework, examines relationships among socioeconomic status (SES), academic performance, perceived peer prejudice, and perceived teacher discrimination as predictors of depressive symptoms among high school adolescents. Overall, the study found that GPA was a significant predictor of depressive symptoms across all three racial groups (Black, White, and Other Minority). Teacher discrimination predicted depressive symptoms among White and Other minority adolescents, but not Black adolescents. These findings suggest the need for interventions within schools for both students and teachers around racial differences in perceptions of prejudice and discrimination. Failure to address overt and covert subtleties of discrimination and prejudice within schools and policies which affect these interpersonal dynamics may have a significant impact on the overall mental wellbeing of adolescents.

Challenges and strategies for conducting sensitive research with an Arab American population

Recruiting minority groups such as Arab Americans (Ar-Am) for research studies has been challenging. To date no studies were found that explicitly addressed challenges to recruit Ar-Am for sensitive research. The purpose of this article is to present the challenges across three pilot studies that involved Ar-Am samples and the strategies that were implemented to overcome these challenges. The challenges faced with conducting studies with Ar-Am included difficulty for participants to express emotions, influence of male/female authority to consent for the study, lack of trust to disclose sensitive information, language barrier, and slow recruitment. Having bilingual female recruiters of Arabic descent, engaging the womens family members in the consent process, and addressing the sensitive topics in culturally appropriate language were effective strategies to overcome these challenges. These strategies might be helpful for other researchers who recruit Ar-Am for sensitive research.

Families' and Victims' Characteristics Influencing Child Sexual Abuse

The purpose: Child sexual abuse is considered an important national public health problem that must be addressed with a sense of urgency. This paper was to provide a comprehensive information on the child and family characteristics which may influence the vulnerability of child sexual abuse. Recent findings: Underreporting of child sexual abuse may be due to family’s and children’s and their families’ characteristics. These include their demographics and personal characteristics. Summary: The important role of healthcare providers as well as parents to be aware of children’s and families’ characteristics which may influence child sexual abuse. It is discussed along with implications for praxis.

Arab American Adolescents’ Perceived Stress and Bullying Experiences: A Qualitative Study:

In 2012, 20% of high school students were bullied in the United States. Bullying is more prevalent among minority populations. Arab American adolescents receive little research attention and are described as the invisible population. This descriptive qualitative study was conducted with 10 Arab American adolescent bullying victims to describe their bullying experiences and related stress. In addition to being bullied because of health problems or social disadvantages, Arab American adolescents reported that they were bullied because of their ethnic/racial background and religious affiliation. Victims described high stress levels and anxiety which compromised their ability to function. They reported feeling sad, angry, overwhelmed, helpless, and hurt when they were bullied. They also lost control over their lives and self-confidence. Family and friends were sources of support but school administrators and teachers were not supportive. Implications for practice and future research were discussed.

Patterns of Sexual Abuse among Children: Victims’ and Perpetrators’ Characteristics

Most child sexual abuse research is based on the recollections of adults whose perspectives and biases might hinder identification of abuse risk factors. This study examined children’s immediate postassault reports. A convenience sample of health records of 95 children ages 6 to 14 treated in emergency departments from 2006 to 2010 was examined. Child victims’ mean age was 11.3; most were African American (87%) girls (86%) who were abused on weekends (73%). Most parents and caregivers (63%) reported alleged sexual abuse within 24 hours; 57% obtained medical help within 12 hours of abuse. Perpetrators had a mean age of 23.3, were overwhelmingly male (97%), and known to the child victims (80%), usually through their mothers, explaining why most children (57%) offered no resistance. Education, research, and health policy are needed to increase awareness of the potential for sexual abuse and physical harm to children by men known to the family.

Gender-related sexual abuse experiences reported by children who were examined in an emergency department.

The purpose of this study was to examine the experiences of sexual abuse by 95 children of two gender groups to determine differences in their reported sexual exploits by perpetrators. Significant differences between female and male children were reported. Male child-victims experienced more anal penetration by penis (54.5%, 10.7% respectively) and finger (27.3%, 2.7% respectively), however; female child-victims experienced more mouth contact to their genitalia (22.7%, 10.0% respectively) and body kisses (47.9%, 9.1% respectively). A more gender-specific approach could help to facilitate prevention, and produce better outcomes.

A methodological pilot: parenting among women in substance abuse treatment.

BackgroundMothers who abuse substances are likely to have insecure emotional attachment with their children, placing their children at risk for social–emotional and psychiatric conditions. Sobriety does not inevitably improve parenting. ObjectivesWe tested recruitment methods, audiovisual (AV) recording procedures, the protocol for identifying child abuse risk, the coding of mother–child interactions, and retention of the sample for repeated measures as the first phase in examining mother–child relational quality of women in substance abuse treatment. DesignThis innovative study involved AV recordings to capture the in-vivo mother–child interactional behaviors that were later coded and analyzed for mean scores on the 64-item Parent–Child Relational Quality Assessment. Repeated measurement was planned during treatment and two months after discharge from treatment. ResultsThe pilot involved a small sample (n = 11) of mother–child (<6 years) dyads. Highest and lowest ratings of interaction behaviors were identified. Mothers showed less enthusiasm and creativity but matched their child’s emotional state. The children showed appropriate motor skill items and attachment behaviors. The dyad coding showed less mutual enjoyment between the mother and child. Eight of the participants could not be located for the second measurement despite multiple contact methods. ConclusionsAV recordings capture rich, descriptive information that can be coded for interactional quality analysis. Repeated measurement with this cohort was not feasible, thus needing to assess for additional/more frequent contacts to maintain the sample.

Living with the loss of a child: mothers in the criminal justice system.

OBJECTIVE Bereaved mothers have expressed the need to maintain a bond with their children who have died, to retain control over the funeral rituals, and to express their loss to others who are empathetic. This study describes grief over the loss of a child in women who have been or are currently incarcerated, and the influence of the womens family members. METHOD This descriptive qualitative study consisted of open-ended interview questions to encourage the women to describe their experience in their own words. A purposive sample (N = 10) was recruited from a prison re-entry program and a county jail. RESULTS All of the participants described maladaptive responses such as the use of alcohol and drugs, restricted family support, and dysfunctional coping. None of the participants had received focused bereavement services. SIGNIFICANCE OF RESULTS The descriptive perspective from the participants can inform clinicians who work with women who have a history of involvement with the criminal justice system, and recommends that they should inquire about the womens children and experiences with loss. Community re-entry and jail/prison counselors should provide access to confidential and group-based therapeutic support, including Compassionate Friends.

Mother–Child Relational Quality of Women in Substance Abuse Treatment

BACKGROUND: Mothers who abuse substances are more likely to have impaired parenting and lose custody of their young children. OBJECTIVE: The pilot study described mother–child relational quality of women in substance abuse treatment. The identification of mothers’ perceptions of being parented, current level of depression, discrete and potentially modifiable mothering behaviors, and self-appraisals of their role. DESIGN: The descriptive study implemented audio-video–recorded mother–child interactions for coding. RESULTS: Twenty-nine dyads participated with children age 4 weeks to 5 years. Mothers had lower levels of caring from their parents and moderate depression that was correlated with many of the relational quality behaviors. Eleven of 29 maternal behaviors were coded as concerning. Reflections by mothers revealed modest, yet confident self-appraisals of their maternal role. CONCLUSIONS: Women who experienced higher depression demonstrated lower maternal quality. Some maternal behaviors were identified as less optimal although many were strengths.

Using Liberating Structures to Increase Engagement in Identifying Priorities for the APNA Research Council

Background: In 2015, the Co-Chairs and Steering Committee of the Research Council members recognized the need to reevaluate the council’s priorities. Objective: To determine the top priorities for the Research Council. Design: Use of liberating structures: Impromptu Speed Networking, 1-2-4-all, and Crowd Sourcing. Results: Identified Research Council priorities included the following: efforts to increase psychiatric mental health (PMH) research funding; serve as a connector to bring researchers together; foster research through state chapters; increase collaboration between PhDs and DNPs; and develop models for organizational support for PMH staff nurse involvement in research. Conclusions: The liberating structures used are valuable strategies for engaging groups of people to identify what matters most to the group. Through the use of these novel techniques, the American Psychiatric Nurses Association Research Council has identified priorities for the work of the council. This has led to actions planned for the coming future with the intent to move PMH nursing research forward.