Michael J. MacKenzie

A meta-analysis of experimental studies of diversion programs for juvenile offenders

OBJECTIVE Research to establish an evidence-base for the treatment of conduct problems and delinquency in adolescence is well established; however, an evidence-base for interventions with offenders who are diverted from the juvenile justice system has yet to be synthesized. The purpose of this study was to conduct a meta-analysis of experimental studies testing juvenile diversion programs and to examine the moderating effect of program type and implementation quality. METHOD A literature search using PsycINFO, Web of Science, and the National Criminal Justice Reference Service data-bases and research institute websites yielded 28 eligible studies involving 57 experimental comparisons and 19,301 youths. RESULTS Recidivism was the most common outcome reported across all studies. Overall, the effect of diversion programs on recidivism was non-significant (k=45, OR=0.83, 95%CI=0.43-1.58). Of the five program types identified, including case management (k=18, OR=0.78), individual treatment (k=11, OR=0.83), family treatment (k=4, OR=0.57), youth court (k=6, OR=0.93), and restorative justice (k=6, OR=0.87), only family treatment led to a statistically significant reduction in recidivism. Restorative justice studies that were implemented with active involvement of researchers led to statistically significant reductions in recidivism (k=3, OR=0.69). Other outcomes, including frequency of offending, truancy, and psycho-social problems were reported infrequently and were not subjected to meta-analysis. CONCLUSIONS High levels of heterogeneity characterize diversion research. Results of this study recommend against implementation of programs limited to case management and highlight the promise of family interventions and restorative justice.

Depressive Symptoms During Pregnancy: Impact on Neuroendocrine and Neonatal Outcomes

OBJECTIVE To explore the interplay of maternal depressive symptoms on the infant limbic-hypothalamic-pituitary axis (LHPA) and neurological development. DESIGN Pregnant women were monitored for depressive symptoms using the Beck Depression Inventory (BDI) at 28, 32, and 37 weeks of gestation and at delivery. A mixture growth curve analysis divided the women into three risk groups: low/stable, intermediate, and high/increasing depression based on BDI scores. The infant neuroendocrine system was examined using cord blood for adrenocorticotrophic hormone (ACTH) and cortisol measurements. Two-week-old infants were examined using Neonatal Intensive Care Unit Neurobehavioral Scale (NNNS). RESULTS Infants born to women of the high/increasing depression group had significant ACTH elevation at birth. On NNNS examination, these infants were more hypotonic and habituated to auditory and visual stimuli. CONCLUSION When compared to non-depressed women, maternal depressive symptoms, even in the absence of major depressive disorder, appeared to facilitate a different developmental pathway for the infant LHPA and early neurological development.

Spanking and Child Development Across the First Decade of Life

OBJECTIVE: To examine the prevalence of maternal and paternal spanking of children at 3 and 5 years of age and the associations between spanking and children’s externalizing behavior and receptive vocabulary through age 9. METHODS: The Fragile Families and Child Well-Being Study, a longitudinal birth cohort study of children in 20 medium to large US cities, was used. Parental reports of spanking were assessed at age 3 and 5, along with child externalizing behavior and receptive vocabulary at age 9 (N = 1933). The data set also included an extensive set of child and family controls (including earlier measures of the child outcomes). RESULTS: Overall, 57% of mothers and 40% of fathers engaged in spanking when children were age 3, and 52% of mothers and 33% of fathers engaged in spanking at age 5. Maternal spanking at age 5, even at low levels, was associated with higher levels of child externalizing behavior at age 9, even after an array of risks and earlier child behavior were controlled for. Father’s high-frequency spanking at age 5 was associated with lower child receptive vocabulary scores at age 9. CONCLUSIONS: Spanking remains a typical rearing experience for American children. These results demonstrate negative effects of spanking on child behavioral and cognitive development in a longitudinal sample from birth through 9 years of age.

Adaptation and translation of mental health interventions in Middle Eastern Arab countries: A systematic review of barriers to and strategies for effective treatment implementation:

Aim: All too often, efficacious psychosocial evidence-based interventions fail when adapted from one culture to another. International translation requires a deep understanding of the local culture, nuanced differences within a culture, established service practices, and knowledge of obstacles and promoters to treatment implementation. This research investigated the following objectives to better facilitate cultural adaptation and translation of psychosocial and mental health treatments in Arab countries: (1) identify barriers or obstacles; (2) identify promoting strategies; and (3) provide clinical and research recommendations. Methods: This systematic review of 22 psychosocial or mental health studies in Middle East Arab countries identified more barriers (68%) than promoters (32%) to effective translation and adaptation of empirically supported psychosocial interventions. Results: Identified barriers include obstacles related to acceptability of the intervention within the cultural context, community and system difficulties, and problems with clinical engagement processes. Whereas identified promoter strategies centre on the importance of partnering and working within the local and cultural context, the need to engage with acceptable and traditional intervention characteristics, and the development of culturally appropriate treatment strategies and techniques. Conclusions: Although Arab cultures across the Middle East are unique, this article provides a series of core clinical and research recommendations to assist effective treatment adaptation and translation within Arab communities in the Middle East.

Intimate Partner Violence and Risk for Child Neglect during Early Childhood in a Community Sample of Fragile Families

The current study explores the relationship between child neglect and intimate partner violence (IPV) in a longitudinal community sample of 1,740 families with young children, with a special focus on the association between specific typologies of both neglect behaviors and IPV. We focused on families followed across early childhood, because infants and toddlers are at the greatest risk of exposure to neglect (the most prevalent type of child maltreatment), and this period spanning the transition to parenthood presents heightened risk for IPV. We found evidence that coercive IPV is an important driver of the connections between IPV and subsequent neglect through affecting the mother’s well-being and ability to provide basic care and nurturance. Implications for intervention and future work addressing definitions and pathways to neglect are discussed.

Contextual influences of parenting behaviors for children with neurodevelopmental disorders : results from a Canadian national survey

Purpose: This population-based study examined correlates of three parenting behaviors (positive interactions, consistency, and ineffective parenting) that have been shown to differ in children with neurodevelopmental disorders (NDDs), with and without externalizing behavior problems (EBPs), as compared to children with neither condition. Method: The sample of children aged 4–11 (N = 14,226) was drawn from the Canadian National Longitudinal Survey of Children and Youth (NLSCY). Analyses examined the associations of child, parental, and social context factors with parenting behaviors, and whether they differed by child health group. Results: Child age, family functioning, and social support variables were significant predictors of all three parenting behaviors. Significant interaction effects highlight the importance of the child’s sex, birth order, and support received from community or social service professionals, and that these factors have differential impacts on parenting behaviors depending on the child’s health group. Conclusions: Other Child, parent, and social context factors are associated with parenting behaviors but these associations vary by the child’s health group. Parenting behaviors differ for children with NDDs with and without EBPs. These findings offer important implications for practice and research and point to the importance of considering multiple contexts of influence, as well as their interactions, in understanding differences in parenting behaviors. Implications for Rehabilitation Our findings have implications for rehabilitation, in particular, for those who provide treatment to children with NDD and behavioral conditions. For practitioners, these findings point towards the importance of an awareness of the impact that a child’s health condition may have on the entire family unit, including parental health, family functioning, and parenting behaviors as well as other child factors. Our results also suggest that support from community professionals can be beneficial for the parenting behaviors of children with health problems, in particular, children with a NDD. Our findings are also relevant to other health care professionals dealing with children with NDD and/or behavior problems and highlight the importance of considering several child characteristics together, not just the child’s health conditions but also child sex and birth order.

Prevalence of Mental Health and Behavioral Problems Among Adolescents in Institutional Care in Jordan

OBJECTIVES This study aimed to establish the prevalence rates of mental health and behavioral problems of Arab youths residing in Jordanian care centers due to family disintegration, maltreatment, or abandonment and to examine how functioning varies by child characteristics and placement history. METHODS Child Behavior Checklist and case history data were collected for 70 youths across four Jordanian care centers. RESULTS Approximately 53% of the adolescents were identified as experiencing mental health problems, and 43% and 46% had high internalizing and externalizing scores, respectively. Ordinary least-squares regression models examining mental health functioning showed that male gender, care entry because of maltreatment, time in care, and transfers were the most significant predictors of problems. CONCLUSIONS Paralleling international research, this study found high levels of mental health needs among institutionalized youths. The impact of transfers on functioning is particularly worrisome, given the standard practice of transferring youths to another facility when they reach age 12. Improving the institutional care model by requiring fewer transfers and offering family-based community alternatives may ameliorate risks of developing mental and behavioral problems.

Stigma and adolescents with psychosis in the Middle East: implications for engaging in mental health treatment.

Abstract Stigma is a fundamental barrier to individuals seeking out mental health treatment in the Middle East. The impact of stigma may be amplified if the engagement in and utilization of mental health services for psychosis further stigmatizes individuals and their families. One hundred four Jordanians (N = 104) participated in an experimental vignette survey examining stigma perceptions and social exclusion related to adolescents with psychosis, with the vignettes varying in sex of the youth and whether their family had sought mental health services. The results found that seeking treatment did not add to perceived stigma, and both the male and female adolescents receiving mental health treatment were viewed as significantly more likely to be helped than those not in treatment (p < 0.001). Therefore, receiving mental health treatment did not further stigmatize these Arab youth with psychosis. In addition, seeking out and engaging adolescents and their family in mental health treatment were positively perceived and may help to improve the youth’s prognosis and outcomes.

MATERNAL SENSITIVITY AND LATENCY TO POSITIVE EMOTION FOLLOWING CHALLENGE: PATHWAYS THROUGH EFFORTFUL CONTROL

The ability to self-generate positive emotions is an important component of emotion regulation. In this study, we focus on childrens latency to express positive emotions following challenging situations and assess whether this ability operates through early maternal sensitivity and childrens effortful control. Longitudinal relations between maternal sensitivity, infant negative affect, effortful control, and latency to positive emotion following challenge were examined in 156 children who were 33 months of age. Structural equation models supported the hypothesis that maternal sensitivity during infancy predicted better effortful control and, in turn, shorter latencies to positive emotions following challenge at 33 months. Directions for future research are discussed.

Foster care as a viable alternative to institutional care in the Middle East: community acceptance and stigma across type of placement in Jordan.

Objective: Utilizing an experimental vignette design, this study assessed attitudes in the Hashemite Kingdom of Jordan toward the implementation of foster care as an alternative to institutions for children in need of care and protection. Methods: A sample of 111 adults were surveyed in Amman and presented with a vignette describing a 14-year-old boy who came into the care of the Ministry of Social Development when he was a baby after being placed by the grandfather because of shame surrounding the mother being unwed. The vignettes systematically varied as to whether the child was described as raised in an orphanage, with a relative in a kinship foster placement, or with a nonkin foster family. Participants were then asked a series of questions about their acceptance of the child, stigma that the community might attach to the child, and potential outcomes for the child. Results: We found no differences across the acceptance and stigma questions between the kinship and nonkin foster conditions. The 2 foster care options were at least as acceptable as current institutional models across all domains, and participants were more likely to accept the child going to school with or being friends with their child if they were in foster care rather than an institution. Conclusions: These results represent the first evidence of public acceptance of foster care as a model of care in Jordan and may inform the process of local stakeholders implementing alternatives to institutional care on a meaningful and sustainable scale in the Kingdom and regionally.