Nikeea Copeland-Linder

Patterns of Community Violence Exposure During Adolescence

This study examined cross-sectional and longitudinal patterns of community violence exposure and malleable predictors of these exposure patterns among a community sample of 543 urban African American early adolescents (45.3% female; mean age: 11.76). In each of grades 6, 7, and 8, latent class analyses revealed two patterns of community violence exposure: high exposure and low exposure. For the majority of participants, experiences with community violence were similar at each grade. Impulsive behavior and depressive symptoms distinguished adolescents in the high and low exposure classes in grade 6. Implications for interventions to prevent community violence exposure are discussed.

Randomized Trial of a Case Management Program for Assault-Injured Youth : Impact on Service Utilization and Risk for Reinjury

Objectives: The purposes of this study were to (1) assess receptiveness of families to violence prevention interventions initiated after an assault injury and (2) assess the effectiveness of a case management program on increasing service utilization and reducing risk factors for reinjury among assault-injured youth presenting to the emergency department. Design/Methods: A randomized controlled trial of youth, aged 12 to 17 years, presenting to a large urban hospital with peer assault injury was conducted. Youth and parents were interviewed at baseline and 6 months to measure service utilization, risk behavior, attitudes about violence, mental health, and injury history. Intervention: Intervention families received case management services by telephone or in person during 4 months by a counselor who discussed sequelae of assault injury and assessed family needs and facilitated service use. Controls received a list of community resources. Results: Eighty-eight families were enrolled; 50 (57%) completed both youth and parent follow-up interviews. Intervention and control groups were not significantly different at baseline on demographics, service utilization, and risk factors. Fighting was common in both groups. Most parents and youth identified service needs at baseline, with recreational programs, educational services, mentoring, and counseling as most frequently desired. There was no significant program effect on service utilization or risk factors for injury. Although intervention families were satisfied with case management services, there was no significant increase in service utilization compared with controls. Conclusions: Youth and parents were receptive to this violence prevention intervention initiated after an emergency department visit. This pilot case management program, however, did not increase service utilization or significantly reduce risk factors for injury. More intensive violence prevention strategies are needed to address the needs of assault-injured youths and their families.

Retaliatory Attitudes and Violent Behaviors Among Assault-Injured Youth

OBJECTIVES To examine the effect of retaliatory attitudes on subsequent violent behavior and fight-related injuries among youth who presented to the emergency department with assault injuries. DESIGN Assault-injured youth were interviewed at baseline, 6 months, and 18 months to assess fighting behavior, retaliatory attitudes, weapon carrying, and injury history as part of a larger randomized control trial. SETTING Two emergency departments in urban areas were selected for the study. PARTICIPANTS A total of 129 adolescents aged 10-15 years were included in the study. OUTCOME MEASURES Fighting behavior, assault injury, weapon carrying, and aggressive behavior. RESULTS Higher retaliatory attitudes at baseline were associated with more aggression and a higher frequency of fighting over time. CONCLUSIONS Retaliatory attitudes may fuel cycles of violence among youth. Medical professionals in acute care settings have an opportunity to identify youths at risk of future assault injury by assessing retaliation, providing anticipatory guidance, and referring to intervention programs.

Burden of Unmet Mental Health Needs in Assault-Injured Youths Presenting to the Emergency Department

OBJECTIVES To determine if there is a gap between behavioral symptoms and previously recognized mental health conditions in youth victims of peer assault injuries and to describe gender differences in psychological symptoms. METHODS A cross-sectional comparison of rates of previously diagnosed mental health conditions and clinical range behavioral symptoms as measured by the Child Behavior Checklist (CBCL) in 168 youths (range, 10-15 years old) presenting to the emergency department (ED) after an interpersonal assault injury. The Fisher exact test was used for comparisons. RESULTS Mental health symptoms were common among assault-injured youths. More than half of the youths demonstrating clinical range symptoms on the attention problems or anxious/depressed scales of the CBCL had no prior diagnosis of these conditions. Girls were more likely than boys to exhibit clinical range aggressive behavior symptoms (odds ratio [OR], 3.61; 95% confidence interval [CI], 1.64-7.97). Aggressive behavior was associated with clinical range scores on the other problem scales of the CBCL. CONCLUSIONS After an ED visit for an assault-related injury, less than half of 10 to 15 year olds with significant symptoms of common mental conditions reported having a previously diagnosed disorder, reflecting a burden of unmet psychological needs. An ED visit for an assault injury provides an opportunity to screen for emotional/behavioral symptoms and to refer to appropriate follow-up mental health care.

Mindfulness-Based Approaches for Children and Youth

Mindfulness meditation is a useful adjunct to behavioral and medical interventions to manage a range of symptoms, including psychological and physical responses to stress, anxiety, depression, and disruptive behavior. Mindfulness approaches can be taught to children, adolescents, and their parents to improve self-regulation, particularly in response to stress. Mindfulness may be particularly relevant for youth and families who have an increased risk for exposure to chronic stress and unique stressors associated with medical and/or social-contextual considerations. Moreover, mindfulness parenting techniques can augment traditional behavioral approaches to improve children׳s behavior through specific parent-child interactions. A growing body of empirical studies and clinical experience suggest that incorporating mindfulness practices will enable clinicians to more effectively treat youth and their families in coping optimally with a range of challenging symptoms.

The Protective Role of Religious Involvement in African American and Caribbean Black Adolescents’ Experiences of Racial Discrimination:

For many Black adolescents, racial discrimination increases the risk of developing adverse psychological outcomes. The purpose of this study is to investigate the interrelationships among religious involvement, racial discrimination, and psychological outcomes among a nationally representative sample of African American adolescents and Caribbean Black adolescents from the National Survey of American Life. Multiple regression models were used to determine the interactive effects of religious involvement and racial discrimination experiences on Black adolescents’ psychological outcomes. Findings indicate that religious involvement was a protective factor for Caribbean Black adolescents but not African American youth. The implications of these findings underscore the varied roles of religious involvement for African American and Caribbean Black adolescents.

Improving self-regulation in adolescents: current evidence for the role of mindfulness-based cognitive therapy

Mindfulness-based cognitive therapy (MBCT) was introduced in 1995 to address the problem of recurrent depression. MBCT is based on the notion that meditation helps individuals effectively deploy and regulate attention to effectively manage and treat a range of psychological symptoms, including emotional responses to stress, anxiety, and depression. Several studies demonstrate that mindfulness approaches can effectively reduce negative emotional reactions that result from and/or exacerbate psychiatric difficulties and exposure to stressors among children, adolescents, and their parents. Mindfulness may be particularly relevant for youth with maladaptive cognitive processes such as rumination. Clinical experience regarding the utility of mindfulness-based approaches, including MBCT, is being increasingly supported by empirical studies to optimize the effective treatment of youth with a range of challenging symptoms. This paper provides a description of MBCT, including mindfulness practices, theoretical mechanisms of action, and targeted review of studies in adolescents.

Religiosity and Coping: Racial Stigma and Psychological Well-Being among African American Girls

This study examined how having a relationship with God served as a protective factor between racial stigma beliefs and psychological well-being. A church sample of African American adolescent girls (N = 117, Mage= 15) completed measures on racial stigma, psychological well-being, and reports on having a relationship with God. After controlling for adolescent age, family income, and church attendance, positive racial beliefs and having a relationship with God were associated with a healthier psychological well-being. Findings also revealed that having a relationship with God and internalizing healthier racial beliefs were associated with a healthier psychological well-being, whereas reporting higher levels of having a relationship with God served as a protective factor for African American girls when internalizing moderate levels of racial stigma. Overall, results suggest that having a relationship with God can serve as a coping mechanism and promote a healthier psychological well-being for African American adolescent girls.

Mindfulness-Based Therapies

Mindfulness meditation has been described as a useful adjunct to behavioral and medical interventions in the effective management of a range of psychological symptoms, including emotional responses to stress, anxiety, depression, and disruptive behavior. Mindfulness approaches can be taught to children, adolescents, and their parents to help reduce negative emotional reactions that result from and/or exacerbate psychiatric difficulties and exposure to stressors. This focus may be particularly relevant for African American youth and their families who have an increased risk for exposure to chronic stress and unique stressors associated with social-contextual considerations. Moreover, mindfulness parenting techniques can augment traditional behavioral approaches to improve children’s behavior through specific forms of mindful parent–child interactions. A growing body of empirical studies and clinical experience suggest that the incorporation of mindfulness meditation will enable clinicians to more effectively treat youth and their families in coping optimally with a range of challenging symptoms. This chapter provides a description of mindfulness approaches, theoretical mechanisms of action, literature review, a sample script for a beginning mindfulness exercise, and case studies.