Peter A. Wyman

Caregiving and developmental factors differentiating young at-risk urban children showing resilient versus stress-affected outcomes: a replication and extension.

This study tested hypotheses from an organizational-developmental model for childhood resilience. In this model resilience reflects a childs mastery of age-salient objectives, in the face of substantial adversity, by drawing on internal and external resources that enhance processes of adaptation specific to each developmental stage. Interviews were conducted with parents of 122 7- to 9-year-old urban children exposed to multiple risk factors, 69 classified as resilient and 53 as maladjusted. Consistent with predictions generated by the model: (1) characteristics of a childs caregiving system and early development differentiated children with resilient and stress-affected adaptations; and (2) variables reflecting emotionally responsive, competent parenting were direct, proximal predictors of resilient status and mediators of other caregiver resources such as education, mental health, and relational history. Identified predictors of resilient status, including competent parenting and caregiver psychosocial resources, largely replicated findings from a prior study with sociodemographically comparable 9- to 12-year-old children.

The role of children's future expectations in self-system functioning and adjustment to life stress: A prospective study of urban at-risk children

Study I examined relationships between an interview measure of childrens future expectations and variables reflecting self-system functioning with 136 9–11-year-old urban children exposed to high psychosocial stress. As expected, future expectations related to affect regulation, self-representations, and school adjustment. Study II, done with a subsample of the original group, showed that early positive future expectations predicted enhanced socioemotional adjustment in school and a more internal locus of control 2½–3½ years later and acted as a protective factor in reducing the negative effects of high stress on self-rated competence. These findings: (a) are consistent with prior data showing positive expectations to be characteristic of resilient children; (b) suggest that early positive future expectations influence later adjustment; and (c) underscore the role children have in actively structuring their environments and, thus, influencing their development. The heuristic value of the construct of self for future studies of resilience is suggested, and implications for preventive interventions are considered.

Developmental and family milieu correlates of resilience in urban children who have experienced major life stress

Reports findings from interviews with parents of demographically-comparable groups of highly-stressed urban children with stress-resilient (SR) and stress-affected (SA) outcomes at ages 10-12. SR and SA children were compared on family milieu and child development variables assessed within a developmental framework. Compared to SAs, parents of SRs scored higher on variables reflecting parent perceptions of a nurturant caregiver-child relationship and self-views as effective caregivers, in the context of positive discipline practices, a childs positive early temperament, and support for primary caregivers. A discriminant function analysis identified seven variables that optimally differentiated the groups and correctly classified 86% of the Ss as SR or SA.

Interviews with Children Who Experienced Major Life Stress: Family and Child Attributes that Predict Resilient Outcomes

Demographically comparable groups of children exposed to major life-stress, with stress resilient (SR) and stress affected (SA) outcomes at ages 10 to 12, were interviewed to assess perceptions of their caregiving environments, peer relationships, and themselves. SR children compared with SA children reported more: (1) positive relationships with primary caregivers, (2) stable family environments, (3) inductive and consistent family discipline practices, and (4) positive expectations for their futures. SR girls viewed their mothers as more nurturing than did SA girls. Perceptions of fathers, quality of peer relationships, and global self-concept did not differentiate the groups. A discriminant function analysis identified four variables that correctly classified 74% of the subjects as SR or SA. Findings support the view that caregiver-child relationships play a key role in moderating childrens developmental outcomes under conditions of high stress.

Methods for testing theory and evaluating impact in randomized field trials: Intent-to-treat analyses for integrating the perspectives of person, place, and time

Randomized field trials provide unique opportunities to examine the effectiveness of an intervention in real world settings and to test and extend both theory of etiology and theory of intervention. These trials are designed not only to test for overall intervention impact but also to examine how impact varies as a function of individual level characteristics, context, and across time. Examination of such variation in impact requires analytical methods that take into account the trials multiple nested structure and the evolving changes in outcomes over time. The models that we describe here merge multilevel modeling with growth modeling, allowing for variation in impact to be represented through discrete mixtures--growth mixture models--and nonparametric smooth functions--generalized additive mixed models. These methods are part of an emerging class of multilevel growth mixture models, and we illustrate these with models that examine overall impact and variation in impact. In this paper, we define intent-to-treat analyses in group-randomized multilevel field trials and discuss appropriate ways to identify, examine, and test for variation in impact without inflating the Type I error rate. We describe how to make causal inferences more robust to misspecification of covariates in such analyses and how to summarize and present these interactive intervention effects clearly. Practical strategies for reducing model complexity, checking model fit, and handling missing data are discussed using six randomized field trials to show how these methods may be used across trials randomized at different levels.

School-based prevention for children at risk : the primary mental health project

The Primary Mental Health Project Roots and Wellsprings How PMHP Operates: An X-Ray PMHPs Early Evolution Setting up and Conducting a PMHP PMHP Mini-Programmes: Extending and Refining the Basic Offerings Evaluating the Effectiveness of PMHP Disseminating the PHMP Programme Model The Social Problem-Solving Programme The Children of Divorce Intervention Programme The Study Buddy Programme The Rochester Child Resilience Programme Conclusion: Where From, Where to? Playground Equipment, Materials and Supplies Child Associate Information and PMHP Assessment Instruments.

Immigration generation status and its association with suicide attempts, substance use, and depressive symptoms among latino adolescents in the USA.

This study investigated the relation between suicide attempts and immigrant generation status using the Latino subset of the National Longitudinal Study of Adolescent Health, a school-based, nationally representative sample. This study also examined whether generation status predicted risk factors associated with elevated suicide behaviors, namely illicit substance use, problematic alcohol use, and depressive symptoms. Finally, hypothesizing that elevated depressive symptoms and substance use mediate the relation between immigrant generation status and suicide attempts among Latino adolescents, a path model was tested. Our findings revealed immigrant generation status was a determinant for suicide attempts, problematic alcohol use, repeated marijuana use, and repeated other drug use for Latino adolescents. US-born Latinos with immigrant parents (i.e., second-generation youth) were 2.87 (95% CI, 1.34, 6.14) times more likely to attempt suicide, 2.27 (95% CI, 1.53, 3.35) times more likely to engage in problematic alcohol use, 2.56 (95% CI, 1.62, 4.05) times more likely to engage in repeated marijuana use, and 2.28 (95% CI, 1.25, 4.17) times more likely to engage in repeated other drug use than were foreign-born youth (i.e., first-generation youth). Later-generations of US-born Latino youth with US-born parents were 3.57 (95% CI, 1.53–8.34) times more likely to attempt suicide, 3.34 (95% CI, 2.18–5.11) times more likely to engage in problematic alcohol use, 3.90 (95% CI, 2.46, 6.20) times more likely to engage in repeated marijuana use, and 2.80 (95% CI, 1.46, 5.34) times more likely to engage in repeated other drug use than were first-generation youth. Results from the path analysis indicated that repeated other drug use may mediate the effect of generation status on suicide attempts.

The Rochester Child Resilience Project: Overview and summary of first year findings

This article describes the Rochester Child Resilience Project (RCRP) and summarizes findings based on its initial year of operation. Among 4th-6th-grade urban children who had experienced significant life stress, convergent sources of evidence about current adjustment identified demographically matched samples of 37 stress-affected (SA) and 40 stress-resilient (SR) children. These two groups were compared on 11 test measures designed to expand the nomological definitional net for the concept of childhood resilience. Additionally, separate in-depth individual interviews were conducted with children and primary caregivers. Both test and interview responses significantly differentiated the groups in the predicted directions. Childrens group status (SR vs. SA) was predictable on the basis of discriminant function analysis involving five test measures, blind ratings done both for the parent and child interviews, and hierarchical regression analyses reflecting major domains of the parent interview.

Adaptive Designs for Randomized Trials in Public Health

In this article, we present a discussion of two general ways in which the traditional randomized trial can be modified or adapted in response to the data being collected. We use the term adaptive design to refer to a trial in which characteristics of the study itself, such as the proportion assigned to active intervention versus control, change during the trial in response to data being collected. The term adaptive sequence of trials refers to a decision-making process that fundamentally informs the conceptualization and conduct of each new trial with the results of previous trials. Our discussion below investigates the utility of these two types of adaptations for public health evaluations. Examples are provided to illustrate how adaptation can be used in practice. From these case studies, we discuss whether such evaluations can or should be analyzed as if they were formal randomized trials, and we discuss practical as well as ethical issues arising in the conduct of these new-generation trials.

Stress resilient children in an urban setting

Overviews the Rochester Child Resilience Project, describes its design and measures, and presents preliminary findings. Within a sample of 313 urban 4th–6th graders, convergent sources of evidence identified subsamples of 37 stress affected (SA) and 40 stress resilient (SR) children, all of whom, based on parent report, had experienced ≥4 stressful life events and circumstances (SLE-Cs). The combined SR/SA groups averaged 8.9 SLE-Cs, significantly more than the rest of the sample. Detailed adjustment ratings by current classroom teachers confirmed that SRs were significantly better adjusted than both SAs and a demographically matched low-stress sample. Factor analysis of the stressful events checklist identified 5 factors. Pooled SRs and SAs had higher scores on these factors than the rest of the sample. In direct comparison of the two groups, SAs had higher scores than SRs only on the Family Separation factor.