Sara Tomek

Trajectories of adolescent alcohol use by gender and early initiation status

Within the adolescent risk behavior literature, questions remain about relationships among behaviors in early adolescence, gender, context, and negative social and health outcomes. Additionally, little attention has focused on trajectories of adolescent risk behavior among impoverished African American youth. Using data from the Mobile Youth Survey, a multiple cohort longitudinal study of adolescents living in impoverished neighborhoods, we have reduced gaps in the literature by identifying trajectories of alcohol use for males and females separately as a function of early initiation of alcohol use. Our findings indicate that early initiation of alcohol use predicts escalating use at least through age 17. Results are especially notable for females who begin drinking before age 12: They drink significantly more than any other group at age 12 and their trajectory remains the highest through age 17. Our findings about the escalation of drinking have implications for efforts to improve the lives of impoverished adolescents.

Using attachment theory in medical settings: Implications for primary care physicians

Background Mental health researchers, clinicians and clinical psychologists have long considered a good provider–patient relationship to be an important factor for positive treatment outcomes in a range of therapeutic settings. However, primary care physicians have been slow to consider how attachment theory may be used in the context of patient care in medical settings. Aims In the current article, John Bowlbys attachment theory and proposed attachment styles are proffered as a framework to better understand patient behaviors, patient communication styles with physicians and the physician–patient relationship in medical settings. Conclusion The authors recommend how primary care physicians and other health care providers can translate attachment theory to enhance practice behaviors and health-related communications in medical settings.

Career Adaptability and Subjective Well-Being in Unemployed Emerging Adults A Promising and Cautionary Tale

Unemployment is associated with increased levels of anxiety, depression, and disconnection among emerging adults. Given the greater risk of unemployment for emerging adults (13.2% in the United States), career adaptability is relevant to understanding how emerging adults survive and thrive in today’s challenging work environment. This study examined the effect of career adaptability on subjective well-being in 184 unemployed diverse emerging adults of age 21–29. Results revealed that emerging adults with higher levels of control and confidence had higher life satisfaction. Control was positively related to positive affect while at the same time negatively related to negative affect. Control was the most consistent informant of subjective well-being (significant on all three subscale measures). The implications of the significant findings, and the caution warranted in relation to these findings, are discussed.

Patterns of Self-Reported Alcohol Use, Depressive Symptoms, and Body Mass Index in a Family Sample: The Buffering Effects of Parentification

Although the impact of parentification on children and adolescents’ psychological health and outcomes has long been studied and well documented, little is known about the impact of parentification on children and adolescents’ physical health and medical outcomes. Moreover, the potential buffering effects of parentification have been examined very rarely. The data in the current study were collected from an understudied, high-priority adolescent population (N = 51 rural adolescent–parent dyads). The authors examined the bivariate relations between parent health (alcohol use, depressive symptoms, and body mass index [BMI]), adolescent health (alcohol use, depressive symptoms, and BMI), and parentification. The effect size of the significant bivariate correlations ranged from small to large (r = .29 to r = .62). Parentification was positively associated with parent BMI and adolescent depressive symptoms. Parent alcohol use was strongly associated with adolescent alcohol use. Regression analyses were performed to determine if parentification moderates the relation between parental health and adolescent health. Parentification was found to function as a buffer of the relation between parent alcohol use and adolescent alcohol use. Parentification did not function as a moderator of the relation between parent depressive symptoms and adolescent depressive symptoms nor in the relationship between parent BMI and adolescent BMI. However, parentification did moderate the association between parent alcohol use and adolescent depressive symptoms.

The Effect of Narrative Information in a Publicly Available Patient Decision Aid for Early-Stage Breast Cancer

This study was designed to (1) evaluate the effect of narratives used in a popular, publicly available patient decision aid for early-stage breast cancer on hypothetical treatment decisions and attitudes toward the decision aid and (2) explore the moderating effects of participant numeracy, electronic health literacy and decision-making style. Two hundred women were asked to imagine that they had been diagnosed with early-stage breast cancer and viewed one of two versions of a video decision aid for early-stage breast cancer. The narrative version of the aid included stories from breast cancer survivors; the control version had no patient stories. After viewing the video decision aid, participants made a hypothetical treatment choice between lumpectomy with radiation and mastectomy, answered several questions about their decision, and evaluated the quality of the decision aid. Participants received

Volunteering and Reemployment Status in Unemployed Emerging Adults A Time-worthy Investment?

100 for completing the study. The two conditions differed in their motivations for the treatment decision and perceptions of the aids trustworthiness and emotionality but showed no differences in preferences for surgical treatments or evaluations of the decision aids quality. However, the impact of patient narratives was moderated by numeracy and electronic health literacy. Higher levels of numeracy were associated with decreased decisional confidence and lower ratings of trustworthiness for the decision aid in the narrative video condition but not in the control video condition. In contrast, higher levels of electronic health literacy were associated with increased decisional confidence and greater perceptions of trustworthiness and credibility of the decision aid in the narrative video condition but not the control video condition.

Race/Ethnicity, Gender, Parentification, and Psychological Functioning Comparisons Among a Nationwide University Sample

Given the alarming unemployment rates among emerging adults in the United States, this study investigates the relationships among volunteering, length of unemployment, likelihood/quality of reemployment, and job search strategies in a sample of emerging adults. Two hundred and sixty-five emerging adults aged between 21 and 29, all of whom were unemployed 6 months prior to taking the survey, completed an online survey. Results affirm positive associations between volunteering and likelihood of reemployment 6 months later. The number of hours spent volunteering was significantly related to reemployment status as was the length of unemployment. The use of an exploratory job search strategy, in contrast to the use of a focused or a haphazard job search strategy, was associated with reemployment. Implications of the findings and suggestions for further research are discussed along with the limitations of the present study.

Predictors of Gang Involvement: A Longitudinal Analysis of Data From the Mobile Youth Survey

Childhood parentification has been reported to have enduring effects on psychological, relational, and physical functioning across the life span. Few studies have examined the implications of race/ethnicity and gender on the levels of parentification. We examined racial/ethnic and gender differences in 977 American college students (81% female, 5% Latino/Latina American, 10% Black American, and 85% White American) who reported a history of childhood parentification. We also examined the extent to which current level of functioning (as indicated by self-rated depressive symptoms, well-being, and posttraumatic growth) is associated with parentification in the current nationwide sample (mean age = 21.39, SD = 5.84). Overall, we found differences in parentification scores based on race/ethnicity and gender. Males had significantly higher levels of parentification than females; this finding was consistent across all racial/ethnic groups. White Americans reported lower levels of parentification compared to Black Americans and Latino/Latina Americans, who shared similar parentification levels. Both gender and race/ethnicity affected some—but not all—of the significant relations among study variables as well. Latino/Latina Americans appeared to receive positive psychological benefit from parentification, while this was not true of Black Americans and White Americans. Future researchers and family counselors should develop research studies and pose clinical questions that account for cultural differences in the assessment and treatment of parentification and its possible wide-ranging aftereffects. The results of the current study suggest that both the benefits and detriments associated with parentification should be considered equally in practice and research.

Chi-Square Test

Using linear growth modeling and data from the Mobile Youth Survey—a 14-year multiple cohort study of adolescents living in low-income neighborhoods in Mobile, Alabama—we investigate the roles of peer influence, family cohesion, and self-worth on gang involvement. The study finds that peer influence, family cohesion, and self-worth have an effect on initial gang involvement, but only family cohesion and gender have any influence on gang involvement across time. Males are more likely to be gang involved than females. Greater family cohesion reduced gang activity across time. This research suggests that family-based interventions and efforts to promote positive peer relationships might decrease the likelihood of gang involvement.

Depression, patient characteristics, and attachment style: correlates and mediators of medication treatment adherence in a racially diverse primary care sample

Previous chapters have presented information on sampling distributions, Central Limit Theorem, confidence intervals, TYPE I error, TYPE II error, and hypothesis testing. This information is useful in understanding how sample statistics are used to test differences between population parameters. The statistical tests presented in this and subsequent chapters depend upon the level of measurement and type of research design.