Pre-existing parental stress and youth internalizing symptoms predict parent-reported COVID-related stress in military families.

Understanding the extent to which youth and families experienced COVID-related stress requires accounting for prior levels of stress and other associated factors. This is especially important for military families, which experience unique stressors and may be reluctant to seek outside help. In this prospective study, we examined the role of pre-pandemic family factors in predicting parent and youth stress during the COVID-19 pandemic. Participants were 234 families with at least one active-duty parent and a 3rd or 5th-grade child. Findings revealed that preexisting factors predicted youth and family COVID-related stress. Specifically, heightened pre-pandemic parental stress and youth internalizing symptoms were significant predictors of COVID-related stress. Implications for mental health professionals and other organizations supporting military parents and families during the COVID-19 pandemic as well as other times of upheaval are discussed.

Moderators of the Link Between Social Preference and Persistent Peer Victimization for Elementary School Children.

OBJECTIVE: Current antibullying programs can reduce overall rates of victimization but appear to overlook processes that give rise to persistent peer victimization. Needed are studies that delineate the interplay between social contextual and individual difference variables that contribute to persistent peer victimization. We examined the extent to which two individual-difference variables - internalizing symptoms (IS) and anxiety sensitivity (AS) - moderated the link between children's average social preference score across the school year and their status as persistent victims. METHOD: Participants included 659 4th-grade students (Mage = 9.31 years, SD = 0.50, 51.8% girls; 42.3% Latinx, 28.9% non-Hispanic White, 10.2% Pacific Islander, 7.7% Bi/Multiracial, 1.9% Black, 1.7% Asian, 1.7% Native American, and 3.4% unreported) from 10 public elementary schools in the U.S. RESULTS: As expected, higher social preference scores predicted a decreased likelihood of being persistently victimized. Conversely, IS and AS were positively linked to persistent victim status. AS significantly moderated the link between social preference and persistent victim status such that for children with high AS, compared to those with AS scores at or below the mean, the negative association between social preference and persistent victim status was attenuated. CONCLUSIONS: Findings provide evidence that children who experience high levels of IS and AS are at risk for being persistently victimized by peers and that high AS could signal increased risk for persistent victimization even when children are generally liked by peers. We discuss the implications of these findings for efforts to develop focused interventions for chronically bullied children.

Lunchroom-Specific Peer Acceptance and Children's Internalizing Symptoms.

Prior research suggests the elementary school lunchroom is an important context for children's social development. Using a sample of 659 fourth-grade students in 10 public schools (50.7% female; 42.7% Hispanic/Latinx, 30.3% White, 10% Pacific Islander, 7.8% bi/multiracial, 2.2% American Indian, 2.2% Black, 1.9% Asian, and 2.9% other), we examined the association between lunchroom-specific peer acceptance and internalizing symptoms (i.e., depression and social anxiety symptoms). We hypothesized that lunchroom peer acceptance would predict self-rated depression and social anxiety symptoms when controlling for social preference scores. Using hierarchical linear modeling, results indicated self-rated lunchtime peer acceptance scores in December significantly predicted depression symptoms in May when controlling social preference scores and accounted for changes in depression scores across a school year. However, some significant gender differences emerged. Results suggest that elementary school lunchroom interventions should attend to children's perceptions of lunchroom likability and their experiences of depression symptoms.

Informal mentoring support as a potential moderator of the relation between adolescent dating violence victimization and substance use.

Research links adolescent dating violence (ADV) victimization to negative developmental outcomes, including involvement in substance use. Informal mentoring is associated with several positive outcomes, including reduced risk of substance use. Addressed in this study is whether support from an informal mentor can function to protect victims of ADV from involvement in substance use. Participants were 152 adolescents (grades 9-12). Findings revealed a significant association between ADV victimization and adolescents' involvement in substance use, as well as some evidence that support from an informal mentor moderates that link. When informal mentor support was low or at the mean, ADV victimization was significantly linked to adolescents' involvement in substance use; when informal mentor support was high, ADV victimization was unrelated to substance use involvement. Discussed are research and practice implications of the potential protective role of informal mentors for victims of ADV.

Perceived barriers, relationship quality, and informal mentors: Adolescents' preference for disclosing about dating violence.

This study examined associations among adolescents' likelihood of disclosure about dating violence, perceptions of barriers to disclosure, and quality of the relationship with various sources of support. Data were gathered from 152 students in a southern high school. Results indicated youth perceived fewer barriers to disclosing to mentors compared with friends and parents, and youth reported highest relationships quality with informal mentors. However, youth indicated highest likelihood of disclosure to friends, followed by informal mentors and parents. Both relationship quality and perceived barriers to disclosure about dating violence were associated with likelihood of disclosure to friends and parents, but only relationship quality was related to likelihood of disclosure to informal mentors. Current findings (a) suggest adolescents' preferences for disclosing about dating violence are influenced by perceived barriers and relationship quality with sources of support and (b) highlight the promise of informal mentors as an additional resource for adolescents.

Back to the Future: Mentoring as Means and End in Promoting Child Mental Health.

Youth mentoring is a potentially powerful tool for prevention and intervention, but it has garnered little attention from clinical child and adolescent psychologists. For decades, the practice of youth mentoring has out-paced its underlying science, and meta-analytic studies consistently reveal modest outcomes. The field is now at an important crossroads: Continue to endorse traditional, widely used models of mentoring or shift to alternative models that are more in line with the tenets of prevention science. Presented here is a bilateral framework to guide the science and practice of mentoring going forward. Our premise is that mentoring relationships can serve as both means to a targeted end and as a valued end unto itself. We present a functional typology of current mentoring programs (supportive, problem-focused, & transitional) and call for greater specification of both the process and expected outcomes of mentoring. Finally, we argue that efforts to leverage mentoring relationships in service of youth development and the promotion of child and adolescent mental health will likely require disrupting the science, practice, and policy that surrounds youth mentoring.

Web-Based Training for School-Based Mentors of Military-Connected Youth: A Multi-Phase Development Study.

This paper describes a multi-phase effort to develop a web-based training for adults serving as mentors in school-based programs for youth with a parent in the military. In Phase 1, we conducted focus groups with military parents to: gauge their receptivity to this type of supportive intervention, identify program features that would make the option of mentoring for their children more or less appealing, and identify specific training needs for adult volunteers preparing for the role of mentor to youth in this population. In Phase 2, we used an iterative process to develop the training protocol, including cycling through multiple drafts, creating a web-based platform, reviewing and incorporating feedback from various stakeholders, and then pilot testing the training with two groups of mentor volunteers as part of a school-based mentoring program for military-connected students. We report on what we learned from the military parent focus groups, including parent skepticism about the need for such a program, concerns about potential stigma, and the need for mentors to have some understanding of military culture. We describe how we used that information to develop a practical and accessible training module for volunteer mentors, especially those without a military background, who could be matched with military-connected youth.

Attachment Tendencies, Big 5 Personality Traits, and Self-Efficacy as Predictors of Mentors' Relationships with Aggressive Children.

Youth mentoring is theorized as a relationship-based intervention in which a strong mentor-mentee bond functions as a mediator of positive outcomes. Given evidence for the importance of a positive relationship, the current study investigated whether differences in mentors' self-reported attachment tendencies (avoidance and ambivalence), Big Five personality traits, and self-efficacy predicted match quality after one academic semester. We also tested whether mentors' experience of conflict in the relationship moderated the relation between these characteristics and match quality. Participants were college student mentors (N = 190) paired with elementary school children identified via teacher and peer reports as highly aggressive. Separate regression analyses indicated that avoidance, openness, and self-efficacy significantly predicted mentor-rated (but not child-rated) match quality in expected directions. Moderator analyses revealed a mixed pattern of results: at low levels of conflict, ambivalence was a negative predictor of match quality, whereas extraversion and agreeableness were positive predictors. At high levels of conflict, openness and conscientiousness were positive predictors of match quality, whereas agreeableness was a negative predictor. The findings suggest it is important for mentoring programs to consider mentor characteristics when screening, training, and matching mentors, particularly in relationships with children identified as aggressive.

Anxiety Sensitivity and Children's Risk for Both Internalizing Problems and Peer Victimization Experiences.

In this study, we examined the degree to which children's level of anxiety sensitivity (AS) was a precursor to both internalizing problems and peer victimization experiences. Participants were 581 fourth-grade children (M age = 9.31; 51.8% girls; 42.3% Hispanic/Latinx) and their teachers. Measures of AS, internalizing problems, and peer victimization were collected across a single academic year (Fall, Spring). Structural equation modeling and logistic regression analyses indicated AS predicted future internalizing symptoms as well as self- and teacher-reports of peer victimization. Also, children with heightened AS were 2.70 times more likely to reach elevated levels of self-rated peer victimization and 11.53 times more likely to have clinically elevated internalizing problems. This is the first study to examine prospectively the link between AS and children's peer victimization experiences. We discuss implications of the findings for developing preventative interventions for children at risk for peer victimization and internalizing difficulties.

Need, access, and the reach of integrated care: A typology of patients.

INTRODUCTION: This paper is a report on a study exploring a potential typology of primary care patients referred for integrated behavioral health care (IBHC) services. We considered whether primary care patients could be grouped into meaningful clusters based on perceived need for behavioral health services, barriers to accessing care, and past-year service utilization. We also described the development of a working partnership between our university-based research team and a federally qualified health center (FQHC). METHOD: A total of 105 adult primary care patients referred for same-day behavioral health appointments completed a brief self-report questionnaire assessing past-year behavioral health concerns, service utilization, and perceived barriers to utilization. RESULTS: Hierarchical and k-means cluster analyses revealed 3 groups: (a) Well-Served patients, characterized by high perceived need for services, high service use, and low barriers to service use (40%); (b) Underserved patients, characterized by high perceived need, low service utilization, and high barriers to service use (20%); and (c) Subclinical patients, characterized by low perceived need, low service use, and low barriers to service use (20%). Clusters were reliably differentiated by age, primary language, insurance status, and global functioning. DISCUSSION: We found primary care patients could be grouped into 3 categories and that 60% (Underserved and Subclinical) represented groups less commonly seen in traditional mental health (MH) settings. IBHC may be a promising approach for extending the reach of MH care, and partnerships between FQHCs and university-based research teams may be a promising approach for conducting research on the IBHC service-delivery model. (PsycINFO Database Record

Social Risk and Peer Victimization in Elementary School Children: The Protective Role of Teacher-Student Relationships.

Children not accepted or actively rejected by peers are at greater risk for peer victimization. We examined whether a positive teacher-student relationship can potentially buffer these children from the risk of peer victimization. Participants were 361 elementary school children in the 4th or 5th grade. Peer-report measures were used to assess teacher-student relationship quality (TSRQ), social preference, and rejected sociometric status; peer victimization was assessed via self-, peer-, and teacher-reports. As expected, social preference assessed in the fall semester was a significant negative predictor of self- and peer-reported victimization measured in the spring, controlling for prior levels of peer victimization. TSRQ in the fall was not a significant unique predictor of self-, peer-, or teacher-reported victimization the following spring, controlling for fall victimization and social preference scores. We found a significant interaction between social preference and TSRQ in predicting self-, peer-, and teacher-reported peer victimization: Social preference significantly predicted peer victimization, but only for those children with relatively poor student-teacher relationships. Subgroup analysis revealed that children actively rejected by peers in the fall reported significantly less peer victimization in the spring (controlling for fall victimization scores) when their fall TSRQ scores were at or above the sample mean compared to rejected children whose TSRQ scores were low (i.e., < -0.5 SD below the mean). Findings offer preliminary support for the notion that teacher-student relationship quality can buffer children at social risk for continued peer victimization.

Exploring Change Processes in School-Based Mentoring for Bullied Children.

We examined change processes associated with the school-based, lunchtime mentoring of bullied children. We used data from a one-semester open trial of Lunch Buddy (LB) mentoring (N = 24) to examine changes in bullied children's lunchtime peer relationships. We also tested whether these changes predicted key outcomes (i.e., peer victimization, social preference) post-mentoring. Results provided partial support that bullied children paired with LB mentors experienced improved lunchtime peer relationships and that gains in lunchtime relationships predicted post-mentoring levels of social preference and peer victimization. Neither child nor mentors' ratings of the mentoring relationship predicted post-mentoring outcomes; however, child-rated mentor support and conflict predicted improvements in lunchtime peer relationships. We discuss implications for future research on school-based mentoring as a form of selective intervention for bullied children.

Diagnoses, intervention strategies, and rates of functional improvement in integrated behavioral health care patients.

OBJECTIVE: Compared with more traditional mental health care, integrated behavioral health care (IBHC) offers greater access to services and earlier identification and intervention of behavioral and mental health difficulties. The current study examined demographic, diagnostic, and intervention factors that predict positive changes for IBHC patients. METHOD: Participants were 1,150 consecutive patients (mean age = 30.10 years, 66.6% female, 60.1% Hispanic, 47.9% uninsured) seen for IBHC services at 2 primary care clinics over a 34-month period. Patients presented with depressive (23.2%), anxiety (18.6%), adjustment (11.3%), and childhood externalizing (7.6%) disorders, with 25.7% of patients receiving no diagnosis. RESULTS: The most commonly delivered interventions included behavioral activation (26.1%), behavioral medicine-specific consultation (14.6%), relaxation training (10.3%), and parent-management training (8.5%). There was high concordance between diagnoses and evidence-based intervention selection. We used latent growth curve modeling to explore predictors of baseline global assessment of functioning (GAF) and improvements in GAF across sessions, utilizing data from a subset of 117 patients who attended at least 3 behavioral health visits. Hispanic ethnicity and being insured predicted higher baseline GAF, while patients with an anxiety disorder had lower baseline GAF than patients with other diagnoses. Controlling for primary diagnosis, patients receiving behavioral activation or exposure therapy improved at faster rates than patients receiving other interventions. Demographic variables did not relate to rates of improvement. CONCLUSION: Results suggest even brief IBHC interventions can be focused, targeting specific patient concerns with evidence-based treatment components. (PsycINFO Database Record

Does Integrated Behavioral Health Care Reduce Mental Health Disparities for Latinos? Initial Findings.

Integrated behavioral health care (IBHC) is a model of mental health care service delivery that seeks to reduce stigma and service utilization barriers by embedding mental health professionals into the primary care team. This study explored whether IBHC service referrals, utilization, and outcomes were comparable for Latinos and non-Latino White primary care patients. Data for the current study were collected from 793 consecutive patients (63.8% Latino; M age = 29.02 years [SD = 17.96]; 35.1% under 18 years; 65.3% women; 54.3% uninsured) seen for behavioral health services in 2 primary care clinics during a 10.5 month period. The most common presenting concerns were depression (21.6%), anxiety (18.5%), adjustment disorder (13.0%), and externalizing behavior problems (9.8%). Results revealed that while Latino patients had significantly lower self-reported psychiatric distress, significantly higher clinician-assigned global assessment of functioning scores, and fewer received a psychiatric diagnosis at their initial visit compared to non-Latino White patients, both groups had comparable utilization rates, comparable and clinically significant improvements in symptoms (Cohen's d values > .50), and expressed high satisfaction with integrated behavioral services. These data provide preliminary evidence suggesting integration of behavioral health services into primary care clinics may help reduce mental health disparities for Latinos.

Mentoring highly aggressive children: pre-post changes in mentors' attitudes, personality, and attachment tendencies.

This study examined the degree to which mentoring highly aggressive children was associated with changes in mentors' attitudes, personality, and attachment tendencies. Participants were 102 college students who each mentored an aggressive, high-risk child across three academic semesters (spring, fall, spring). We examined pre- to post-mentoring changes in attitudes about mentoring efficacy and future parenting, Big Five personality characteristics, and attachment tendencies. Mentors also rated the impact of the mentoring relationship in their lives, and both mentors and mentees rated support of the mentoring relationship. Results indicated a statistically significant decrease over time in mentors' ratings of self-efficacy, openness, conscientiousness, extraversion, and agreeableness. These findings held even when controlling for ratings of relationship impact. However, mentors who rated the mentoring relationship as supportive tended to experience increased openness, conscientiousness, and agreeableness and less attachment-related avoidance over time. Child-rated support negatively predicted mentors' post-mentoring attitudes toward future parenting. Discussed are the potential costs of mentoring highly aggressive children and strategies that could help increase benefits to mentors.

Deconstructing serendipity: focus, purpose, and authorship in lunch buddy mentoring.

Lunch buddy mentoring is a particular kind of school-based mentoring program: college student mentors meet twice weekly during school lunch with mentees, and a new mentor is provided each semester. The program is designed to benefit elementary school children who are highly aggressive or chronically bullied. Novel to lunch buddy mentoring is a deemphasis on the strength and length of the relationship as mechanisms of change. It is thought that lunch buddy mentoring operates through provisions that are temporally proximal and context specific. Proposed are two key mechanisms: enhanced social reputation among lunchtime peers and positive interactions with lunchtime peers. Cavell and Henrie describe how lunch buddy mentoring fits within the conceptual framework of focus, purpose, and authorship.

School-based mentoring as selective prevention for bullied children: a preliminary test.

This preliminary study tested the benefits of school-based lunchtime mentoring as a form of selective prevention for bullied children. Participants were 36 elementary school children in grades 4 and 5 who had been identified as bullied (based on child and teacher reports). Children in the Lunch Buddy program (n = 12) were paired with a college student mentor who visited twice each week during the spring semester of an academic year. Also participating were 24 matched-control children; 12 were from the same school as Lunch Buddy children ("Same" controls) and 12 were from a school different from that of Lunch Buddy children ("Different" controls). Results indicated that compared to Different control children, Lunch Buddy children experienced significantly greater reductions in peer reports of peer victimization from fall to spring semesters. Lunch Buddy children and mentors viewed the relationship as positive, and parents and teachers were very satisfied with Lunch Buddy mentoring. We discuss the implications of our findings for both research and practice.

Examining motivational interviewing from a client agency perspective.

Although empirical investigations strongly support the use of motivational interviewing (MI), there is no theory to clearly explain how or why MI works. The authors propose that MI is efficacious because it mobilizes clients' inherent resources for motivation, learning, creativity, problem solving, and goal-driven activity. Examining MI from a client agency perspective reveals new ways of conceptualizing several critical issues, including MI's fundamental "spirit," the function of resolving ambivalence, the importance of change talk, MI's ability to combine well with other approaches, and the success of brief MI interventions. Implications for the science and practice of MI are discussed from the standpoint that clients are primarily responsible for driving therapeutic gains.

Relationship quality and the mentoring of aggressive, high-risk children.

We used data from a randomized clinical trial to examine the degree to which relationship quality predicted outcomes for aggressive children in two different mentoring programs. Data were available for 145 aggressive children in Grades 2 and 3. Children were blocked by school and randomly assigned to PrimeTime (n = 75) or Lunch Buddy (n = 70) programs. PrimeTime combined community-based mentoring with child-focused skills training and consultation for parents and teachers, and mentors were extensively trained and supervised. Lunch Buddy was a stand-alone, school-based mentoring program that involved lunchtime visits and a different mentor each semester. PrimeTime children rated their mentors as more supportive than did Lunch Buddy children. Relationship conflict predicted changes in teacher-rated externalizing problems. Ratings of relationship quality interacted with treatment in predicting changes in parent-rated externalizing behavior for PrimeTime children only.

Adverse school context moderates the outcomes of selective interventions for aggressive children.

Drawing on social ecological theory and empirical studies on the role of school context in aggression, the authors argue that school adversity is an important consideration in choosing selective interventions for aggressive children. The moderating role of school adversity on intervention effectiveness is illustrated with data from a randomized clinical trial study investigating 2 selective interventions administered to 86 aggressive 2nd and 3rd graders. The authors expected that PrimeTime, an intervention targeting child competencies, would be more effective in low-adversity schools, whereas Lunch Buddy, an intervention targeting peer ecology, would be more effective in high-adversity schools. Hierarchical linear regression analyses showed significant posttreatment effects on composite measures of aggression and achievement for the interaction between the level of school adversity and treatment condition.