Multicomponent Co-Occurring Disorders Treatment and Wraparound Services for Individuals Experiencing Chronic Homelessness.

Individuals experiencing chronic homelessness have high rates of persistent co-occurring mental health and substance use disorders (COD), and they often have difficulty with service engagement and retention, resulting in symptom exacerbation and housing loss. This study pilot tested Maintaining Independence and Sobriety Through Systems Integration, Outreach and Networking (MISSION), a multicomponent wraparound treatment approach to improve COD symptoms and housing stability among individuals experiencing chronic homelessness and persistent COD. This open pilot study enrolled and assessed 109 individuals with a COD experiencing chronic homelessness and offered one year of MISSION. Statistically significant improvements were observed in behavioral health symptoms and functioning, days of illicit drug use, and housing stability. By treatment completion, 85% of participants were referred to social and behavioral supports. This pilot study demonstrates that MISSION helped to successfully engage participants in treatment, reduce substance use and mental health symptoms, and improve housing outcomes.

Community reentry: Racial/ethnic differences in unmet needs among adults with co-occurring opioid use and mental health disorder.

BACKGROUND: Adults with co-occurring opioid use and mental health disorder (COD) recently released from incarceration have many social and health needs that place them at the most significant risk for overdose and poor reentry outcomes. Little is known about racial/ethnic differences in this population. METHODS: To examine racial/ethnic differences in social and health needs, data were analyzed for 293 adults with COD within two weeks of release, a high-risk period for overdose, from six Massachusetts jails. RESULTS: Overall, participants (62.6% non-Hispanic White, 23.1% Hispanic, 14.3% non-Hispanic Black, and 73.5% male) reported multiple health and social needs across groups. Chi-square tests and Kruskal-Wallis one-way ANOVAs were used to compare social and health needs among racial/ethnic groups. Non-Hispanic Black participants reported more problems with crack/cocaine, whereas Non-Hispanic White and Hispanic participants reported more problems with opioids (p < .001). Despite similar lifetime rates of illicit substance use, non-Hispanic Black and Hispanic participants received less treatment (p < .001). Non-Hispanic White participants reported more opioid and alcohol use (p < .006), trauma symptoms (p = .020), utilization of behavioral health treatment (p = .008), and more medical needs than Hispanic and/or non-Hispanic Black participants (p = .001). Non-Hispanic Black and Hispanic participants reported more needs related to social determinants of health (p = .008). CONCLUSIONS: While re-entry is a vulnerable period for all adults with COD, this paper identifies specific needs by race/ethnicity and proposes strategies to advance equity and improve care for all formerly incarcerated adults with a COD.

Impact of tablet use on young children's inhibitory control and error monitoring.

The purpose of this study was to investigate the cognitive impacts of tablet use on young children's inhibitory control and error monitoring. A total of 70 children (35 boys) aged 3.5 to 5 years completed an age-appropriate go/no-go task and were then randomly assigned to a technology group or a comparison group. In the technology group, children completed a cooking task on a tablet for 15 min. In the comparison group, children completed a similarly structured cooking task with toys for the same length of time. Children then completed the go/no-go task again. Compared with children in the comparison group, children in the technology group demonstrated poorer inhibitory control as evidenced by lower accuracy on no-go trials after the cooking task. However, both groups displayed post-error reaction time slowing. Collectively, these results suggest that brief tablet use can impose selective impairment on young children's cognitive abilities for a short period of time following use.

Impact of L2 automated systems on hazard anticipation and mitigation behavior of young drivers with varying levels of Attention Deficit Hyperactivity Disorder symptomatology.

Level 2 (L2) driving automation systems that maintain latitudinal and longitudinal control of the vehicle decrease mental workload and result in drivers failing to monitor and respond to potential roadway hazards. This issue is potentially important for young drivers with symptoms of Attention Deficit Hyperactivity Disorder (ADHD) since they have known difficulties anticipating and mitigating potential hazards on the road, a skill which requires attention. The objective of this study is to investigate how the use of partially automated (L2) systems and manual systems impacts hazard anticipation and mitigation among young drivers with varying levels of ADHD symptomatology. Sixty-eight drivers, classified into two groups - high and low ADHD symptomatology-navigated twice through three scenarios on a driving simulator, once with an L2 and once with a manual system. The results indicated that: (i) the hazard anticipation skills of drivers with both high and low ADHD symptomatology were depressed in the L2 condition relative to the manual condition; (ii) the hazard mitigations skills of drivers with both high and low ADHD symptomatology were depressed in the L2 condition relative to the manual condition on two measures, but improved on a third measure; and (iii) the hazard anticipation and mitigation skills of drivers with high and low ADHD symptomatology were differentially impacted, both within and across the two levels of automation. Taken together, the results indicate the pernicious and often hard to predict consequences of higher levels of automation for different populations of younger drivers.

Parenting and Children's Executive Function Stability Across the Transition to School.

When children transition to school between the ages of 4 and 6 years, they must learn to control their attention and behavior to be successful. Concurrently, executive function (EF) is an important skill undergoing significant development in childhood. To understand changes occurring during this period, we examined the role of parenting in the development of children's EF from 4 to 6 years old. Participants were mother and child dyads (N = 151). Children completed cognitive tasks to assess overall EF at age 4 and age 6. At both time points, mothers and children completed interaction tasks which were videotaped and coded to assess various parenting dimensions. Results indicated that children with high EF at age 4 were more likely to have high EF at age 6. In addition, results suggested that higher levels of positive parenting across the transition to school promote stability of individual differences in EF.

Television use and its effects on sleep in early childhood.

OBJECTIVES: The purpose of this study was to investigate the impacts of television (TV) viewing and bedroom TV presence on young children's sleep as measured by actigraphy. DESIGN: Analyses of covariance were run to examine differences in sleep duration and quality among children based on the presence of TVs in their bedrooms and the amount of TV watched. SETTING: Recruited in preschools in Massachusetts; recorded ambulatory (in home, environs). PARTICIPANTS: Participants were 470 children between 33 and 71 months of age (M = 51.02). MEASUREMENTS: Children were instructed to wear an actigraph watch for 16 days. Caregivers reported demographic information, completed behavior questionnaires, and answered questions regarding their child's TV use. RESULTS: Children who watched more TV and had TVs in their bedroom displayed significantly shorter sleep duration and worse sleep, but they also napped significantly longer in the daytime. Nonetheless, total 24-hour sleep was shorter for those who watched more TV and had TVs in their bedroom compared to those who did not have TVs in their bedrooms or watch TV frequently. Children who had TVs in their bedrooms watched TV later at night, watched more adult TV programs, and had higher negative affect than children without TVs in their bedrooms. CONCLUSIONS: These findings suggest that TV use in young children does impact sleep duration and quality as measured by actigraphy, and daytime napping does not offset these negative impacts.