Rates of Recent Adverse Childhood Experiences Among Indigenous Children.

The current paper describes rates of recent (past six months) adverse childhood experiences (ACEs) and examines the association of ACEs with cultural connection and depressive symptoms among Indigenous children aged 10 to 14 (N = 177; mean age = 11.8; 48.3% boys; 44.3% girls; 7.4% another gender identity). Children completed baseline surveys as part of a larger evaluation of a culturally grounded, strengths-focused, family-based program to prevent ACEs. Surveys included an inclusive measure of ACEs developed for the current study, an adapted measure of connection to culture, and the Children's Depression Screener. Results for ACEs indicated that 18.6% of Indigenous children reported none, 37.2% reported one to three, and 44.2% reported four or more in the past six months. Importantly, children who reported no ACEs reported greater cultural connection than children who reported one to three ACEs. Depressive symptoms were higher among children who reported one to three and four or more ACEs compared to children who reported no ACEs.

Programs to Prevent Violence Against Children in Sub-Saharan Africa: A Systematic Review.

Violence against children-which includes maltreatment (including physical, sexual, psychological and emotional violence, and neglect), bullying (including cyberbullying), youth violence (including physical assault with or without weapons), intimate partner violence (including exposure to domestic violence and direct involvement in teen dating violence), and sexual violence-continues to present itself as a significant public health crisis in Sub-Saharan Africa (SSA) leading to numerous short- and long-term deleterious outcomes. As such, the prevention of violence against children in SSA is a critical public health priority. In this systematic literature review, we identified 45 articles that reported on results from 22 programs that seek to reduce violence against children in SSA. Results suggested that programs that focus on (1) economic strengthening, (2) teachers schools, (3) entire families, (4) caregivers only, and (5) children only are generally effective in reducing violence against children by promoting focused action on the mechanisms of change (e.g., parenting skills, enhanced parent-child relationships, resistance skills for children). To date, no research in SSA has examined the impact of policy interventions on childhood victimization or community-level interventions to change norms and values that support violence against children. Future research is needed to examine the impacts of comprehensive efforts to prevent violence against children in SSA as well as factors that predict uptake and sustainability of such prevention efforts in SSA.

Perceptions of Addiction Medications Within Collegiate Recovery Communities.

OBJECTIVES: Addiction medications (AM) are effective in improving recovery outcomes, but many barriers still exist that reduce their implementation among young adults. While the perception of AM has been explored within clinicians and counselors in many settings, it has not yet been documented within collegiate recovery communities (CRC). The aim of this brief report is to assess the acceptability and intent to use AM among students in recovery, and to evaluate the effect of attitudes, perceived AM effectiveness, and social norms on these outcomes. METHODS: Using the Theory of Planned Behavior, CRC students (N = 162; 44% female) within the United States completed an online survey. RESULTS: Results from a hierarchical linear model indicated that the perceived acceptance of AM use by important others was significantly related to the intent to use AM ( ß = 0.47, P < 0.01) and encourage others to use AM ( ß = 0.16, P < 0.05). Positive attitudes about AM predicted acceptability of AM use ( ß = 0.42, P < 0.01) and encouraging other CRC students to use AM ( ß = 0.38, P < 0.01). Perceived AM effectiveness was positively associated with acceptability ( ß = 0.36, P < 0.01) and encouragement of others ( ß = 0.27, P < 0.01). CONCLUSIONS: Results highlight the importance of promoting effectiveness, improving attitudes, and tapping social networks to increase AM use and acceptability among CRC students. Implications for CRC policy and programming are discussed.

Social networks and violence victimization and perpetration among youth: A longitudinal analysis.

Interpersonal violence (IV) is a serious concern for adolescents in the United States that has devastating impacts for individuals and communities. Given the increased importance placed on friendships during adolescence, the purpose of the current study was to examine the extent to which IV experiences cluster within youths' friendship networks. Participants were students (N = 1303) in grades 7th to 10th who completed surveys at the beginning and end of an academic year. Results showed that friends' average perpetration (i.e., the percentage of the friends they nominated who perpetrated IV) was strongly associated with likelihood of individual perpetration at baseline but not at the follow-up. For victimization, friends' average report of victimization (i.e., the percentage of the friends they nominated who were victimized) was associated with higher likelihood reporting of victimization (at both baseline and follow-up). Although future research is needed to understand explanatory mechanisms underlying these findings, it is possible that the effectiveness of prevention initiatives may be enhanced by incorporating peer group information.

Rates and Correlates of Intimate Partner Abuse Among Indigenous Women Caregivers.

Intimate partner abuse (IPA) is a public health crisis that disproportionately impacts indigenous women. We know little about rates and correlates of IPA victimization (IPAV) and abuse directed at one's partner (ADP) among indigenous women caregivers (people who take care of children). The purpose of the current study was to address this critical gap in the literature. Participants were 44 indigenous women caregivers in the United States in a current relationship who completed a survey. Most women reported IPAV and ADP experiences in the past 6 months, and IPAV and ADP abuse directed at partner were positively associated. Further, IPAV was positively associated with adverse childhood experiences (ACEs), participants' engagement in harsh parenting, and depressive symptoms. IPAV was negatively associated with age, income, indigenous cultural identity, and social support. ADP was positively associated with ACEs, harsh parenting, and depressive symptoms. ADP was negatively associated with age and income. ADP was not associated with indigenous cultural identity and social support. These data suggest the urgency with which efforts are needed to prevent and respond to IPA among indigenous women caregivers, especially those who are younger and of lower income, and that culturally grounded initiatives that seek to build social support may be especially impactful.

Indigenous Cultural Identity Protects Against Intergenerational Transmission of ACEs Among Indigenous Caregivers and Their Children.

A large body of empirical research has demonstrated that caregiver adverse childhood experiences (ACEs) predict ACEs in one's child, a phenomenon known as the intergenerational transmission of ACEs. Little of this empirical research, however, has focused specifically on Indigenous peoples despite a growing body of theoretical literature and the wisdom of Elders and Traditional Knowledge Keepers that speaks to the presence of this phenomenon within Indigenous communities as well as the protective role of Indigenous cultural identity in preventing the intergenerational transmission of ACEs. The purpose of the current study was to conduct an empirical evaluation of this hypothesis, specifically that Indigenous cultural identity and social support protects against the intergenerational transmission of ACEs among Indigenous peoples and their children in the USA. Participants were 106 Indigenous women caregivers of children ages 10 to 14 in South Dakota who completed surveys. Results showed that Indigenous cultural identity moderated the association between caregiver ACEs and child ACEs. At high levels of cultural identity, there was no association between caregiver ACEs and child ACEs. At low levels of Indigenous cultural identity, however, there was a strong and positive relationship between caregiver ACEs and child ACEs. Social support did not moderate the association between caregiver ACEs and child ACEs. These findings underscore the need for initiatives that enhance Indigenous cultural identity and social support among Indigenous caregivers to prevent the intergenerational transmission of ACEs.

Trajectories of incarcerated coparenting: Examining differences across race and ethnicity.

Emerging research suggests that those coparenting with an incarcerated person experience multiple challenges. Examining incarcerated coparenting among minority fathers is especially salient as their incarceration rates are substantially higher than White males. This study utilized data from the Multi-Site Family Study on Incarceration, Parenting and Partnering Study to examine changes in coparenting relationships when the male partner was incarcerated. Theoretically guided by structural family therapy, latent growth models were used to evaluate trajectories of fathers' coparenting reliability and coparenting cohesion across 34 months. Results indicated average declines within incarcerated men's reported coparenting responsibility and coparenting cohesion with their partner. Incarcerated men with higher relationship quality at T1 was significantly associated with higher initial levels of coparenting cohesion and coparenting responsibility-but not with the trajectories of coparenting change. Incarcerated fathers identifying as Hispanic and Other declined at a significantly steeper rate in coparenting responsibility than Black and White incarcerated fathers. Clinical implications and future research directions are provided.

Using intergenerational photovoice to understand family strengths among Native American children and their caregivers.

The purpose of the current study was to examine Native American children and caregivers' perspectives of family and cultural strengths using photovoice and to identify lessons learned from the first-ever implementation of intergenerational photovoice with Native Americans. Participants were Native American, low-income caregivers (n = 6) and their children (n = 12) between the ages of 10 and 15 who participated in six photovoice sessions. The themes that emerged from photos and group discussion included myriad challenges faced by Native American families including exposure to community violence, substance abuse, and criminal offending and incarceration. Themes also emerged that highlighted the strengths of Native families that were used to overcome identified challenges, including religion/spirituality, engagement in traditional cultural practices (e.g., prayer, song, dance), healthy activities (e.g., running, meditation). These data provided foundational information that is currently being used, along with other data, to develop a culturally grounded, strengths-focused, family-based program (Tiwahe Wicagwicayapi [Strengthening/Growing Families in Lakota]) to prevent adverse childhood experiences. We also discuss the challenges of intergenerational photovoice and lessons learned to inform future intergenerational photovoice projects.

Searching for Mental Health Services: Search Strings and Information Acquisition.

Based on decision sciences and information processing theories, how information is acquired is the foundation of decisions and choices subsequently made. Adapting the Active Information Search methodology, the aim for this study is to examine what information potential mental health clients look for in a service provider through their use of search strings. College students (N = 519) from a large public university from the southwest USA (data collection from August to December 2018) were asked in an online survey to imagine themselves needing mental health services and list down the search string they would use in a search engine (e.g., Google). Content analysis indicated seven search string categories: location of nearby services, symptoms, types of services/specialty, asking for advice, questions about resources, questions about whether they have a problem, and looking for the "best." Further, multivariate logistic analysis indicated that gender, psychological distress, perceived normativeness of utilizing mental health services, and type of medical insurance were associated with the type of search string the participant used in searching for mental health services. Understanding how individuals search for mental health services can help guide mental health practitioners in what information should be included in their websites. Further findings and implications are discussed.

Early Trauma and Later Sexual Victimization in College Women: A Multiple Mediation Examination of Alexithymia, Impulsivity, and Alcohol Use.

Childhood abuse and sexual violence against women are prevalent in the United States. However, researchers have not fully explored the intersection among important predisposing factors that predict recent sexual violence experienced by women who are also survivors of childhood abuse. The purpose of this study was to examine the relationships among early childhood trauma, alexithymia, impulsivity, alcohol use severity, and sexual victimization in later life among female college students from the United States (n = 1,178). Participants were part of a larger cross-cultural study, conducted between 2012 to 2014, which examined sexual aggression and victimization in the context of alcohol use. The current study aimed to examine if: (a) early trauma, impulsivity, alexithymia, and alcohol use severity impact sexual victimization in later life, and (b) if impulsivity, alexithymia, and alcohol use severity mediate the relationship between early trauma and victimization in later life. It was hypothesized that impulsivity, alexithymia, and alcohol use severity would significantly mediate the relationship between early trauma and sexual victimization in later life. Using a multiple mediation path analysis, results indicated that early childhood trauma was significantly linked with impulsivity, alcohol use severity, and sexual victimization in later life. A partial mediation through impulsivity and alcohol use severity was observed. Alexithymia did not produce mediation effects. These findings align with previous research examining how early childhood trauma influences the occurrence of sexual victimization in later life and provides further recommendations for helping professionals as they attempt to stifle the sexual victimization rates among female college students.

A Cross-Cultural Comparison of the Role of Sexual Objectification in the Relationship Between Alcohol Use and Sexual Assault Perpetration.

In this study, we examined how sexual objectification can help explicate the relationship between alcohol use and sexual assault perpetration. Specifically, we examined a mediation and a moderation model. Moreover, given that gender roles and sexual norms vary across cultures, we also examined the structural invariance of the models between a U.S. male (n = 404) and Philippines male (n = 100) college sample. Path analyses were used to examine the mediation and the moderation model, and multiple groups analysis was utilized to examine model differences between samples. Sexual objectification fully mediated the relationship between alcohol use severity and sexual aggression. Furthermore, the mediation model was invariant between the U.S. sample and Philippines sample. A significant alcohol use severity by sexual objectification interaction effect was found for both samples. Simple slopes analysis indicated that alcohol use severity was not associated with sexual aggression among those with high sexual objectification scores. Among men with low sexual objectification scores, alcohol use severity was associated with higher likelihood toward sexual assault. For the Filipino sample, the impact of alcohol consumption on sexual aggression is more pronounced compared with the U.S. sample. Sexual objectification is a key variable in understanding the alcohol use-sexual aggression relationship. Country differences in alcohol use, cultural meanings of Filipino masculinity, and sexual norms and behaviors accounts for noninvariance in the moderation model. Implications for sexual assault reduction programs were also discussed.

Alexithymia, Prior Trauma, Alcohol Use, and Sexual Aggression Perpetration: A Cross-Cultural Comparison of a Moderated Mediation Model.

In this study, we examined the relationships between prior trauma, alexithymia, and sexual aggression perpetration among 610 U.S. college students and 107 college students from the Philippines utilizing a cross-sectional retrospective design. We tested a moderated mediation model with alexithymia as the mediator between prior trauma and sexual aggression perpetration, and alcohol use as a moderator of the alexithymia-sexual aggression link. Moreover, given that cultural norms may influence these relationships, we also examined the structural invariance of the proposed moderated mediation model. Path analyses and multiple group analysis were used to examine the moderated mediation model, and examine model differences between samples. We did not find evidence for alexithymia as a mediator, but there was a significant interaction between alcohol use severity and alexithymia on sexual aggression perpetration across both samples. Alexithymia is a key variable in understanding the alcohol use-sexual aggression perpetration relationship. Clinical implications and recommendations for future research are also discussed.

Living With Parkinson's: The Process of Finding Optimism.

Individuals with Parkinson's disease (PD) often experience poor mental and emotional well-being, which negatively affect their quality of life. Optimism is a protective factor which has been shown to promote resiliency, reduce distress in health crises, and protect against the effects of negative mental health outcomes. The current article utilized grounded theory methodology to examine personal accounts (N = 85) detailing how individuals were able to cultivate optimism despite challenges presented by PD. The grounded theory indicated that a process occurs in which individuals with PD move through the following five phases on their journey toward optimism: (a) diagnosis, (b) initial reactions, (c) adjustment, (d) acceptance, and (e) living with optimism. These findings indicate that individuals with PD often struggle to experience optimism. Nevertheless, by reframing optimism as a choice rather than a feeling, participants were able to make decisions that allowed them to progress on their journey toward optimism.

Codependency and Prefrontal Cortex Functioning: Preliminary Examination of Substance Use Disorder Impacted Family Members.

BACKGROUND AND OBJECTIVES: Substance use disorders (SUDs) have negative impacts on an entire family system and each family member may be at risk to develop a "codependency" on their SUD loved-one. Research has demonstrated that SUDs in the family environment associate with altered brain functioning of family members; however, research has not examined specific associations between codependency and brain functioning. METHODS: Prefrontal cortex (PFC) activation of family members (n = 38) was assessed using functional near-infrared spectroscopy as they viewed images of a SUD loved-one (experimental group; n = 26) or of a "target family member" (control group; n = 12). Correlations between PFC activation and codependency were examined. RESULTS: A significant negative association was found between codependency and left dorsomedial PFC activation in response to images of a loved-one with a SUD. This association was significantly larger than that found in the control group in response to a target family member, and that found in response to other affective images. DISCUSSION AND CONCLUSIONS: The left dorsomedial PFC is associated with executive functioning during responses to emotional and social situations. Findings may suggest that family members experiencing codependency may be limited in effectively responding to their SUD loved-one, and highlight the importance of systemic treatment and family member recovery. SCIENTIFIC SIGNIFICANCE: Codependency is often discussed as a learned condition and research has only recently examined brain processes of family members with a loved-one with a SUD. This research is the first to demonstrate an association between codependency and PFC functioning. (Am J Addict 2019;28:367-375).

Examining the role of a brief online alcohol use risk feedback on accessing information about available treatment resources for alcohol issues.

Research suggests college-aged young adults are hesitant to seek treatment for alcohol use disorder and highlights barriers contributing to a gap in treatment utilization. One barrier to treatment utilization is the lack of information about available treatment resources. Motivated by the literature on web-based screening and brief interventions (eSBIs), the current study examined whether providing a brief online feedback of one's alcohol use risk severity will make college students more likely to access information about available treatment options for alcohol-related issues. College students (N = 724) who responded to the Alcohol Use Disorder Identification Test (Babor, Higgins-Biddle, Saunders, & Monteiro, 2001) were randomly assigned to receive a brief online feedback on their alcohol use risk or to a no-feedback condition. Overall, only 20% of all participants opted to view available treatment services for alcohol issues. Participants in the feedback group (15%) were significantly less likely to view information for available services compared to the no-feedback group (24%). A significant feedback condition x stigma interaction effect was found, such that those with average and high stigma towards substance use scores were less likely to view treatment information when provided feedback. Without a thorough discussion of individual risks and without the safeguards against psychological reactance present in eSBIs, providing college students with brief online feedback about their alcohol use risk severity made them less likely to access information concerning available on-campus mental health resources for alcohol issues. On the other hand, improving help-seeking attitudes could help increase treatment utilization.