Matching Items (6)
Filtering by

Clear all filters

151502-Thumbnail Image.png
Description
It is well-established that maternal depression is significantly related to internalizing and externalizing behavioral problems and psychopathology in general. However, research suggests maternal depression does not account for all the variance of these outcomes and that other family contextual factors should be investigated. The role of fathers beyond their simple

It is well-established that maternal depression is significantly related to internalizing and externalizing behavioral problems and psychopathology in general. However, research suggests maternal depression does not account for all the variance of these outcomes and that other family contextual factors should be investigated. The role of fathers beyond their simple presence or absence is one factor that needs to be further investigated in the context of maternal depression. The proposed study used prospective and cross-sectional analyses to examine father effects (i.e., paternal depression, alcohol use, involvement, and familism) on youth internalizing and externalizing symptoms within the context of maternal depression. The sample consisted of 405 Mexican-American families who had a student in middle school. Data were collected when the students were in 7th and 10th grade. Results from path analyses revealed that maternal depression significantly predicted concurrent youth internalizing symptoms in 7th and 10th grade and externalizing symptoms in 10th grade. In contrast, paternal depression was not related to adolescent symptomatology at either time point, nor was paternal alcoholism, and analyses failed to support moderating effects for any of the paternal variables. However, paternal involvement (father-report) uniquely predicted youth internalizing and externalizing symptoms over and above maternal depression in 7th grade. Youth report of paternal involvement uniquely predicted both internalizing and externalizing in 7th and 10th grade. Paternal familism uniquely predicted youth externalizing symptoms in 7th grade. The present findings support that maternal depression, but not paternal depression, is associated with concurrent levels of youth symptomatology in adolescence. The study did not support that fathers adjustment moderated (exacerbate or buffer) maternal depression effects. However, paternal involvement and paternal familism showed compensatory effects on youth symptomatology in concurrent analyses.
ContributorsMontano, Zorash (Author) / Gonzales, Nancy A. (Thesis advisor) / Tein, Jenn-Yun (Committee member) / Roosa, Mark (Committee member) / Arizona State University (Publisher)
Created2013
152951-Thumbnail Image.png
Description
Although research has documented robust prospective relationships between externalizing symptomatology and subsequent binge drinking among adolescents, the extent to which internalizing symptoms increase risk for drinking remains controversial. In particular, the role of anxiety as a predictor of binge drinking remains unclear. Recent evidence suggests that one possible reason for

Although research has documented robust prospective relationships between externalizing symptomatology and subsequent binge drinking among adolescents, the extent to which internalizing symptoms increase risk for drinking remains controversial. In particular, the role of anxiety as a predictor of binge drinking remains unclear. Recent evidence suggests that one possible reason for these mixed findings is that separate dimensions of anxiety may differentially confer risk for alcohol use. The present study tested two dimensions of anxiety - worry and physiological anxiety -- as predictors of binge drinking in a longitudinal study of juvenile delinquents. Overall, results indicate that worry and physiological anxiety showed differential relations with drinking behavior. In general, worry was protective against alcohol use, whereas physiological anxiety conferred risk for binge drinking, but both effects were conditional on levels of offending. Implications for future research examining the role of anxiety in predicting drinking behavior among youth are discussed.
ContributorsNichter, Brandon (Author) / Chassin, Laurie (Thesis advisor) / Barrera, Manuel (Committee member) / Presson, Clark (Committee member) / Arizona State University (Publisher)
Created2014
151186-Thumbnail Image.png
Description
This study examined the influence of the traditional values held by Mexican heritage parents on the intention of their adolescent children to use drugs. Specifically, the study tested a mediation model in which the traditional cultural values of parents were hypothesized to influence adolescent drug use intentions indirectly by influencing

This study examined the influence of the traditional values held by Mexican heritage parents on the intention of their adolescent children to use drugs. Specifically, the study tested a mediation model in which the traditional cultural values of parents were hypothesized to influence adolescent drug use intentions indirectly by influencing ethnic identify and adolescent perceptions of parental injunctive norms against drug use. Parents reported on traditional cultural values and expectations for their child. Adolescents reported perceived reaction from parents if they used drugs (parental injunctive norms), ethnic identity, and their intention to use drugs in the future. Two direct effects were observed: parental values on expectations and parental injunctive norms on adolescent drug use intentions. Two paths were also moderated by the sex of the adolescent. The path from parent values to parent expectations was significantly stronger for adolescent girls than boys; the path from ethnic identity affirmation to drug intentions was protective for boys but not for girls. The negative relationship between perceived parental reaction and adolescent drug use intentions suggests that anti-drug norms communicated by parents had a protective influence and can deter youth from using drugs. The results of the current study did not support the hypothesized mediational model, but did provide additional support for the importance of parental influence on adolescents' plans and ideas about using alcohol, cigarettes, and marijuana. More research is necessary to examine the influence of culture and the mechanisms by which cultural values impact Mexican heritage adolescents' intentions to use drugs and subsequent use.
ContributorsGarvey, Meghan (Author) / Gonzales, Nancy A. (Thesis advisor) / Marsiglia, Flavio F. (Committee member) / Mackinnon, David P. (Committee member) / Arizona State University (Publisher)
Created2012
156097-Thumbnail Image.png
Description
Mexican American adolescents report high rates of internalizing symptomatology and alcohol use. However, very little research has explored to what extent internalizing distress may contribute to alcohol use among this population. The current study utilized longitudinal data from a community sample of Mexican American adolescents (n=626, 51% female) to test

Mexican American adolescents report high rates of internalizing symptomatology and alcohol use. However, very little research has explored to what extent internalizing distress may contribute to alcohol use among this population. The current study utilized longitudinal data from a community sample of Mexican American adolescents (n=626, 51% female) to test a series of hypotheses about the role of internalizing distress on alcohol use and misuse. Specifically, this study used a bifactor modeling approach to investigate (1) whether different forms of internalizing distress are composed of common and unique components; (2) whether and to what extent such components confer risk for alcohol use; and (3) whether youth cultural orientation plays a role in these associations. Confirmatory factor analyses revealed that a bifactor model with a general factor and three specific factors (depressed mood, general worry, social anxiety) provided good fit to the data. The general distress factor was significantly associated with past month alcohol use but not binge drinking. However, these effects were conditional based on level of acculturation. Differential relations were found between the specific factors of internalizing distress and alcohol use. Depressed mood predicted past month alcohol use among girls; social anxiety negatively predicted past three month binge drinking among boys. Overall, results highlight the multidimensional nature of internalizing distress and suggest that both common and unique components of internalizing distress may be relevant to the etiology of alcohol use among Mexican-American adolescents. Findings underscore the importance of considering cultural orientation as a moderating factor when investigating substance use among Hispanic youth. Implications for future research examining the etiological relevance of the internalizing pathway to alcohol use among Hispanic adolescents are discussed.
ContributorsNichter, Brandon (Author) / Gonzales, Nancy (Thesis advisor) / Chassin, Laurie (Committee member) / Barrera, Manuel (Committee member) / Tein, Jenn (Committee member) / Arizona State University (Publisher)
Created2018
154292-Thumbnail Image.png
Description
This study examined an adverse effect of an adolescent group intervention. Group interventions represent one of the most economical, convenient, and common solution to adolescent behavior problems, although prior findings from program evaluation studies have suggested that these groups can unexpectedly increase the externalizing behaviors that they were designed to

This study examined an adverse effect of an adolescent group intervention. Group interventions represent one of the most economical, convenient, and common solution to adolescent behavior problems, although prior findings from program evaluation studies have suggested that these groups can unexpectedly increase the externalizing behaviors that they were designed to reduce or prevent. The current study used data from a longitudinal, randomized controlled trial of the Bridges to High School / Puentes a La Secundaria Program, a multicomponent prevention program designed to reduce risk during the middle school transition, which has demonstrated positive effects across an array of outcomes. Data were collected at the beginning of 7th grade, with follow-up data collected at the end of the 7th, 8th, 9th, and 12th grade from a sample of Mexican American adolescents and their mothers. Analyses evaluated long-term effects on externalizing outcomes, trajectories of externalizing behaviors across adolescence, and potential mediators of observed effects. Results showed that the adverse effect that was originally observed based on adolescent self-report of externalizing symptoms at 1-year posttest among youth with high pretest externalizing symptoms was not maintained over time and was not reflected in changes in adolescents' trajectories of externalizing behaviors. Moreover, neither of the peer mediators that theory suggests would explain adverse effects were found to mediate the relationship between intervention status and externalizing symptoms at 1-year posttest. Finally, only beneficial effects were found on externalizing symptoms based on mother report. Together, these findings suggest that the Bridges intervention did not adversely affect adolescent problem behaviors and that future studies should use caution when interpreting unexpected adverse effects.
ContributorsWong, Jessie Jong-Chee (Author) / Gonzales, Nancy A. (Thesis advisor) / West, Stephen G. (Thesis advisor) / Chassin, Laurie (Committee member) / Dishion, Thomas (Committee member) / Arizona State University (Publisher)
Created2015
609-Thumbnail Image.png
Description

Background: The cost of substance use (SU) in the United States (U.S.) is estimated at $1.25 trillion annually. SU is a worldwide health concern, impacting physical and psychological health of those who use substances, their friends, family members, communities and nations. Screening, Brief Intervention (BI) and Referral to Treatment (SBIRT)

Background: The cost of substance use (SU) in the United States (U.S.) is estimated at $1.25 trillion annually. SU is a worldwide health concern, impacting physical and psychological health of those who use substances, their friends, family members, communities and nations. Screening, Brief Intervention (BI) and Referral to Treatment (SBIRT) provides an evidence-based (EB) framework to detect and treat SU. Evidence shows that mental health (MH) providers are not providing EB SU management. Federally grant-funded SBIRT demonstrated evidence of decreased SU and prevention of full disorders. Implementation outcomes in smaller-scale projects have included increased clinician knowledge, documentation and interdisciplinary teamwork.

Objective: To improve quality of care (QOC) for adolescents who use substances in the inpatient psychiatric setting by implementing EB SBIRT practices.

Methods: Research questions focused on whether the number of SBIRT notes documented (N=170 charts) increased and whether training of the interdisciplinary team (N=26 clinicians) increased SBIRT knowledge. Individualized interventions used existing processes, training and a new SBIRT Note template. An SBIRT knowledge survey was adapted from a similar study. A pre-and post-chart audit was conducted to show increase in SBIRT documentation. The rationale for the latter was not only for compliance, but also so that all team members can know the status of SBIRT services. Thus, increased interdisciplinary teamwork was an intentional, though indirect, outcome.

Results: A paired-samples t-test indicated clinician SBIRT knowledge significantly increased, with a large effect size. The results suggest that a short, 45-60-minute tailored education module can significantly increase clinician SBIRT knowledge. Auditing screening & BI notes both before and after the study period yielded important patient SU information and which types of SBIRT documentation increased post-implementation. The CRAFFT scores of the patients were quite high from a SU perspective, averaging over 3/6 both pre- and post-implementation, revealing over an 80% chance that the adolescent patient had a SU disorder. Most patients were positive for at least one substance (pre- = 47.1%; post- = 65.2%), with cannabis and alcohol being the most commonly used substances. Completed CRAFFT screenings increased from 62.5% to 72.7% of audited patients. Post-implementation, there were two types of BI notes: the preexisting Progress Note BI (PN BI) and the new Auto-Text BI (AT BI), part of the new SBIRT Note template introduced during implementation. The PN BIs not completed despite a positive screen increased from 79.6% to 83.7%. PN BIs increased 1%. The option for AT BI notes ameliorated this effect. Total BI notes completed for a patient positive for a substance increased from 20.4% to 32.6%, with 67.4% not receiving a documented BI. Total BIs completed for all patients was 21.2% post-implementation.

Conclusion: This project is scalable throughout the U.S. in MH settings and will provide crucial knowledge about positive and negative drivers in small-scale SBIRT implementations. The role of registered nurses (RNs), social workers and psychiatrists in providing SBIRT services as an interdisciplinary team will be enhanced. Likely conclusions are that short trainings can significantly increase clinician knowledge about SBIRT and compliance with standards. Consistent with prior evidence, significant management involvement, SBIRT champions, thought leaders and other consistent emphasis is necessary to continue improving SBIRT practice in the target setting.

Keywords: adolescents, teenagers, youth, alcohol, behavioral health, cannabis, crisis, documentation, drug use, epidemic, high-risk use, illicit drugs, implementation, mental health, opiates, opioid, pilot study, psychiatric inpatient hospital, quality improvement, SBIRT, Screening, Brief Intervention and Referral to Treatment, substance use, unhealthy alcohol use, use disorders

ContributorsMaixner, Roberta (Author) / Guthery, Ann (Thesis advisor) / Mensik, Jennifer (Thesis advisor) / Uriri-Glover, Johannah (Thesis advisor)
Created2019-05-02