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- Genre: Doctoral Dissertation
Description
In past decades, adverse childhood experiences (ACEs) rapidly gained attentionas a public health crisis due to dose-response relationships with a range of health and
social problems, and early mortality. Converging studies show that ACEs are a pandemic
in the general population of the United States—even in middle to upper-middle class
families that are considered to be ‘better off’. There have been collaborative efforts in
public health to target root-causes of childhood adversity and increase resilient
adaptation in individuals and families at risk. Due to the importance of fostering positive
adaptation in the midst of adversity, this dissertation sought to examine both
vulnerability and protective factors in children’s proximal ecology—e.g., parents and
caring adults at school. A population-based study in this dissertation revealed that
parents’ emotional well-being, measured as negative feelings toward parenting, greatly
influences developing children, so as support and resources for parenting. The presence
of caring adults as a protective factor in teens with highly competitive settings—a newly
identified at-risk group due to high pressure to achieve and internalizing/externalizing
problems. Lastly, this dissertation discusses conceptual and methodological limitations
in current ways of measuring ACEs and provide future directions for research, practice,
and policy. Suggestions include frequent assessments on reaching consensus on how to
define ACEs, expanding the concept of ACEs, considering the duration, timing, and
severity of the event. Healthcare professionals have important roles in public health;
they incorporate frequent assessments on parents’ emotional wellbeing and needs for
parenting as a part of care. Ongoing support from multiple disciplines is necessary to
reduce the impact of ACEs and strengthen resilience development of children and
families.
ContributorsSuh, Bin (Author) / Luthar, Suniya (Thesis advisor) / Pipe, Teri (Thesis advisor) / Castro, Felipe (Committee member) / Arizona State University (Publisher)
Created2022
Description
The purpose of this study was to examine if certain child demographics and risk modifiers of the child (i.e., anxiety sensitivity, depressive symptoms, anxiety control, and social competence) predict program response to a Child Anxiety Indicated Prevention and Early Intervention protocol (Pina, Zerr, Villalta, & Gonzales, 2012). This anxiety protocol focused on cognitive behavioral techniques (e.g., systematic and gradual exposure) that used culturally responsive implementation strategies (Pina, Villalta, & Zerr, 2009). The current study aims to investigate specific predictors of program response to this anxiety protocol. First, it was of interest to determine if child demographics and risk modifiers of the child at baseline would predict program response to the early anxiety intervention protocol. Second, it was of interest to see if an interaction with one of the four risk modifiers at baseline and sex or protocol condition would predict program response to the early anxiety intervention protocol. This study included 88 youth (59.14% Hispanic/Latino and 40.9% Caucasian) who were recruited through referrals from public schools and randomized to one of two protocol conditions (i.e., child-only or the child-plus-parent protocol), which had varying levels of mothers’ participation within the Child Anxiety Indicated Prevention and Early Intervention protocol (Pina et al., 2012). Participants ranged from 6 to 17 years of age (M = 10.36, SD = 2.73), and 48.9% were boys. The four risk modifiers were assessed using the Childhood Anxiety Sensitivity Index (CASI; Silverman, Fleisig, Rabian, & Peterson, 1991), Children's Depression Inventory (CDI; Kovacs, 1981), Anxiety Control Questionnaire for Children-Short Form (ACQ-C-S; Weems, 2005), and Social Competence scale from the Child Behavior Checklist (CBCL; Achenbach & Resorla, 2001). Program response was measured by pre-to-posttest changes in anxiety outcomes. Regarding the first aim, each of the four risk modifiers was related to pre-to-posttest changes in program response outcomes. Regarding the second aim for interactions between each of the four focal predictors, sex and protocol condition emerged as moderators. These results have potential implications for clinicians and researchers interested in understanding why some children might experience more or less change when participating in an early intervention protocol for anxiety.
ContributorsWynne, Henry (Author) / Pina, Armando (Thesis advisor) / Luthar, Suniya (Committee member) / Enders, Craig (Committee member) / Wolchik, Sharlene (Committee member) / Arizona State University (Publisher)
Created2017