background: Being concerned and stressed over one’s economic situation is common among adults in the U.S. Studies have linked stress over economic matters to declines in physical (sleep problems, smoking, coronary heart disease) and emotional health (depression, anxiety, irritability, substance abuse). In addition to its negative effects on individuals, economic stress seems to take a serious toll on couple relationships. Money is a major source of conflict for one third of adults in committed romantic relationships and couples argue more intensely and longer about money in comparison to other topics. Within couples, economic stress is shown to be associated with an increase in partners’ negative interactions (e.g., conflict, psychological aggression) and a decrease in positive interactions (e.g., warmth, validation, support, intimacy), and relationship satisfaction and stability.

methods: The present study was a randomized control trial of the TOGETHER program, a 20-hour relationship and financial psychoeducational workshop for couples. Both control (n=147) and intervention (n=145) couples, completed self-report instruments upon enrollment (Time 1), 8 weeks later/end of intervention (Time 2), and six months later (Time 3) in four areas: individual well-being, individual coping, relationship functioning, and financial management. Dyadic multilevel models were used to test Time 1 – Time 2 mean differences between the intervention and control groups and to estimate growth curves across all three time points between both groups.

results: Upon program completion, and over time, intervention couples reported better outcomes related to individual well-being. In particular, the intervention group showed significant reductions in depression (B=–1.06, SE=0.22, p<.001), anxiety (B=–0.61, SE=0.13, p<.001), stress (B=–5.49, SE=0.79, p<.001), emotion regulation difficulties (B=–3.98, SE=1.63, p<.05), and negative coping behaviors. Intervention couples reported a significant reduction in financial stress (B=–1.94, SE=0.7, p<.01) and significant improvements in several domains of individual coping with finances. Additionally, individuals participating in the TOGETHER program showed a reduction in psychological aggression, physical assault.

conclusions: This study suggests that psycho-educational programs such as TOGETHER that integrate relationship and financial education can bring changes in both individual and relational well-being as well as financial matters for couples.

Background: Approximately 25% of youth in detention centers meet criteria for depression. Family stress factors such as violence, drug use, or parental incarceration have been linked to youth mental health. Studies have reported protective factors, through a parent, peer, and school that mitigate the development of depression among at risk youth. However, few have investigated how these protective factors function with family stress. This study seeks to identify protective factors that mitigate development of depression across heterogeneous familial stress profiles.

Methods: The current study included 1,188 (M_age=16.04; 14-18 baseline range) serious adolescent offenders who were prospectively followed from 2000-2003 to 2007-2010. Latent class analysis (LCA) was used to create the familial stress variable and levels of stress from five parental indicators at baseline: (1) parental arrest, (2) parental drug use, (3) verbal violence, (4) physical violence and (5) parents getting along. Following, Latent growth modeling was used to determine depression trajectories (through the Brief Symptom Inventory) overtime between emergent classes. Finally, we estimated a series of nested models that assessed effects of protective factors on depression trajectories that included the:(1) individual (Psychosocial Maturity Inventory-Identity & Maturity subscales) (2) parent (Quality of Parental Relationships Inventory), (3) peer (Resistance to Peer Influence Measure & Friendship Quality Scale), (4) school (survey indicators of bonding to a teacher & school engagement), and (5) neighborhood (survey indicators of involvement in community activities).

Results: Results from the LCA indicated a four-class solution fit. Classes were labeled low all (11.4%), high all (28.09%), high verbal violence (19.1%), and moderate parent stress and verbal violence in the home (41.3%). When estimating depression slopes for youth across emergent classes – findings demonstrate that those in the high all class had significantly higher starting points and remained high on depression throughout young adulthood. Results for our protective factors indicated identity development and resistance to peer influence reduced initial levels of depression.

Conclusions: Our findings demonstrate the importance of developing self-esteem and clarity of the self (elements of identity), as well as strategies to promote resistance to peer influence to protect against depression symptoms overtime for serious offending youth.

Background: Childhood mental and behavioral dysfunction (CMBD) reflects a biopsychosocial dysregulation and is associated with several risk factors. Epidemiologic data indicate excess prevalence of CMBD among racial/ethnic minorities, mainly Blacks. However, the racial/ethnic disparities are not fully understood, requiring further causal pathway investigation for specific identification and potential intervention mapping. We aimed to assess the correlation between parental Substance Use Disorder (PSUD) and CMBD, and the subpopulation differences in risk prediction.

Methods: A cross-sectional design with the National Survey of Children’s Health (NSCH 2016/17) data were utilized to examine the postulated correlations between PSUD and CMBD. While the Chi-square statistic was used for the distribution of the variables by race/ethnicity, the univariable and multivariable binomial regression model were employed for risk prediction.

Results: The prevalence of CMBD was highest among Blacks (19.6%), intermediate among Whites (18.8%) and lowest among Hispanics (17.2%). PSUD was highest among Hispanics (9.6%), intermediate among Whites (9.0%) and lowest among Blacks (7.5%). There was an increased risk of CMBD associated with PSUD, Risk Ratio (RR)= 2.46, 99%CI = 2.38 – 2.55. There was racial heterogeneity in CMBD with the observed risk highest among Blacks (RR= 1.17, 95% CI = 1.05 – 1.29) and intermediate among Whites, RR = 1.10, 95%CI = 1.03 – 1.18 relative to Hispanics. After controlling for potential confoundings, there was a risk reduction among Blacks, (adjusted RR (aRR) = 1.09, 99% CI= 0.99 – 1.21) and increased risk among Whites, aRR = 1.12, 99%CI= 1.05 – 1.2 relative to Hispanics.

Conclusion: Parental substance use disorder predicts childhood mental and behavioral dysfunction in a representative sample of non-institutionalized children, with increased risk of CMBD observed among Blacks relative to Hispanics and Whites. The findings are indicative of prospective cohort assessment of the cause of causes, mainly social gradient in excess CMBD among non-Hispanic blacks.

background: Two decades of research has illuminated how Adverse Childhood Experiences (ACEs) significantly increase an individual’s risk for a widespread list of negative health outcomes in adulthood. Latinx immigrant youth may experience unique ACEs due to the circumstances they fled, the migration process, and experiences as newly arrived minorities in the US, but these adversities are not captured by traditional measures of ACEs.

methods: Self-report data were collected by a community partner serving Latinx immigrant youth. Data from a preliminary sample of 95 Latinx immigrant adolescents from Central America were analyzed in order to: (1) establish rates of traditional ACEs and immigrant-specific ACEs in a sample of Latinx immigrant adolescents and (2) assess the relationship between traditional and immigrant-specific ACEs and adolescents’ health risk behaviors (tobacco use, alcohol, other drug use, sexual risk behaviors, and physical fights) and psychological health as measured by the Strengths and Difficulties Questionnaire.

results: Latinx immigrant adolescents experience high levels of traditional ACEs and even higher levels of immigrant-specific ACES. For example, on their journey to the US, 59% of Latinx immigrant adolescents lacked food and water, 32% feared they were lost, and 24% feared they would die. Preliminary bivariate analyses indicate that greater exposure to traditional ACEs is associated with increased emotional difficulties (r = .42, p<.001), peer issues (r=.29, p<.01) and depressive symptoms (r=.31, p<.01). Immigrant-specific ACEs are correlated with emotional difficulties (r=.28, p<.01) and worse parent-child relationships (r=-.26, p<.01). Analysis of the full sample of 250 will extend these findings and also examine individual immigrant-specific ACEs, and the psychometrics properties of the immigrant-specific ACEs measure.

conclusions: These findings will increase our understanding of the ACEs experienced by Latinx youth, and expand our conceptualization of what constitutes adversities for this population. Such findings lay the foundation for examining the mechanisms by which ACEs influence health in Latinx youth, ultimately informing the development of more culturally relevant interventions that support resiliency.

Background: Evidence has revealed that mothers unmarried at childbirth experience multiple risk factors for depression, including housing instability. Disproportionately represented by Black or Hispanic mothers in urban areas, as well as victims of recent intimate partner violence, the unmarried mothers are two-to-three times more likely to experience housing instability within five years following childbirth. As unmarried mothers are currently responsible for 40 percent of all childbirths in the United States, maternal depression continues to be a significant public health concern. However, evidence is limited for long-term housing instability risks and its association with future depression among the at-risk mothers. Thus, this study aims to examine cumulative housing instability risks over a 15-year period and its impact on depression among mothers unmarried at childbirth.

Methods: Using data from the Fragile Families and Child Wellbeing Study (FFCWS) Year 1−15, we first examined the 15-year cumulative residential moves and changes in housing arrangements among mothers unmarried and married at childbirth. Then, we tested the associations between their cumulative residential moves and major depressive episodes (MDE) at Year 15 while controlling for major sociodemographic and other major mental health covariate (i.e. parenting stress).

Results: One in every four mothers unmarried at childbirth reported six or more residential moves during the 15-year study period. After 15 years since childbirth, only 16.6% (95% CI=13.9-19.7) of the unmarried mothers were homeowners (vs. 59.8% [95% CI=52.5%-66.7%] among the married counterparts), while over 80% of them were either renters or lived with family or friends. Multiple logistic regression models suggest that one additional residential move was associated with 9.3% higher odds (95% CI=1.035-1.153) of having a past-year MDE at Year 15. This translates into gradual increases in the MDE prevalence from 8.5% for zero move to 17.2% for 10 moves.

Conclusions: As preventive efforts for depression, greater attention should be paid to the housing needs among mothers unmarried at childbirth. Such measures may include temporary housing assistance or more fundamental programs to improve housing instability (e.g., homeownership assistance, employment services).

Background: Studies predicting service utilization of young children in community-based mental health programs are scarce. Linking Actions with Unmet Needs in Children’s Health (LAUNCH) was a pediatric mental health program to increase services for young children (0-8 years) at risk of socioemotional challenges in three primary care sites across three cities in Massachusetts. The aim of this study is to identify baseline predictors of service utilization for families enrolled in LAUNCH.

Methods: Data come from 114 families who consented to participate in the evaluation of LAUNCH. Service utilization was defined as the number of visits with the LAUNCH team. A priori we identified covariates that might be associated with service utilization such as caregiver depression (PHQ-9), caregiver parenting stress (PSI-SF), caregiver age, caregiver race, caregiver employment status, caregiver education, single parent household, and child socioemotional concern score (ASQ:SE-2). Modified Poisson regression, adjusted for clustering at the site level, was used to model these baseline covariates predicting service utilization. Advanced analysis is ongoing. Missing data will be accounted for using multiple imputation.

Results: Mean service utilization was 7.6 visits. Sixty-six percent of the sample were single parent households, 34% were currently employed, 42% had at least a high school diploma or equivalent, and 84% utilized some form of public assistance. The sample was primarily Latino (77%), with 12% White, 9% African-American, and 2% Other race. Preliminary results suggest that in a multivariable Poisson model, caregiver depression scores and race significantly predicted service utilization. Increasing depression scores were associated with decreasing service utilization (Incident Rate Ratio (IRR)=0.97, p < .0001). African-American participants had a lower rate of service utilization compared to White participants (IRR=0.44, p < .05).

Conclusion: Findings highlight the need to (1) address barriers to engagement for African-American families and (2) monitor and treat baseline caregiver depression to improve mental health service utilization for children at risk of socioemotional difficulties. Providers should consider the role of family-level factors when developing strategies to engage families of young children in pediatric mental health services.

Background-Increasingly childhood screen time has been identified as a predictor of child physical activity and overall well-being. The goals of this survey were to summarize screen time habits among Wisconsin youth. Increasing use of electronic devices has also been associated with altered sleep habits among children, and children with more rules around screen time have less disturbed and longer sleep. Few population-based results are available to estimate the magnitude of this growing public health challenge.

Methods-Data came from the 2014-2016 Survey of the Health of Wisconsin (SHOW) cohort (n=2824), a population-based sample of n=1957 adults (ages 18+) and n=867 children and adolescents (ages 0-17). Analyses examined estimated total screen time in children (ages 3-11) and adolescents/teens (ages 13-17) and examined household policies for screen time and use of electronic devices in bedrooms.

Results-Among younger children, parents reported 71% of children had 1-3 hours of screen time, and about 12% were exposed to greater than four hours per day of screen time. Among adolescents who self-reported screen time, approximately 20% indicated four or more hours per day of screen time. Over one-third (39%) of children ages 3-11 are allowed to use a smartphone or tablet in their bedroom. Among adolescents ages 12-17, over three-quarters (78%) are allowed to have smartphone or tablet in their bedroom.

Conclusions-Survey results indicate a dangerous trend in screen time habits among both children and adolescents in Wisconsin. Opportunities for altering these troubling patterns exist. Public health initiatives should focus on early educational programs in preschool, elementary school, and into high school to educate children and parents about the adverse effects of screen time on child development. Educational initiatives should also promote healthy habits and support children and adolescents in identifying individual alternatives to screen time. Training parents to model more effective screen time behaviors and create a family media plan, with the goal of reducing screen time, could improve child and adolescent well-being as well as support healthy sleep habits.

Background:

Children with attention deficit (hyperactivity) disorder (ADD/ADHD) and autism spectrum disorder (ASD) are disproportionately burdened by negative biopsychosocial consequences of bullying due to impaired ability navigating social situations, complicating peer interaction. Identifying factors that lessen their exposure to bullying is crucial for promoting a positive trajectory for their social development. Supportive family dynamics can help build cognitive and social skills in these children, potentially reducing exposure to bullying.

Methods:

Data from the 2018 National Survey of Children’s Health were used to perform multinomial logistic regression to compare bullying victimization and perpetration in children ages 6-17 (n=21,767) with ADD/ADHD (n=2,552), ASD (n=659), and comorbid ADD/ADHD and ASD (n=321) to traditionally developing children (TDC) and assess the moderating effect of family support on bullying behavior in these children.

Results:

Compared to TDC, children with ADD/ADHD have a greater likelihood of being bullied (OR=3.27, p< 0.01), being a bully (OR=3.37, p< 0.01), and both being bullied and being a bully (OR=5.00, p< 0.01). Children with ASD have a greater likelihood of being bullied (OR=4.31, p< 0.01) and both being bullied and bullying (OR=2.87, p< 0.01) but are not more likely to only be a bully. Children with comorbid ADD/ADHD and ASD have a greater likelihood of being bullied (OR=8.51, p< 0.01), being a bully (OR=5.01, p< 0.01), and both being bullied and being a bully (OR=11.07, p< 0.01).

Children with ADD/ADHD and strong family support (FS) report being bullied less (OR=3.04 compared to OR=3.27), bullying less (OR=2.73 compared to OR=3.37), and both being bullied and bullying less (OR=3.96 compared to OR=5.00) than those with weak FS. Children with ASD and strong FS report being bullied less (OR=3.59 compared to OR=4.31), bullying less (OR=0.61 compared to OR=1.00 without FS), and both being bullied and bullying less (OR=1.72 compared to OR=2.87). Children with comorbid ADD/ADHD and ASD report being bullied less (OR=7.44 compared to OR=8.51), bullying less (OR=3.53 compared to OR=5.01), and both being bullied and bullying (OR=7.57 compared to OR=11.07).

Conclusion:

Promoting strong FS has the potential to reduce the likelihood that children with ADD/ADHD and ASD are victims and perpetrators of bullying.