What does self-esteem have to do with behavioral health among low-income youth in Chicago?

Many studies have examined risk factors associated with poorer behavioral health among low-income African American youth, such as low school engagement, delinquency, mental health problems, drug use, and risky sex. However, fewer studies have examined protective factors for such behavioral health risk behaviors. This study sought to address this gap by examining whether high levels of self-esteem were associated with better behavioral health factors for this population. A survey was administered to a sample of 638 low-income African American adolescents in Chicago to examine the degree to which high self-esteem was associated with less delinquency, substance use, and sexual risk behaviors, and more school engagement, and whether such associations varied by gender. Stepwise linear and logistic regression models were estimated to assess the influence of self-esteem. Higher self-esteem for this sample of low-income African American adolescents was associated with lower rates of delinquency, drug use, and risky sexual behaviors and increased rates of school engagement. Gender moderated only a few of these relationships. These findings suggest that programs that promote high self–esteem alone or in combination with other resilience factors may promote better behavioral health factors for African American adolescents.     

Violence exposure and bullying among African American adolescents: Examining the protective role of academic engagement

While African American youth are at disproportionate risk for both community violence exposure and bullying, few studies have examined the association between these two forms of violence in this population. Moreover, given the countless hours that youth spend in schools, identifying school experiences that might protect against this association is an important step to reducing the likelihood of engagement in bullying. The present study explored whether academic engagement buffers the association between exposure to community violence (i.e., hearing about violence, witnessing or victimization) and bullying involvement (i.e., perpetration or victimization) in a cross-sectional sample of low-income African American adolescents residing in Chicago. A convenience sample of 638 African American high school students were recruited from several Chicago neighborhoods between 2014 and 2015. A series of hierarchical linear regression models assessed the relation between types of community violence exposure, academic engagement and bullying behaviors. We found that youth exposed to community violence – specifically, those who had been victimized and heard about violence – were at increased risk for being victims and perpetrators of bullying. High academic engagement reduced the likelihood that youth who heard about violence well would be at higher risk for bullying involvement. Prevention efforts aimed at reducing bullying involvement would benefit from assessing and targeting violence and victimization in the community, in addition to youths' school experiences.     

Step-Up: Promoting Youth Mental Health and Development in Inner-City High Schools

African American and Latino youth who reside in inner-city communities are at heightened risk for compromised mental health, as their neighborhoods are too often associated with serious stressors, including elevated rates of poverty, substance abuse, community violence, as well as scarce youth-supportive resources, and mental health care options. Many aspects of disadvantaged urban contexts have the potential to thwart successful youth development. Adolescents with elevated mental health needs may experience impaired judgment, poor problem-solving skills, and conflictual interpersonal relationships, resulting in unsafe sexual behavior and drug use. However, mental health services are frequently avoided by urban adolescents who could gain substantial benefit from care. Thus, the development of culturally sensitive, contextually relevant and effective services for urban, low-income African American and Latino adolescents is critical. Given the complexity of the mental health and social needs of urban youth, novel approaches to service delivery may need to consider individual (i.e., motivation to succeed in the future), family (i.e., adult support within and outside of the family), and community-level (i.e., work and school opportunities) clinical components. Step-Up, a high school-based mental health service delivery model has been developed to bolster key family, youth and school processes related to youth mental health and positive youth development. Step-Up (1) intervenes with urban minority adolescents across inner-city ecological domains; (2) addresses multiple levels (school, family and community) in order to target youth mental health difficulties; and (3) provides opportunities for increasing youth social problem-solving and life skills. Further, Step-Up integrates existing theory-driven, evidence-based interventions. This article describes Step-Up clinical goals, theoretical influences, as well as components and key features, and presents preliminary data on youth engagement for two cohorts of students.     

Alternative Practicum in Health Education

Abstract

Young African American men in the inner city have higher rates of mortality and morbidity from potentially preventable causes than other American men of the same age. They suffer disproportionately high rates of preventable illness from violence, sexually transmitted diseases, and HIV infection. These young men present with problems related to sexual concerns, mental health issues, substance abuse, and violence. They also report substantial risk-taking behaviors, including unprotected sex, substance use, and weapon carrying, as well as exposure to violence. Access to and use of preventive primary care services has been limited for these patients in the past because of financial barriers and competing social issues. Racism and historical oppression have created barriers of mistrust for young men of color. Factors that contribute to their adverse health status, as well as ways to address these problems, are discussed.     

Lesbian,Gay, Bisexual,Sexual-Orientation Questioning Adolescents Seeking Mental Health Services

Summary

Lesbian, gay, bisexual, and sexual-orientation questioning (LGBQ) adolescents have many of the same health needs as straight adolescents. In addition, they must learn to manage a stigmatized identity that may create confusion, anxiety, and emotional turbulence for them. Beyond stigma, LGBQ youth are often found to be at higher risk for substance abuse, violence, depression, suicide, and sexual health problems. Based on responses given by urban adolescents seeking mental health services to a clinical self-assessment questionnaire (Adquest), this article examines the relationship between sexual identity and risk factors related to safety, health, sex, substance use, family and friends, worries, and their desire to talk about these in counseling. Findings indicate that LGBQ youth are at higher risk than straights, and express greater desire to talk about substance use, health, their personal lives, and their friends. Mental health practitioners working with these young persons must properly assess and address their risks by creating a sense of community and safe environment for open discussion.     

Clinical Uses of an Adolescent Intake Questionnaire

Summary

Open dialogue concerning behavioral and environmental risks is key to effective, holistic intervention with urban adolescents. Topics for discussion must include substance use, sexual behaviors and abuse, health concerns, exposure to violence and racism, school performance, and relationships with family and peers. Clinical engagement of adolescents requires focusing the therapeutic relationship on issues of their own choice, at their own pace. This article describes the clinical uses and practice impacts of a comprehensive adolescent self-assessment questionnaire (Adquest). By normalizing sensitive topics and allowing clients to exercise control over the therapeutic agenda and pace, Adquest serves as a “bridge to engagement,” a device for keeping the clinical dialogue open and a mode of induction to the client role. For staff, it represents a way of standardizing and broadening clinical assessment, identifying treatment objectives, and framing psycho-educational interventions.     

Adolescents in residential treatment: The prevalence of ACEs,substance use and justice involvement

Abstract

Although associations between developmental trauma, juvenile justice involvement and youth substance use have been previously reported in the published literature, the interconnection among these three factors has not been adequately studied. This article describes the interconnection among these three factors and calls for greater attention to the role of adverse childhood experiences (ACEs) in the diagnosis and treatment of youth who present with histories of substance use and/or offending behavior. Pilot data are presented that show high rates of self-reported trauma exposure, substance use history, justice involvement, and mental health problems in a sample of adolescents in residential treatment. The data point to the need for residential treatment centers to consider trauma histories in developing treatment plans for youth with current and prior substance use and offending behavior.     

Street Life–Oriented African American Males and Violence as a Public Health Concern

This article discusses concerns pertaining to the impact of continued exposure to violence for African American street life–oriented adolescent males as a public health concern and the importance of social work and human services to address this issue. Youth interviewed in this study discuss issues of exposure to violence and the navigation of multiple systems involvement, including child welfare, juvenile justice, educational systems, and their neighborhood life. Implications for social workers include the development of community-centric interventions that provide opportunities for youth voice and access to relationship building with trusted professionals and mentors.     

Primary care for young African American men

Young African American men in the inner city have higher rates of mortality and morbidity from potentially preventable causes than other American men of the same age. They suffer disproportionately high rates of preventable illness from violence, sexually transmitted diseases, and HIV infection. These young men present with problems related to sexual concerns, mental health issues, substance abuse, and violence. They also report substantial risk-taking behaviors, including unprotected sex, substance use, and weapon carrying, as well as exposure to violence. Access to and use of preventive primary care services has been limited for these patients in the past because of financial barriers and competing social issues. Racism and historical oppression have created barriers of mistrust for young men of color. Factors that contribute to their adverse health status, as well as ways to address these problems, are discussed.     

Latina and African‐American Girls in the Juvenile Justice System: Needs,Problems, and Solutions

This review focuses on Latina and African‐American girls in the juvenile justice system with a special emphasis on their mental health, substance abuse, and treatment needs. Like many young women in the juvenile justice system, Latina and African‐American girls often have histories of neglect, abuse, and trauma, which contribute to later mental health and substance abuse issues. Despite these histories, juvenile justice professionals sometimes rely on stereotypes rooted in cultural deficit thinking to explain Latina and African‐American girls' delinquency. Relying on gendered, racialized, and classed stereotypes and assumptions can result in decisions that negatively impact Latina and African‐American girls' access to mental health, substance abuse, and other types of treatment. Policy and practice implications for better addressing the needs of Latina and African‐American girls are discussed.     

Future orientation and health related factors among African American adolescents

African American youth are frequently confronted by economic and structural hardships, which can often suggest that their lives do not matter. This study examined the extent to which having high future orientation was related to a broad spectrum of health related factors. Among a sample of 638 largely low-income African American youth, this study assessed measures of demographics, future orientation, delinquency, sexual risk behaviors, and school engagement constructs. Major findings indicated that higher future orientation was related to lower levels of delinquency and a reduced likelihood of engaging in risky sex. In addition, stronger future orientation was related to higher levels of school bonding and student-teacher relationships. Overall, findings point to an overall protective relationship between future orientation and several health related factors among African American youth; this suggests that promoting a sense of future orientation among this population could be related to advancing more healthy youth development.     

The role of fathers in reducing dating violence victimization and sexual risk behaviors among a national sample of Black adolescents

PurposeStructural equation modeling (SEM) was used to explore the impact of father-figures' involvement on reducing both dating violence and sexual risk among a national sample of Black American youth well as the possible mediating effect of dating violence on the relationship between father figure involvement and sexual risk behaviors.MethodsTo explore this phenomenon, sexually active Black adolescents between the ages of 13–21 with a romantic partner in the previous 18 months were selected (N = 422) from wave II of the National Longitudinal Study of Adolescent Health.ResultsThe analyses indicated that overall, perceived closeness to father figures reduced dating violence victimization among Black youth. When separated by gender, our hypothesis for male respondents was supported indicating that perceived closeness with their father figures resulted in a reduction in dating violence. However, the same hypothesis was not supported for female respondents. On the other hand, perceived closeness to father figures resulted in lower sexual risk behaviors for girls.ConclusionGiven the study's findings, researchers, practitioners, and policy makers should consider the importance of the father–child relationship in reducing problem behaviors among Black adolescents. In particular, emphasis should be given to the quality of the father–child relationship rather than general father involvement in reducing dating violence victimization and risky sexual behavior among sexually experienced Black adolescents.     

Which Adolescents Need to Talk About Safety and Violence?

Summary

Exposure to violence has harmful psychological effects on adolescents, and when asked, inner-city adolescents will talk openly about violence in their lives. In response to a clinical self-assessment questionnaire, prospective adolescent mental health clients revealed high rates of exposure to physical, sexual, and community violence: 73.5% had witnessed violence, 43.6% had been a victim of violence, 26.4% had had their bodies touched in a way that made them feel uncomfortable, 24.4% had been threatened with a weapon, and 11.1% had experienced forced sex. Clients also expressed substantial worry about their own and their friends' dangerous behaviors. Desire to talk to a counselor about safety was significantly related to overall safety risk (p < .001), and over three-quarters of adolescents either wanted or needed to talk with a counselor. Age and gender differences in patterns of vulnerability and type of counseling need were explored.     

War Traumas and Community Violence

SUMMARY

This cross-sectional survey study examined the relationship between exposure to war traumas and community violence and academic, behavioral, and psychological well-being among Khmer refugee adolescents. The 144 adolescents studied were exposed to high rates of violence. One third had symptoms indicative of PTSD and two thirds had symptoms indicative of clinical depression. The number of violent events they were exposed to significantly predicted their level of PTSD, personal risk behaviors, and GPA, but not their level of depression or behavior problems reported at school. Perceived social support made a difference in the lives of these youth and predicted better outcomes. The implications for research and practice are discussed.     

Pathways from family violence exposure to disruptive behavior and suspension in elementary school

Abstract

Suspension is associated with a host of negative outcomes, including future suspension and poor academic engagement. A number of demographic and behavioral factors, such as behaviors and race/ethnicity, have been found to predict a child’s risk of suspension, however factors in the family environment, such as family violence, have not been widely explored within this body of literature. The current study examined whether disruptive behaviors mediated the relationship between family violence exposure and suspension in elementary school using data from the age 8 wave of the LONGSCAN dataset. In this sample, 68% of children had been exposed to some sort of family violence and 6.6% of children had been suspended. The direct pathway from family violence to suspension was significant, as was the indirect pathway through disruptive behaviors, where children exposed to more family violence were more likely to exhibit disruptive behaviors and more likely to be suspended. In this sample, boys and African American students were also more likely to be suspended. These findings support the need for school-based responses that addresses both the impact of violence exposure and racial disparities within discussions of children’s outcomes.     

Examining the impact of gender, race/ethnicity, and family factors on mental health issues in a sample of court-involved youth

Faced with anywhere between one half and two thirds of its youth having a diagnosable mental illness, the identification and treatment of mental health concerns is a critically important endeavor for professionals working with youth who have contact with the juvenile justice system. In addition, the literature suggests that factors related to both the family and to the gender of the adolescent must be incorporated into any approach to assessment and intervention within this special population. Further, prior work that has documented the interaction of gender and family issues with adolescent race/ethnicity warrants further empirical attention, as does the intermediary role that the family may play in the development of both internalizing and externalizing behaviors. The present study extends this literature by examining factors related to gender, race/ethnicity, family factors, and mental health issues in a sample of 2,549 Caucasian and African American youth coming to the attention of juvenile courts. Multivariate analysis of variance results indicated significant main effects for gender and race/ethnicity, as well as a significant gender x race/ethnicity interaction for the family and externalizing variables. A multiple group structural equation modeling procedure was employed in order to test the hypothesis that family environment mediates the relationship between gender and mental health problems, as well as to test for potential differences in these relationships as a function of race/ethnicity. Results indicated support for the mediation model in the sample of African American youth but not in the sample of Caucasian youth.     

Adolescents' Self-Reported Substance Risks and Need to Talk About Them in Mental Health Counseling

Summary

Although adolescents seeking mental health services may not consider them related, the prevalent co-morbidity of substance use and mental health problems makes it imperative that practitioners find ways of engaging troubled youth about substance issues. Based on their responses to a clinical self-assessment questionnaire (Adquest), this study shows that mental health service applicants are willing to disclose their substance use behaviors and are open to talking about them to intake workers. Age and gender differences in substance use patterns and willingness to talk are explored.     

Risk Factors of Sexual Harassment by Peers: A Longitudinal Investigation of African American and European American Adolescents

The present research explores risk factors for, and longitudinal associations of, sexual harassment by peers during adolescence. Eight‐hundred and seventy‐two African American and European American adolescents (65.4% African American, 51.1% females) were assessed during the summer after the eighth grade (mean age=14.2 years) and then again in the 11th grade (mean age=17.1 years). At the first assessment, adolescents were asked about their experiences with sexual harassment, their psychological reactions to sexual harassment, and also about their peer relationships, perceived pubertal timing, problem behavior, and mental health. At the second assessment, adolescents reported on their problem behavior and mental health. In general, youth who associated with peers who were involved in problem behavior were at risk for victimization. Among females, those who perceived themselves to be experiencing early pubertal development were also at risk. Additionally, for some adolescents, sexual harassment predicted later adjustment difficulties.