Adolescent crisis and suicidal behavior: Dynamics and treatment

Suicide among adolescents is increasing. Three interacting factors—the crisis of adolescent development, family dysfunctioning, and social factors—create vulnerability to feelings of rejection and worthlessness among suicidal adolescents. Long-term family problems that are not openly acknowledged but for which the adolescent feels responsible are particularly relevant. The authors recommend a multiple approach to assessment and treatment in which crisis intervention is employed initially; and individual treatment for the adolescent and family therapy are utilized concurrently on a long-term basis.     

On the choice of a discrepancy functional for model selection

Consider the problem of several mathematical models competing to explain an empirical phenomenon. it is argued that fundamental model selection questions of model discrimination, model correctness and model adequacy can be answered by measuring the discrepancy of each model from an estimate of the unknown data generating process. Formally, the framework adopted is that of Linhart and Zucchini (1986), who considered a very general definition of discrepancy. In the present paper, it is demonstrated that requiring a discrepancy to possess several very reasonable properties is in fact equivalent to requiring it to be a metric on the relevant space of probability distributions.     

Relating mothers' social framing to their children's entry competence with peers

The purpose of this study was to examine how mothers view and construct meaning their children's social interactions, and to understand the interpretive frames they bring to filtering the social world and conveying meaning to their children. Maternal narrations to their children' videotaped entry behavior revealed narration patterns related to their children' entry behavior and the group's response. Generally, when their children were behaving competently, mothers appeared to have a broad based, context embedded view of the interaction, but focused more specifially when difficulties arose, These narration patterns were influenced ny the mothers' own remembered childhood social competence and recollections of positive and anxious peer experiences. Implications of these results for the socialization process were discussed.     

Key considerations for logic model development in research partnerships: a Canadian case study

Community-academic partnership research is a fairly new genre of community-based participatory research. It has arisen in part, from recognition of the potential role of alliances in the development and translation of applied knowledge and the elimination of health disparities. This paper reports on the learning process of academic and community members who worked together in developing a logic model for a research program focusing on partnerships with vulnerable populations. The Partners in Community Health Research is a 6-year training program that seeks to combine research, training, and practice through the work of its "learning clusters". As these types of partnerships proliferate, the articulation and exploration of clear models will assist in their implementation. The authors, coming from both academia and community agencies, present a logic model meant to facilitate program management. Key considerations in the model's development are discussed in the context of an ongoing research partnership; namely, the complexity of the research partnership, power and accountability, alignment with health promotion policy, and the iterative nature of program design. Recommendations challenge academics, policy-makers, service providers, and community members to reflect on the elements needed to support and manage research partnerships and the tools necessary to ensure continued collaboration.     

An exploration of the effect of on-site 12-step meetings on post-treatment outcomes among polysubstance-dependent outpatient clients

Rates of return to active substance use after addiction treatment tend to be high; participation in 12-step fellowships (e.g., Alcoholics Anonymous) reduces relapse rates but many clients do not attend or attend for a short period only. This quasi-experimental study uses repeated measurement to explore the role of presence/absence of on-site 12-step meetings during treatment on post-treatment outcomes. Polysubstance-dependent clients (N = 219) recruited at a program with and one without 12-step on-site, were followed for one year post-treatment. On-site 12-step enhanced 12-step attendance, especially during treatment, and predicted continuous abstinence for the post-treatment year. Holding 12-step meetings on-site is a low-cost strategy that programs should consider to foster post-treatment remission maintenance.     

Factors associated with the positive well-being of grandparents caring for their grandchildren

Prior research on grandparent caregivers has focused on stress, depression, and other negative outcomes. This paper describes research on factors that are associated with grandparents' positive well-being. In particular, it investigated the extent to which the perception of grandparental stress and grandparents' resources are associated with grandparents' well-being, after controlling for sociodemographic and health factors. A sample of 129 grandparents had individual interviews. Using a hierarchical block multiple regression analysis, the authors found that a low perception of stress related to caring for grandchildren and resources were responsible for a high level of wellbeing. The findings of this study suggest that social workers can best help grandparent caregivers by lowering their perception of stress and enhancing their informal supports and community resources. This can be incorporated into supportive, strengths-based individual or family counseling.     

Family Structure,Parental Involvement,and Academic Motivation in Latino Adolescents

Self-report data from 594 Latino adolescents about parental involvement (general support, monitoring, academic support, and educational aspirations) and academic motivation were examined across three family structures (intact, stepfather, single-mother/nonresident involved father). Significant differences were found in fathers' but not mothers' involvement depending on the family structure. Dominance analyses showed that the form of mothers' involvement that explained the most unique variance in academic motivation follows: monitoring for youth in intact and single-mother/nonresident involved father families and academic support for youth in stepfather families. The form of fathers' involvement that explained the greatest unique variance in academic motivation follows: monitoring for youth in intact families, academic support for youth in stepfather families, and academic aspirations for youth in single-mother/nonresidential involved father families.     

Are Adult Patients More Tolerant of Treatment Risks Than Parents of Juvenile Patients?

Understanding patient-specific differences in risk tolerance for new treatments that offer improved efficacy can assist in making difficult regulatory and clinical decisions for new treatments that offer both the potential for greater effectiveness in relieving disease symptoms, but also risks of disabling or fatal side effects. The aim of this study is to elicit benefit-risk trade-off preferences for hypothetical treatments with varying efficacy and risk levels using a stated-choice (SC) survey. We derive estimates of "maximum acceptable risk" (MAR) that can help decisionmakers identify welfare-enhancing alternatives. In the case of children, parent caregivers are responsible for treatment decisions and their risk tolerance may be quite different than adult patients' own tolerance for treatment-related risks. We estimated and compared the willingness of Crohn's disease (CD) patients and parents of juvenile CD patients to accept serious adverse event (SAE) risks in exchange for symptom relief. The analyzed data were from 345 patients over the age of 18 and 150 parents of children under the age of 18. The estimation results provide strong evidence that adult patients and parents of juvenile patients are willing to accept tradeoffs between treatment efficacy and risks of SAEs. Parents of juvenile CD patients are about as risk tolerant for their children as adult CD patients are for themselves for improved treatment efficacy. SC surveys provide a systematic method for eliciting preferences for benefit-risk tradeoffs. Understanding patients' own risk perceptions and their willingness to accept risks in return for treatment benefits can help inform risk management decision making.