Medical Specialties Commons^™

Addressing The Access And Barriers To Mental Health Resources In High School Students, Tainiz Polanco, Ocean Alam, Diana Lopez, Vanessa Pizutelli

Rowan-Virtua Research Day

Minority populations throughout the world are hit with obstacles that interfere with their mental health, especially high school students. The recent COVID-19 pandemic has had drastic effects on the performance of these individuals and their social engagement. As observed, there is a divide amongst different races of students that highlights the lack of mental health resources provided to them and how they are utilized. After conducting further research on such issues, we were able to determine the major barriers existing today that tend to push students away from utilizing existing resources. Some of these barriers could vary from external stress …

Effect Of Yoga And Mindfulness Intervention On Symptoms Of Anxiety And Depression In Young Adolescents Attending Middle School: A Pragmatic Community-Based Cluster Randomized Controlled Trial In A Racially Diverse Urban Setting, Alessandra N. Bazzano, Yaoyao Sun, Vaughne Chavez-Gray, Temitope Akintimehin, Jeanette Gustat, Denise Barrera, Cody Roi

School of Medicine Faculty Publications

Mental health conditions in childhood and adolescence are increasing in the U.S. population and require early intervention, as highlighted by a recent Surgeon General’s Advisory on Protecting Youth Mental Health. These health issues, which have been exacerbated by the COVID-19 pandemic, impair functioning, and may lead to longer term reductions in quality of life. Young adolescents are likely to experience stressors including academic pressure, feelings of loneliness and isolation, and excessive exposure to social media, all of which have been made worse by the pandemic and associated disruptions. Universal preventive programs at school serve as an important strategy for equipping …

Assessing The Impact Of The Covid-19 Pandemic On Adolescent Mental Health, Vanessa Pizutelli, Yanil Morales, Christina Copeland, Archana Salek

Rowan-Virtua Research Day

Adolescence is a crucial period in which adverse childhood experiences, social relationships, and habits can influence mental wellbeing. According to the CDC, the onset of mental illness is 14.5 years old, which is why it is imperative that individuals with mental health conditions receive early intervention. Since the start of the Covid-19 pandemic, research has shown a dramatic decline in adolescent mental health. Specifically in New Jersey, it has been reported that individuals ages 18-23 have the highest levels of stress and depressive symptoms since the start of the pandemic. In light of these findings, it is vital that more …

Family-Centered Training And Therapy As Substance Abuse Intervention In Adolescents, Ryan St. John, Cam'ron Klotz, Muskaan Bibi, Archana Salek, Health Careers Opportunity Program - Rowansom, Rowan University

Rowan-Virtua Research Day

We hypothesized that providing mental health resources for adolescents and educating their parents and families would decrease the prevalence of substance abuse in the Camden, NJ community given that overdose death had risen 138% from 2014-2018. Educating parents and families on the importance of adolescents dealing with mental disorders may help evaluate the mental stability of their child and prevent them from turning to illicit substance to cope. Increasing the communication and the availability of resources for adolescents to turn to before resorting to illicit substances can have beneficial effects.

The Impact On Adolescent Mental Health In South Jersey Due To The Cancelation And Return Of Sports, Tara Pellegrino, Tara Young

Rowan-Virtua Research Day

Due to the Covid-19 pandemic, many organized sports programs have been canceled or limited in participation. While research prior to the pandemic has strongly suggested that participation in organized sports has benefits for mental and physical health, especially in adolescence, there have been minimal studies on how the removal of organized sports affects mental health outcomes. Additionally, studies have found that the stress of the pandemic and its associated life changes has greatly decreased mental health outcomes in our target population. These findings may indicate the importance of return to organized sports in a time where mental health outcomes are …

Parents' Reports Of Children's Physical And Sedentary Behavior Engagement Among Parents In Weight Management, Catherine Van Fossen, Haley Kiser, Callie Lambert Brown, Joseph Skelton, Keeley Jean Pratt

Department of Psychiatry and Human Behavior Faculty Papers

Background: The purpose of this study was to explore the associations between demographics, family exercise participation, family discouragement of exercise, and the children's physical and sedentary behaviors to identify specific areas of physical activity intervention for children with parents engaged in medical weight management (MWM).

Methods: Parents (n = 294) of children aged 2-18 years old were recruited from two university MWM programs to complete a one-time survey. Bivariate analyses tested associations.

Results: Parents reported that sedentary activity was higher for children who identified as racial minorities (t(141) = -2.05, p < 0.05). Mobile phone and tablet use was higher for adolescents compared to school age and young children (H(2) = 10.96, p < 01) Exercise game use was higher for racial minority children compared to white children (U = 9440.5, z = 2.47, p ≤ 0.03). Male children (t(284) = 1.83, p < 0.07), children perceived to have a healthy weight status (t(120) = 4.68, p < 0.00), and younger children (t(289) = 1.79, p < 0.08) all engaged in more strenuous physical activity. Family exercise participation (t(162) = -2.93, p < 0.01) and family discouragement of exercise (U = 7813.50, z = -2.06, p ≤ 0.04) were significantly higher for children in racial minority families.

Conclusions: Future work should determine methods to engage children …

Identifying Youth At Clinical High Risk: What’S The Emotional Impact?, K A. Woodberry, K S. Powers, C Bryant, D Downing, M Verdi, L Kennedy, D I. Shapiro, R Girgis, G Brucato, D Huang, F M. Crump, C M. Corcoran, L I. Seidman, B Link, W R. Mcfarlane, L Yang

Maine Medical Center

Background:

Early intervention in major mental illness promises to improve the lives of those identified.

• But could identifying youth as at clinical high risk (CHR) for psychosis also do harm given that the majority never develop a psychotic disorder?

• Could telling someone they are at risk for psychosis activate internalized stigma that has been associated with increased emotional distress, social withdrawal, non-engagement in treatment, and suicide risk in CHR youth?

• Within the context of a larger study of stigma in CHR, we compared emotional responses to the CHR concept assessed before and after clinical feedback by study …

Lack Of Diagnostic Pluripotentiality In Patients At Clinical High Risk For Psychosis: Specificity Of Comorbidity Persistence And Search For Pluripotential Subgroups., S. W. Woods, A. R. Powers, J. H. Taylor, C. A. Davidson, J. K. Johannesen, J. Addington, D. O. Perkins, C. E. Bearden, B. A. Cornblatt, T. H. Mcglashan, +5 Additional Authors

Journal Articles

More than 20 years after the clinical high risk syndrome for psychosis (CHR) was first articulated, it remains controversial whether the CHR syndrome predicts onset of psychosis with diagnostic specificity or predicts pluripotential diagnostic outcomes. Recently, analyses of observational studies, however, have suggested that the CHR syndrome is not pluripotential for emergent diagnostic outcomes. The present report conducted additional analyses in previously reported samples to determine (1) whether comorbid disorders were more likely to persist in CHR patients compared to a comparison group of patients who responded to CHR recruitment efforts but did not meet criteria, termed help-seeking comparison subjects …

The Competence-Related Abilities Of Adolescent Defendants In Criminal Court, Norman Poythress, Frances Lexcen, Thomas Grisso, Laurence Steinberg

Norman Poythress

Increasing numbers of youths are being tried in criminal court because of statutory measures that have decreased the use of judicial review as the primary mechanism for transfer. The relative immaturity of adolescents suggests that transferred youths might have impaired competence-related abilities compared to adults. To test this hypothesis, we compared the competence-related abilities and developmental characteristics of a sample of direct-filed 16-17-year-olds charged in criminal court in the state of Florida (Direct File sample) to a sample of 18-24-year-old adults charged in criminal courts (Adult Offender sample) and to a separate sample of 16-17-year-olds charged in juvenile court (Juvenile …

Atomoxetine Treatment In Children And Adolescents With Attention-Deficit Hyperactivity Disorder: What Are The Long-Term Health-Related Quality-Of-Life Outcomes?, Amy Perwien, Christopher Kratochvil, Douglas Faries, Brigette Vaughan, Thomas Spencer, Ronald Brown

Ronald Brown

OBJECTIVE: Numerous investigations have examined the efficacy of pharmacological treatment for attention-deficit/hyperactivity disorder (ADHD) in children. However, relatively few studies have addressed the impact of treatment on long-term subjective, psychosocial outcomes, such as health-related quality of life (HRQL). This study examines the long-term effects of pharmacological treatment with atomoxetine on HRQL in children and adolescents with ADHD. METHODS: Participants included 6- to 17-year-old children and adolescents (n = 912) with ADHD enrolled in a 24-month, multicenter, open-label trial of atomoxetine. Outcomes included clinician ratings of ADHD, parent ratings of ADHD, and a widely used measure of HRQL (The Child Health …

Is It Abuse? Deaf Female Undergraduates' Labeling Of Partner Violence, Melissa Anderson, Caroline Kobek Pezzarossi

Melissa L. Anderson

The current study investigated the labeling of abuse experiences in a sample of 97 Deaf female undergraduate students, exploring the following questions: What is the prevalence of violent behaviors experienced by Deaf female undergraduates in their past-year relationships, what proportion of these relationships are identified as "abuse," and what scripts and strategies do Deaf female undergraduates utilize to label their experiences of partner violence? Results indicated that over half of the sample chose not to label past-year experiences of psychological aggression, physical assault, and sexual coercion as abuse, even when these experiences included severe violence. Implications for the Deaf education …

Intimate Partner Violence Against Deaf Female College Students, Melissa Anderson, Irene Leigh

Melissa L. Anderson

It has been estimated that roughly 25% of all Deaf women in the United States are victims of intimate partner violence (Abused Deaf Women's Advocacy Services [ADWAS]), a figure similar to annual prevalence rates of 16% to 30% for intimate partners in the general population. One goal of the present study was to ascertain the prevalence of intimate partner violence victimization in a sample of Deaf female college students. When comparing the prevalence of physical assault, psychological aggression, and sexual coercion victimization to hearing female undergraduates, the current sample was approximately two times as likely to have experienced victimization in …

Deaf Students And Their Classroom Communication: An Evaluation Of Higher Order Categorical Interactions Among School And Background Characteristics, Thomas Allen, Melissa Anderson

Melissa L. Anderson

This article investigated to what extent age, use of a cochlear implant, parental hearing status, and use of sign in the home determine language of instruction for profoundly deaf children. Categorical data from 8,325 profoundly deaf students from the 2008 Annual Survey of Deaf and Hard-of-Hearing Children and Youth were analyzed using chi-square automated interaction detector, a stepwise analytic procedure that allows the assessment of higher order interactions among categorical variables. Results indicated that all characteristics were significantly related to classroom communication modality. Although younger and older students demonstrated a different distribution of communication modality, for both younger and older …

Black Deaf Individuals' Reading Skills: Influence Of Asl, Culture, Family Characteristics, Reading Experience, And Education, Candace Myers, M. Diane Clark, Millicent Musyoka, Melissa Anderson, Gizelle Gilbert, Selina Agyen, Peter Hauser

Melissa L. Anderson

Previous research on the reading abilities of Deaf individuals from various cultural groups suggests that Black Deaf and Hispanic Deaf individuals lag behind their White Deaf peers. The present study compared the reading skills of Black Deaf and White Deaf individuals, investigating the influence of American Sign Language (ASL), culture, family characteristics, reading experience, and education. (The descriptor Black is used throughout the present article, as Black Deaf individuals prefer this term to African American. For purposes of parallel construction, the term White is used instead of European American.) It was found that Black Deaf study participants scored lower on …

From Case Management To Court Clinic: Examining Forensic System Involvement Of Persons With Severe Mental Illness, William Fisher, Ira Packer, Thomas Grisso, Melissa Mcdermeit, Julie-Marie Brown

Ira K Packer

The study examined the flow of a state mental health agency's case-managed clients into its forensic mental health court clinic systems for evaluation of competency to stand trial (CST) for a criminal offense. An analysis of merged encounter data from the case management and court clinic systems revealed that roughly 2% of the case-managed population were referred to court clinics for evaluation of CST during a 1-year period, but that these 2% represented roughly one eighth of that year's court clinic evaluees. The likelihood of this involvement was higher for males, African-Americans, and Latinos, and for persons with a history …

Treatment Preferences Among Problem Drinkers In Primary Care., Daniel Z Lieberman, Anne Cioletti, Suena H Massey, Rochelle S Collantes, Brad B Moore

Psychiatry and Behavioral Sciences Faculty Publications

OBJECTIVE: Alcohol misuse is common among primary care patients, yet many do not receive treatment because doctors believe problem drinkers are "in denial," or are unwilling to change their drinking habits. The real problem, however, may be that patients are being offered treatment modalities that do not meet their needs. This study was designed to measure the acceptability of various treatment options among drinkers who were currently not receiving treatment.

METHOD: Patients in a primary care clinic were given a self-report questionnaire that included: (1) the Alcohol Use Disorders Questionnaire, (2) a measure of readiness to change drinking behavior, and …

Onset Of Alcohol Or Substance Use Disorders Following Treatment For Adolescent Depression., John Curry, Susan Silva, Paul Rohde, Golda Ginsburg, Betsy Kennard, Christopher Kratochvil, Anne Simons, Jerry Kirchner, Diane May, Taryn Mayes, Norah Feeny, Anne Marie Albano, Sarah Lavanier, Mark Reinecke, Rachel Jacobs, Emily Becker-Weidman, Elizabeth Weller, Graham Emslie, John Walkup, Elizabeth Kastelic, Barbara Burns, Karen Wells, John March

Journal Articles: Psychiatry

OBJECTIVE: This study tested whether positive response to short-term treatment for adolescent major depressive disorder (MDD) would have the secondary benefit of preventing subsequent alcohol use disorders (AUD) or substance use disorders (SUD).

METHOD: For 5 years, we followed 192 adolescents (56.2% female; 20.8% minority) who had participated in the Treatment for Adolescents with Depression Study (TADS; TADS Team, 2004) and who had no prior diagnoses of AUD or SUD. TADS initial treatments were cognitive behavior therapy (CBT), fluoxetine alone (FLX), the combination of CBT and FLX (COMB), or clinical management with pill placebo (PBO). We used both the original …

Privatized Medicaid Managed Care In Massachusetts: Disposition In Child And Adolescent Mental Health Emergencies, Joanne Nicholson, Stephen Young, Lorna Simon, William Fisher, Anne Bateman

Joanne Nicholson

Data from child and adolescent emergency mental health screening episodes prior and subsequent to privatized Medicaid managed care in Massachusetts are used to investigate the relationship between payer source and disposition and to compare the match between clinical need and disposition level of care. Having Medicaid as the payer in the post-Medicaid managed care period decreased the odds of hospitalization by nearly 60%. None of the clinical need variables that contributed to hospitalization for Medicaid episodes in the pre-Medicaid managed care period were significant in the post-Medicaid managed care period. Multiple forces shaping professional standards, decision making, and quality of …

A Qualitative Study Of Programs For Parents With Serious Mental Illness And Their Children: Building Practice-Based Evidence, Joanne Nicholson, Beth Hinden, Kathleen Biebel, Alexis Henry, Judith Katz-Leavy

Joanne Nicholson

The rationale for the development of effective programs for parents with serious mental illness and their children is compelling. Using qualitative methods and a grounded theory approach with data obtained in site visits, seven existing programs for parents with mental illness and their children in the United States are described and compared across core components: target population, theory and assumptions, funding, community and agency contexts, essential services and intervention strategies, moderators, and outcomes. The diversity across programs is strongly complemented by shared characteristics, the identification of which provides the foundation for future testing and the development of an evidence base. …

A Comparison Of Mothers With Co-Occurring Disorders And Histories Of Violence Living With Or Separated From Minor Children, Joanne Nicholson, Norma Finkelstein, Valerie Williams, Jennifer Thom, Chanson Noether, Megan Devilbiss

Joanne Nicholson

Data from the Women with Co-occurring Disorders and Histories of Violence Study are used to examine characteristics distinguishing mothers currently providing care for all their minor children (n = 558) from mothers separated from one or more minor children (n = 1396). Mothers are described and compared on background characteristics and experiences, well-being and current functioning, situational context, and services used. Analyses control for number of children, race, and years of education. Mothers separated from children have more children, less education, have more often been homeless, in juvenile detention or jail, and have lower incomes than mothers living with all …

An Overview Of Issues In Research On Consumer Satisfaction With Child And Adolescent Mental Health Services, Stephen Young, Joanne Nicholson, Maryann Davis

Joanne Nicholson

Research that focusses on consumer satisfaction with child and adolescent mental health services is reviewed. Satisfaction is broadly conceived to include any study where the perspectives of children, adolescents or their parents about mental health services were gathered and presented. Important conceptual issues in research on consumer satisfaction with children's mental health services are discussed. Some of the general methodological issues that have faced satisfaction researchers are also considered. The wide range of methodological variations that have been used to investigate this topic area are outlined. The most significant findings of previous research are presented and critiqued. In conclusion, suggestions …

Family Options For Parents With Mental Illnesses: A Developmental, Mixed Methods Pilot Study, Joanne Nicholson, Karen Albert, Bernice Gershenson, Valerie Williams, Kathleen Biebel

Joanne Nicholson

OBJECTIVE: The objective of this paper is to provide a description of Family Options, a rehabilitation intervention for parents with serious mental illnesses and their children focusing on recovery and resilience, and to report the findings from a pilot study at 6-months post-enrollment for participating mothers. METHODS: A developmental design, and mixed quantitative and qualitative methods facilitate an in-depth understanding of Family Options and its impact on parents early in the implementation process. RESULTS: Participating families faced significant challenges, including long-term mental health conditions in adults, and emotional and behavioral difficulties in children. Data from mothers (n = 22) demonstrate …

The Invisible Children's Project: Key Ingredients Of An Intervention For Parents With Mental Illness, Beth Hinden, Kathleen Biebel, Joanne Nicholson, Liz Mehnert

Joanne Nicholson

This study used a collective case study design to identify key ingredients of the Invisible Children's Project, an intervention program for families in which a parent has a mental illness. Data were obtained from interviews with parents and service providers, and from family file records. Qualitative analyses were used to generate hypotheses regarding key ingredients and targeted outcomes, and to develop a testable intervention model. Key ingredients were defined as core processes, essential services, and mediators. Strong convergence across parents and providers suggested core processes defined by family-centered, strengths-based, emotionally supportive, and comprehensive approaches; essential services including family case management, …

Impact Of Medicaid Managed Care On Child And Adolescent Emergency Mental Health Screening In Massachusetts, Joanne Nicholson, Stephen Young, Lorna Simon, Anne Bateman, William Fisher

Joanne Nicholson

OBJECTIVE: The study evaluated the impact of Medicaid managed care on decision making during emergency mental health screening and the outcomes of such screening for children and adolescents. METHODS: Data on client attributes and on system characteristics (payer, referral source, and disposition) were available for 297 Medicaid and non-Medicaid episodes of emergency mental health screening that occurred one year before the implementation of a statewide managed Medicaid program in Massachusetts and 393 episodes that occurred one year after implementation. Outcomes included changes in the volume of service provided and in the pattern of dispositions, particularly inpatient admissions. RESULTS: Although the …

Emerging Issues In Adolescent Healthcare : An Urgent Call For Action, Waris Qidwai Dr, Tabinda Ashfaq Ashfaq

Department of Family Medicine

No abstract provided.

An Exploratory Analysis Of The Impact Of Family Functioning On Treatment For Depression In Adolescents., Norah C. Feeny, Susan G. Silva, Mark A. Reinecke, Steven Mcnulty, Robert L. Findling, Paul Rohde, John F. Curry, Golda S. Ginsburg, Christopher J. Kratochvil, Sanjeev M. Pathak, Diane E. May, Betsy D. Kennard, Anne D. Simons, Karen C. Wells, Michele Robins, David Rosenberg, John S. March

Journal Articles: Psychiatry

This article explores aspects of family environment and parent-child conflict that may predict or moderate response to acute treatments among depressed adolescents (N = 439) randomly assigned to fluoxetine, cognitive behavioral therapy, their combination, or placebo. Outcomes were Week 12 scores on measures of depression and global impairment. Of 20 candidate variables, one predictor emerged: Across treatments, adolescents with mothers who reported less parent-child conflict were more likely to benefit than their counterparts. When family functioning moderated outcome, adolescents who endorsed more negative environments were more likely to benefit from fluoxetine. Similarly, when moderating effects were seen on cognitive behavioral …

Dysfunctional Attitudes Scale Perfectionism: A Predictor And Partial Mediator Of Acute Treatment Outcome Among Clinically Depressed Adolescents., Rachel H. Jacobs, Susan G. Silva, Mark A. Reinecke, John F. Curry, Golda S. Ginsburg, Christopher J. Kratochvil, John S. March

Journal Articles: Psychiatry

The effect of perfectionism on acute treatment outcomes was explored in a randomized controlled trial of 439 clinically depressed adolescents (12-17 years of age) enrolled in the Treatment for Adolescents with Depression Study (TADS) who received cognitive behavior therapy (CBT), fluoxetine, a combination of CBT and FLX, or pill placebo. Measures included the Children's Depression Rating Scale-Revised, the Suicidal Ideation Questionnaire-Grades 7-9, and the perfectionism subscale from the Dysfunctional Attitudes Scale (DAS). Predictor results indicate that adolescents with higher versus lower DAS perfectionism scores at baseline, regardless of treatment, continued to demonstrate elevated depression scores across the acute treatment period. …

Treatment Response In Depressed Adolescents With And Without Co-Morbid Attention-Deficit/Hyperactivity Disorder In The Treatment For Adolescents With Depression Study., Christopher J. Kratochvil, Diane E. May, Susan G. Silva, Vishal Madaan, Susan E. Puumala, John F. Curry, John Walkup, Hayden Kepley, Benedetto Vitiello, John S. March

Journal Articles: Psychiatry

OBJECTIVE: In the Treatment for Adolescents with Depression Study (TADS), fluoxetine (FLX) and the combination of fluoxetine with cognitive-behavioral therapy (COMB) had superior improvement trajectories compared to pill placebo (PBO), whereas cognitive-behavioral therapy (CBT) was not significantly different from PBO. Because attention-deficit/hyperactivity disorder (ADHD) and major depressive disorder (MDD) frequently co-exist, we examined whether ADHD moderated these outcomes in TADS.

METHOD: A total of 439 adolescents with MDD, 12-17 years old, were randomized to FLX, CBT, COMB, or PBO. Random coefficients regression models examined depression improvement in 377 depressed youths without ADHD and 62 with ADHD, including 20 who were …

Remission And Recovery In The Treatment For Adolescents With Depression Study (Tads): Acute And Long-Term Outcomes., Betsy D. Kennard, Susan G. Silva, Simon Tonev, Paul Rohde, Jennifer L. Hughes, Benedetto Vitiello, Christopher J. Kratochvil, John F. Curry, Graham J. Emslie, Mark Reinecke, John March

Journal Articles: Psychiatry

OBJECTIVE: We examine remission rate probabilities, recovery rates, and residual symptoms across 36 weeks in the Treatment for Adolescents with Depression Study (TADS).

METHOD: The TADS, a multisite clinical trial, randomized 439 adolescents with major depressive disorder to 12 weeks of treatment with fluoxetine, cognitive-behavioral therapy, their combination, or pill placebo. The pill placebo group, treated openly after week 12, was not included in the subsequent analyses. Treatment differences in remission rates and probabilities of remission over time are compared. Recovery rates in remitters at weeks 12 (acute phase remitters) and 18 (continuation phase remitters) are summarized. We also examined …

Antidepressant Prescribing Practices For The Treatment Of Children And Adolescents., Supriya K. Bhatia, Amy J. Rezac-Elgohary, Benedetto Vitiello, Michael A. Sitorius, Bruce A. Buehler, Christopher J. Kratochvil

Journal Articles: Psychiatry

OBJECTIVE: This study evaluates pediatric antidepressant prescribing practices of Nebraska clinicians.

METHODS: Surveys were sent in July, 2005, to 1,521 prescribing clinicians throughout Nebraska to assess pediatric antidepressant use along with any practice changes following the U.S. Food and Drug Administration (FDA) "black box" warning issued in October, 2004.

RESULTS: Over half (n = 866) of the clinicians responded to the survey, of which 96.8% reported awareness of the FDA "black box" warning. Of the respondents, 76.9% (n = 666) were prescribing antidepressants to children and/or adolescents. Clinicians reported decreased prescribing frequency for both children (15.5%) and adolescents (36.6%), with …