Upholding the Human Rights and Well-Being of Refugee Children Through Effective Clinical Care.

Refugee children are often exposed to adversities and traumatic experiences that can harm the mental health and well-being of refugee children. These include human trafficking and exploitation and dangers in detention centers and refugee camps. All these adverse events can be traumatic and contribute to poor mental health, including posttraumatic stress, anxiety, depression, and substance use disorders.

Integrating Spirituality and Religious Beliefs in a Mindfulness Based Cognitive Behavioral Therapy for PTSD with Latinx Unaccompanied Immigrant Children.

Unaccompanied immigrant children (UIC) experience significant mental health concerns, particularly posttraumatic stress. This is a vulnerable population, yet little systematic research has examined the effectiveness of evidence-based models such as cognitive behavioral therapy (CBT) to meet their needs. Integrating religious beliefs and spirituality into therapy could elucidate better understandings of traumatic stress, and posttraumatic cognitions when working with UIC with strong faith traditions/beliefs.

The trauma and learning policy initiative (TLPI)'s inquiry-based process: Mapping systems change toward resilience.

Trauma is much more than our individual experiences. Fundamentally, trauma is rooted in our social conditions, interrelated with the oppression and violence in our communities and in societies at large. Trauma is knotted within cycles of harm in our relationships and in our communities and institutions.

The Impact of COVID-19 on Anxiety Disorders in Youth: Coping with Stress, Worry, and Recovering from a Pandemic.

The primary objective of this article is to consider the impact of the coronavirus disease-19 pandemic on pediatric anxiety from both a clinical and system-of-care lens. This includes illustrating the impact of the pandemic on pediatric anxiety disorders and consideration of factors important for special populations, including children with disabilities and learning differences. We consider the clinical, educational, and public health implications for addressing mental health needs like anxiety disorders and how we might promote better outcomes, particularly for vulnerable children and youth.

Juvenile Justice, Technology and Family Separation: A Call to Prioritize Access to Family-Based Telehealth Treatment for Justice-Involved Adolescents' Mental Health and Well-Being.

Separating children from families has deleterious effects on children's mental health and well-being, which is highly relevant for youth in juvenile detention and other out-of-home residential placements. Despite growth in the evidence of family-based interventions in mitigating adverse behavioral health outcomes for justice involved adolescents (JIA), gaps remain in intervention dissemination for JIA; this particularly true for those leveraging digital health technologies, a need that has intensified with the COVID-19 pandemic. Use of digital health technologies for JIAs is pressing to address structural barriers in maintaining JIA-family connections, but also to improve treatment access for detained JIAs.

Researchers' Perspectives on Digital Mental Health Intervention Co-Design With Marginalized Community Stakeholder Youth and Families.

Co-design of digital mental health technology with youth and families is a relatively new but growing approach to intervention development. In this perspective article, researchers used collaborative reflexivity through duoethnography methodology to reflect and report on experiences and lessons learned conducting co-designed projects with marginalized youth and families. Researchers engaged in written reflective dialogue regarding projects designed to co-develop technology-based apps and computer programs to support mental health of youth and their families.

Focusing on Racial, Historical and Intergenerational Trauma, and Resilience: A Paradigm to Better Serving Children and Families.

Research across populations demonstrates that intergenerational trauma can have lasting biological, psychological, and social consequences and affects groups of individuals in different ways. An appreciation of intergenerational trauma as experienced in diverse populations is important not only for understanding vulnerabilities and risk but also for cultivating opportunities for posttraumatic growth and healing. Understanding the contexts of trauma for children and families and the unveiling of structural inequities, both past and present, offers the opportunity to address these in using clinical and systems of care approaches in the public health spheres.

Unpacking the Layers: Dismantling Inequities in Substance Use Services and Outcomes for Racially Minoritized Adolescents.

Minoritized youth have lower prevalence rates of substance use disorders (SUD) compared with White peers, but proportionally those that are diagnosed are less likely to engage in specialized care and there are few culturally responsive treatments or programs available. We examine social determinants of SUD, with emphasis on the impact of trauma, including racial trauma, and include an intersectional approach incorporating race, ethnicity, and gender. This review of the literature highlights evidence-based effective clinical practice as examples for the field in developing therapeutic approaches to SUD for this population.

Racial Disparities in the Education System: Opportunities for Justice in Schools.

Data from the US Department of Education clearly documents the chronic and persistent disproportionality of negative educational outcomes for students of color. To move closer to an antiracist system that provides all youth with the resources, protections, and opportunities to which they are entitled through public education, we recommend that mental health clinicians understand the social determinants of education; become familiar with the historical legacy of inequity in schools; identify current trends of racial disparities in education; engage in opportunities for antiracist school transformation; and reflect on their personal practices in providing access, diagnosis, and treatment to underresourced and minoritized youth.

Time trends and disparities in anxiety among adolescents, 2012-2018.

Purpose: Prior studies have been inconclusive in documenting whether the prevalence of adolescent anxiety is increasing, given sampling and measurement limitations. This study adds new information on recent time trends in anxiety prevalence, specifically investigating trends among previously unexamined sociodemographic subgroups.

Methods: Weighted data of 37,360 youth respondents (51.

Development of a cognitive behavioral therapy with integrated mindfulness for Latinx immigrants with co-occurring disorders: Analysis of intermediary outcomes.

Transdiagnostic interventions have been increasingly used in the management of a variety of mental health and substance use conditions, and in the context of chronic stress. We discuss the development and evaluation of the Integrated Intervention for Dual Problems and Early Action (IIDEA), a 10-session manualized intervention that includes cognitive therapy and mindfulness practice designed to improve symptoms of anxiety, depression, posttraumatic stress, and co-occurring substance use problems. In this secondary analysis of a randomized-controlled trial of IIDEA conducted with an international sample of immigrant Latinx in the United States and Spain, we evaluate intermediate outcomes-mindful awareness, working alliance with clinician and illness self-management-and integrate statistical findings with results from qualitative interviews with participants.

Inequity and the disproportionate impact of COVID-19 on communities of color in the United States: The need for a trauma-informed social justice response.

COVID-19 has had disproportionate contagion and fatality in Black, Latino, and Native American communities and among the poor in the United States. Toxic stress resulting from racial and social inequities have been magnified during the pandemic, with implications for poor physical and mental health and socioeconomic outcomes. It is imperative that our country focus and invest in addressing health inequities and work across sectors to build self-efficacy and long-term capacity within communities and systems of care serving the most disenfranchised, now and in the aftermath of the COVID-19 epidemic.

Affirmative Care Across Cultures: Broadening Application.

Affirmative practice is an approach to health and behavioral health care that validates and supports the identities stated or expressed by those served. Affirmative care requires the practitioner to actively honor and celebrate identity while at the same time validating the oppression felt by individuals seeking services. Validation and empathy fundamentally result from increased understanding of individuals' history, cultural context, and lived experiences.

Trauma, immigration, and sexual health among Latina women: Implications for maternal-child well-being and reproductive justice.

Latina immigrant women are vulnerable to traumatic stress and sexual health disparities. Without autonomy over their reproductive health and related decision-making, reproductive justice is elusive. We analyzed behavioral health data from 175 Latina immigrant participants (M age = 35; range = 18-64) of the International Latino Research Partnership (ILRP) study.

Sleep disturbance as a predictor of time to drug and alcohol use treatment in primary care.

Background: Sleep Disturbances (SDs) are a symptom common to mental health disorders (MHD) and substance use disorders (SUD). We aimed to identify the value of SD as a predictor for subsequent treatment of illicit drug and alcohol use disorders (SUDs) in primary care and relative to the predictive value of mental health disorders (MHDs).

Methods: We used electronic health records data from ambulatory primary care in a safety net Boston area healthcare system from 2013 to 2015 (n = 83,920).

Which girls, which boys? The intersectional risk for depression by race and ethnicity, and gender in the U.S.

We sought to conduct the first systematic review of studies applying an intersectional lens to assessing risk and protective factors for depression in minority adolescents in the United States. Twenty-five studies were identified which investigated the role of racial and ethnic identity and gender for minority groups and how marginalization may be associated with differential outcomes in depression symptomology. The results showed substantial variability in whether studies intentionally operationalized intersectionality through theoretical frameworks, study design, sampling, and analyses.

A treatment development study of a cognitive and mindfulness-based therapy for adolescents with co-occurring post-traumatic stress and substance use disorder.

Objective: Substance use is common among adolescents with post-traumatic stress disorder (PTSD). We aimed to develop and study an integrated treatment for adolescents with co-occurring disorders.

Design: This is a therapy development and open pilot trial study of a manualized therapy for adolescents with post-traumatic stress, depression, and substance use that uses a combination of cognitive therapy (CT) and mindfulness.

Posttraumatic Stress Symptoms and their Relationship to Drug and Alcohol use in an International Sample of Latino Immigrants.

We identify the prevalence and correlates of posttraumatic stress (PTSD) symptoms and their relationship to alcohol and substance use disorders (AUD/SUD) among Latino immigrants in two countries. A screening battery assessing PTSD symptoms (PCL-C), alcohol use (AUDIT), drug abuse (DAST), and psychological measures was administered to 562 Latino immigrants recruited in clinics. We used logistical regression analyses to evaluate the relationship between PTSD symptoms and AUD/SUD.

Disparities in Access to Easy-to-Use Services for Children with Special Health Care Needs.

Objectives: Families, clinicians and policymakers desire improved delivery of health and related services for children with special health care needs (CSHCN). We analyzed factors associated with ease of use in obtaining such services. We also explored what were specific difficulties or delays in receiving services.

Distal and Proximal Religiosity as Protective Factors for Adolescent and Emerging Adult Alcohol Use.

Data from emerging adults (ages 18-29, = 900) in the National Comorbidity Survey Replication Study was used to examine the influence of childhood and emerging adult religiosity and religious-based decision-making, and childhood adversity, on alcohol use. Childhood religiosity was protective against early alcohol use and progression to later abuse or dependence, but did not significantly offset the influence of childhood adversity on early patterns of heavy drinking in adjusted logistic regression models. Religiosity in emerging adulthood was negatively associated with alcohol use disorders.

Relation between language experiences in preschool classrooms and children's kindergarten and fourth-grade language and reading abilities.

Indirect effects of preschool classroom indexes of teacher talk were tested on fourth-grade outcomes for 57 students from low-income families in a longitudinal study of classroom and home influences on reading. Detailed observations and audiotaped teacher and child language data were coded to measure content and quantity of verbal interactions in preschool classrooms. Preschool teachers' use of sophisticated vocabulary during free play predicted fourth-grade reading comprehension and word recognition (mean age=9; 7), with effects mediated by kindergarten child language measures (mean age=5; 6).

Childhood trauma and psychiatric disorders as correlates of school dropout in a national sample of young adults.

The effect of childhood trauma, psychiatric diagnoses, and mental health services on school dropout among U.S.-born and immigrant youth is examined using data from the Collaborative Psychiatric Epidemiology Surveys, a nationally representative probability sample of African Americans, Afro-Caribbeans, Asians, Latinos, and non-Latino Whites, including 2,532 young adults, aged 21-29.

Measurement Uncertainty in Racial and Ethnic Identification Among Adolescents of Mixed Ancestry: A Latent Variable Approach.

In this article, we operationalize identification of mixed racial and ethnic ancestry among adolescents as a latent variable to (a) account for measurement uncertainty, and (b) compare alternative wording formats for racial and ethnic self-categorization in surveys. Two latent variable models were fit to multiple mixed-ancestry indicator data from 1,738 adolescents in New England. The first, a mixture factor model, accounts for the zero-inflated mixture distribution underlying mixed-ancestry identification.

A qualitative study of clinicians' use of the cultural formulation model in assessing posttraumatic stress disorder.

The Cultural Formulation (CF) of the Diagnostic and Statistical Manual (DSM) provides a potential framework for improving the diagnostic assessment of Posttraumatic Stress Disorder (PTSD) in culturally diverse patients. We analyzed data from the Patient-Provider Encounter Study, a multi-site study that examines the process of diagnosis and clinical decision-making during an initial clinical intake session, in order to examine use of CF for PTSD diagnosis. We find that while the CF is generally used inconsistently or underutilized in routine community settings, when employed appropriately it may assist the formulation and interpretation of traumatic experiences.