The Impact of Traumatic Stress, Social Support, and Substance Problems on Graduation Among Female Offenders in a Prescription Drug Court Program.

Trauma exposure and comorbid substance use are highly prevalent among female drug court participants. Despite the pervasiveness of the issue, few studies have investigated the impact of posttraumatic stress symptoms (PTSS) and nonmedical prescription drug use among this specific population. The present study examined the impact of posttraumatic stress, social support, and nonmedical prescription drug use on graduation outcomes among female participants in a specialized drug court program (N = 210).

Predictors of Continuing Bonds Among Bereaved Adolescents.

This study examined the relationship between continuing bonds (CBs) among 50 bereaved youth (ages 11-17) and their bereaved adult caregivers, and predictors of CBs among youth. Results indicated there was not a significant relationship between caregiver CB and youth CB. However, significant relationships were found between youth bereavement symptomatology, their relationship to the deceased, and youth CB.

Assessing Longitudinal Invariance of the Center for Epidemiologic Studies-Depression Scale Among Middle-Aged and Older Adults.

Background And Purpose: The longitudinal invariance of the Center for Epidemiologic Studies-Depression (CES-D) scale among middle-aged and older adults is unknown. This study examined the factorial invariance of the CES-D scale in a large cohort of community-based adults longitudinally.

Methods: 1,204 participants completed the 20-item CES-D scale at 4 time points 1 year apart.

The Role of Conflict Identification and Management in Sustaining Community Collaboration: Report on a Four-Year Exploratory Study.

Community collaboration has become increasingly common in behavioral health services. Conflict is likely to occur in any community coalition bringing together organizations with differing mandates, missions, and histories. However, research on how coalitions identify and handle conflict, and on the impact of conflict on sustainability is scarce.

Symptom severity, social supports, coping styles, and quality of life among individuals' diagnosed with Ménierè's disease.

Objectives: To (1) examine the quality of life of individuals with Ménierè's disease in relation to symptom severity, social supports, and coping styles and (2) develop a prediction model to identify factors most strongly associated with quality of life.

Methods: Data were collected using a web-based survey that included previously developed and validated measures (i.e.

An Exploratory Study of Conflict and Its Management in Systems of Care for Children with Mental, Emotional, or Behavioral Problems and Their Families.

Since 1993, the Substance Abuse and Mental Health Services Administration has invested more than $1 billion establishing systems of care (SOC) in over 173 local communities to provide services to children with mental, emotional, and behavioral problems and their families. The SOC model requires that effective partnerships be developed between parents and professionals and also among different service sectors and agencies. To date, there has been no systematic examination of these interagency partnerships associated with the presence of conflict and its management.

Impact of mental health problems on self-perceived oral health needs in a Medicaid population.

The purpose of this study was to examine the prevalence of self-perceived oral health needs among Medicaid-enrolled adults with and without mental health problems and to identify factors predictive of enrollees' perceived oral health needs. The study involved a secondary analysis of 1,721 respondents to the Florida Health Services Survey. Contrary to the previous research, the findings from this study indicated that respondents with mental health problems (52.

A clustering method to identify who benefits most from the treatment group in clinical trials.

In randomized controlled trials (RCTs), the most compelling need is to determine whether the treatment condition was more effective than control. However, it is generally recognized that not all participants in the treatment group of most clinical trials benefit equally. While subgroup analyses are often used to compare treatment effectiveness across pre-determined subgroups categorized by patient characteristics, methods to empirically identify naturally occurring clusters of persons who benefit most from the treatment group have rarely been implemented.

The Psychometric Properties of the Simple Screening Instrument for Substance Abuse.

The Simple Screening Instrument for Substance Abuse (SSI-SA) is gaining widespread use as a self-report measure of substance abuse; yet, little information exists regarding the instrument's psychometric properties. This study examined the SSI's psychometric properties within a population of 6,664 adult Medicaid enrollees in Florida, who responded to a survey conducted as part of a statewide evaluation of Medicaid services. The SSI-SA had excellent internal consistency (.

Community characteristics and implementation factors associated with effective systems of care.

How are characteristics of communities associated with the implementation of the principles of systems of care (SOC)? This study uses multilevel modeling with a stratified random sample (N = 225) of US counties to explore community-level predictors of the implementation factors of the System of Care Implementation Survey. A model composed of community-level social indicators fits well with 5 of 14 factors identified as relevant for effective SOCs. As hypothesized, community disadvantage was negatively and residential stability positively associated with the implementation of SOC principles.

Development of a measure to assess the implementation of children's systems of care: the Systems of Care Implementation Survey (SOCIS).

The children's system of care framework has been extensively implemented in the U.S. Since its inception in 1993, the Comprehensive Community Mental Health Services for Children and Their Families Program has invested in excess of $1 billion supporting the development of systems of care in 164 grantee sites across the country.

Multilevel confirmatory factor analysis of the Systems of Care Implementation Survey (SOCIS).

A major impediment to obtaining national information on systems of care implementation has been the lack of a psychometrically sound large-scale survey instrument. The present study provided information on the factorial and concurrent validity of the Systems of Care Implementation Survey scales. Multilevel confirmatory factor analysis and multilevel regression analysis were used to test these indicators of internal and external validity.

Levels of system of care implementation: a national study.

The results of a survey to measure the implementation of the systems of care (SOC) approach in a nationally representative sample of counties are presented. The results from 910 informants within 225 counties reveal a moderate level of implementation of SOC factors, with the level of poverty and population size influencing implementation. Furthermore, mental health informants generally tended to rate the implementation of systems of care greater than administrators associated with the school system, other family serving agency personnel or family members.

Adherence to practice guidelines, clinical outcomes, and costs among Medicaid enrollees with severe mental illnesses.

The treatment of Medicaid enrollees diagnosed with depression or schizophrenia was examined to determine whether adherence to treatment guideline was associated with health care financing strategy, clinical outcomes, and cost-effectiveness. Individuals in a fee-for-service condition were significantly more likely to receive treatment consistent with guidelines than those in managed care. Mental health costs were higher for individuals diagnosed with schizophrenia, individuals in an acute phase of illness at intake into the study, and those receiving treatment consistent with practice guidelines.

The psychometric properties of the Colorado Symptom Index.

The Colorado Symptom Index (CSI: Shern et al. 1994, Milbank Quart 72:123-148) is widely used in research as a self-report measure of psychiatric symptomatology, yet little information exists regarding the scale's psychometric properties. Additionally, the CSI has no cut-off score denoting the need for further psychiatric assessment.

Medicaid managed care and the distribution of societal costs for persons with severe mental illness.

Objective: Managed care financing strategies that involve financial risk to insurers can reduce budgeted health expenditures. However, resource substitution may occur and negate apparent savings in budgeted expenditures. These substitutions may be important for individuals with disabling illnesses.

Predictors of enrollees' satisfaction with a county-sponsored indigent health care plan.

This article summarizes the findings from a study examining the predictors of satisfaction among individuals enrolled in a county-sponsored indigent health care plan. Mail survey procedures were used to obtain information from enrollees regarding their satisfaction with the health care plan, as well as enrollees' demographics, health care status, and trust in their providers. Results of a stepwise regression model developed using a random half of the respondents revealed enrollees' trust in health care providers was the strongest predictor of general satisfaction, followed by perception of change in health status, and age.

Evaluation of a summer research institute in behavioral health for undergraduate students.

Because of the need for additional researchers in the interdisciplinary field of behavioral health services research, the Florida Mental Health Institute at the University of South Florida developed and pilot tested a summer research institute for undergraduate students. Participants completed a 6-week program in which they developed a research project with a mentor and participated in a research seminar. The long-term objectives of the program were to attract promising students to the field and encourage them to pursue careers in behavioral health services research; short-term goals of the program were to strengthen participants' research skills and knowledge, provide an intensive and enjoyable learning experience, and positively impact participants' intentions to pursue graduate education in behavioral health.

Understanding the findings of resilience-related research for fostering the development of African American adolescents.

African American youth face a number of challenges to prosocial development that the majority of American youth never encounter. Despite this, the research clearly documents that African American youth often are resilient in the face of these challenges. This article explores various factors associated with resilience in African American children and their implications for practitioners.

Predictors of emotional well-being in at-risk adolescent girls: developing preventive intervention strategies.

This article examines the degree to which various demographic characteristics, personality traits, and environmental factors are associated with overall emotional well-being of 125 adolescent girls whose mothers were involved in welfare reform. Daughters participated in a 4-year, mixed method study and annually completed a structured interview protocol and a sub-group also completed a qualitative interview. The quantitative findings from the study suggest that daughters having an internal locus of control, experiencing fewer negative life events, and reporting stronger parental and teacher social support had enhanced emotional well-being over the 4-year study compared to daughters without these factors.

Examination of the effects of financial risk on the formal treatment costs for a Medicaid population with psychiatric disabilities.

Objectives: We examined the effects of differing financial risk arrangements for mental health, physical health, and pharmacy services on the overall costs of these services with particular attention to cost containment and cost shifting.

Methods: Comprehensive service utilization information was obtained from a sample of 458 adults with severe mental illnesses during a 12-month period. Rate information was used to calculate costs for health, mental health and pharmacy.

Poor and depressed, the tip of the iceberg: the unmet needs of enrollees in an indigent health care plan.

Depression is a leading cause of disability [World Health Organization (WHO), 2001] with economic costs exceeding 63 billion dollars per year in the US [U.S. Department of Health and Human Services (DHHS), 1999].

Assessment of Medicaid managed behavioral health care for persons with serious mental illness.

Objectives: This five-site study compared Medicaid managed behavioral health programs and fee-for-service programs on use and quality of services, satisfaction, and symptoms and functioning of adults with serious mental illness.

Methods: Adults with serious mental illness in managed care programs (N=958) and fee-for-service programs (N=1,011) in five states were interviewed after the implementation of managed care and six months later. After a multiple regression to standardize the groups for case mix differences, a meta-analysis using a random-effects model was conducted, and bioequivalence methods were used to determine whether differences were significant for clinical or policy purposes.

Clinical outcomes of defendants in mental health court.

Objective: Mental health courts successfully divert defendants into treatment. However, few studies have examined whether this increased access to services positively affects client outcomes. This study compared changes in symptoms in a sample of defendants in Broward County mental health court with such changes in a comparison sample of defendants in a regular court.