Examining Perceptions About Mental Health Care and Help-Seeking Among Rural African American Families of Adolescents

Rural African American children living in poverty have a higher prevalence rate of mental health disorders than their urban counterparts. While access to mental health services is lacking in resource scarce rural communities, African American rural residents may also be the most likely to confront significant barriers to care and help-seeking. Studies of mental health help-seeking behavior among rural families are rare, even rarer are studies of African Americans living in these areas. To address this gap, the current study examined perceptions about help-seeking for adolescents with mental health problems among rural African American families. Data were obtained from African American mothers in rural Georgia to assess their perceptions of the mental health service system, help-seeking processes, and service experiences. A mixed-method approach was implemented, integrating a quantitative survey (n = 163) with qualitative interviews (subsample n = 21). Most of the mothers expressed confidence in mental health care providers’ to help. Preferred sources of support, however, were family, church, and schools. Community stigma towards children with mental health problems and their families was a frequently endorsed perceived barrier to help-seeking. Although cultural mistrust was one of the two most frequently endorsed barriers in the survey, it did not emerge as a universal barrier to help-seeking for the mothers in this sample. Implications for research, policy, and practice include addressing family concerns about stigma, preferences for informal support and non-specialty services in addressing adolescents’ mental health problems, and building community resources to enable all youth to participate in community life.     

Overcoming Challenges to Using Evidence-Based Interventions in Schools

The Center for School Mental Health Assistance at the University of Maryland recently completed a review of evidence-based prevention and treatment programs that can be used by school mental health clinicians. Based on the review, a school-based program operating in 22 Baltimore City schools has purchased and trained clinicians in a number of protocols for evidence-based interventions. We present findings from this review and make pragmatic recommendations for school mental health programs to overcome the challenges associated with the use of evidence-based interventions.She received her doctorate in childclinical psychology from the University of Missouri-Columbia. Her research interests are in the area of the development, prevention, and treatment of juvenile delinquency and youth externalizing disorders.who does research in the area of childrens mental health services and the implementation of wraparound services in real-world settings.University of Maryland School of Medicine. His research is in the area of testing the effectiveness of School Mental Health Programs and the effects of community violence on youth mental health.involved in research related to school mental health, school-based health centers, and prevention of risky behavior among adolescents.Postdoctoral fellow at the time of the study.Postdoctoral fellow at the time of the study.     

The Influence of Pubertal Timing on Alcohol Use and Heavy Drinking Trajectories

Early pubertal timing has been associated with increased alcohol use, drunkenness, and alcohol use disorders in both boys and girls during adolescence. It is not clear, however, whether the effect of early pubertal timing persists into late adolescence and young adulthood, whether its effect differs by gender, and if contextual factors (e.g., peer alcohol use) amplify such effect. This study attempts to address these questions by examining the trajectories of alcohol use and heavy drinking from early adolescence to young adulthood in males and females using data from the National Longitudinal Study of Adolescent Health (Add Health). Results show that for both males and females, early pubertal timing was associated with higher alcohol use and heavy drinking trajectories. These effects persisted into young adulthood and were found to be stronger for males than for females. Moreover, there was a significant interaction effect between friends’ drinking and pubertal timing on alcohol use and heavy drinking trajectories; but the interaction effect also differed for males and females. These findings suggest that early pubertal timing is a risk factor for alcohol use and has long-term implication for individuals’ health. Michael Biehl’s research focuses on adolescent development and problem behaviors. He is particularly interested in developmental pathways leading to substance use and affective disorders and how different contexts influence these developmental pathways. Misaki Natsuaki is interested in how adolescent problem behavior changes over time. Her research focuses particularly on the effects and timing of transitional events, such as puberty, on trajectories of internalizing and externalizing behaviors in adolescence. Xiaojia Ge’s research focuses on interaction effects of biological and social contextual factors on socioemotional development. He is particularly interested in how pubertal timing affects adolescent development.     

Attitudes toward mental health services among homeless and matched housed youth

Homeless youth experience high rates of mental health problems yet they under-utilize mental health services. The present study surveyed 56 homeless youth and 97 matched at-risk housed youth on their attitudes toward mental health services, and investigated the link between social support and attitudes. Results showed groups shared similar neutral to positive attitudes. Higher levels of social support were associated with increased positive attitudes toward services. Further analyses found that lesbian/gay/bisexual/questioning youth held more positive attitudes compared to heterosexual youth. Implications of the current study can assist service providers with eliminating barriers and increasing mental health service use.     

The Impact of Gender and Family Processes on Mental Health and Substance Use Issues in a Sample of Court-Involved Female and Male Adolescents

Greater empirical attention directed toward gender-sensitive assessment strategies that concentrate on family-specific factors is thought to be both timely and necessary, especially with regard to outcome variables associated with mental health and substance abuse in at-risk adolescent populations. A sample of 2,646 court-involved adolescents was used to test two competing models regarding relationships among disruptive family processes, mental health (as both internalizing and externalizing problems), and substance abuse issues according to gender. The results of multiple group structural equation modeling procedures indicated that disrupted family processes were significantly associated with higher levels of internalizing problems, externalizing problems, and substance abuse in both male and female youth. For females, however, disrupted family processes were more related to internalizing problems and substance abuse than externalizing problems. Further, the relationship between disrupted family processes and substance abuse was not mediated by mental health issues, indicating a lack of support for the alternative model tested in this study. Together, the findings underscore the primacy of the family’s impact on issues related to adolescent development and well-being in tandem with the need for a more gender sensitive approach to the needs of court-involved males and females.

Risk and Protective Factors Associated with Alcohol,Cigarette, and Marijuana Use During Adolescence

The purpose of this study was to increase the knowledge base of adolescent substance use by examining the influences of risk and protective factors for specific substance use, namely alcohol, cigarettes, and marijuana. Participants included 271 adolescents and their primary caregivers referred for mental health services across North Carolina. A series of hierarchical multiple regressions showed that the relative influences of risk and protective factors differed depending on the target substance in some cases. History of parental felony predicted use of all 3 substances, although the direction of association was substance specific. Parental behavioral control (how families express and maintain standards of behavior) was predictive only of cigarette and marijuana use, not alcohol use. The different links among risk factors, protective factors, and specific substance use are discussed, and recommendations for both mental health and substance use professionals are offered.She received her M.A. in Psychology from Wake Forest University and is currently a doctoral student in Clinical Psychology at the University of North Carolina at Greensboro. Her major research interests include developmental pathways to aggressive behavior among females.An evaluator for the North Carolina Department of Health and Human Services, her major research interests include system of care intervention programming.She received her PhD in Clinical Psychology from Purdue University. Her major research interests include developmental psychopathology and early intervention.His research interests focus on youth violence and youth involved with the juvenile justice system.She received her PhD in Clinical Psychology from the University of North Carolina at Greensboro. Her research interests focus on early intervention with young children.     

The relationship between physical activity and mental health among adolescents in six middle-income countries: A cross-sectional study

Physical inactivity and poor mental health are emerging worldwide youth problems. Using the Global School-based Health Survey, this secondary data analysis study examined the link between physical activity and adolescent mental health among 23,372 adolescents between 11 and 17 years of age in six middle-income countries. The authors assessed physical activity by participation in (a) exercise for 60 min and (b) walking/biking in any day of a week in the past 7 days. The authors assessed mental health by the presence of (a) loneliness, (b) anxiety, (c) depression, (d) suicidal ideation, and (e) suicide attempts in the past 12 months. There was a low prevalence of physical activity among the participants. In general, there was a low prevalence of 12-month mental health problems among adolescents. Further research may incorporate physical activity to promote positive youth mental health for possible cost-effective interventions.     

Contextual Socioeconomic Status and Mental Health Counseling Use Among US Adolescents with Depression

Most adolescents with depressive disorders do not receive any mental health services, even though effective treatments exist. Although research has examined numerous individual-level factors associated with mental health service use among depressed adolescents, less is known about the role of contextual factors. This study examines the relationship between contextual-level socioeconomic status (SES) and clinic-based mental health counseling use among US adolescents with high depressive symptoms in urban and suburban areas. Data from the first two waves of the National Longitudinal Study of Adolescent Health (N = 1,133; 59 % female) were analyzed using multilevel logistic models in which adolescents were nested within counties. After controlling for individual-level predisposing, enabling, and need characteristics, as well as county racial/ethnic composition, county SES was positively associated with clinic-based counseling use among depressed youth. A one standard deviation increase in the county affluence index was associated with 43 % greater odds of receiving any clinical counseling services. Furthermore, the positive relationship between county affluence and clinical counseling use was no longer significant after controlling for the county supply of mental health specialist physicians. The results indicate that county residential context is a key correlate of mental health service use among depressed adolescents, such that those who live in lower SES counties with fewer mental health specialists are less likely to receive treatment.     

Predictors of receiving counseling in a national sample of youth: the relative influence of symptoms,victimization exposure,parent–child conflict,and delinquency

This paper identifies factors that predict children’s use of counseling services within a 2-year period. Using two waves of data from a national survey of 1009 youth age 6–17, we describe differences in utilization by demographic characteristics and compare receipt of counseling between children who scored high versus lower on: (1) levels of mental health symptoms, (2) multiple victimization exposure; (3) levels of delinquency; and (4) parent–child conflict. Multivariate logistic regressions were also performed to examine the relative and independent effects of a these factors on receiving counseling. Results indicate that counseling was received by only one- quarter or less of the 10–17 year olds and one-third or less of the 6–9 year olds with the highest levels of symptoms, victimization or delinquency. For the 10–17 year olds, delinquency and parent–child conflict were better predictors of treatment than were mental health symptoms or victimization exposure. In contrast, younger children (age 6–9) were most likely to receive counseling if they lived in a single parent or stepfamily household. The findings suggest that more counseling should be made available to distressed and victimized children, particularly those who do not engage in high delinquency and conflict which tend to promote referral.

Parents’ Communication with Adolescents About Sexual Behavior: A Missed Opportunity for Prevention?

Parents may wait to talk to their teens about sexuality until they believe their child is in a romantic relationship. To examine this, telephone surveys were conducted with 1069 parents of adolescents. Measures assessed parents’ perception of teens’ romantic involvement and parent-child communication about several sexuality topics. Multivariable regression models determined the odds of talking about each topic among parents who reported their teen had been in a romantic relationship compared to those who did not. Most parents reported talking at least a moderate amount about some sex-related topic. Parents who believed their teen had been romantically involved were more likely to have discussed most of the topics examined here (ORs=1.64 – 2.56). For some topics, associations were more pronounced among parents of younger teens. Findings suggest that parents may miss important opportunities to influence behavior, and should initiate conversations about sexuality before they believe their child to be romantically involved.Assistant Professor at the University of Minnesota. She received her Sc.D. in Social Epidemiology from the Harvard School of Public Health. Her major research interests are the social influences on high risk health behaviors among adolescents.Associate Professor with the School of Nursing and the Department of Pediatrics at the University of Minnesota. She received her Ph.D. in Epidemiology from the University of Minnesota. Her research focuses on on family, peer, and individual-level influences on adolescents’ sexual behaviors and violence involvement. She is also Deputy Director of the Healthy Youth Development Prevention Research Center, which conducts research and disseminates actionable knowledge that promotes healthy youth development and reduces health disparities among young people.Professor and Director of the Center for Adolescent Nursing at the University of Minnesota School of Nursing. She received her Ph.D. in Educational Psychology from the University of Minnesota. Her major research interests focus on understanding key risk and protective factors in adolescence, particularly among vulnerable populations of youth.President of Midwestern Professional Educational and Research Services, Inc., a DHHS funded non-profit agency serving as a Title X Regional Training Center. She received her Masters in Psychology from Miami University and worked for 12 years in flight psychophysiology before moving into public health. Her primary research interests center on identifying barriers that limit adolescent and low income population’s access to publicly funded reproductive health care services.Professor and Director of the Healthy Youth Development Prevention Research Center at the University of Minnesota Department of Pediatrics. He received his Ph.D. in Health Services Research and Policy from the University of Minnesota. His major research interests are understanding risk and protective factors in the lives of young people, particularly around issues of reproductive health, pregnancy, and violence.     

Youth Homelessness and Social Stigma

Building upon previous exploratory qualitative research (Kidd SA (2003) Child Adol Social Work J 20(4):235–261), this paper examines the mental health implications of social stigma as it is experienced by homeless youth. Surveys conducted with 208 youths on the streets and in agencies in New York City and Toronto revealed significant associations between perceived stigma due to homeless status and sexual orientation, pan handling and sex trade involvement, and amount of time homeless. Higher perceived stigma was also related to low self esteem, loneliness, feeling trapped, and suicidal ideation, with guilt/self-blame due to homeless status having the strongest impact on mental health variables. Sean Kidd is an assistant professor with the McMaster Department of Psychiary and Behavioural Neurociences. He received his Ph.D. in clinical psychology from the University of Windsor, Ontario, in 2003. His primary research areas are suicide and resiliency among homeless youth and the application of qualitative methodologies in psychological research.     

The Relative Importance of Mothers’ and Youths’ Neighborhood Perceptions for Youth Alcohol Use and Delinquency

Prior studies have examined the influence of neighborhood perceptions on youth outcomes, but few studies have examined whose report of neighborhoods, parents’ or youths,’ are most important in predicting youth outcomes. This study addresses the relative associations of youths’ and mothers’ neighborhood perceptions with youth alcohol use and delinquency. The sample includes 499 mother-child dyads (youth age: 10 to 16 [mean=13.3; SD=2]). Structural equation modeling showed that youths’ perceived neighborhood problems were significantly associated with their delinquency but not their alcohol use. However, mothers’ perceived neighborhood problems were not related to either youth alcohol use or delinquency, suggesting that youths’ perceptions are better indicators of youth behavior. Youth reports may reflect their activities in the neighborhood and their exposure to different forms of deviance, so youths’ reports would be better indicators of exposure to neighborhood risk. Challenges for prevention are discussed. NIAAA Postdoctoral Fellow and Associate Research Scientist at the School of Public Health, University of California, Berkeley, and the Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA. Her research interests include psychosocial and environmental factors influencing youth problem behaviors. Interests are interventions for children with substance use or externalizing problems and their families. She is currently conducting alcohol, drug and other risky behavior prevention studies that include a focus on young adults in club settings as well as a variety of different family-based studies in different geographic regions (San Francisco Bay Area, Alaska, Thailand). Her work integrates both quantitative and qualitative research methods and centers on alcohol and other drug use, and related health issues among adolescents and young adults. She is especially interested in applying theoretical models of socially learned behaviors to populations with different cultural and social backgrounds     

Alcohol Use, Outcome Expectancies, and HIV Risk Status among American Indian Youth: A Latent Growth Curve Model with Parallel Processes

Alcohol use is cited as a risk factor for exposure to HIV infection through risky sexual behavior, especially among adolescents. From Social Cognitive Theory, positive outcome expectancies about the use of alcohol have often been presented as a critical aspect of alcohol use. Yet little is known about how they might be related to different aspects of HIV risk. Using latent growth curve modeling with data from 292 American Indian youth across seven years, both alcohol use and positive expectancies increased significantly; a lower-risk group showed significantly slower increases in both. Changes in alcohol use and outcome expectancies were significantly interrelated, providing support for reciprocal influence between the two constructs. Positive alcohol outcome expectancies may provide a preventive intervention point worthy of further consideration as influencing alcohol use and lowering HIV sexual risk among adolescents.Associate Professor at the University of Colorado at Denver and Health Sciences Center. She received her Ph.D. in Community Psychology from Michigan State University. Her major research interests are adolescent development among minority youth with an emphasis on positive and problem behaviors.Associate Professor at the University of Colorado at Denver and Health Sciences Center. She received her Ph.D. in Social Psychology from the University of Michigan. Her major research interests are in areas of American Indian mental health and services research.Assistant Professor at the University of Colorado at Denver and Health Sciences Center. She received her Ph.D. in Sociology from the University of Michigan. Her primary research interests are in demography and contextual effects of individual health behavior, with a special emphasis on adolescent development.In addition to the above people, the Project Team included Sonia Bauduy, Cathy A.E. Bell, Cecelia K. Big Crow, Dedra Buchwald, Nichole Cottier, Amy D. Dethlefsen, Ann Wilson Frederick, Ellen M. Keane, Shelly Hubing, Natalie Murphy, Angela Sam, Jennifer Settlemire, Jennifer Truel, and Frankee White Dress.     

Family Relationships and Adolescent Well-Being: Are Families Equally Protective for Same-Sex Attracted Youth?

Existing research suggests that sexual minority youth experience lower levels of well-being, in part because they perceive less social support than heterosexual youth. Sexual minority youth with strong family relationships may demonstrate resilience and increased well-being; however, it is also possible that the experience of sexual stigma may make these relationships less protective for sexual minority youth. Using two waves of data from the National Longitudinal Study of Adolescent Health, we explore the links between same-sex attraction, family relationships, and adolescent well-being in a sample of over 13,000 7th–12th grade adolescents (51 % female, 52 % non-Latino/a white, 17 % Latino, 21 % African American, and 7 % Asian). Specifically, we examine whether lower levels of parental closeness, parental involvement, and family support among same-sex attracted youth explain in part why these youth experience increased depressive symptoms and risk behaviors, including binge drinking, illegal drug use, and running away from home, relative to other-sex attracted youth. Second, we ask whether family relationships are equally protective against depressive symptoms and risk behaviors for same-sex attracted and other-sex attracted youth. We find that same-sex attracted youth, particularly girls, report higher levels of depressive symptoms, binge drinking, and drug use in part because they perceive less closeness with parents and less support from their families. Results also suggest that parental closeness and parental involvement may be less protective against risk behaviors for same-sex attracted boys than for their other-sex attracted peers. Findings thus suggest that interventions targeting the families of sexual minority youth should educate parents about the potentially negative effects of heteronormative assumptions and attitudes on positive adolescent development.     

Sleep and Delinquency: Does the Amount of Sleep Matter?

Sleep, a key indicator of health, has been linked to a variety of indicators of well-being such that people who get an adequate amount generally experience greater well-being. Further, a lack of sleep has been linked to a wide range of negative developmental outcomes, yet sleep has been largely overlooked among researchers interested in adolescent delinquency. The purpose of this study was to explore the relationship between hours of sleep and delinquent behavior among adolescents by using data from Wave 1 of the National Longitudinal Study of Adolescent Health (n = 14,382; 50.2% female, 63.5% white). A series of negative binomial regressions showed that youth who typically sleep seven or fewer hours per night reported significantly more property delinquency than youth who sleep the recommended 8–10 h. Further, youth who reported sleeping 5 or fewer hours per night reported significantly more violent delinquency than youth who reported sleeping the recommended number of hours per night. The findings suggest that sleep is an important, and overlooked, dimension of delinquent behavior and studies that focus on adolescent health should further investigate the effects of insufficient sleep. Finally, the authors recommend that sleep and other relevant health behaviors be considered in the context of more comprehensive approaches to delinquency prevention and intervention.     

Cross-National Adolescent Multidimensional Life Satisfaction Reports: Analyses of Mean Scores and Response Style Differences

Although numerous cross-national studies have assessed life satisfaction among adults, similar studies using adolescent samples have been rare. To address this shortage of research, a total of 1338 youth adolescents from two individualistic nations (Ireland, USA) and two collectivistic nations (China, South Korea) were administered the Multidimensional Students’ Life Satisfaction Scale (MSLSS: Huebner, 1994) to assesses general life satisfaction and satisfaction with family, friends, school, self, and living environment. Responses were analyzed to assess potential cross-national differences in (a) mean levels of life satisfaction, and (b) response styles, specifically acquiescence and extreme responding. Mean scores revealed positive ratings by adolescents from all four nations across all domains, with the exceptions of satisfaction with school experiences (Ireland, South Korean, USA), living environment (China, South Korea), self (South Korea), and general life satisfaction (South Korea). Results also revealed significant response style differences across all MSLSS domains. Significant gender and gender-by-nation effects were observed for both mean score and response style differences, although the effect sizes were small. The implications of these findings were discussed, particularly with respect to “individualistic” vs. “collectivistic” cultural differences. Rich Gilman is Associate Professor in the Department of Educational and Counseling Psychology at the University of Kentucky. His research interests include positive well-being among youth, perfectionism, and socially ostracized adolescents. Scott Huebner is Professor in the Department of Psychology at the University of South Carolina. His research interests involve the conceptualization, measurement, and implications of positive psychological well-being constructs among youth. He is a fellow of Division 16 of the APA and the International Society for Quality of Life Studies. Lili Tian is Associate Professor at South China Normal University. She received her Ph.D. in psychology from Beijing Normal University. Her major research interests include adolescent's school well-being, acculturation of immigrant children and personality assessment. Nansook Park is Associate Professor at the University of Rhode Island. She received her Ph.D. from University of South Carolina. Her major research interests among youth include character strengths and virtues, positive experience and life satisfaction and how they are related to well-being, family functioning, health and education. Jenny O’Byrne received her BA in the Department of Counselling & Psychotherapy from the Dublin Business School. Recent research interests focus on child and adolescent development, and she recently completed her pre-clinical training in psychoanalytic psychotherapy with the Lincoln Centre in London. Dina Sverko is a research assistant at the University of Zagreb (Croatia). She received her Ph.D. in psychology from the University of Triest (Italy). Her major research interests include personality assessment and health psychology. Miriam Schiff is lecturer (equivalent to Assistant Professor) at the Hebrew University School of Social Work and Social Welfare in Jerusalem. Her major research interests include trauma and substance use, and general mental health among adolescents in clinic settings. Heather Langknecht received her Ed.S. from the University of Kentucky in 2004. She currently works as a school psychologist at Virginia Beach Public Schools (Virginia). Her primary research interests are cross-national quality of life issues among children and youth.     

Mother-Adolescent Language Proficiency and Adolescent Academic and Emotional Adjustment Among Chinese American Families

This study examined the role of adolescents’ and mothers’ self-reports of English and heritage language proficiency in youth’s academic and emotional adjustment among 444 Chinese American families. Adolescents who were proficient in English tended to exhibit higher reading achievement scores, math achievement scores, and overall GPA. Mothers who were English proficient tended to have children with higher academic achievement and fewer depressive symptoms. Results also indicated that adolescents’ heritage language maintenance was associated with positive adjustment, particularly amongst foreign-born youth and for youth whose parents were highly proficient in the heritage language. Mother-adolescent match in heritage language proficiency was related to higher math achievement scores and overall GPA. Additionally, higher heritage language proficiency was associated with fewer depressive symptoms for foreign-born but not U.S.-born youth. Overall, the findings suggest that proficiency in both the English and heritage language may confer advantages to Chinese American youth.

Characteristics and Co-occurrence of Adolescent Non-Suicidal Self-Injury and Suicidal Behaviours in Pediatric Emergency Crisis Services

During the potentially tumultuous adolescent period, non-suicidal self-injury (NSSI) and suicide attempts are relatively common, particularly amongst youth who present to mental health services. These phenomena frequently co-occur but their relationship is unclear. This study evaluated clinical data from 468 youth between the ages of 12 and 17 years (63.5% female) to determine the incidence of NSSI 24 h prior to presentation at emergency crisis services, evaluated the overlap between NSSI and suicide attempt, and examined the characteristics of different types of self-harm. Half of the adolescents presenting to emergency crisis services had self-harmed within the previous 24 h, with most of these (91%) classified as NSSI only. The percentage of youth with a suicide attempt was 5% and the co-occurrence of these two behaviours was 4%. Group differences in depressive symptoms, suicidal ideation and impulsivity were identified, with the co-occurring NSSI and suicide attempt group presenting with the highest level of psychopathology. This study underscores the necessity of assessing suicidal ideation and NSSI in all youth presenting to mental health services.     

Parental Cultural Affiliation and Youth Mental Health Service Use

Studies indicate that African American, Asian/Pacific Islander, and Latino youth have higher rates of unmet mental health needs and lower rates of mental health service utilization compared to non-Hispanic White youth, suggesting that obstacles may exist in the help-seeking and service utilization pathway for minority youth. Parental cultural factors may significantly impact youth service use, and acculturation is one way to measure adherence to culture specific values, beliefs, attitudes, and behaviors. In this study, parental acculturation level, conceptualized as cultural affinity to 1) mainstream American culture and 2) an alternative culture, were examined as potential mediators of the relationship between race/ethnicity and youth service use. The current subsample (n=1364) was drawn from the Patterns of Care study, a larger study of at-risk youth who were active to at least one of five public sectors of care. Our subsample included all youth aged 6–17 who were African American, Asian/Pacific Islander, Latino, or Non-Hispanic Whites (66.6% male). The results indicate that parental acculturation level as measured by affinity to an Alternative Culture was a partial mediator in the relationship between race/ethnicity and mental health service use for Asian/Pacific Islander and Latino youth. Doctoral student in the SDSU/UCSD Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Court, Suite 100, San Diego CA, graduate research assistant, Child and Adolescent Services Research Center, Children’s Hospital, San Diego, 3020 Children’s Way (MC 5033), San Diego, CA 92123 Assistant Professor of Psychology, San Diego State University; Assistant Adjunct Professor of Psychiatry, University of California, San Diego, Research Scientist, Child and Adolescent Services Research Center, San Diego, 3020 Children’s Way (MC 5033), San Diego, CA 92123 Research Scientist, Child and Adolescent Services Research Center, Children’s Hospital, San Diego, Assistant Professor of Psychology, University of San Diego; Adjunct Assistant Professor of Psychiatry, University of California, San Diego, 3020 Children’s Way (MC 5033), San Diego, CA 92123 Research Professor of Psychiatry and Family and Community Medicine at the University of New Mexico, Adjunct Professor of Psychiatry at the University of California, San Diego; Emeritus Professor of Sociology at San Diego State University; Senior Research Scientist at the Child and Adolescent Services Research Center, Children’s Hospital, San Diego, 3020 Children’s Way (MC 5033), San Diego, CA 92123     

Socioeconomic Context, Social Support, and Adolescent Mental Health: A Multilevel Investigation

This study examined whether the impact of contextual-level socioeconomic disadvantage on adolescent mental health is contingent upon individual-level perceptions of social support. Data are from the National Longitudinal Study of Adolescent Health (Add Health), a panel survey of a nationally representative United States sample (analytic N=18,417) of students in 7th through 12th grade. Effects of social support and social context on both internalizing problems (depressive symptoms) and externalizing problems (minor delinquency and violent behavior) are analyzed. Contextual-level socioeconomic disadvantage is positively associated with depressive symptoms, negatively associated with minor delinquency, and not directly associated with violent behavior. High perceived support from family, friends, and other adults offsets poor mental health, but is most protective in areas of low socioeconomic disadvantage. The mental health benefits of perceived social support are dampened in socioeconomically disadvantaged areas, compared to advantaged areas. Results suggest that interventions targeting only individual- or family-level processes within disadvantaged contexts may be inadequate at stemming psychological distress among adolescents. Richard G. Wight, Assistant Research Sociologist, conducts life course mental health research in the UCLA Department of Community Health Sciences. His work emphasizes the intersection of individual- and contextual-level factors that impact health within dyads, families, and neighborhoods. Amanda L. Botticello is a doctoral student in the UCLA Department of Community Health Sciences, where her work addresses the reciprocal relationships between depressive symptoms and problem drinking among adolescents. Carol S. Aneshensel is a Professor of Community Health Sciences at UCLA, where she applies principals of social stratification and life course theory to the analysis of quantitative data to better understand disparities in mental health risks.