Adolescent Co-occurring Disorders Treatment: Clinicians' Attitudes,Values, and Knowledge

This study examined community-based clinicians’ (N = 294) attitudes, background/experiences, values, and knowledge relating to issues of co-occurring disorders, which occur at a high rate among adolescents involved in the juvenile justice system. Study results reveal that clinicians self-rate their clinical values and attitudes at or above the expected level of competency, but they concede that their skill and knowledge levels are not adequate. Comparison measures reveal that employment setting conditions, geographic region, hours worked per week, and strongly held convictions about the importance of integrated mental health and substance use disorders service delivery distinguish clinicians’ co-occurring disorders knowledge levels. Implications are offered.     

“Making It”: Understanding Adolescent Resilience in Two Informal Settlements (Slums) in Nairobi,Kenya

Many adolescents living in contexts characterized by adversity achieve positive outcomes. We adopt a protection–risk conceptual framework to examine resilience (academic achievement, civic participation, and avoidance of risk behaviors) among 1,722 never-married 12–19 year olds living in two Kenyan urban slums. We find stronger associations between explanatory factors and resilience among older (15–19 years) than younger (12–14 years) adolescents. Models for prosocial behavior and models for antisocial behavior emerge as key predictors of resilience. Further accumulation of evidence on risk and protective factors is needed to inform interventions to promote positive outcomes among youth situated in an ecology of adversity.     

Is Russia a militocracy? Conceptual issues and extant findings regarding elite militarization

The dominant paradigm for understanding contemporary Russia holds that Vladimir Putin's tenure in office has been accompanied by a massive influx of former KGB and military personnel – so-called “siloviki” – into positions of power and authority throughout the polity and economy. Claims of extensive elite militarization, however, are largely based on the analyses of only one research program and, moreover, the validity of the estimates produced by that research program is open to question on numerous grounds. In this article, we review existing research on elite militarization in Russia; discuss a series of conceptual and empirical issues that need to be resolved if valid and meaningful estimation of military–security representation is to be achieved; introduce new findings; and evaluate the totality of existing evidence regarding whether the Russian state under Putin deserves to be labeled a militocracy. We find that the most straightforward reading of existing data indicates that the percentage of siloviki in the political elite during Putin's first two terms as president was approximately half of that which has been widely reported in both scholarship and the media, and also declined during the Medvedev presidency. In addition, our analysis of a broader cross section of the elite estimates military–security representation during the Putin presidency to have been lower still. Overall, existing data paint a less alarming picture of the depths to which siloviki have penetrated the corridors of power since 2000 than has been commonly portrayed and thereby cast doubt on Russia's status as an “FSB state.” On the other hand, past trends also provide some basis for expecting that the numbers of siloviki will once again rise during Putin's current presidential term.     

INSTITUTIONAL LAYERING IN GOVERNING HEALTHCARE QUALITY

Since the 1980s, regulated markets and New Public Management have been introduced in the public sector across the world. How they have affected existing governance mechanisms such as self‐regulation and state regulation has remained largely unexplored, however. This article examines the origins and consequences of institutional layering in governing healthcare quality. Dutch health care, where a market‐based system has been introduced, is used as a case study. The results show that this market‐based system did not replace but modified existing institutional arrangements. As a result, hospitals have to deal with the fragmentation of quality demands. Using the concept of institutional layering, this study shows how different arrangements interact. As a consequence, the introduction of a certain policy reform will work out differently in different countries and policy sectors. Our ‘archaeological’ study in this layering can be seen as an example of how such incremental change can be studied in detail.     

Cultural Stressors and Mental Health Symptoms Among Mexican Americans: A Prospective Study Examining the Impact of the Family and Neighborhood Context

Studies of stress consistently have linked individuals’ experiences of stress to maladjustment, but limited attention has been given to cultural stressors commonly experienced by minority individuals. To address this, the current study examined the links between cultural stressors and prospective changes in mental health symptoms in a sample of 710 (49 % female) Mexican American youth. In addition, the moderating role of both family and neighborhood cohesion was examined. In-home interviews were completed with youth, mothers (required) and fathers (optional) to collect data on youth’s experiences of cultural stressors (discrimination and language hassles) and internalizing/externalizing behavior, and mothers’ report of family cohesion and mothers’ and fathers’ report of neighborhood cohesion. Analyses revealed that youth’s experiences of discrimination and language hassles at 5th grade were related positively to increases in internalizing symptoms at 7th grade. Additionally, youths who reported higher levels of language hassles in 5th grade experienced increases in externalizing symptoms across the 2-year span. Both family and neighborhood cohesion emerged as significant moderating factors but their impact was conditional on youth’s gender and nativity. Limitations and future implications are discussed.     

Associations Between Adolescents’ Perceived Discrimination and Prosocial Tendencies: The Mediating Role of Mexican American Values

Experiences with perceived discrimination (e.g., perceptions of being treated unfairly due to race or ethnicity) are expected to impact negatively youths’ prosocial development. However, resilience often occurs in light of such experiences through cultural factors. The current longitudinal study examined the influence of perceived discrimination on the emergence of Mexican American adolescents’ later prosocial tendencies, and examined the mediating role of Mexican American values (e.g., familism, respect, and religiosity). Participants included 749 adolescents (49 % female) interviewed at 5th, 7th, and 10th grade. Results of the current study suggested that, although perceived discrimination was associated negatively with some types of prosocial tendencies (e.g., compliant, emotional, and dire) and related positively to public prosocial helping, the associations were mediated by youths’ Mexican American values. Directions for future research are presented and practical implications for promoting adolescents’ resilience are discussed.