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Gains in holistic approaches to adult mental health have been associated with increasing interest in understanding psychological wellbeing (PWB) among adolescents. Empirical examination of measurement models for PWB in adolescence is lacking. Thus, the current study examined PWB in a longitudinal, diverse sample of 433 adolescents (non-Latinx Black: 37.6%; non-Latinx White: 25.9%; Latinx: 36.5%; Male adolescents: 50.1%). A one-factor, correlated six-factor and hierarchical models were examined across racial/ethnic (White, Black, and Hispanic) and gender (female, male) identities, after which the best fitting model was selected to undergo invariance testing. A one-factor structure was superior, and exhibited strict invariance across racial/ethnic and gender identities at each wave of the study, as well as longitudinal invariance within the entire sample., (© 2024 Society for Research on Adolescence.)

Prior work has suggested that discrimination and immigration-related stress may impede mental health care seeking and utilization among Latinx populations. These effects may be more nuanced as both discrimination and immigration-related stress may increase symptomology, particularly post-traumatic stress disorder (PTSD) and depression. Both symptoms may, in turn, prompt attempts to seek care. The current study examined the direct effects of discrimination and immigration-related stress on care access, as well as potentially indirect effects with PTSD and depression symptoms as mediators. Interviews and online surveys were completed with 234 Latinx residents of the Midwest, assessing everyday discrimination, discrimination in healthcare, PTSD symptoms, depression symptoms, current mental health utilization, and previous unsuccessful attempts to seek care. Direct effects of discrimination and immigration-related stress were largely unrelated to care access variables. Discrimination in healthcare settings predicted both unsuccessful attempts to seek care and current use, but this effect was positive. The indirect effect was largely supported, but only for PTSD symptoms and not depression. Results indicate that further investigation is necessary to understand the direct effects of discrimination on care access. Further, discrimination and immigration-related stress may indirectly prompt attempts to seek mental health care.

Mental health systems need scalable solutions that can reduce the efficacy-effectiveness gap and improve mental health outcomes in community mental health service settings. Two major challenges to delivery of high-quality care are providers' fidelity to evidence-based treatment models and children's and caregivers' engagement in the treatment process. We developed a novel, tablet-based application designed to enhance via technology the quality of delivery of trauma-focused cognitive-behavioral therapy (TF-CBT). We piloted its use in four community mental health service organizations using a blocked randomized controlled trial to examine the feasibility of implementing tablet-facilitated TF-CBT versus standard TF-CBT with 13 providers and 27 families. Provider fidelity and child engagement in treatment were observationally measured via session audio recording. Parent and child perceptions of the tablet application were assessed using structured interviews and mixed-method analyses. Providers actively and appropriately used tablet TF-CBT to facilitate treatment activities. Providers and families expressed high satisfaction with its use, demonstrating acceptability of this approach. Youth and caregivers in both conditions reported high alliance with their providers. Overall, we found that tablet-facilitated treatment is accepted by providers and families and may be integrated into mental health treatment with minimal training. Further study is needed to examine the extent to which technology-based applications may enhance the reach, quality, and clinical outcomes of mental health treatment delivered to children and families., (Copyright © 2018. Published by Elsevier Ltd.)

Purpose: The purpose of the present study was to investigate ethnic differences in trauma-related mental health symptoms among adolescents, and test the mediating and moderating effects of polyvictimization (i.e., number of types of traumas/victimizations experienced by an individual) and household income, respectively., Methods: Data were drawn from the first wave of the National Survey of Adolescents-replication study (NSA-R), which took place in the US in 2005 and utilized random digit dialing to administer a telephone survey to adolescents ages 12-17. Participants included in the current analyses were 3312 adolescents (50.2 % female; mean age 14.67 years) from the original sample of 3614 who identified as non-Hispanic White (n = 2346, 70.8 %), non-Hispanic Black (n = 557, 16.8 %), or Hispanic (n = 409, 12.3 %). Structural equation modeling was utilized to test hypothesized models., Results: Non-Hispanic Black and Hispanic participants reported higher levels of polyvictimization and trauma-related mental health symptoms (symptoms of posttraumatic stress and depression) compared to non-Hispanic Whites, though the effect sizes were small (γ ≤ 0.07). Polyvictimization fully accounted for the differences in mental health symptoms between non-Hispanic Blacks and non-Hispanic Whites, and partially accounted for the differences between Hispanics and non-Hispanic Whites. The relation between polyvictimization and trauma-related mental health symptoms was higher for low-income youth than for high-income youth., Conclusions: Disparities in trauma exposure largely accounted for racial/ethnic disparities in trauma-related mental health. Children from low-income family environments appear to be at greater risk of negative mental health outcomes following trauma exposure compared to adolescents from high-income families.

Objective: Compared with more traditional mental health care, integrated behavioral health care (IBHC) offers greater access to services and earlier identification and intervention of behavioral and mental health difficulties. The current study examined demographic, diagnostic, and intervention factors that predict positive changes for IBHC patients., Method: Participants were 1,150 consecutive patients (mean age = 30.10 years, 66.6% female, 60.1% Hispanic, 47.9% uninsured) seen for IBHC services at 2 primary care clinics over a 34-month period. Patients presented with depressive (23.2%), anxiety (18.6%), adjustment (11.3%), and childhood externalizing (7.6%) disorders, with 25.7% of patients receiving no diagnosis., Results: The most commonly delivered interventions included behavioral activation (26.1%), behavioral medicine-specific consultation (14.6%), relaxation training (10.3%), and parent-management training (8.5%). There was high concordance between diagnoses and evidence-based intervention selection. We used latent growth curve modeling to explore predictors of baseline global assessment of functioning (GAF) and improvements in GAF across sessions, utilizing data from a subset of 117 patients who attended at least 3 behavioral health visits. Hispanic ethnicity and being insured predicted higher baseline GAF, while patients with an anxiety disorder had lower baseline GAF than patients with other diagnoses. Controlling for primary diagnosis, patients receiving behavioral activation or exposure therapy improved at faster rates than patients receiving other interventions. Demographic variables did not relate to rates of improvement., Conclusion: Results suggest even brief IBHC interventions can be focused, targeting specific patient concerns with evidence-based treatment components. (PsycINFO Database Record, ((c) 2015 APA, all rights reserved).)