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Psychiatric epidemiologists, developmental psychopathologists, prevention scientists, and treatment researchers have long speculated that treating child anxiety disorders could prevent alcohol and other drug use disorders in young adulthood. A primary challenge in examining long-term effects of anxiety disorder treatment from randomized controlled trials is that all participants receive an immediate or delayed study-related treatment prior to long-term follow-up assessment. Thus, if a long-term follow-up is conducted, a comparison condition no longer exists within the trial. Quasi-experimental designs (QEDs) pairing such clinical samples with comparable untreated epidemiological samples offer a method of addressing this challenge. Selection bias, often a concern in QEDs, can be mitigated by propensity score weighting. A second challenge may arise because the clinical and epidemiological studies may not have used identical measures, necessitating Integrative Data Analysis (IDA) for measure harmonization and scale score estimation. The present study uses a combination of propensity score weighting, zero-inflated mixture moderated nonlinear factor analysis (ZIM-MNLFA), and potential outcomes mediation in a child anxiety treatment QED/IDA (n = 396). Under propensity score-weighted potential outcomes mediation, CBT led to reductions in substance use disorder severity, the effects of which were mediated by reductions in anxiety severity in young adulthood. Sensitivity analyses highlighted the importance of attending to multiple types of bias. This study illustrates how hybrid QED/IDAs can be used in secondary prevention contexts for improved measurement and causal inference, particularly when control participants in clinical trials receive study-related treatment prior to long-term assessment.

Objectives: 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. Methods: 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. Results: The IIDEA intervention group showed higher levels of mindful awareness, illness self-management, and working alliance over an enhanced treatment as usual control group (usual treatment plus scheduled assessments) and qualitative data offer insights into the importance of therapeutic alliance and integration of mindfulness practice with cognitive therapy management skills. Conclusions: Findings suggest that skills related to the studied intermediary outcomes can be helpful for Latinx immigrants experiencing circumstances of ongoing exposure to adversity and traumatic stress. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

In an Editorial, Guest Editors Alexander Tsai, Margarita Alegria and Steffanie Strathdee discuss the accompanying Special Issue on Substance Use, Misuse and Dependence.

Research seeking to understand and improve social conditions for marginalized youth would benefit from merging complex mixed methods research designs emphasizing multilevel data and participatory social justice principles. We contribute to mixed methods research by introducing a novel framework that accomplishes this task and by illustrating its real-world application via "PhotoStories," a multistage study aimed at understanding youths' community-based experiences and emotional well-being. During the project's three phases (preparation, training, and dissemination) we obtained and integrated quantitative and qualitative data at multiple ecological levels. Additionally, we examined youth perceptions about their participation, an important outcome given our focus on participatory social justice. We also provide lessons learned and recommendations for investigators seeking to use a similar approach for youth-focused research.

While positive impacts of recovery capital and social capital in facilitating substance use disorder (SUD) recovery is increasingly documented, research has shown that low-income and marginalized individuals have lower social capital and may rely on different networks. A more comprehensive approach is needed to understand the social capital of low-income individuals with SUD and how these relationships impact their treatment and recovery. Qualitative data were gathered through semi-structured interviews and analyzed employing thematic analysis. Participants included individuals with SUD (n = 10), clinicians (n = 12), and policy leaders (n = 13). Three themes emerged: 1) Patients' positive and negative interpersonal relationships with friends and family influenced decisions to seek treatment; 2) strong patient-provider relationships, often defined by the quality of SUD providers and treatment settings, were perceived as crucial for staying in treatment; and 3) justice involvement facilitated treatment access yet deteriorated treatment engagement. Themes emphasized social and structural factors that inhibit patients from fostering support and treatment engagement. Our study underscores the importance of interpersonal relationships in SUD treatment-seeking and recovery and the need for positive interactions across the care continuum within broader social networks. Opportunities for positive interpersonal relationships include increasing access to language-concordant treatment; provider training to enhance cultural humility and patient-provider relationships; and mechanisms that improve interpersonal relationships between patients, parole officers, and other justice system members. Accentuating the role of interpersonal relationships and expanding social support interventions can pave the way for structural changes that improve recovery by harnessing different types of social capital. [ABSTRACT FROM AUTHOR]

Background: Parental psychopathology is associated with their children's posttraumatic stress symptoms (PTSS). However, the mechanisms through which this occurs remain unclear. We hypothesized that exposure to childhood adversities is the mechanism linking parental psychopathology to child PTSS and that parenting practices moderated these associations. Methods: Participants (N = 1,402) with an average age of 24.03 years old (SD = 2.20), were all Puerto Ricans (50% Male and 50% Female) from the Boricua Youth Study, which is a four‐wave longitudinal study spanning almost 20 years, following individuals from childhood (ages 5–13 at Wave 1) to young adulthood. Measured variables include parental psychopathology at Wave 1, childhood adversities and parenting practices at Waves 2–3, and PTSS at Wave 4. A traditional mediation model estimated the association between parental psychopathology and child PTSS via childhood adversities. A moderated mediation model was used to examine whether parenting practices moderated this mediation model. Results: Results showed that the total effect of parental psychopathology at Wave 1 on PTSS at Wave 4 was fully mediated by childhood adversities at Waves 2–3 (direct effect b = 1.72, 95% CI = [−0.09, 3.83]; indirect effect b = 0.40, 95% CI = [0.15, 0.81]). In addition, the magnitude of this pathway varied by levels of parenting practices (i.e. parental monitoring and parent–child relationship quality). Specifically, the indirect effect of additional adversities in the psychopathology‐PTSS link was stronger with higher levels of parental monitoring but weaker with higher parent–child relationship quality scores. Conclusions: Intergenerational continuity of psychopathology may be mitigated through the prevention of additional childhood adversities via upstream interventions, emphasizing providing parents with mental health needs with parenting tools. Family‐based interventions focused on providing families with the tools to improve parent–child relationships may reduce the negative impact of childhood adversities on mental health across the life course. [ABSTRACT FROM AUTHOR]

This cohort study examines 4 waves of data from the Boricua Youth Study to determine what sociocultural resilience factors in childhood are associated with better young adult mental health in the context of adverse childhood experiences. Key Points: Question: What childhood sociocultural resilience factors are relevant in the context of adverse childhood experiences (ACEs)? Finding: This cohort study found that positive adult-child relationships were associated with a lower odds of later young adulthood depression and anxiety disorders regardless of exposure to ACEs. Higher family religiosity, unexpectedly, was associated with more perceived stress when ACEs were high. Meaning: Positive relationships with parents and with nonparental adults during childhood may reduce the risk of later mental disorders regardless of exposure to ACEs, but factors involving sources of meaning, such as family religiosity, may not be protective among children highly exposed to ACEs. Importance: Knowledge about childhood resilience factors relevant in circumstances of marginalization and high numbers of adverse childhood experiences (ACEs) can improve interventions. Objective: To identify sociocultural resilience factors in childhood that are associated with better young adult mental health in the context of ACEs. Design, Setting, and Participants: This cohort study examined 4 waves of data from the Boricua Youth Study, which included Puerto Rican children from the South Bronx, New York, and San Juan, Puerto Rico. Participants were aged 5 to 17 years at waves 1 through 3 (2000-2003) and aged 15 to 29 years at wave 4 (2013-2017). Linear and logistic regression models tested the associations of 7 childhood resilience factors and their interaction with ACEs on young adult mental health outcomes. Data were analyzed from June 2021 to October 2023. Main Outcomes and Measures: Perceived stress, major depressive disorder and/or generalized anxiety disorder (MDD/GAD), and substance use disorder (SUD) in young adulthood. Results: Among a total 2004 participants, the mean (SD) age at wave 4 was 22.4 (2.9) years; 1024 participants (51.1%) were female, and 980 (48.9%) were male. Positive parent-child relationships and nonparental adult support during childhood were associated with both lower perceived stress (β = −0.14; SE = 0.02; P <.001; β = −0.08; SE = 0.03; P =.003, respectively) and lower odds of MDD/GAD (adjusted odds ratio [aOR], 0.84; 95% CI, 0.73 to 0.97; aOR = 0.81; 95% CI, 0.69 to 0.95, respectively) in young adulthood. Maternal warmth reported during childhood was also associated with lower young adult perceived stress (β = −0.11; SE = 0.02; P <.001). None of the resilience factors were associated with SUD. The resilience factors familism, friendships, and family religiosity were not associated with any of the mental health outcomes. ACEs were associated with poorer mental health outcomes; however, none of the resilience factors exhibited interactions consistent with being protective for ACEs. Unexpectedly, higher family religiosity was associated with more perceived stress in the presence of higher ACEs. Conclusions and Relevance: The results of this study suggest that promoting positive relationships with adults during childhood may reduce later young adulthood stress and MDD/GAD. However, there is still a need to identify sociocultural childhood protective factors for ACEs. Caution should be taken in assuming what resilience factors are relevant for a given group, as higher family religiosity (one postulated resilience factor) was unexpectedly associated with a stronger, rather than a weaker, association between ACEs and perceived stress in young adulthood. [ABSTRACT FROM AUTHOR]