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Cyclosporin A (CsA) inhibits the opening of the mitochondrial permeability transition pore (MPTP) by interacting with cyclophilin D (CypD) and ameliorates neuronal cell death in the central nervous system against ischemic injury. However, the molecular mechanisms underlying CypD/MPTP opening-mediated cell death in ischemic retinal injury induced by acute intraocular pressure (IOP) elevation remain unknown. We observed the first direct evidence that acute IOP elevation significantly upregulated CypD protein expression in ischemic retina at 12 h. However, CsA prevented the upregulation of CypD protein expression and promoted retinal ganglion cell (RGC) survival against ischemic injury. Moreover, CsA blocked apoptotic cell death by decreasing cleaved caspase-3 protein expression in ischemic retina. Of interest, although the expression level of Bcl-xL protein did not show a significant change in ischemic retina treated with vehicle or CsA at 12 h, ischemic damage induced the reduction of Bcl-xL immunoreactivity in RGCs. More importantly, CsA preserved Bcl-xL immunoreactivity in RGCs of ischemic retina. In parallel, acute IOP elevation significantly increased phosphorylated Bad (pBad) at Ser112 protein expression in ischemic retina at 12 h. However, CsA significantly preserved pBad protein expression in ischemic retina. Finally, acute IOP elevation significantly increased mitochondrial transcription factor A (Tfam) protein expression in ischemic retina at 12 h. However, CsA significantly preserved Tfam protein expression in ischemic retina. Studies on mitochondrial DNA (mtDNA) content in ischemic retina showed that there were no statistically significant differences in mtDNA content among control and ischemic groups treated with vehicle or CsA. Therefore, these results provide evidence that the activation of CypD-mediated MPTP opening is associated with the apoptotic pathway and the mitochondrial alteration in RGC death of ischemic retinal injury. On the basis of these observations, our findings suggest that CsA-mediated CypD inhibition may provide a promising therapeutic potential for protecting RGCs against ischemic injury-mediated mitochondrial dysfunction.

This study of Mexican American two-parent families (N = 246) examined the role of parents' well-being (i.e., depressive symptoms, role overload) as a potential mechanism through which parent occupational conditions (i.e., self-direction, hazardous conditions, physical activity, work pressure) are linked to parent-adolescent relationship qualities (i.e., warmth, conflict, disclosure). Depressive symptoms mediated the links between maternal and paternal work pressure and parent-adolescent warmth, conflict, and disclosure. For mothers, depressive symptoms also mediated the links between self-direction and mother-adolescent warmth, conflict, and disclosure; for fathers, role overload mediated the links between work pressure and hazardous conditions with father-adolescent warmth. [ABSTRACT FROM AUTHOR]

Rationale: Previous studies have shown that approximately 55% of patients with familial pulmonary arterial hypertension (FPAH) have BMPR2 coding sequence mutations. However, direct sequencing does not detect other types of heterozygous mutations, such as exonic deletions/duplications.Objective: To estimate the frequency of BMPR2 exonic deletions/duplications in FPAH.Methods: BMPR2 mRNA from lymphoblastoid cell lines of 30 families with PAH and 14 patients with idiopathic PAH (IPAH) was subjected to reverse transcriptase-polymerase chain reaction (RT-PCR) and sequencing. Sequencing of genomic DNA was used to identify point mutations in splice donor/acceptor sites. Multiplex ligation-dependent probe amplification (MLPA) was used to detect exonic deletions/duplications with verification by real-time PCR.Measurements and Main Results: Eleven (37%) patients with FPAH had abnormally sized RT-PCR products. Four of the 11 patients were found to have splice-site mutations resulting in aberrant splicing, and exonic deletions/duplications were detected in the remaining seven patients. MLPA identified three deletions/duplications that were not detectable by RT-PCR. Coding sequence point mutations were identified in 11 of 30 (37%) patients. Mutations were identified in 21 of 30 (70%) patients with FPAH, with 10 of 21 mutations (48%) being exonic deletions/duplications. Two of 14 (14%) patients with IPAH exhibited BMPR2 point mutations, whereas none showed exonic deletions/duplications.Conclusions: Our study indicates that BMPR2 exonic deletions/duplications in patients with FPAH account for a significant proportion of mutations (48%) that until now have not been screened for. Because the complementary approach used in this study is rapid and cost effective, screening for BMPR2 deletions/duplications by MLPA and real-time PCR should accompany direct sequencing in all PAH testing. [ABSTRACT FROM AUTHOR]

Rationale: Serotonin is a pulmonary vasoconstrictor and smooth muscle cell mitogen. The serotonin transporter (SERT) is abundant in pulmonary vascular smooth muscle. Compared with the short (S) allele, the long (L) SERT promoter allele is associated with increased SERT transcription and more severe pulmonary hypertension in a cohort of patients with chronic obstructive pulmonary disease, and was more prevalent in a cohort with idiopathic pulmonary arterial hypertension (IPAH), compared with control subjects.Objective: We hypothesized that the SERT L allele would associate with an earlier age at diagnosis and/or shorter survival interval in pulmonary arterial hypertension (PAH) than the S allele.Methods: SERT promoters from 166 familial PAH (FPAH), 83 IPAH, and 125 control subjects were sequenced. One hundred twenty-seven of the patients with FPAH had a known mutation in bone morphogenetic protein receptor 2 (BMPR2).Results: The mean age at diagnosis was 35.8 yr in patients with FPAH and 41.1 yr in patients with IPAH (p = 0.02). There were no significant differences in distribution of the LL, LS, or SS genotypes in IPAH, FPAH, or unaffected BMPR2 mutation carriers. In FPAH, the LL genotype was associated with an earlier age at diagnosis (p < 0.02).Conclusions: In patients with IPAH, these SERT genotypes do not correlate with age at diagnosis or survival interval. In patients with FPAH, the LL genotype correlates with an earlier age at diagnosis than SL or SS, although survival among the groups was similar. The correlation of the SERT promoter polymorphism with age at diagnosis in FPAH suggests a possible relationship between the SERT and BMPR2. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To describe a unique multidisciplinary outpatient intervention for patients at high risk for lower-extremity amputation. RESEARCH DESIGN AND METHODS: Patients with foot ulcers and considered to be high risk for lower-extremity amputation were referred to the High Risk Foot Clinic of Operation Desert Foot at the Carl T. Hayden Veterans Affairs' Medical Center in Phoenix, Arizona, where patients received simultaneous vascular surgery and podiatric triage and treatment. Some 124 patients, consisting of 90 diabetic patients and 34 nondiabetic patients, were initially seen between 1 October 1991 and 30 September 1992 and followed for subsequent rate of lower-extremity amputation. RESULTS: In a mean follow-up period of 55 months (range 3-77), only 18 of 124 patients (15%) required amputation at the level of the thigh or leg. Of the 18 amputees, 17 (94%) had type 2 diabetes. The rate of avoiding limb loss was 86.5% after 3 years and 83% after 5 years or more. Furthermore, of the 15 amputees surviving longer than 2 months, only one (7%) had to undergo amputation of the contralateral limb over the following 12-65 months (mean 35 months). Compared with nondiabetic patients, patients with diabetes had a 7.68 odds ratio for amputation (95% CI 5.63-9.74) (P < 0.01). CONCLUSIONS: A specialized clinic for prevention of lower-extremity amputation is described. Initial and contralateral amputation rates appear to be far lower in this population than in previously published reports for similar populations. Relative to patients without diabetes, patients with diabetes were more than seven times as likely to have a lower-extremity amputation. These data suggest that aggressive collaboration of vascular surgery and podiatry can be effective in preventing lower-extremity amputation in the high-risk population. [ABSTRACT FROM AUTHOR]

Abstract Background Brimonidine is a common drug for lowering ocular pressure and may directly protect retinal ganglion cells in glaucoma. The disease involves early loss of retinal ganglion cell transport to brain targets followed by axonal and somatic degeneration. We examined whether brimonidine preserves ganglion cell axonal transport and abates degeneration in rats with elevated ocular pressure induced by laser cauterization of the episcleral veins. Results Ocular pressure was elevated unilaterally by 90% for a period of 8 weeks post- cauterization. During this time, brimonidine (1mg/kg/day) or vehicle (phosphate-buffered saline) was delivered systemically and continuously via subcutaneous pump. Animals received bilateral intravitreal injections of fluorescent cholera toxin subunit β (CTB) two days before sacrifice to assess anterograde transport. In retinas from the vehicle group, elevated pressure induced a 44% decrease in the fraction of ganglion cells with intact uptake of CTB and a 14-42% reduction in the number of immuno-labelled ganglion cell bodies, with the worst loss occurring nasally. Elevated pressure also caused a 33% loss of ganglion cell axons in vehicle optic nerves and a 70% decrease in CTB transport to the superior colliculus. Each of these components of ganglion cell degeneration was either prevented or significantly reduced in the brimonidine treatment group. Conclusions Continuous and systemic treatment with brimonidine by subcutaneous injection significantly improved retinal ganglion cell survival with exposure to elevated ocular pressure. This effect was most striking in the nasal region of the retina. Brimonidine treatment also preserved ganglion cell axon morphology, sampling density and total number in the optic nerve with elevated pressure. Consistent with improved outcome in the optic projection, brimonidine also significantly reduced the deficits in axonal transport to the superior colliculus associated with elevated ocular pressure. As transport deficits to and from retinal ganglion cell projection targets in the brain are relevant to the progression of glaucoma, the ability of brimonidine to preserve optic nerve axons and active transport suggests its neuroprotective effects are relevant not only at the cell body, but throughout the entire optic projection.

Sexual minority (SM) men's sexual revictimization (SR; i.e. experiences of adult victimization among childhood sexual abuse survivors) is an understudied topic despite evidence that SM men are disproportionately impacted by sexual violence (SV) over the life course. This study addresses this gap utilizing a diverse sample ( n  = 2859) of SM men (age 18-30) from the U.S. Results demonstrated that over 10% of SM men had experienced SR. Further, strength-based (e.g. sense of LGBTQIA2S+ community) and minority-stress (e.g. internalized homonegativity) related factors were examined as moderators of the relationship between child sexual abuse (CSA) and adult sexual assault victimization (ASAV) in the past six months. One factor emerged as a significant moderator of the CSA-ASAV relationship: perceived discrimination. Practice-based implications are provided.

Objectives: The purpose of this study was to develop, pilot, and evaluate a culturally grounded, family-based program to prevent adverse childhood experiences (ACEs) among low-income and Indigenous children aged 10 to 14. The Tiwahe Wicagwicayapi program (TWP) is a 7-session program that teaches skills to prevent ACEs and is rooted in Lakota culture, language, and history., Methods: A total of 124 families (124 caregivers [96% Indigenous; 90% reported yearly income <$40 000] with 194 children aged 10 to 14 [93% Indigenous]) were randomly assigned to treatment (N = 66 families and 173 individuals) or waitlist (N = 58 families and 145 individuals) control groups. Caregivers and children completed a baseline, immediate posttest, and 6-month follow-up survey., Results: Treatment effects were detected, indicating, compared with control participants, reductions in the incidence of child ACEs (incidence rate ratio [IRR] = 0.64), bullying victimization (odds ratio = 0.53), depression (d = -0.20), and externalizing behaviors (d = -0.23) and increased parent-child communication (g = 0.27) and child help-seeking behaviors (d = 0.28). For caregivers, the effects indicated that the program prevented intimate partner violence victimization (IRR = 0.36) and perpetration (IRR = 0.45), harsh parenting (g = -0.35), and depression (d = -0.24) and increased emotion regulation (d = 0.37), social support (d = 0.33), and cultural connection (d = 0.34)., Conclusions: The TWP holds great promise in preventing ACEs among low-income, Indigenous children, showing potential promise for widespread public health impact. Future rigorous research on the TWP is warranted., (Copyright © 2024 by the American Academy of Pediatrics.)

Purpose: Rape occurs at high rates in South Sudan and Kakuma refugee camps, a region characterized by armed conflict, gender inequity, and economic crisis. To date, we know little about how to prevent rape in this region of the world. As such, the purpose of this study was to examine outcomes of Empowerment Transformation Training (ETT) (an adapted empowerment self-defense program; empowerment self-defense) among female participants in South Sudan and the Kakuma refugee camp., Methods: Schools were assigned to the treatment (ETT) condition (n = 7) or control (life skills) condition (n = 9) and used as the unit of analysis given the cluster-randomized design. Female participants anonymously completed a baseline (T1) and 12-month follow-up (T2) paper and pencil survey., Results: Annual rape victimization rates decreased from 10.7% to 5.5% in the ETT schools (risk ratio [RR] = 0.51); there was no change in the control schools (10.0%-9.0%). Empowerment Transformation Training (ETT) schools had increased confidence at T2 (T1: 42.4%; T2: 75.4%; RR = 1.79) and greater rates of confidence at T2 compared to control schools (54.3%; RR = 1.39). Knowledge of effective self-defense strategies (T2) was greater for ETT schools (47.4%) compared to control schools (30.1%) (RR = 1.57)., Discussion: The ETT program reduced rates of rape, increased confidence, disclosures of rape (among victims), and knowledge of effective self-defense strategies. Empowerment self-defense programs are a critical component to rape prevention across global communities, including those characterized by armed conflict, gender inequity, and economic crisis., (Copyright © 2023 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Sexual minority, individuals who are not heterosexual, college students experience high rates of intimate partner violence (IPV), which is linked to a myriad of deleterious outcomes. However, little work has evaluated whether there are differences in IPV outcomes among sexual minority college students as compared to heterosexual college students. Further, the extent to which minority stress at the institutional and individual level relates to IPV outcomes among sexual minority students is understudied. As such, the purpose of the current study was to evaluate IPV outcomes in a large sample of undergraduate students attending 18 medium- to large-sized universities across the contiguous U.S. Results supported that sexual minority victims of IPV had more anxious and depressive symptoms than heterosexual victims of IPV but were not more likely to engage in hazardous drinking. Further, analyses supported that several campus-level (but not individual-level) indicators of minority stress moderated the relation between IPV victimization and negative outcomes among sexual minority students, such that the association between IPV and negative outcomes was stronger among students embedded in campuses with higher levels of minority stressors. Results support the critical importance of interventions addressing campus-level minority stressors to reduce deleterious IPV outcomes among sexual minority college student victims., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interests with respect to the authorship and/or publication of this article.

Newcomer immigrant adolescents (NIA) represent a particularly vulnerable group in the United States, facing numerous stressors placing them at risk for social-emotional and academic concerns. Schools play a critical role in supporting NIA in the United States. Despite this, insufficient research addressing the needs of this group within schools has been conducted. Considering the complexity of engaging in community-based research with marginalized populations, such as NIA, in this article, we elaborate on the challenges we faced during our research with NIA and propose solutions to these challenges. We do so with the goal of promoting continued engagement of such efforts within our field as to better address the needs of NIA within the United States. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Sexual stigma operates at multiple levels (institutional, group, individual), which serves to disadvantage sexual minority (LGBQ+) individuals and increases risk for deleterious outcomes. The current study evaluated a novel multilevel sexual stigma model of intimate partner violence (MLSSM-IPV) that incorporates multiple levels of sexual stigma as related to IPV risk via several pathways (e.g. hazardous drinking, affective symptoms). We evaluated this model in a longitudinal study of LGBQ+ undergraduate college students ( n  = 2,415) attending 18 universities who completed surveys in the Fall and Spring semesters. Group-level sexual stigma on each campus was assessed via surveys with heterosexual students ( n  = 8,517) and faculty, staff, and administrators ( n  = 2,865), and institutional-level stigma was evaluated via a campus climate assessment. At the campus level, institutional stigma was related to LGBQ+ students' self-stigma and identity concealment. Moreover, self-stigma prospectively predicted IPV victimization, and hazardous drinking mediated the relations between self-stigma and IPV perpetration and victimization. Results suggest that interventions addressing stigma and hazardous drinking may be efficacious in reducing IPV among LGBQ+ students. Further, comprehensive efforts to improve campus climate for LGBQ+ students are likely to produce a plethora of benefits for these students.

Intimate partner abuse (IPA) is a public health crisis that disproportionately impacts indigenous women. We know little about rates and correlates of IPA victimization (IPAV) and abuse directed at one's partner (ADP) among indigenous women caregivers (people who take care of children). The purpose of the current study was to address this critical gap in the literature. Participants were 44 indigenous women caregivers in the United States in a current relationship who completed a survey. Most women reported IPAV and ADP experiences in the past 6 months, and IPAV and ADP abuse directed at partner were positively associated. Further, IPAV was positively associated with adverse childhood experiences (ACEs), participants' engagement in harsh parenting, and depressive symptoms. IPAV was negatively associated with age, income, indigenous cultural identity, and social support. ADP was positively associated with ACEs, harsh parenting, and depressive symptoms. ADP was negatively associated with age and income. ADP was not associated with indigenous cultural identity and social support. These data suggest the urgency with which efforts are needed to prevent and respond to IPA among indigenous women caregivers, especially those who are younger and of lower income, and that culturally grounded initiatives that seek to build social support may be especially impactful.

A large body of empirical research has demonstrated that caregiver adverse childhood experiences (ACEs) predict ACEs in one's child, a phenomenon known as the intergenerational transmission of ACEs. Little of this empirical research, however, has focused specifically on Indigenous peoples despite a growing body of theoretical literature and the wisdom of Elders and Traditional Knowledge Keepers that speaks to the presence of this phenomenon within Indigenous communities as well as the protective role of Indigenous cultural identity in preventing the intergenerational transmission of ACEs. The purpose of the current study was to conduct an empirical evaluation of this hypothesis, specifically that Indigenous cultural identity and social support protects against the intergenerational transmission of ACEs among Indigenous peoples and their children in the USA. Participants were 106 Indigenous women caregivers of children ages 10 to 14 in South Dakota who completed surveys. Results showed that Indigenous cultural identity moderated the association between caregiver ACEs and child ACEs. At high levels of cultural identity, there was no association between caregiver ACEs and child ACEs. At low levels of Indigenous cultural identity, however, there was a strong and positive relationship between caregiver ACEs and child ACEs. Social support did not moderate the association between caregiver ACEs and child ACEs. These findings underscore the need for initiatives that enhance Indigenous cultural identity and social support among Indigenous caregivers to prevent the intergenerational transmission of ACEs., (© 2023. W. Montague Cobb-NMA Health Institute.)

While parenting children with difficult behaviors can intensify stress within the entire family system, families may lean on other familial relationships to mitigate that stress. The coparenting relationship is known to play a key role within the family system for child outcomes and familial interactions, but it is not clear whether it eases the stress and challenge of raising a difficult child, nor how that plays out differently for mothers versus fathers. Ninety-six couples (89.7% married) parenting young children (Mean age = 3.22 years) were included in this study. Using cross-sectional and aggregated daily response data, actor-partner interdependence models were used to examine how mothers' and fathers' perceived coparenting support lessened or intensified parenting stress and/or daily problems with their child/children-for themselves or their parenting partner. We found that greater coparenting support reported by mothers coincided with stronger links between the mother's report of child difficulty and daily problems encountered by both mothers and fathers. In contrast, when fathers reported greater coparenting support, the intensity between reported child difficulty and daily problems decreased for mothers, and fathers reported lower parenting stress. Coparenting support also moderated associations between parents' perception of child difficulty and daily problems with their children. These results suggest that mothers incur heightened coparenting support from fathers when experiencing more difficult child behavior and that coparenting support experienced by fathers may alleviate parenting challenges for mothers. These findings further contribute to the literature by emphasizing distinct differences between mothers and fathers in coparenting associations within the family system., (© 2023 The Authors. Family Process published by Wiley Periodicals LLC on behalf of Family Process Institute.)

Instructors use a variety of online formative assessment (FA) activities to support learning outside class. Previous studies have revealed barriers for students in online courses, but little is known about the barriers students experience when completing online FA assignments. Understanding these barriers to access is critical to fostering more inclusive learning for all students. Using a framework from previous work in online learning, we examined student perceptions of online FA access with respect to five barrier categories: technical resources, instructor organization, social interactions, personal engagement, and learning environment. We developed and administered a survey to more than 1200 undergraduate biology students at 2-year and 4-year institutions. Students responded to statements using Likert scales and open-ended prompts. Statistical models indicated differences in access across the barrier categories and revealed that demographic characteristics were associated with certain barrier categories. Furthermore, technical resources, instructor organization, and personal engagement barriers were associated with lower course performance. In open-ended responses, students most frequently suggested that changes to scheduling logistics, course delivery, and FA format would improve their online FA experience. We discuss how these findings and student suggestions can inform instruction, particularly how instructors can alter their FA characteristics to better suit their student populations.

Conjoint behavioral consultation (CBC), a teacher-parent partnership intervention, has been shown to yield immediate improvements in problem-solving skills and communication quality with parents for kindergarten through third grade teachers in rural schools. The purpose of the present study was to determine whether CBC can yield maintained effects on teacher skills and communication over a 1-year follow-up period. We used an experimental design to examine maintenance effects of CBC ( n CBC = 84, n Control = 68). Outcomes were assessed four times: baseline, 12-week posttest (immediate effects), and twice during a 1-year follow-up period (maintenance effects). Longitudinal growth modeling revealed that immediate improvements in perceived problem-solving competence and communication quality with parents for teachers in the CBC condition compared to teachers in the control condition were maintained 1-year postintervention. CBC appears to support teachers' professional practices over time. Implications for enhancing families' and schools' capacities to address student behavior concerns are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

This study evaluated the effectiveness of a 6-session (12-hour) empowerment self-defense classroom delivered curriculum (i.e., IMpower ) among American Indian girls. Girls ( N  = 74) in one middle school and two high schools on an Indian Reservation in the Great Plains region of the United States received the intervention and completed a pre-test and a post-test six months following the final program session. The surveys administered assessed hypothesized intermediary (i.e., efficacy to resist a sexual assault, self-defense knowledge), primary (i.e., sexual violence victimization), and secondary (i.e., physical dating violence, sexual harassment) outcomes. Native American girls ( N  = 181) in five middle schools and three high schools in a nearby city where there was no sexual assault prevention occurring completed surveys assessing sexual violence, physical dating violence, and sexual harassment victimization approximately six months apart, thus serving as a comparison to girls in the treatment condition on primary and secondary outcomes. Girls exposed to the IMpower program reported significant increases over time in efficacy to resist a sexual assault and knowledge of effective resistance strategies. Furthermore, propensity score analyses suggested that girls who received the IMpower program reported significantly fewer types of sexual assault and sexual harassment at follow-up compared to girls in the control condition. However, no effect was found for physical dating violence. These data suggest that empowerment self-defense is a promising approach in preventing sexual assault and sexual harassment among American Indian girls.

Objective: This longitudinal study had three aims: (a) to examine whether ethnic-racial identity (ERI; i.e., public regard, private regard, and centrality) was associated with academic self-efficacy and changes in educational adjustment (i.e., educational values and academic performance) among Latinx adolescents over 3 years, (b) to investigate whether academic self-efficacy would operate as a promotive mechanism in links between domains of ERI and changes in educational adjustment, and (c) to explore within-group variability by gender on the relations between domains of ERI, academic self-efficacy, and educational adjustment., Method: Data came from 329 Latinx families (i.e., middle school students and their parents) living in the Southwest U.S. Parents' data were used from the first wave and adolescents' (M = 13.69, SD = .56; 53% girls) data were used from three study waves. A series of structural equation models were estimated., Results: All three domains of ERI related to higher levels of academic self-efficacy. Further, public regard was associated with increased levels of educational values, whereas private regard and centrality did not associate with either indicator of educational adjustment. Results provided support for academic self-efficacy serving as a mediator of associations between private regard and centrality and educational adjustment. The results were consistent across gender., Conclusions: The findings suggest that fostering ERI is promotive of Latinx adolescents' academic self-efficacy. Further, through academic self-efficacy, private regard and centrality support educational adjustment. ERI and academic self-efficacy may be potential targets for programming aimed to address educational disparities among Latinx adolescents. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Sexual assault is a widespread problem on college campuses, and survivors rarely use campus supports. However, there is no established measure of service barriers for this population. This study develops and provides preliminary evidence for a measure of psychological service barriers. Data were collected from 100 college sexual assault survivors. Results provide evidence for three factors: social-emotional barriers, negative treatment barriers, and minimization barriers. Additional tests offer evidence for consistency and reliability in these factors over time and across campus supports. This work offers preliminary evidence for the psychometric properties of this measure and lays the groundwork for future validation research.

Objective: This study examined Mexican-origin parents' perceived workplace discrimination, familism, family conflict, and gender as related to parents' well-being (i.e., self-esteem, depressive symptoms, and general physical health) over a 2-year period during the 2007-2009 "Great Recession" in the U.S., Method: Data were drawn from two waves of a larger study of 246 Mexican-origin predominantly immigrant families with adolescents. Using a matched-pairs sample of mothers and fathers, path analyses were conducted to test the hypothesized relations., Results: Moderation analyses revealed that high levels of familism weakened the link between workplace discrimination and parents' depressive symptoms, whereas high levels of parent-youth conflict exacerbated the association to parents' psychosocial well-being. There was variation by parent gender, with parent-youth conflict being more strongly associated with fathers' self-esteem than mothers'., Conclusions: Findings indicate that Mexican-origin parents' familism can mitigate and family conflict can exacerbate the risks of workplace discrimination on parents' psychosocial well-being. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Introduction: This paper examined individual, family, and peer roles in promoting Latinx youths' math and science performance. The role of maternal/paternal modeling in education was examined as shaping academic self-efficacy and, in turn, math/science grades among a population considered at risk of low academic achievement. Moreover, the study tested the moderating roles of class ethnic fit (i.e., feelings of fit based on having same-ethnic peers in class) and gender., Method: Cross-sectional data came from a southwestern U.S. sample of Latinx adolescents (N = 329; 54% female, M age  = 13.69 years, SD = 0.56) who reported on maternal/paternal educational modeling, academic self-efficacy, math/science grades, class ethnic fit, and gender., Results: Adolescents' perceptions of maternal modeling, but not paternal, related to higher levels of academic self-efficacy which, in turn, related to higher math/science performance. Moderation results revealed: (a) for adolescents who perceived low science class ethnic fit, high levels of parental modeling related to higher levels of academic self-efficacy which, in turn, were related to higher science grades, and (b) maternal modeling positively related to girls', but not boys', academic self-efficacy and paternal modeling positively related to girls', but not boys', math/science performance., Conclusions: These results suggest maternal modeling is a promotive factor, supporting Latinx youths' academic self-efficacy which, in turn, related to math/science grades. Additionally, a negative direct relation between maternal modeling and science grades suggests maternal modeling generally support academic self-efficacy, but not necessarily science attainment. These associations are nuanced as they are informed by context and parent-child gender., (Copyright © 2021. Published by Elsevier Ltd.)

Finding ways to protect youth from maladjustment during adolescence and young adulthood is important, and youth of Mexican descent are key targets for such efforts given that they experience higher rates of depressive symptoms, risky behaviors, and sexual risk behaviors compared to youth from other ethnic/racial groups. Using a sample of younger ( M age Time 1 = 12.77 years) and older ( M age Time 1 = 15.70 years) siblings from an 8-year longitudinal study of 246 Mexican-origin families, we conducted path analyses to test whether older siblings' reports of sibling intimacy predicted younger siblings' later positive values and adjustment problems controlling for prior adjustment and maternal and paternal warmth. Additionally, we tested whether younger siblings' familism values moderated and their positive values mediated the sibling intimacy to adjustment problem linkages. Findings revealed that sibling intimacy in early adolescence predicted younger siblings' adjustment problems in young adulthood via their positive values in later adolescence, but only for younger siblings with strong familism values. This study highlights the importance of examining promotive factors, such as positive relationship qualities and familism values, and how positive values protect against problems in young adulthood. Results also have practical implications for prevention programs including the utility of promoting positive sibling relationships and values. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

This study examined an integrated model that proposes that alcohol availability and alcohol norms will directly and indirectly via binge drinking predict physical, sexual, and emotional teen dating violence (TDV) victimization. These data come from 22,336 high school students (49.6%) from 69 schools who participated in the New Hampshire Youth Risk Behavior Survey in 2017. All teens included in the analyses reported dating in the past year. Perceptions of alcohol availability and peer and parental acceptance of teen drinking related to an increased likelihood of binge drinking, and binge drinking related to an increased risk of physical, sexual, and emotional TDV victimization. Also, alcohol availability and perceived parental and peer norms exerted a direct influence on the increased likelihood of TDV victimization. Lastly, we examined the moderating role of gender on these associations. Only one significant association emerged, such that for boys, but not for girls, perceived parental alcohol norms related to an increased likelihood of emotional TDV victimization. Findings suggest that TDV prevention and risk reduction initiatives need to focus on efforts that reduce binge drinking in teens. Reducing alcohol availability and shifting perceptions of parental alcohol norms and peer alcohol norms could be helpful in reducing both binge drinking and TDV victimization.

Background: There is limited understanding of the prevalence of psychological distress and associated stressors and supports among displaced adults in low- and middle-income first asylum countries., Method: This article reports the findings of a cross-sectional study. We recruited 245 Congolese adults (18-80 years) residing in Nairobi, Kenya using snowball sampling. Data were collected using an interviewer-administered questionnaire consisting of sociodemographic characteristics, the Self-Reporting Questionnaire (SRQ-20), and a locally developed stressors and supports survey. We used multivariable logistic regression to examine associations among sociodemographic, stressor, and support variables and the likelihood of experiencing psychological distress., Results: More than half of the participants (52.8%) reported symptoms indicative of psychological distress. Factors associated with increased psychological distress included perceiving to have a useful role in one's family or community, AOR = 1.85; 95% CI [1.1.17, 3.11], p = .012, feeling confused or not knowing what to do, AOR = 2.13; 95% CI [1.20, 4.6], p = .014, and feeling afraid to leave home for medical/health care to help with an illness, AOR = 1.57; 95% CI [1.17, 2.15], p < .01. Additionally, ethnic Banyamulenge Congolese adults without legal refugee status had an increased likelihood of experiencing psychological distress, AOR = .07; 95% CI [0, .74], p = .035., Conclusion: Future research is warranted to understand how to implement targeted mental health and psychosocial support (MHPSS) to improve urban-displaced adults' sense of safety and belonging. Our findings suggest that legal refugee status is an important structural determinant of mental health, which should be considered in MHPSS practice and policy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Cultural-ecological frameworks posit that there are harmful effects of social stratification on developmental outcomes. In particular, awareness of aspects of social stratification in society and interpersonal experiences of discrimination, more generally and within specific contexts, may differentially influence outcomes across life stages; yet, few studies have examined the distal effects during adolescence on early adult developmental outcomes. The current study fills this gap by examining distal mechanisms linking adolescents' (Time 1: ages 13-15) awareness of and perceived general and school discrimination to young adults' (Time 3: ages 23-25) socioeconomic attainment (i.e., educational attainment, occupational prestige, earned income) through adolescents' (Time 2: ages 16-18) academic adjustment (i.e., grades and educational expectations). The study also examined variation by adaptive culture (i.e., English and Spanish language use behavior, familism values) and youth gender. Data are from the Children of Immigrants Longitudinal Study (N = 755 Mexican-origin adolescents and their foreign-born parents; 51.5% male adolescents; Time 1 M age = 14.20 years). The results revealed that adolescent's awareness of societal discrimination (Time 1) related to adolescents' higher grades (Time 2), which, in turn, related to higher educational attainment and occupational prestige in early adulthood (Time 3). For young women, but not men, sources of perceived discrimination within the school context during adolescence related to lower educational attainment. Additional variation by adaptive culture and gender was also found. Implications discussed are related to positive development among Mexican-origin youth in immigrant families.

Background: Balance responses to perturbations often involve the arms in an attempt to either restore balance or protect against impact. Although a majority of research has been dedicated to understanding age-related changes in lower limb balance responses, there is a growing body of evidence supporting age-related changes in arm responses. This systematic review aimed to summarize differences in arm responses between older and younger adults under conditions requiring counterbalancing, reaching to grasping, and protection against impact., Methods: Following a systematic review and critical appraisal of the literature, data regarding the arm response in studies comparing young and older adults was extracted. The resulting articles were also assessed for quality to determine risk of bias., Results: Fifteen high quality studies were identified. The majority of these studies reported delayed onsets in muscle activation, differences in arm movement strategies, delayed movement timing, increased impact forces, and greater grasp errors in older compared to young adults. These differences were also identified under varied visual and cognitive conditions., Conclusions: The studies included in this review demonstrate age-related differences in arm responses regardless of the direction and nature of the perturbation. These differences could provide insight into developing more targeted rehabilitation and fall prevention strategies. More research is needed to assess whether the identified age-related differences are a necessary compensation or a contributory factor to balance impairments and fall risk in older adults., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background: Difficulties in coping with stress and regulating emotions are transdiagnostic risk factors for self-harming behavior. Due to sociocultural stressors, ethnic minority adolescents may be at greater risk for self-regulation difficulties and self-harm. Dialectical behavior therapy for adolescents (DBT-A) frames adaptive skill acquisition as a mechanism of change, but few studies have investigated its impact on ethnic minority adolescents' self-regulation (i.e. coping, emotion regulation). Therefore, this pilot study examined relations between self-regulation and self-harm among ethnic minority adolescents and investigated changes in their self-regulation upon completing DBT-A., Methods: A clinically referred sample of 101 ethnic minority adolescents (M age  = 14.77; female = 69.3%) completed questionnaires about a history of self-harm, coping (DBT Ways of Coping Checklist), and emotion regulation (Difficulties in Emotion Regulation Scale). Of the initial sample, 51 adolescents (M age  = 14.73; female = 80.4%) entered a 20-week DBT-A program due to self-harm and/or Borderline Personality features., Results: In a pretreatment sample, the frequency of dysfunctional coping, but not of adaptive coping, differentiated self-injurers from non-self-injurers. Full information maximum likelihood estimation was used to address high attrition (60.8%) from DBT-A. Those who completed DBT-A (n = 20) reported significantly improved emotion regulation. Adaptive coping at pretreatment predicted increased DBT skills use at post-treatment., Conclusions: This non-randomized pilot study highlights dysfunctional coping and emotion dysregulation as risk factors for self-harm and suggests that 20-week DBT-A may help improve emotion regulation. Future research should employ a randomized design to further examine the effect of DBT-A on these transdiagnostic processes of psychopathology., Key Practitioner Message: Due to cultural and environmental stressors, ethnic minority adolescents may be at greater risk for developing self-regulatory difficulties - transdiagnostic mechanisms known to underly self-harming behaviors; however, we know little about whether empirically supported treatments for self-harm will improve youth's coping and emotion regulation. In a clinically referred, pretreatment sample of ethnic minority youth, levels of BPD symptomatology, emotion dysregulation, and dysfunctional coping, but not of adaptive coping, differentiated teens who self-harmed from those who did not. Self-harming ethnic minority youth who participated in an uncontrolled, pilot trial of dialectical behavior therapy for adolescents (DBT-A) at an urban mental health clinic reported improved emotion regulation at post-treatment. Baseline emotion regulation skills were not predictive of treatment-related changes, suggesting that other factors, such as DBT-A, may have played a decisive role in improving teens' emotion regulation. In contrast, adaptive coping skills at pretreatment were linked to increased DBT skills use at post-treatment, indicating that patients' baseline coping skills may play a predictive role in psychotherapy outcomes. Future research should employ a randomized control trial to examine the effect of DBT-A on vulnerable ethnic minority youth's development of self-regulation. It should also investigate the hypothesized mediating role of self-regulation in effecting lasting clinical gains., (© 2020 Association for Child and Adolescent Mental Health.)

Introduction: Although numerous efforts have aimed to reduce suicides in the U.S. Army, completion rates have remained elevated. Army leaders play an important role in supporting soldiers at risk of suicide, but existing suicide-prevention tools tailored to leaders are limited and not empirically validated. The purpose of this article is to describe the process used to develop the Behavioral Health Readiness and Suicide Risk Reduction Review (R4) tools for Army leaders that are currently undergoing empirical validation with two U.S. Army divisions., Materials and Methods: Consistent with a Secretary of the Army directive, approximately 76 interviews and focus groups were conducted with Army leaders and subject matter experts (SMEs) to obtain feedback regarding existing practices for suicide risk management, leader tools, and institutional considerations. In addition, reviews of the empirical literature regarding predictors of suicide and best practices for the development of practice guidelines were conducted. Qualitative feedback, empirical predictors of suicide, and design considerations were integrated to develop the R4 tools. A second series of 11 interviews and focus groups with Army leaders and SMEs was also conducted to validate the design and obtain feedback regarding the R4 tools., Results: Leaders described preferences for tool processes (eg, incorporating engaged leadership, including multiple risk identification methods), formatting (eg, one page), organization (eg, low-intermediate-high risk scoring system), content (eg, excluding other considerations related to vehicle safety, including readiness implications), and implementation (eg, accounting for leadership judgment, tailoring process to specific leadership echelons, consideration of institutional barriers). Evidence-based predictors of suicide risk and practice guideline considerations (eg, design) were integrated with leadership feedback to develop the R4 tools that were tailored to specific leadership echelons. Leaders provided positive feedback regarding the R4 tools and described the importance of accounting for potential institutional barriers to implementation. This feedback was addressed by including recommendations regarding the implementation of standardized support meetings between different echelons of leadership., Conclusions: The R4 development process entailed the simultaneous integration of leadership feedback with evidence-based predictors of suicide risk and design considerations. Thus, the development of these tools builds upon previous Army leadership tools by specifically tailoring elements of those tools to accommodate leader preferences, accounting for potential implementation barriers (eg, institutional factors), and empirically evaluating the implementation of those tools. Future studies should consider utilizing a similar process to develop empirically based resources that are more likely to be incorporated into the routine practice of leaders supporting soldiers at risk of suicide, very often located at the company level and below., (Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2019. This work is written by (a) US Government employee(s) and is in the public domain in the US.)

Community Health Workers (CHWs) are often incorporated into efforts to reduce health disparities for vulnerable populations. However, their voices are rarely the focus of research when considering how to increase their job effectiveness and sustainability. The current study addresses this gap by privileging the voices of 28 CHWs who work with Latinx communities in Nebraska through in-depth, semistructured interviews. Using a multilevel, Culture-Centered Approach (CCA) to Health Communication, we identified two key structural communication issues: (a) increasing language accommodation and (b) increasing (and stabilizing) network integration across three ecological levels of health behavior ( individual, microsystem , and exosystem ). This study shows the uniquely valuable perspective that CHWs have as they navigate hierarchical health care structures and community cultures to meet the needs of their Latinx clients. Findings suggest that CHWs should be included in health care organization and policy discussions to reduce health disparities for Latinx populations.

Purpose: To develop a focal photoreceptor degeneration model by blue light-emitting diode (LED)-induced phototoxicity (LIP) and investigate the protective effects of topical brimonidine (BMD) or intravitreal brain-derived neurotrophic factor (BDNF), ciliary neurotrophic factor (CNTF), or basic fibroblast growth factor (bFGF)., Methods: In anesthetized, dark-adapted, adult female Swiss mice, the left eye was dilated and exposed to blue light (10 seconds, 200 lux). After LIP, full-field electroretinograms (ERG) and spectral-domain optical coherence tomography (SD-OCT) were obtained longitudinally, and reactive-Iba-1 + monocytic cells, TUNEL + cells and S-opsin + cone outer segments were examined up to 7 days. Left eyes were treated topically with BMD (1%) or vehicle, before or right after LIP, or intravitreally with BDNF (2.5 μg), CNTF (0.2 μg), bFGF (0.5 μg), or corresponding vehicle right after LIP. At 7 days, S-opsin + cone outer segments were counted within predetermined fixed-size areas (PFA) centered on the lesion in both flattened retinas., Results: SD-OCT showed a circular region in the superior-temporal left retina with progressive thinning (207.9 ± 5.6 μm to 160.7 ± 6.8 μm [7 days], n = 8), increasing TUNEL + cells (peak at 3 days), decreasing S-opsin + cone outer segments, and strong microglia activation. ERGs were normal by 3 days. Total S-opsin + cones in the PFA for LIP-treated and fellow-retinas were 2330 ± 262 and 5601 ± 583 ( n = 8), respectively. All neuroprotectants ( n = 7-11), including topical BMD pre- or post-LIP, or intravitreal BDNF, CNTF, and bFGF, showed significantly greater S-opsin + cone survival than their corresponding vehicle-treated groups., Conclusions: LIP is a reliable, quantifiable focal photoreceptor degeneration model. Topical BMD or intravitreal BDNF, CNTF, or bFGF protect against LIP-induced cone-photoreceptor loss., Translational Relevance: Topical BMD or intravitreal BDNF, CNTF, or bFGF protect cones against phototoxicity., (Copyright 2019 The Authors.)

Challenging behavior problems are common in early childhood and, if left untreated, may escalate into more severe and intractable problems in adolescence and early adulthood. This trajectory is of particular importance in rural schools, where disruptive behaviors are more prominent than in urban and suburban schools. Conjoint behavioral consultation (CBC) is a family-school partnership intervention with documented efficacy in producing immediate decreases in child problem behaviors and increases in child adaptive behaviors and social skills. The purpose of the present study was to determine whether the immediate effects of CBC maintain over a 1-year follow-up period. Participants at study enrollment were students (N = 267) and their parents, as well as both the students' original (N = 152) and subsequent (N = 135) teachers in 45 Midwest rural schools. At the time of initial study enrollment, students were assigned randomly to an active CBC intervention or "business as usual" control condition. Results demonstrated that immediate effects of parent-rated adaptive and social skills and teacher-rated school problems were maintained at the 1-year follow-up. Additionally, for parent-rated adaptive skills and teacher-rated school problems, improvements during the maintenance phase were statistically equivalent to gains in the control group. However, increases in parent-rated social skills for the control group during the follow-up phase significantly outpaced increases among the CBC group. Implications for use of CBC in rural communities, as well as future research directions, are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Guided by a process model of parenting and the integrative model, this study examined sources of emotional support (i.e., partner, maternal, paternal) as related to stress and satisfaction resulting from the parenting role in a sample of Mexican-origin young adult parents who participated in the National Longitudinal Study of Adolescent to Adult Health (Add Health) during Wave IV. Participants were male and female parents (26-35 years of age; 59% female; N = 737) who had children and a partner. Results from structural equation modeling revealed support from mothers as salient; high levels of maternal support were associated with high levels of parenting satisfaction. Tests of indirect effects suggested that parenting satisfaction played an intervening role in the link between maternal support and parenting stress. The pattern of results held across levels of linguistic acculturation but varied by gender. Understanding the mechanisms that predict parenting stress and satisfaction within the Mexican-origin population may help in the identification of culturally sensitive intervention strategies., (© 2018 Family Process Institute.)

Background: Substance use in multiracial adolescents exceeds rates identified in the general population. Despite this fact, there is limited research examining risk and protective factors for multiracial substance use. Objectives: The current study examined the moderating effect of social support on the relationship between ethnic identity and substance use in a sample of multiracial adolescent youth. Methods: Multiracial youth ( N  = 523) completed a survey that asked questions related to their ethnic identity, perceived social support, and substance use. A series of path analyses were conducted to test the hypothesized relationships between ethnic identity, social support, and substance use. Results: Analyses indicated that ethnic affirmation was negatively related to frequency of, but not quantity of substance use. Teacher support was negatively related to both frequency and quantity of substance use, while parent support was only related to frequency. Further, teacher and parent support emerged as moderators of ethnic affirmation and frequency and quantity of substance use respectively. Conclusions/Importance: Our findings add to the current understandings of the relationship between ethnic identity, social support, ethnic identity, and substance use among the understudied multiracial adolescent population.

Background: Open microsurgical clipping of unruptured intracranial aneurysms has long been the gold standard, yet advancements in endovascular coiling techniques have begun to challenge the status quo., Objective: To compare endovascular coiling with microsurgical clipping among adults with unruptured middle cerebral artery aneurysms (MCAA) by conducting a meta-analysis., Methods: A systematic search was conducted from January 2011 to October 2015 to update a previous meta-analysis. All studies that reported unruptured MCAA in adults treated by microsurgical clipping or endovascular coiling were included and cumulatively analyzed., Results: Thirty-seven studies including 3352 patients were included. Using the random-effects model, pooled analysis of 11 studies of microsurgical clipping (626 aneurysms) revealed complete aneurysmal obliteration in 94.2% of cases (95% confidence interval [CI] 87.6%-97.4%). The analysis of 18 studies of endovascular coiling (759 aneurysms) revealed complete obliteration in 53.2% of cases (95% CI: 45.0%-61.1%). Among clipping studies, 22 assessed neurological outcomes (2404 aneurysms), with favorable outcomes in 97.9% (95% CI: 96.8%-98.6%). Among coiling studies, 22 examined neurological outcomes (826 aneurysms), with favorable outcomes in 95.1% (95% CI: 93.1%-96.5%). Results using the fixed-effect models were not materially different., Conclusion: This updated meta-analysis demonstrates that surgical clipping for unruptured MCAA remains highly safe and efficacious. Endovascular treatment for unruptured MCAAs continues to improve in efficacy and safety; yet, it results in lower rates of occlusion.

Dyadic matched-pairs (each person paired with one other person) research designs that include parallel data from both members of a relationship dyad provide a rigorous method for examining questions of interdependence. These designs require the use of analytic methods that account for statistical dependencies due to dyad member characteristics and environments. Using structural equation modeling, we illustrate two alternative analytic approaches for distinguishable (nonexchangeable) two-wave dyadic data: (a) a hybrid of the two-intercept and actor-partner interdependence models and (b) a difference model. Few studies have used these rigorous analytic approaches to analyze dyadic data with Latinos, despite demographic shifts in the U.S. and the cultural relevance of family values and relationship interdependence for this population. As such, our illustrative data were drawn from a larger longitudinal study of Mexican-origin families, with husbands and wives both reporting on somatic symptoms and marital negativity ( N = 246 marital dyads). Results revealed that Mexican-origin spouses' somatic symptoms related to increases in partners' marital negativity five years later. Prior levels of wives' marital negatively linked to more discrepancies in marital negativity five years later, whereas husbands' marital negativity related to fewer discrepancies. We conclude by discussing the benefits of prospective dyadic data designs for researchers examining questions related to Latino populations.

Guided by ecological, work-family spillover and crossover frameworks, this study examined mechanisms linking parental work travel (i.e., nights per year) to youth adjustment (i.e., externalizing and internalizing behaviours) through youth's perceptions of parenting (i.e., knowledge, solicitation) with traveller and youth gender as moderators in a sample of 78 children in 44 two-parent families residing in the United States. The findings from multilevel analyses suggested that mothers' travel nights predicted lower levels of maternal knowledge, with variation by traveller and youth gender. Mothers' and fathers' work travel and perceived parenting were predictors of youth's externalizing behaviours, whereas only fathers' work travel and perceived parenting were predictors of youth's internalizing behaviours. Tests of indirect effects indicated that maternal work travel linked to youth's externalizing behaviours through youth's perceptions of maternal knowledge. These findings add to our limited understanding of work-family issues for parents who have the unique work demand of frequently travelling., Competing Interests: Disclosure Statement The authors report no conflict of interests, financial interest, or benefit in the direct applications of this research.

This study investigated youth's modeling of and de-identification from parents in romantic relationships, using two phases of data from adolescent siblings, mothers, and fathers in 246 Mexican-origin families. Each parent reported his/her marital satisfaction and conflict, and youth reported on parent-adolescent warmth and conflict at Time 1. Youth's reports of modeling of and de-identification from their mothers and fathers and three romantic relationship outcomes were assessed at Time 2. Findings revealed that higher parental marital satisfaction, lower marital conflict, and higher warmth and lower conflict in parent-adolescent relationships were associated with more modeling and less de-identification from parents. Moreover, higher de-identification was linked to a greater likelihood of youth being involved in a romantic relationship and cohabitation, whereas more modeling was linked to a lower likelihood of cohabitation and older age of first sex. Discussion underscores the importance of assessing parental modeling and de-identification and understanding correlates of these processes.

Objective: The current study sought to examine the prospective relationship between anxiety and depressive symptoms among Asian American (AA) early adolescents, a crucial period for the development of depression among youth. Further, as guided by cultural-ecological frameworks, a second aim of this study was to identify protective factors (i.e., parent support, peer support, teacher support, and school engagement) that might buffer the relationship between anxiety and depressive symptoms among this understudied population., Method: Participants included AA youth (N = 186; Mage = 12.50, SD = 1.16; 51.1% male) who completed questionnaires on 2 occasions with a 1-year interval., Results: Results from path analysis indicated that high anxiety symptoms were related to increased depressive symptoms over time. Further, teacher support was related to decreased depressive symptoms over time. Additionally, teacher and parent support moderated the association between adolescents' anxiety and depressive symptoms., Conclusions: Findings contribute to our understanding of the development of depression among early adolescent youth and have implications for the development of programming for Asian American youth with anxiety and depression. (PsycINFO Database Record, ((c) 2017 APA, all rights reserved).)