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The effect of the "Adapted-Coping with Stress" (A-CWS) intervention on social support coping was examined, using a randomized controlled trial design. The participants were 410 ninth-grade students (ages 14 to 16 years and mostly African American) living in low-resourced neighborhoods. Participants were randomly assigned 1:1 to either the A-CWS intervention or a standard care control condition. All participants were assessed at their schools before implementation of the intervention, at intervention completion, and again at 6- and 12-month post-intervention. Engagement in social support coping was examined in both intention-to-treat and treatment-as-received samples (i.e., intervention participants who attended at least 12 A-CWS treatment sessions and participants in the standard care control condition), using latent growth models. In intention-to-treat analyses, no significant treatment effects were identified. In treatment-as-received analyses, results revealed a significant association between social support coping and treatment condition; levels of social support coping decreased over time in the control condition, but they remained relatively stable in the treatment condition. The results indicate adequate intervention adherence and efficacy of the A-CWS to sustain social support coping within a sample of youth at high risk for stress exposure and associated disorders.

Objective: Suicide rates among African American adolescents have increased exponentially in recent years. The socioecological stressors that can increase suicide risk for African American adolescents, in conjunction with unique suicide risk manifestations within this group, require culturally sensitive preventive interventions. This study examines the efficacy of the Adapted-Coping With Stress course (A-CWS), a culturally tailored preventive intervention, to reduce suicidal ideation in African American adolescents, utilizing a randomized controlled design. Method: Participants included 410 ninth-grade students in a large Midwestern city; most students identified as Black/African American. Participants were randomly assigned to either the A-CWS intervention or standard care control condition. All participants were assessed at baseline, immediately postintervention, and 6 and 12 months postintervention. Results: Treatment effects were examined using latent growth models comparing suicidal ideation trajectories in control and intervention conditions. Analyses were conducted using both intention-to-treat and treatment-as-received samples (i.e., intervention condition participants who attended at least 80% of sessions). In both intention-to-treat and treatment-as-received analyses, there was a significant treatment effect: Individuals in the A-CWS intervention condition with higher baseline ideation evidenced a superior reduction in suicidal ideation over the course of the study, relative to their counterparts in the standard care control condition. Conclusion: Findings indicate that the A-CWS preventive intervention is efficacious in reducing suicidal ideation among African American adolescents with higher levels of baseline suicidal ideation and that effects sustain over time, with the strongest effect evidenced 12 months postintervention. What is the public health significance of this article?: This study indicates that the Adapted-Coping With Stress course, a culturally tailored suicide prevention program for African American adolescents, is associated with reductions in suicidal ideation among African American adolescents with higher levels of pretreatment ideation. Effects were most pronounced 12 months after participating in the intervention. [ABSTRACT FROM AUTHOR]

We examined the role of family stress as a mediator of the relationship between poverty and depressed mood among 1,704 low-income, inner-city African-American adolescents. Nearly half of participants (47%) reported clinically significant levels of depressive symptoms. Being female, reporting higher levels of family stress, and scoring higher on a poverty index were significantly associated with increased reports of depressed mood. Family stress significantly mediated the relationship between poverty and adolescent depressed mood, explaining 50% of the total effect. Sex-specific analyses revealed that this relationship only held for females, and there was no direct relationship between poverty and depressed mood for males. Results lend further support to family stress theory, although they suggest that the model may be more relevant for females than males. Implications for community-based preventive intervention and social policy are discussed.

This study examined exposure to community violence and depressive and post-traumatic stress disorder (PTSD) symptoms within a non-random sample of low-income, African-American male adolescents. The moderating effect of social support on these relationships was also examined. Seventy-seven African-American adolescent males were recruited from an inner-city, Midwestern high school and surveyed on exposure to violence, depression, post-traumatic stress, and social support. Regression analyses revealed that exposure to violence was significantly associated with both depressive and PTSD symptoms. However, social support was not found to moderate the relationship between exposure to community violence and psychological distress. Implications for intervention are discussed.

The purpose of this project was to qualitatively explore how identity formation may be affected by the presence of HIV disease. Eight HIV-infected adolescents (three males, five females), aged 17-21, participated in a semi-structured interview that combined measures of identity development with open-ended, qualitative questions aimed at eliciting the adolescents' personal stories and experiences of living with HIV. All participants fell into either Diffusion or Achievement identity statuses, which in turn impacted their response to having HIV. The impact that HIV had on the participants' values and future goals varied across the sample. Findings are discussed in terms of clinical intervention implications, contextual variables, and the need for larger, more comprehensive research efforts.

Examined the influence of gang membership on rates of participation in sexual activity, substance use, and violence among African American adolescent girls. Found that gang members had higher participation rates in all three risk behaviors. (JPB)

Presents first phase of Project REACH (Risk Behavior Is Adolescence: Prediction and Prevention), school-based project aimed at identifying factors associated with risk and resiliency in urban African American youth, and evaluating role of school-based adolescent health centers for this population. Identifies methodological challenges and discusses strategies for resolution. (Author/NB)

Community violence is a complex phenomenon, and many theories have been put forth to explain the causes of community violence and disparities in community violence across neighborhoods. One notable theory, collective efficacy theory (CET), posits that collective efficacy (i.e., a neighborhood's social cohesion and informal social control) mediates the association between concentrated disadvantage and community violence. As CET theorizes an inverse feedback loop between collective efficacy and community violence, collective efficacy could mitigate the link between neighborhood disadvantage and community violence. The current study examines the reciprocal association between collective efficacy and community violence exposure using data from 604 low-resourced, urban African American ninth-grade students from a large Midwestern city. Data were collected at 6-month intervals over 2 years. Significant cross-sectional associations were found between each of the collective efficacy constructs (social cohesion and informal social control) and community violence exposure, although no significant longitudinal cross-lagged associations were found. There were positive cross-sectional associations between (a) collective efficacy and community violence exposure and (b) informal social control and community violence exposure; however, the association between social cohesion and community violence exposure was negative. Associations between overall collective efficacy, as well as its subscales, and community violence exposure were consistent with hypothesized directions for social cohesion, but not for collective efficacy or informal social control. Findings support the use of collective efficacy as two constructs, rather than a single construct as proposed by Sampson et al. Implications for expanding original assumptions of CET are discussed. [ABSTRACT FROM AUTHOR]

The purpose of this project was to qualitatively explore how identity formation may be affected by the presence of HIV disease. Eight HIV-infected adolescents (three males, five females), aged 17–21, participated in a semi-structured interview that combined measures of identity development with open-ended, qualitative questions aimed at eliciting the adolescents'' personal stories and experiences of living with HIV. All participants fell into either Diffusion or Achievement identity statuses, which in turn impacted their response to having HIV. The impact that HIV had on the participants'' values and future goals varied across the sample. Findings are discussed in terms of clinical intervention implications, contextual variables, and the need for larger, more comprehensive research efforts. Copyright 2002 The Association for Professionals in Services for Adolescents. Published by Elsevier Science Ltd. All rights reserved. [Copyright &y& Elsevier]

Results from a survey of the attitudes of African-American Baptist ministers (N = 92) toward acquired immune deficiency syndrome (AIDS) revealed that most of the clergy did not perceive human immunodeficiency virus (HIV) as being a significant risk to their communities. Ministers who had previous HIV prevention/education training felt more comfortable counseling a person with AIDS and were more likely to sponsor workshops and training sessions for their members than were ministers who had not had previous HIV training. Ministers who held professional or college degrees were more likely to not believe that AIDS was a punishment by God and that people with AIDS deserved their illness than were their counterparts with less formal education. Older ministers tended to hold more pejorative attitudes toward homosexuals, HIV, and individuals infected with the virus than did their younger peers. [ABSTRACT FROM AUTHOR]

Comments on the article 'Unequal Access to Mental Health Services: The Challenge to Professional Integrity' by Kenneth S. Pope and William Winslade published in the spring/summer 1987 issue of the 'Business and Professional Ethics Journal' on the issue of equal access to mental health services. Deliberate continuation of discriminatory practices within mental health profession.

It may be that mental health professionals never examined true alternatives to mental health delivery beyond those prescribed by their mentors. I applaud the candor, courage, and professional integrity shown by Pope and Winslade (1985) by openly challenging a popular and seemingly entrenched modus operandi within the mental health profession. W. LaVome Robinson Kenneth Pope and William Winslade (1985) have very pointeo •. unclothed those mental health professionals guilty of perpetuating inade- quate, unequal, and unresponsive services to those in our society falling short of what Schofield (1964) labels the YAVIS standard (i.e., Youthful, Attractive, Verbal, Intelligent, and Successful) among mental healtll profes- Sionals. [Extracted from the article]

Overall rates of African American adolescent suicide have been increasing for the past 50 years; however, the research literature examining factors related to suicide for these vulnerable youth is sparse. The shortage of research literature on suicidality protective factors is particularly significant. Little is known about the impact of protective factors on African American youth, especially within subgroups (e.g., gender and socioeconomic status). Approximately 40% of African American youth live in poverty, exposing them to contextual stressors that place them at increased risk for suicidality. Females are significantly more likely to have suicidal ideation and make attempts, whereas males surpass females in their rates of completions. To better understand suicidality protective factors, we conducted a systematic review of the research literature on protective factors for African American adolescents, with a focus on gender differences and urban, low-income youth. This review yielded 26 articles that met inclusion criteria and identified protective factors in the following categories: familial, religiosity-based, relational/social, personal, and socioecological. Gender differences and protective factors for urban, low-income youth are discussed, regarding their role in the prevention of suicidality. This review highlights a need for further research to identify and clarify suicidality protective factors for African American adolescents.

This paper explores the impact of school-based heath centers (SBHCs) on the substance use behaviors of low-income, inner-city African American adolescents. Researchers surveyed 2,114 9th- and 11th-grade students from seven inner-city public high schools (three with SBHCs and four without SBHCs). Of the initial 2,114 students, 598 SBHC students and 598 non-SBHC students were successfully matched using ethnicity, grade, gender, and propensity scores. The results of separate grade × gender × SBHC ANOVAs indicated significant grade × SBHC interactions (i.e., such that substance use decreased in SBHC schools while increasing in non-SBHC schools) for cigarettes (p = .05) and marijuana (p< .001), but not for alcohol. These findings show that the SBHC intervention model is promising toward the prevention and reduction of substance use among high-risk African American adolescents and highlight the importance of accessible, holistic, and culturally appropriate health care.