Psychology

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    The efficacy of a behavioral activation intervention among depressed US Latinos with limited English language proficiency: study protocol for a randomized controlled trial
    (Springer Nature, 2014-06-18) Collado, Anahi; Long, Katherine E; MacPherson, Laura; Lejuez, Carl W
    Major depressive disorder is highly prevalent among Latinos with limited English language proficiency in the United States. Although major depressive disorder is highly treatable, barriers to depression treatment have historically prevented Latinos with limited English language proficiency from accessing effective interventions. The project seeks to evaluate the efficacy of behavioral activation treatment for depression, an empirically supported treatment for depression, as an intervention that may address some of the disparities surrounding the receipt of efficacious mental health care for this population. Following a pilot study of behavioral activation treatment for depression with 10 participants which yielded very promising results, the current study is a randomized control trial testing behavioral activation treatment for depression versus a supportive counseling treatment for depression. We are in the process of recruiting 60 Latinos with limited English language proficiency meeting criteria for major depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders 4th and 5th Edition for participation in a single-center efficacy trial. Participants are randomized to receive 10 sessions of behavioral activation treatment for depression (n = 30) or 10 sessions of supportive counseling (n = 30). Assessments occur prior to each session and at 1 month after completing treatment. Intervention targets include depressive symptomatology and the proposed mechanisms of behavioral activation treatment for depression: activity level and environmental reward. We will also examine other factors related to treatment outcome such as treatment adherence, treatment satisfaction, and therapeutic alliance. This randomized controlled trial will allow us to determine the efficacy of behavioral activation treatment for depression in a fast-growing, yet highly underserved population in US mental health services. The study is also among the first to examine the effect of the proposed mechanisms of change of behavioral activation treatment for depression (that is, activity level and environmental reward) on depression over time. To our knowledge, this is the first randomized controlled trial to compare an empirical-supported treatment to a control supportive counseling condition in a sample of depressed, Spanish-speaking Latinos in the United States.
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    Understanding Secondary Educators’ Knowledge of Mental Health and Their Perceptions of Their Role in Addressing Student Mental Health
    (2019) Ross, Ana-Sophia; Wang, Cixin; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Adolescents have significant unmet mental health needs and schools represent the most common place for youth to receive mental health services. Teachers are primarily responsible for recognizing and working with students with mental health needs. Scholarship has investigated teachers’ knowledge pertaining to signs and symptoms for mental illness and found that teachers report little confidence in their knowledge, and have difficulty accurately identifying students struggling with mental illness. Research has provided some insight into how teachers can promote positive mental health amongst their students but little is known about classroom educators’ perceptions about how they can address student mental health concerns. Thus, this qualitative study utilized thematic analysis to investigate 27 teacher/classroom educators’ perceptions about how they can help students who struggle with mental health problems. Five main themes emerged from the analysis: 1) school collaboration, 2) student support, 3) family involvement/family-school partnership, 4) school reform/systematic change, and 5) teacher professional development training. Additionally, the study also investigated educator’s knowledge of signs and symptoms of depression, anxiety, and eating disorders. Eighty-five percent of teachers were able to correctly identify depression from a vignette while all participants were able to identify an eating disorder from a vignette. This study provides insights about how to improve school-based mental health efforts, with specific attention to classroom-based educators’ role in the provision of services.
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    MENTAL HEALTH AND EMOTION REGULATION AMONG REFUGEE STUDENTS IN MALAYSIA
    (2016) Gosnell, Nicole; O'Neal, Colleen R; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    The global refugee crisis has propelled over 65.3 million refugees into flight, including 33 million children (UNHCR, 2016). This study utilizes a mixed-methods design to examine mental health and emotion regulation among post-conflict Southeast Asian refugee children. To understand stressors that may cause mental health challenges, this study explores themes raised in qualitative interviews addressing oppression in Burma, flight to Malaysia, and life in Malaysia. Quantitative study participants included 90 refugee children in Malaysia aged 10-19 years (M = 14.22, 74.4% Burmese, 51.1% female). Measures included the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL) and the Emotions as a Child (EAC) Qualitative participants included four refugee boys who participated in a group interview about their individual experiences. This study examined: rates of PTSD and MDD among refugee students, the relation between emotion regulation and mental health, and the unique post-conflict stressors experienced by refugee children.
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    Childhood Attention Problems and the Development of Comorbid Symptoms at the Transition to High School: The Mediating Role of Parent and Peer Relationships
    (2015) LeMoine, Kaitlyn Ashley; Chronis-Tuscano, Andrea; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Children with Attention-Deficit/Hyperactivity Disorder (ADHD) are at increased risk for the development of depression and delinquent behavior. Children and adolescents with ADHD also experience difficulty creating/maintaining high quality friendships and parent-child relationships, and these difficulties may contribute to the development of co-morbid internalizing and externalizing symptoms in adolescence. However, there is limited research examining whether high quality friendships and parent-child relationships mediate the relation between ADHD and the emergence of these co-morbid symptoms at the transition to high school. This study examines the mediating role of relationship quality in the association between ADHD and depressive symptoms/delinquent behaviors at this developmentally significant transition point. Results revealed significant indirect effects of grade 6 attention problems on grade 9 depressive symptoms through friendship quality and quality of the mother-child relationship in grade 8. Interventions targeting parent and peer relationships may be valuable for youth with ADHD to promote successful transitions to high school.
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    Evaluating the Efficacy of Behavioral Activation Among Spanish-Speaking Latinos
    (2014) Collado, Anahi; Lejuez, Carl W; MacPherson, Laura; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Major depressive disorder (MDD) is highly prevalent among U.S. Spanish-speaking Latinos. Although MDD is very treatable, the lack of empirically-supported treatments precludes this population's access to quality mental health care. Following the promising results of a small open-label pilot study in which we tested the efficacy of Behavioral Activation Treatment for Depression (BATD) in a sample Latinos with Spanish-speaking preference, we conducted a randomized control trial (RCT; N = 46) that compared BATD (N = 23) to supportive counseling (N = 23) across various domains, including depression, BATD proposed mechanisms (activity level and environmental reward), and non-specific psychotherapy factors. Results indicated that relative to SC, BATD led to greater decreases in depressive symptoms over time (p = 0.04) and greater MDD remission at the end of treatment and at the one-month follow-up (p = 0.01). Activity level (p = 0.01) and environmental reward (p = 0.05) showed greater increases over time among participants who received BATD compared to SC. Further, proposed BATD mechanisms of change did not correspond over time with depressive symptomatology. Treatment adherence, therapeutic alliance, and treatment satisfaction did not differ between the groups (ps > 0.17). The one-month follow-up suggested sustained clinical gains across therapies. The current study adds to a limited treatment research literature and suggests that BATD, a time-limited and straightforward intervention, is efficacious in reducing depression and increasing activity level and environmental reward in this important, yet underserved population of the U.S. The current study sets the stage for a larger RCT to examine BATD against an empirically-supported treatment, with additional moderators of treatment and mechanisms of change.
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    Parental Depression, Parenting, and Cortisol Reactivity in Preschoolers
    (2011) Tolep, Marissa; Dougherty, Lea R; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    This study systematically examined individual differences in stress sensitivity as a vulnerability marker for depression in young children. We collected five salivary cortisol samples from 142 preschool-age children who were exposed to a laboratory stressor paradigm. Parents (N = 88 with family history of depression) completed clinical interviews and an observational parent-child interaction task. We found that hostile parenting behavior moderated the relation between maternal depression and offspring cortisol. Specifically, the offspring of mothers who had a history of depression during the child's life and whose mothers exhibited hostility evidenced increasing cortisol levels in response to the stressor paradigm. Conversely, the offspring of mothers who had no history of depression and whose mothers exhibited hostility evidenced decreasing cortisol levels in response to the stressor. The data highlight the critical role of the early caregiving environment on offspring's developing stress system and add to our understanding of transmission of depression risk.
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    An Examination of the Pathways of Depressive Symptoms and Heavy Drinking from Adolescence to Adulthood
    (2011) Gustafson, Emily Anne; Stein, William; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    This study examined the dynamic interaction of heavy alcohol use and depressive symptoms at three points over a time period of 11 years from adolescence to adulthood using a subset of data from the nationally representative, multi-year, longitudinal data source, the National Longitudinal Study of Adolescent Health (Add Health). Results revealed that, in general, those that drink heavily with greater frequency are more likely to have a greater number of depressive symptoms. Conversely, those with more early depressive symptoms are more likely to be early heavy drinkers, but less likely to be heavy drinkers six years down the road. Additionally, early depressive symptoms affect later trajectories in binge drinking. Gender, racial/ethnic group, and college attendance all affected the relationship over time for heavy drinking and were generally related to the average but not the change over time of depressive symptoms. Results are discussed in the context of Elder's life course theory that views developmental trajectories in relation to social pathways.
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    Toward a Better Understanding of the Relationship Between Gender and Crack/Cocaine Use and Dependence
    (2008-08-27) Reynolds, Elizabeth Keats; Lejuez, Carl W.; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Building on previous research, this cross-sectional, exploratory study of 142 crack/cocaine users, currently enrolled in residential substnace abuse treatment, aimed to replicate previous findings indicating that females evidence greater use (past year and heaviest use) and dependence (current and lifetime) of crack/cocaine compared to males. In addition, this study sought to examine potential risk factors in the relationship between gender and crack/cocaine drug use. Results indicated that females used crack/cocaine significantly more frequently in the past year. Males and females did not differ on dependence or lifetime heaviest use. Frequency of use by romantic partner and lifetime major depressive disorder diagnosis were significantly related to both gender and past year crack/cocaine use frequency, and met criteria as risk factors in this relationship. This study adds to previous reports of greater crack/cocaine use among inner-city females and identified potential factors underlying this greater frequency of use by women.