Targeting the Proximal Mechanisms of Stress Adaptation in Early Adolescence to Prevent Mental Health Problems in Youth in Poverty

Abstract

ABSTRACT Objective This study used a randomized clinical trial design to evaluate the success with which The Building a Strong Identity and Coping Skills intervention (BaSICS) engaged the proximal mechanisms of poverty-related stress’s impact on the psychosocial functioning and mental health of young adolescents living in high poverty contexts. Method 129 youth from very low-income families were randomized to receive the 32-hour group-based intervention or no-treatment control – 16 of these families withdrew before the intervention groups began. The remaining 113 youth aged 11–12 (53% assigned to intervention; 54% female; 40% Hispanic, 63% Black, 20% White) participated in the study, which included four assessment waves: pretest, posttest, 6-month follow-up and 12-month follow-up assessments. Primary control, secondary control, and disengagement coping were assessed via a combination of parent and youth reports as well as via interviews and questionnaires. Hypothalamic-pituitary-adrenal axis (HPA) reactivity was assessed via salivary cortisol responses occurring during a lab-based stress induction (Trier Social Stress Test). Results Multilevel regression models with repeated measures nested within subjects revealed that in comparison to controls, intervention youth had sustained significant increases in their knowledge about primary control coping (e.g., problem solving, emotion modulation), knowledge and utilization of secondary control (e.g., cognitive restructuring) coping, as well as decreased reliance on disengagement coping. These were accompanied by decreased cortisol reactivity in intervention versus control youth. Conclusions These findings support that BaSICS engages several proximal mechanisms of poverty-related stress’ impact on early adolescent mental health – coping skills and HPA reactivity – during the neurodevelopmentally plastic pubertal period.