Family Adversity Research Articles

Impact of Poverty and Family Adversity on Adolescent Health: A Multi-Trajectory Analysis Using the UK Millennium Cohort Study

Background: Children exposed to poverty and family adversities including domestic violence, parental mental ill health and parental alcohol misuse may experience poor outcomes across the life course. However, the complex interrelationships between these exposures in childhood are unclear. We therefore assessed the clustering of trajectories of household poverty and family adversities and their impacts on adolescent health outcomes. Methods: We used longitudinal data from the UK Millennium Cohort study on 11564 children followed to age 14 years. Family adversities included parent reported domestic violence and abuse, mental ill health and frequent alcohol use. We used a group-based multi-trajectory cluster model to identify trajectories of poverty and family adversity for children. We assessed associations of these trajectories with child physical, mental and behavioural outcomes at age 14 years using multivariable logistic regression, adjusting for confounders. Findings: Six trajectories were identified: low poverty and family adversity (43·2%), persistent parental alcohol use (7·7%), persistent domestic violence and abuse (3·4%), persistent parental mental ill health (11·9%), persistent poverty (22·6%) and persistent poverty and parental mental ill health (11·1%). Compared with children exposed to low poverty and adversity, children in the persistent adversity trajectory groups experienced worse outcomes; those exposed to persistent parental mental ill health and poverty were particularly at increased risk of socioemotional behavioural problems (adjusted odds ratio 6·4; 95% CI 5·0 – 8·3), cognitive disability (aOR 2·1; CI 1·5 – 2·8), drug experimentation (aOR 2·8; CI 1·8 – 4·2) and obesity (aOR 1·8; CI 1·3 – 2·5). Interpretation: In a contemporary UK cohort, persistent poverty and/or persistent parental mental ill health affects over four in ten children. The combination of both affects one in ten children and is strongly associated with adverse child outcomes, particularly poor child mental health. Funding Information: This work was funded by the National Institute for Health Research (NIHR) Policy Research Programme (ORACLE: OveRcoming Adverse ChiLdhood Experiences, Grant reference number NIHR200717); and the National Institute for Health Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London) at King’s College Hospital NHS Foundation Trust. DTR is supported by the NIHR School for Public Health Research, the NIHR Public Health Policy Research and by the Medical Research Council (MRC) on a Clinician Scientist Fellowship (MR/P008577/1). VSS is supported by the Swedish Research Council for Health, Working Life and Welfare (FORTE) [2016-07148; 2020-00274]. Professors Kaner and Howard are supported by NIHR Senior Investigator awards and Prof Kaner is Director of the NIHR Applied Research Collaboration for the North East and North Cumbria. The views expressed in this publication are those of the authors and not necessarily those of the NIHR, MRC or FORTE. Declaration of Interests: All authors declare no competing interests. Ethics Approval Statement: Ethical approval for each wave of the MCS was granted by NHS Multicenter Research Ethics Committees. No further ethical approval was required for this secondary analysis of MCS data.

Self-harm among in-school and street-connected adolescents in Ghana: a cross-sectional survey in the Greater Accra region

ObjectivesTo identify the prevalence, methods, associations and reported reasons for self-harm among in-school and street-connected adolescents in Ghana.DesignA cross-sectional survey. We applied multi-level regression models and model-based cluster analysis to...

Anxiety Disorders Across Childhood and Adolescence in a U.K Population-Based Cohort

Background: Patterns of development and underlying factors explaining anxiety disorders in children and adolescents have been an under-researched area, despite their high prevalence, impact on social and educational functioning and associations with other mental disorders. We aimed to characterize the development of anxiety disorders, to understand the underlying trajectories of each of the anxiety disorders, and to examine the possible socio-demographic and health-related predictors of persistent anxiety disorders, across childhood and adolescence using data from a large birth cohort. Methods: This cohort study assessed 13988 participants in the ALSPAC birth cohort. The Development and Wellbeing Assessment (DAWBA) questionnaire was administered to parents to capture child and adolescent anxiety total scores and anxiety diagnoses. The following anxiety disorders at 8, 10 and 13 years were selected: separation anxiety, specific phobia, social anxiety, acute stress reaction, and generalized anxiety. Further, we included the following socio-demographic and health-related factors: sex, birth weight, sleep difficulties at 3.5 years, ethnicity, family adversity, maternal age at birth, maternal postnatal anxiety, maternal postnatal depression, maternal bonding, maternal socio-economic status and maternal education. Descriptive analyses for anxiety diagnoses and symptomatology, group trajectories of each of the anxiety disorders using latent class growth analysis, and associations with socio-demographic and health-related factors were quantified. Outcomes: Different anxiety disorders presented different prevalence and patterns of development over time. Further, latent class growth analyses yielded a trajectory characterized by individuals with persistent high levels of anxiety across childhood and adolescence, for specific phobia, social anxiety, acute stress reaction and generalized anxiety. Finally, different risk factors were specifically and significantly associated with each of the persistent high levels of anxiety disorders, with child sleeping difficulties and postnatal maternal depression and anxiety being the most important. Interpretation: Ours findings show that despite trends of general improvement in most individuals with anxiety disorders, a small group of children and adolescents continue to suffer from frequent and severe anxiety. Further, when considering treatment strategies for anxiety disorders in children and adolescents, children’s sleep difficulties and postnatal maternal depression and anxiety need to be assessed as these may predict a more prolonged and severe course of illness. Funding: This study was supported by the UK Medical Research Council and Wellcome Trust. Declaration of Interest: We declare no competing interests. Ethical Approval: Ethical approval was obtained from the ALSPAC Law and Ethics Committee and local research ethics committees. Informed consent was obtained from participants following the recommendations of the ALSPAC Ethics and Law Committee at the time.

Family Hardiness and Parent and Family Functioning in Households with Children Experiencing Adverse Life Conditions: a Meta-Analysis.

.Objective: The purposes of the meta-analysis were to evaluate the relationship between family hardiness and different dimensions of parent and family functioning in households experiencing adverse child or family life events and circumstances and determine if family hardiness had either or both stress-buffering and healthenhancing effects on parent and family functioning. Method: Studies were included if the correlations between family hardiness and different dimensions of parental or family functioning were reported. The synthesis included 53 studies (N = 4418 participants) conducted in nine countries between 1992 and 2017. Results: showed that family hardiness was related to less parental stress, anxiety/depression, and parenting burden/demands and positively related to parental global health, well-being, and parenting practices. Results also showed that family hardiness was negatively related to family stress and positively related to family life satisfaction, adaptation, and cohesion. The effects sizes between family hardiness and positive parent and family functioning indicators were larger than those for stress-buffering indicators. Child and family life events and child age moderated the relationship between family hardiness and family but not parental functioning. Conclusion: The results are consistent with the hypothesis that family hardiness is an internal resource that simultaneously has stress-buffering and health-enhancing effects on parent and family functioning.

Depression and behavior problems among children residing at welfare hostels and orphanages

Context: Childhood-onset of depression is often associated with childhood family adversity, parental neglect, and problematic peer relationships. Emotional and behavioral problems and high rates of depression were more common in orphans when compared to nonorphan. Aim: The aim was to study and compare the depression and behavioral problems among children residing at welfare hostels and orphanages. Materials and Methods: This study is a cross-sectional and descriptive study. Three welfare hostels and four orphanages run by nongovernment organizations were approached, and children between the ages of six and fourteen were recruited. Children residing at home were taken as controls. Children's Depression Rating Scale and Rutter's Behavior Scale for Children were applied to assess depression and behavioral problems, respectively. Statistical Analysis Used: Statistical analysis was done using Epi Info software. Results: Depression is found to a greater extent among children in the orphanages' group than in the welfare group. Rutter's score ≥9 was observed in 15%, 8.3%, and 5% of children in the welfare hostels' group, orphanages' group, and controls' group, respectively. Conclusions: The prevalence of depression is found to be more among orphanage children, followed by children residing at welfare hostels compared to the control group. Behavior problems are more among children residing at welfare hostels than children residing at orphanages.

Adverse Childhood Experiences (ACEs) in English Electronic Health Records of Linked Mothers and Children: Validation Study Using a Multistage Risk-Prediction Model

Background: Electronic health records (EHRs) are readily available and increasingly used for identifying adverse childhood experience (ACEs), yet well-developed indicators for ACEs remain limited. We aimed to develop clinically relevant indicators of ACEs for routine EHRs of mothers and children using multi-stage risk prediction models of child maltreatment (CM) and maternal intimate partner violence (mIPV). Methods: We developed a representative population-based birth cohort of 211 ·393 linked mother-child pairs (422·786 total patients) followed from 2-years pre-birth up to 5-years post-birth (2002-2018) across the Clinical Practice Research Datalink (primary care), Hospital Episode Statistics (secondary care), and the Office for National Statistics mortality register. We randomly assigned the cohort into a derivation cohort (2/3 of sample) and a validation cohort by GP practice. The primary outcome (reference standard) was any CM or mIPV in the mother's or child's record from 2-years pre-birth (mIPV only) up to 5-years post-birth. We used 8 prediction models combined with expert ratings to systematically developed indicators. We validated the final indicators by integrating results from machine learning models, survival analyses and clustering analyses in the validation cohort. Findings: We included 63 indicators in six ACE domains: maternal mental health problems (mMHPs), maternal substance misuse (MSM), adverse family environments (AFE), CM, mIPV, and high-risk presentations for CM (HRP-CM) . Excluding the 7 indicators in the reference standard, 56 indicators showed high discriminative validity for family violence (validation cohort, area under the receiver operating characteristic curve: 0·85, 95% CI: 0·84-0·86). The prevalence over the 2-year period before and after birth were 39·1% for any of the 63 ACE indicators, 22·2% for mMHPs, 15·7% for AFE, 8·1% for HRP-CM, 6·9% for MSM, and 3·0% for any CM (2·4%) and mIPV (1·0%). 74·1% of ACEs were recorded only in primary care. Interpretation: We developed and quantified clinically relevant indicators for identifying ACEs using EHRs of mothers and children presenting to health care during pregnancy and early childhood. Details of all ACEs and indicators are publicly available for further evaluation (https:/ACEsinEHRs.com). Funding: None to declare. Declaration of Interest: None to declare. Ethical Approval: The study was approved by the MHRA (UK) Independent Scientific Advisory Committee

The mediating effect of job-seeking stress in the relationship between family adversity and suicidal ideation of college students: The mediated moderation effect of resilience

The mediating effect of job-seeking stress in the relationship between family adversity and suicidal ideation of college students: The mediated moderation effect of resilience

Presenting problem profiles for adolescents with ADHD: differences by sex, age, race, and family adversity.

Adolescents with attention-deficit/hyperactivity disorder (ADHD) experience developmentally distinct challenges from children and adults with ADHD. Yet no work in this age group identifies treatment-related phenotypes that can inform treatment matching, development of tailored treatments, and screening efforts. This study uses Latent Profile Analysis to detect unique presenting problem profiles among adolescents with ADHD and to test whether these profiles differ by key individual characteristics (age, sex, race, family adversity level). Participants were 854 ethnically diverse adolescents (ages 10-17) from the ADHD Teen Integrative Data Analysis Longitudinal (TIDAL) dataset who were assessed at clinical referral. Parent, adolescent, and teacher ratings, educational testing, and school records measured eight key presenting problems at intake. A three-profile solution emerged. ADHD simplex (63.7%) was characterized by a mix of the ADHD-Inattentive and ADHD-Combined subtypes, moderate impairment levels, and infrequent comorbidities. ADHD+internalizing (11.4%) was characterized by higher likelihood of comorbid anxiety and/or depression. The disruptive/disorganized ADHD (24.9%) profile was characterized by severe organization, time management, and planning (OTP) problems, the ADHD-Combined subtype, and frequent disruptive behavior at school. Age did not vary across these phenotypes. More females were present in the ADHD+internalizing phenotype; males were more likely to be found in the disruptive/disorganized ADHD phenotype. Higher family adversity and African American race were associated with the disruptive/disorganized ADHD phenotype. Adolescents with ADHD demonstrate varying presenting problem phenotypes that vary by sex, family adversity, and race/ethnicity. Consideration of these phenotypes may inform treatment matching and efforts to improve screening among under-diagnosed groups.

The Online Adaptation and Outcomes of a Family-Based Intervention Addressing Substance Use Disorders

Purpose: This article compares outcomes of a family-based prevention program from its original in-person mode to an online mode in response to the COVID-19 pandemic. Celebrating Families!™ is designed to improve parenting skills, family functioning, and family relationships to break the cycle of substance use problems. Method: This mixed-methods, quasi-experimental study compared outcomes of in-person and online treatment conditions and content analysis of open-ended responses to a satisfaction survey. Results: Both groups showed improvement in outcomes, with moderate effect sizes and high satisfaction. Average scores of the online groups were generally lower than the in-person scores. Qualitative data yielded participants’ accounts of improvements in parenting behaviors, family relationships, coping skills, and knowledge insights. Conclusions: Despite the contexts of COVID-19, findings provided evidence that such relational group interventions can be feasibly administered online and can effect changes required to break the cycle of substance use problems and adverse family experiences.

Factors Associated with Self-regulation in a Nationally Representative Sample of Children Ages 3-5 Years: United States, 2016.

The aim of the present study was to describe self-regulation (the ability to influence or control one's thoughts or behavior in response to situational demands and social norms) in children ages 3-5years using a nationally representative sample and examine risk and protective factors to identify opportunities to support children and families. Using a cross-sectional design, we examined data from a parent-reported pilot measure of self-regulation from the 2016 National Survey of Children's Health (NSCH). We compared U.S. children aged 3-5years who were described by parents as "on track" with self-regulation development with children who were not. In addition, we described how health care and developmental services, community, family, and child health and development factors are associated with children's self-regulation. The majority of children (4 of 5) were described by their parents to be developmentally on track with self-regulation. Compared to children described as not on track, children described as on track more often lived in financially and socially advantaged environments and less often experienced family adversity. They also had other positive health and development indicators, whether or not they were receiving developmental services. However, only half of children not on track received developmental surveillance, and only 1 in 4 children described as not on track received educational, mental health, or developmental services. The findings are a step towards using self-regulation as an indicator of healthy child development and as a potential strategy to identify groups of children who may need additional support.

Factors affecting resilience among early adolescents living in homes for children: A model testing

Abstract Living in the foster care system because of adverse family conditions can affect the resilience of early adolescents. This study aimed to test a causal model of factors affecting resilience among adolescents aged 10–14 years living in homes for children in the Bangkok metropolitan region of Thailand. Data were collected by using self-report questionnaires. The final modified model was a fit with the empirical data. Problem-focused coping, self-concept, and school engagement had positive direct effects on resilience while social connectedness had indirect effects. The model accounted for 40% of the overall variance in the prediction of resilience. Promoting interventions that focus on these factors would be beneficial in strengthening resilience among early adolescents living in homes for children.

Adolescent Problem Gambling in Rural Ghana: Prevalence and Gender Differentiation

Problem gambling among young people is now a public health challenge in sub-Saharan Africa. However, the behaviour remains understudied, particularly, among rural-dwelling young people in countries within the subregion. We aimed to estimate the 12 months prevalence of problem gambling and to describe the overall and gender differences and commonalities in personal factors and social adversities associated with problem gambling among adolescents in rural Ghana. We conducted a cross-sectional survey involving a random sample of 1101 in-school adolescents aged 10–19 years in a rural district in Eastern Ghana; we used the DSM-IV-Multiple Response-Juvenile (DSM-IV-MR-J) questionnaire to assess problem gambling during the previous 12 months. Personal lifestyle and psychosocial variables were assessed using adopted items from the 2012 WHO–Global School-based Student Health Survey. Overall, three in 10 adolescents (3 in 10 females; 4 in 10 males) in rural Ghana reported problem gambling in the previous 12 months. Female adolescents who experienced problem gambling were more likely to report family-related social adversities, while adolescent male problem gambling was associated with school-related factors and interpersonal factors outside the family context. Regardless of gender, sexual abuse victimisation was associated with three times increase in the odds of experiencing problem gambling. Relative to the prevalence of gambling among adolescents in urban contexts in other countries within sub-Saharan Africa, the estimates of problem gambling among in-school rural adolescents in Ghana are higher. Although further studies are needed to understand the nuances of the behaviour, the evidence of this study underscores the need for general and targeted health promotion, intervention and prevention efforts to mitigate the family, school, and interpersonal social adversities associated with adolescent problem gambling in rural Ghana.

Relative Incidence of Office Visits and Cumulative Rates of Billed Diagnoses Along the Axis of Vaccination.

We performed a retrospective analysis spanning ten years of pediatric practice focused on patients with variable vaccination born into a practice, presenting a unique opportunity to study the effects of variable vaccination on outcomes. The average total incidence of billed office visits per outcome related to the outcomes were compared across groups (Relative Incidence of Office Visit (RIOV)). RIOV is shown to be more powerful than odds ratio of diagnoses. Full cohort, cumulative incidence analyses, matched for days of care, and matched for family history analyses were conducted across quantiles of vaccine uptake. Increased office visits related to many diagnoses were robust to days-of-care-matched analyses, family history, gender block, age block, and false discovery risk. Many outcomes had high RIOV odds ratios after matching for days-of-care (e.g., anemia (6.334), asthma (3.496), allergic rhinitis (6.479), and sinusitis (3.529), all significant under the Z-test). Developmental disorders were determined to be difficult to study due to extremely low prevalence in the practice, potentially attributable to high rates of vaccine cessation upon adverse events and family history of autoimmunity. Remarkably, zero of the 561 unvaccinated patients in the study had attention deficit hyperactivity disorder (ADHD) compared to 0.063% of the (partially and fully) vaccinated. The implications of these results for the net public health effects of whole-population vaccination and with respect for informed consent on human health are compelling. Our results give agency to calls for research conducted by individuals who are independent of any funding sources related to the vaccine industry. While the low rates of developmental disorders prevented sufficiently powered hypothesis testing, it is notable that the overall rate of autism spectrum disorder (0.84%) in the cohort is half that of the US national rate (1.69%). The practice-wide rate of ADHD was roughly half of the national rate. The data indicate that unvaccinated children in the practice are not unhealthier than the vaccinated and indeed the overall results may indicate that the unvaccinated pediatric patients in this practice are healthier overall than the vaccinated.

Neighborhood disadvantage, childhood adversity, bullying victimization, and adolescent depression: A multiple mediational analysis

Each of the home, school, and neighborhood environmental factors for adolescent depression has received substantial attention in the literature; however, there remains a paucity of research which systematically examines the mechanisms whereby neighborhood structural and social characteristics in early childhood affects later depressive symptoms in adolescence as transmitted through family and school adversities. The present study used nationally representative sampled data from the Fragile Families and Child Wellbeing Study, a longitudinal survey following a cohort of 4,898 children along with their parents and teachers at the child's birth and at 1, 3, 5, 9, and 15 years of age. Public and restricted-use data were used to merge individual surveys and neighborhood profiles. Our findings suggest that both neighborhood structural disadvantage and collective efficacy have direct impacts on adverse childhood experiences, bullying victimization, and social emotional development as well as indirect impacts on adolescents' depressive symptoms. Neighborhood collective efficacy, but not structural disadvantage, was found to directly contribute to later depressive symptoms of adolescents. Resilience factors such as familial support and stable relationships were not considered in the current study. Due to the unavailability of data, potential reciprocal relationships among peer bullying, social emotional problems, and depressive symptoms were not examined. Our finding that neighborhood characteristics contribute to the development of adolescents' depression emphasizes the importance of a healthy neighborhood environment, which also provides implications for multi-faceted interventions to promote neighborhood resources and support systems, as well as community-wide bullying prevention programs and childhood adversity screenings.

Development of a Family-Based Mental Health Program for Runaway Adolescents Using an Intervention Mapping Protocol.

The mental health and related quality of life of runaway adolescents are global public health issues. As few intervention studies have considered the family contexts of runaway adolescents, we aimed to develop an intervention tailored specifically to the needs of this population using an Intervention Mapping protocol. First, a literature review and interviews with runaway adolescents and youth shelter workers were conducted to create a logic model of the problem. Second, the behavioral and environmental outcomes were set to adapt to stressful situations and enable families to become more resourceful in dealing with family adversity, based on the results of needs assessment. Performance objectives and changeable determinants were also created by reviewing the pertinent theories and studies. Third, theory- and evidence-based methods to influence changes in the determinants were identified. Fourth, we designed an eight-session family-based mental health program incorporating individual and family approaches for runaway adolescents. Fifth, we determined that mental health nurses at community mental health centers linked to youth shelters would serve as the program implementers. Finally, we planned a randomized controlled trial to evaluate the effects of our program on improving runaway adolescents’ mental health status and perceived family functioning.

Long-Term Effects of Home-Based Family Therapy for Non-responding Adolescents With Psychiatric Disorders. A 3-Year Follow-Up.

ObjectiveHome-based treatment of families with low socio-economic status and multiple psychosocial problems (multi-problem families, MPFs) is gaining importance in clinical social epidemiology and health services research. The sustainability of the treatment is of special importance in order to breach transgenerational effects.MethodsWe examined outcome, effect size, and clinical significance of home-based treatment for 84 multi-problem families in a naturalistic setting. 48 of the families were available for a follow-up after 3 years. The baseline characteristics of these family systems included low collaboration, an increased family adversity index, minors with high rates of child psychiatric disorders, a high prevalence of comorbidity, low relational family functioning, and adolescents who refused any form of treatment or had unilaterally terminated different forms of treatment before. The home-based family therapy consisted of one or two face-to-face counseling sessions per week over an average of 28.8 months (SD = 19.2). The symptoms and competence of the adolescents, the caregivers, and the family structure were assessed with 13 variables.ResultsAll variables showed significant improvement rates (pre- vs. post- treatment) with medium to high effect sizes (mean of Cohen’s d = 1.04, range = 0.34 – 2.18). All variables showed a sustained or even further improvement at follow-up.ConclusionThis study provides evidence of statistically (p), practically (d), and clinically (RCI) significant changes in symptom and competence-related variables among adolescents and caregivers in MPFs with sustainable long-term effects in the 3-year follow-up period.

Intraindividual reaction time variability as an index of attentional control acts as a moderator of the longitudinal relationships between marital quality and children’s externalizing problems

The current study investigated whether trial-to-trial intraindividual reaction time variability (IIRTV), which serves as an index of attentional control fluctuations, moderates the effect of marital quality at 7 years of age on the development of children’s externalizing problems from 7 to 9 years of age (N = 197). At the first assessment (T1), a flanker task was administered to children for assessing their IIRTV. The Chinese version of a marital quality questionnaire (Evaluating and Nurturing Relationship Issues, Communication, and Happiness [ENRICH]) and the Chinese version of the Child Behavior Checklist (CBCL) were completed by children’s mothers to assess marital quality and children’s externalizing problems. At the second and third assessments (T2 and T3), children’s externalizing problems were reassessed by their mothers. Growth curve analyses showed that boys’ externalizing problems were relatively high and significantly decreased over time, whereas girls’ externalizing problems were relatively low and stable. Importantly, the results indicated that boys’ IIRTV (but not girls’ IIRTV) and parental marital quality interactively predict the concurrent and developmental trajectories of externalizing problems. Specifically, boys with greater IIRTV were found to exhibit a relatively persistent high level of externalizing problems in the context of poor parental marital quality, whereas boys with lower IIRTV were found to exhibit a relatively low level of externalizing problems over time regardless of their parental marital quality. The findings suggest that poorer attentional control indexed by greater IIRTV is a robust predictor of boys’ externalizing problems and that better attentional control indexed by lower IIRTV may buffer the negative impact of adverse family environment on the development of boys’ externalizing problems.

Unintended and teen pregnancy experiences of trans masculine people living in the United States

Background Trans masculine people are more likely than cisgender peers to have a teen or unintended pregnancy, though little is known about the origins of these disparities. Aims This study aimed to describe teen and unintended pregnancy experiences among trans masculine people in order to elucidate risk factors and pregnancy-related needs. Methods As a part of the United States-based SexuaL Orientation, Gender Identity, and Pregnancy Experiences (SLOPE) study, in-depth, semi-structured interviews were conducted between March 2017 and August 2018 with 10 trans masculine people, ages 20–59 years, who experienced a teen or unintended pregnancy. Audio-recorded interviews were professionally transcribed, then analyzed using immersion/crystallization and thematic analysis approaches. The themes were contextualized using sociodemographic survey data. Results The four themes that were developed from participants’ narratives highlighted: 1) how trans masculine people navigated having a pregnant body (e.g., heightened gender dysphoria due to being pregnant); 2) the importance of the cultural environment in shaping experiences as a trans masculine pregnant person (e.g., pregnancy and gender-related job discrimination); 3) the development of the pregnancy over time (e.g., decision-making processes); and 4) how pregnancy (and gender identity) affected relationships with other people (e.g., adverse family of origin experiences). Discussion This study identified a number of risk factors for teen and unintended pregnancies among trans masculine people including physical and sexual abuse as well as ineffective use of contraception. This research also identifies unique needs of this population, including: relieving gender dysphoria, combating discrimination, and ensuring people feel visible and welcome, particularly in reproductive healthcare spaces. Public health practitioners, healthcare providers, and support networks (e.g., chosen family) can be key sources of support. Attention to risk factors, unique needs, and sources of support will improve reproductive healthcare and pregnancy experiences for trans masculine people.

Improving emotion recognition is associated with subsequent mental health and well-being in children with severe behavioural problems

Impaired emotion recognition is a transdiagnostic risk factor for a range of psychiatric disorders. It has been argued that improving emotion recognition may lead to improvements in behaviour and mental health, but supportive evidence is limited. We assessed emotion recognition and mental health following a brief and targeted computerised emotion recognition training in children referred into an intervention program because of severe family adversity and behavioural problems (n = 62; aged 7–10). While all children continued to receive their usual interventions, only children impaired in emotion recognition (n = 40) received the emotion training. Teachers blind to whether or not children had received the training rated children’s mental health problems before and 6 months after the training. Participants who received the emotion training significantly improved their recognition of negative and neutral facial expressions. Although both groups showed improved behaviour at follow-up, the reduction in behavioural problems was only significant in children who received the emotion training. Post-training emotion recognition scores predicted mental health problems 6 months later independently of initial emotion recognition ability and severity of behavioural problems. The results are consistent with the view that targeting emotion recognition can improve longer term functioning in individuals with disruptive behaviour, although further research using fully randomised designs is needed before causal conclusions can be drawn with confidence.

Adult Family Adversities and Bullying among Urban African American Adolescents

ABSTRACT The current study examined how adverse family events (i.e., adult family incarceration, adult family substance use, and adult family mental illness) were associated with adolescent bullying perpetration. More specifically, this study examined whether levels of future orientation mediated the link between adult family incarceration, substance use, and mental illness and bullying perpetration. A sample of 637 African American adolescents from the Southside of Chicago was used for this study. Adult family incarceration, substance use, and mental illness were all found to be positively associated with bullying perpetration. Also, adult family substance use and mental illness were positively associated with low levels of future orientation, which was significantly related to bullying perpetration. These findings demonstrate the importance of understanding how adverse family events are related to adolescent bullying. Implications for future research are discussed.