Greater Family Conflict Research Articles

Family conflict and less parental monitoring were associated with greater screen time in early adolescence.

The current study investigated the prospective relationships between parental monitoring, family conflict, and screen time across six screen time modalities in early adolescents in the USA. We utilised prospective cohort data of children (ages 10-14 years) from the Adolescent Brain Cognitive Development (ABCD) Study (years baseline to Year 2 of follow-up; 2016-2020; N = 10 757). Adjusted coefficients (B) and 95% confidence intervals (CIs) were estimated using mixed-effect models with robust standard errors. A higher parental monitoring score was associated with less total screen time (B = -0.37, 95% CI -0.58, -0.16), with the strongest associations being with video games and YouTube videos. Conversely, a higher family conflict score was associated with more total screen time (B = 0.08, 95% CI 0.03, 0.12), with the strongest associations being with YouTube videos, video games, and watching television shows/movies in Years 1 and 2. The current study found that greater parental monitoring was associated with less screen time, while greater family conflict was linked to more screen time. These results may inform strategies to reduce screen time in adolescence, such as improving communication between parents and their children to strengthen family relationships.

Examining the relationship between psychosocial adversity and inhibitory control: an fMRI study of children growing up in extreme poverty.

Exposure to psychosocial adversity (PA) is associated with poor behavioral, physical, and mental health outcomes in adulthood. As these outcomes are related to alterations in developmental processes, growing evidence suggests that deficits in executive functions-inhibitory control in particular-may, in part, explain this relationship. However, literature examining the development of inhibitory control has been based on children in higher resource environments, and little is known how low resource settings might exacerbate the link between inhibitory control and health outcomes. In this context, we collected fMRI data during a Go/No-Go inhibitory control task and PA variables for 68 children 5 to 7 years of age living in Dhaka, Bangladesh, an area with a high prevalence of PA. The children's mothers completed behavioral questionnaires to assess the child's PA and their own PA. Whole-brain activation underlying inhibitory control was examined using the No-Go versus Go contrast, and associations with PA variables were assessed using whole-brain regressions. Childhood neglect was associated with weaker activation in the right posterior cingulate, whereas greater family conflict, economic stress, and maternal PA factors were associated with greater activation in the left medial frontal gyrus, right superior and middle frontal gyri, and left cingulate gyrus. These data suggest that neural networks supporting inhibitory control processes may vary as a function of exposure to different types of PA, particularly between those related to threat and deprivation. Furthermore, increased activation in children with greater PA may serve as a compensatory mechanism, allowing them to maintain similar behavioral task performance.

UNTANGLING THE MODEL MINORITY STEREOTYPE: PROMOTING HEALTH EQUITY AMONG ASIAN AMERICAN OLDER ADULTS

Abstract The “model minority” stereotype portrays Asian Americans (AAs) as a monolithic group with common traits, e.g., high levels of education and income, and better health status. Five studies in this symposium used multiple data sources and provided rich information to untangling this stereotype. The first study highlighted racial/ethnic disparities in help-seeking behaviors among Americans with subjective cognitive decline, revealing that AAPIs exhibit the lowest likelihood of seeking help for cognitive problems. The second study examined the degree to which socioeconomic disparity contributes to functional impairment among older AAs relative to other racial/ethnic groups, revealing that AAs fare worst in the burden of functional impairment due to education disparity. The third paper explored the cultural adaptation of the NYUCI for Chinese and Korean dementia caregivers, showing that cultural beliefs have a profound effect on caregivers’ views of dementia and caregiving, their use of social and family support, and their understanding of self-care and counseling services. The fourth study assessed factors linked to depressive symptoms among older Southeast AAs, revealing that Vietnamese Americans have significantly more depressive symptoms than Indonesian and Filipino Americans. Resilience and age are negatively related to depressive symptoms, while greater family conflict and inability to speak English fluently are positively associated with depressive symptoms. The fifth study used a large longitudinal survey on older Chinese Americans and demonstrated that higher acculturation levels are associated with a more rapid decline in depression and a slower decline in activities of daily living but are not related to long-term cognitive changes.

Sexual Orientation Disparities in Early Adolescent Sleep: Findings from the Adolescent Brain Cognitive Development Study.

Purpose: The purpose of this study was to examine associations between sexual minority status (e.g., gay or bisexual) and sleep problems in a demographically diverse, national sample of U.S. early adolescents. Methods: We analyzed cross-sectional data from the Adolescent Brain Cognitive Development Study (Year 2, 2018-2020) to estimate associations between sexual orientation and sleep problems or disturbance, adjusting for confounders and testing potential mediators (depressive problems, stress problems, family conflict, and parental monitoring). Results: In a sample of 8563 adolescents 10- to 14-years-old, 4.4% identified as sexual minority individuals. Sexual minority status was associated with self-reported trouble falling or staying asleep (risk ratio [RR] = 2.24, 95% confidence interval [CI] = 1.88-2.68) and caregiver-reported sleep disturbance (RR = 1.50, 95% CI = 1.29-1.75). The association between sexual minority status and trouble falling or staying asleep was partially mediated by greater depressive problems, more family conflict, and less parental monitoring, whereas the association between sexual minority status and caregiver-reported sleep disturbance was partially mediated by greater depressive problems, higher stress, and greater family conflict. Conclusions: Our results indicate that sexual minority status may be linked to sleep disturbance in early adolescence. Depressive problems, stress, family conflict, and less parental monitoring partially mediate disparities in sleep health for sexual minority youth. Future research could test interventions to promote family and caregiver acceptance and mental health support for sexual minority youth to improve their sleep and other health outcomes.

283-OR: Neighborhood Disadvantage for Teens with Type 1 Diabetes (T1D) : Associations with Glycemic and Psychosocial Outcomes

Background: For teens with T1D, stress related to neighborhood disadvantage may exacerbate diabetes distress and contribute to disparities in care and outcomes. Objective: We explored associations among neighborhood disadvantage and clinical/psychosocial outcomes to identify patterns to inform future stress-resilience interventions. Methods: At baseline of a 2-site psychosocial intervention trial, 173 teens aged 13-18 years with T1D ≥1 year and elevated diabetes distress (57% Female, 2% American Indian/Alaska Native, 4% Asian, 15% Black, 11% Hispanic White, 6% Hispanic Non-White, 63% Non-Hispanic White, mean A1c= 8.7±2.1, 66% pump use) completed a demographics form and measures of resilience, diabetes distress, diabetes quality of life and family conflict.. We retrieved area deprivation index (ADI) scores for home addresses; this measure of neighborhood disadvantage considers factors related to income, education, employment, and housing quality at the census block group level and provides a state-relative decile score (higher scores indicate more disadvantage) . Fisher’s exact tests and regression analyses were used to examine associations of ADI with A1c and survey data. Results: Participant ADI spanned all deciles, M = 3.7± 2.4. Hispanic White/Non-White and Black teens and those not using pump had higher mean ADI. Higher ADI was associated with higher A1c (β=.18 [.06, 0.29], p=.003) and higher family conflict (β=.63 [.12, 1.1], p=.015) . ADI was not significantly related to resilience, diabetes distress, or quality of life. Conclusions: In a diverse sample of distressed teens with T1D, neighborhood disadvantage was associated with Hispanic ethnicity and Black race, lower pump use, poorer glycemic control and greater family conflict. Considering neighborhood disadvantage may help providers deliver personalized care to target systemic sources of stress, ultimately improving clinical and psychosocial outcomes. Disclosure M.B.O'donnell: None. M.E.Hilliard: None. J.Yi-frazier: None. B.Duran: None. C.Zhou: None. F.Malik: n/a. C.Pihoker: None. S.R.Scott: None. B.M.Ellisor: None. S.Garcia perez: None. D.Desalvo: Consultant; Dexcom, Inc., Insulet Corporation, Research Support; Insulet Corporation. Funding US National Institutes of Health R01DK121224

Multi-level predictors of depression symptoms in the Adolescent Brain Cognitive Development (ABCD) study.

While identifying risk factors for adolescent depression is critical for early prevention and intervention, most studies have sought to understand the role of isolated factors rather than across a broad set of factors. Here, we sought to examine multi-level factors that maximize the prediction of depression symptoms in US children participating in the Adolescent Brain and Cognitive Development (ABCD) study. A total of 7,995 participants from ABCD (version 3.0 release) provided complete data at baseline and 1-year follow-up data. Depression symptoms were measured with the Child Behavior Checklist. Predictive features included child demographic, environmental, and structural and resting-state fMRI variables, parental depression history and demographic characteristics. We used linear (elastic net regression, EN) and non-linear (gradient-boosted trees, GBT) predictive models to identify which set of features maximized prediction of depression symptoms at baseline and, separately, at 1-year follow-up. Both linear and non-linear models achieved comparable results for predicting baseline (EN: MAE = 3.757; R2 = 0.156; GBT: MAE = 3.761; R2 = 0.147) and 1-year follow-up (EN: MAE = 4.255; R2 = 0.103; GBT: MAE = 4.262; R2 = 0.089) depression. Parental history of depression, greater family conflict, and shorter child sleep duration were among the top predictors of concurrent and future child depression symptoms across both models. Although resting-state fMRI features were relatively weaker predictors, functional connectivity of the caudate was consistently the strongest neural feature associated with depression symptoms at both timepoints. Consistent with prior research, parental mental health, family environment, and child sleep quality are important risk factors for youth depression. Functional connectivity of the caudate is a relatively weaker predictor of depression symptoms but may represent a biomarker for depression risk.

227 Poor sleep as a predictor of COVID-19 related stress, fear and sadness in young adolescents: a longitudinal study

IntroductionAdolescence is a transitional life-stage accompanied by large biopsychosocial changes and greater psychophysiological vulnerability. Global events like the COVID-19 pandemic may increase vulnerability to depression and anxiety in this population. Poor sleep is often associated with depression, and both sleep and mood have been shown to be strongly impacted by the COVID-19 pandemic, with most studies focusing on adults. The current study investigates psychological distress in young adolescents during the pandemic, and specifically, whether poor sleep before the pandemic predicts psychological distress.MethodsSelf-report data were analyzed from 3099 adolescents (9-10 years at baseline) in the population-based, demographically diverse, Adolescent Brain Cognitive Development (ABCD) study across three pre-pandemic annual visits and 3 monthly time points during the COVID-19 pandemic (ages 11-13 years). At each assessment, children and their guardians completed questionnaires including those about sleep, environment, and psychological wellbeing. Gradient Boosted Tree machine learning algorithms were used to identify the strongest predictors of pandemic-related psychological distress in individuals. We trained models using pre-pandemic sleep measures along with demographics, economic, and social measures during the pandemic. We evaluated the performance of the models using area under curve (AUC) metrics and interpreted the models by using the recently proposed SHapley Additive exPlanations methodology.ResultsPandemic-related perceived stress, fear and sadness were accurately detected with our classifiers (AUC = 0.83 for perceived stress, AUC = 0.73 for fear, AUC = 0.79 for sadness). Across all models, shorter sleep duration, prolonged sleep onset latency, and longer time between waking and getting out of bed predicted greater distress. Moreover, female sex, and pandemic-related factors, including greater family conflict, fewer economic resources, and more screen time contributed to prediction performance in all three models.ConclusionFindings highlight the importance of addressing sleep problems and ensuring sufficient sleep duration in children to protect against the psychological impact of major life events, including the COVID-19 pandemic. Considering the long-lasting effects of sleep, it would be crucial to improve sleep health by targeted prevention, intervention and increased awareness among adolescents.Support (if any)NIH U01DA041022

Father–daughter relationship dynamics & daughters’ body image, eating patterns, and empowerment: An exploratory study

ABSTRACT Research indicates the role of parents in women’s body dissatisfaction and maladaptive eating patterns. Fathers, in particular, have unique roles in determining daughters’ protection against these health risks. Additionally, self-esteem, feminist values, and psychological empowerment are linked with body dissatisfaction and maladaptive eating patterns among women. This study examined the contributions of these psychological factors, family relational factors, and the role of fathers in empowering their daughters. Seventy-seven young adult women from intact families were recruited from Amazon Mechanical Turk and a university campus and completed self-report surveys. Participants were between the ages of 18 and 38 and primarily White. Results indicate that women with higher self-esteem and psychological empowerment endorsed greater body satisfaction. Women with higher self-esteem and endorsement of feminist values also reported significantly fewer maladaptive eating patterns. Greater family conflict was related to more maladaptive eating patterns. Analyses indicated increased body dissatisfaction and increased eating disorder risk decreased the odds of women reporting agency and fatherly supportive resources in their father–daughter communication narratives. Narrative data analysis revealed that fathers play a crucial role in promoting daughter’s empowerment, egalitarian gender-role socialization, and healthy psychological wellbeing. Implications for research and clinical community-based treatment and prevention strategies are discussed.

Prevalence and correlates of maladaptive guilt in middle childhood

BackgroundMaladaptive guilt can develop by age three and is associated with severe affective psychopathology in adolescents and adults. Yet, little is known about its prevalence prior to adolescence, or which children are at greatest risk of developing this symptom. This study examined the prevalence and correlates of maladaptive guilt in middle childhood. MethodsThis study examined a large community sample of 9-to 10-year-old children (N = 4485) from the Adolescent Brain and Cognitive Development (ABCD) study. Maladaptive guilt was assessed through the Kiddie Schedule for Affective Disorders and Schizophrenia for DSM-5. Parental rejection, family conflict, and parental depression were assessed via questionnaires. ResultsIn depressed children, a 1-month prevalence of maladaptive guilt of 18.4% and a lifetime prevalence of 30.8% was found. Lifetime rates ranged from 1.8 to 4.1% in children with other psychiatric disorders. Cross-sectionally, maladaptive guilt was associated with lower family income-to-needs, greater family conflict, a history of maternal depression, and greater parental rejection. These findings held when controlling for children's depressive severity, indicating that these associations are specific to maladaptive guilt. LimitationsMaladaptive guilt was assessed through one item, though many studies of maladaptive guilt measure the symptom in this manner. ConclusionsFindings suggest that it may be beneficial for clinicians to assess for maladaptive guilt beyond the context of assessment for depression, particularly with children of low socioeconomic status and children of depressed mothers, whom this study suggests are at higher risk. Negative family climates and parenting might also be important targets of preventative interventions.

Perceived family functioning among adolescents with and without loss of control eating

Youth with loss of control eating (LOC) have poorer social relationships than youth without LOC. However, perceived family functioning among youth reporting LOC is relatively unexplored. We examined perceived family functioning among 990 twins (age = 17.47 ± 0.71 years, 53% female) from the Colorado Center for Antisocial Drug Dependence with (n = 158) and without (n = 832) LOC. LOC was assessed with one binary item. Associations between family functioning and LOC were examined using general linear models that accounted for dependence in twin data. Girls with greater family conflict had higher odds of endorsing LOC (p = .02), but not after accounting for depressive symptoms (p = .26). Further analysis indicated that depressive symptoms mediated the association between LOC and family conflict (p = .04). This finding is consistent with an interpersonal model, which proposes that interpersonal difficulties lead to negative emotional states, which promotes LOC as a method of coping with negative affect. Family cohesion and expressiveness were not associated with LOC in girls, and none of the family functioning variables were associated with LOC in boys (ps > .05). Future studies are needed to clarify these relations and to determine any relevant treatment indications.

Comorbid disorders as moderators of response to family interventions among adolescents with bipolar disorder.

While family interventions have shown efficacy in improving mood symptoms and family functioning in pediatric bipolar disorder, few studies have examined the effects of comorbid psychiatric conditions on patients' symptomatic or functional responses to treatment. 145 adolescents with bipolar I or II disorder were randomly assigned to family-focused therapy (FFT-A) or a brief psychoeducational therapy (enhanced care; EC) and followed over 2 years. Participants received pharmacotherapy for the study's duration. We examined whether comorbid anxiety disorders, attention-deficit/hyperactivity disorder (ADHD), and disruptive behavior disorders (DBDs; i.e., oppositional defiant and conduct disorder) predicted the proportion of weeks that participants experienced mood symptoms during follow-up, and whether comorbid disorders moderated the effects of treatment assignment on mood symptoms and family conflict. Comorbid anxiety was associated with a greater proportion of weeks with depressive symptoms, more severe (hypo)manic symptoms during follow-up, and greater family conflict over the 2-year study. Comorbid ADHD was associated with a greater proportion of weeks with (hypo)manic symptoms, more severe (hypo)manic symptoms, and greater family conflict. Additionally, youth with comorbid ADHD who received FFT-A had more favorable trajectories of (hypo)manic symptoms and family functioning than youth with comorbid ADHD who received EC. Comorbid DBDs were consistently associated with more severe depressive symptoms and greater family conflict throughout the study. Randomization to treatments was not stratified on comorbid disorders. The longitudinal trajectories of anxiety, attentional, and disruptive behavior symptoms were not examined. The course of bipolar disorder in adolescents is strongly affected by comorbid disorders. Future research should examine whether adolescents with more complex presentations of bipolar disorder should be treated with different or more intensive psychosocial protocols than adolescents without these presentations.

Associations of Executive Function (EF) with Diabetes Management and Glycemic Control in Teens with Type 1 Diabetes (T1D)

Background: Management of T1D requires processes of EF such as planning, problem-solving, and task-completion. This study examined associations of EF with T1D management and outcomes in teens with T1D. Methods: Teens and their parents completed self-report and parent proxy-report versions, respectively, of the Behavior Rating Inventory of Executive Function (BRIEF). Scores ≥60, as total (Global Executive Composite [GEC]) score or on 2 indices (Behavioral Regulation [BRI] and Metacognition [MI]) indicate EF problems. Parents completed validated surveys assessing teen adherence, teen T1D self-efficacy, parent involvement in T1D care, and diabetes-specific family conflict. Results: The sample (N=169, 54% male) was 15.9±1.3 (M±SD) years old and had T1D for 8.4±3.7 years; 67% were pump treated, A1c was 8.5±1.2%. Parent reported vs. teen reported GEC scores uncovered 25% vs. 9% of teens with EF problems (p<.001). Teens with EF problems (GEC, BRI, MI) by parent proxy-report were less likely to use pump therapy and had higher A1c, poorer adherence, lower T1D self-efficacy, more parent involvement, and greater family conflict (Table). Conclusions: Parents appear to be more likely than teens to identify teen EF problems. Screening for executive dysfunction in teens with T1D should be considered in order to identify teens in need of family and healthcare team support. Disclosure M. Hansmann: None. Z. Guo: None. L. Volkening: None. L.M. Laffel: Consultant; Self; Eli Lilly and Company, Novo Nordisk Inc., Sanofi US, MannKind Corporation, Roche Diagnostics Corporation, Dexcom, Inc., Insulet Corporation, AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Johnson & Johnson Diabetes Institute, LLC..

Problems With Self-Regulation, Family Conflict, and Glycemic Control in Adolescents Experiencing Challenges With Managing Type 1 Diabetes

This study explored the associations between problems with self-regulation and glycemic control (HbA1c) in teens experiencing challenges with managing type 1 diabetes by examining greater diabetes-related family conflict and poorer adherence as serial mediators of the link between greater problems with self-regulation and higher HbA1c. Teens experiencing challenges with managing type 1 diabetes (n = 93, HbA1c ≥8%, 96% White, 57% male) completed an HbA1c test, and their parents completed assessments including measures of adherence and family conflict related to diabetes management during an intake for a larger Web-based intervention study or fMRI study. Teen problems with self-regulation were indexed the Child Behavior Checklist using the dysregulation profile. Bivariate correlations found significant associations between greater problems with self-regulation, greater family conflict about diabetes management, poorer adherence, and higher HbA1c. However, only greater family conflict, and not adherence, significantly explained the association between greater self-regulation problems and higher HbA1c. These findings suggest that among teens experiencing challenges with managing type 1 diabetes, interventions that decrease family conflict may be critical to promoting optimal glycemic control in those teens with greater problems with self-regulation.

Perceived Social Change, Parental Control, and Family Relations: A Comparison of Chinese Families in Hong Kong, Mainland China, and the United States.

This study examined the relationship between perceived social change, parental control and family relations in a sample of 419 4th and 5th grade children and their mothers who are of Chinese descent but reside in three different contexts: Los Angeles (LA), Hong Kong (HK), and Beijing (BJ). HK mothers endorsed the highest levels of psychological control and the lowest levels of autonomy support compared to BJ and LA mothers. Perceived social change as measured by mothers’ endorsement of new values and ideologies was associated with increased use of both autonomy support and psychological control. Results of the mediation analyses suggested that perceived social change explained differences between LA and HK mothers in autonomy support, but group differences in psychological control were magnified when perceived social change was accounted for. Finally, whereas autonomy support was associated with higher levels of child perceived acceptance in HK and LA, psychological control was associated with greater family conflict in BJ and LA. Findings suggested that as families undergo urbanization or social change, it may shift the implications of traditional strategies that are intended to socialize the child toward interpersonal attunement. Overall, the study highlights the importance of moving beyond ethnic-group or cross-national comparisons to investigate the role of changing social and economic contexts in understanding differences in the use of parental control and their associations with family relations.

Prevalence and predictors of conflict in the families of patients with advanced cancer: A nationwide survey of bereaved family members.

Family conflict has several adverse impacts on caregivers. Thus, there is significant value in determining the prevalence and predictors of family conflict, which can enable the health care provider to intervene if family conflict arises during end-of-life care. Accordingly, we aimed to explore the prevalence and predictors of conflict among the families of patients with advanced cancer who died in palliative care units. This study was a nationwide multicenter questionnaire survey of bereaved family members of cancer patients who died in Japanese palliative care units participating in evaluation of the quality of end-of-life care. We sent out 764 questionnaires, and 529 questionnaires (69.2%) were returned. As 70 family members refused to participate and we could not identify the answers in one questionnaire, we analyzed a total of 458 responses. The average Outcome-Family Conflict score was 13.5±4.9 (maximum score: 39.5), and 42.2% of family members reported at least one family conflict during end-of-life care. Greater family conflict was significantly associated with younger family age, with family members asserting control over decision making for patient care and with communication constraints among family members, although absent family members "coming out of the woodwork" reduced family conflict. Many families of patients with advanced cancer experienced conflict during end-of-life care. Family members asserting control over decision making and communication constraints among family members after diagnosis of cancer can predict the occurrence of family conflict. Absent family members "coming out of the woodwork" might reduce family conflict in particular cultures.

Associations of Parent-Adolescent Discrepancies in Family Cohesion and Conflict with Adolescent Impairment

Family cohesion and family conflict are important protective and risk factors respectively in the development of child psychopathology. Our study examines parent-adolescent discrepancy of the family environment constructs, family cohesion and family conflict, and their associations with adolescent impairment. The sample consists of 141 parent-adolescent dyads evaluated at an outpatient behavioral health clinic. The mean adolescent age is 14.8 (range 11–18) while the mean parent age is 48.9 (range 32–67). Findings show that adolescents report significantly less family cohesion but do not differ significantly in reports of family conflict. Greater family cohesion is associated with less adolescent impairment by multiple reporters. Nonetheless, greater family conflict is associated with more adolescent impairment by the same reporter. The results show that both adolescent and parent reports of family cohesion and conflict are important to consider when integrating information gathered in a clinical assessment.

The Impact of Perceived Need and Relational Factors on Mental Health Service Use Among Generations of Asian Americans.

The present study examined generational differences in the patterns and predictors of formal and informal mental health service utilization among a nationally representative sample of 1850 Asian Americans from the National Latino and Asian American Study. We focused on the effects of perceived need and relational factors on service utilization among 1st-, 1.5-, and 2nd-generation Asian Americans. Results of hierarchical logistic regression showed significant intergenerational differences. Specifically, 1.5-generation Asian Americans exhibited distinctive pattern of service use, with perceived need being associated with a higher likelihood of using formal mental health services, but only for those with high level of social support. First- and second-generation Asian Americans, on the other hand, perceived need was independently associated with formal service use, and a significant predictor of informal service use for first generation. Greater family conflict was also associated with greater use of formal and informal services for both first- and second generations. However, family cohesion was associated with only informal service use among first -generation Asian Americans. Implications for mental health service policy were discussed.

The effect of Teach One Reach One (TORO) on youth acceptance of couple violence.

This study evaluated the impact of the Teach One Reach One intervention, a community-based participatory research project designed to address the co-occurrence of adolescent risk behaviors on acceptance of teen dating violence. Data were derived from 331 rural African American youth between 10-14 years of age who participated in caregiver-youth dyads as either: 1) peer lay health advisor dyads, or Ambassadors, 2) caregiver-youth dyads recruited by Ambassadors, or Allies, or 3) comparison dyads. The following study focuses on participating youth only and our results indicated that: 1) Ambassadors and Allies reported less acceptance of couple violence than youth within the comparison group, and 2) less family cohesion, greater family conflict, and greater knowledge of healthy dating behaviors predicted greater acceptance of couple violence. Our findings highlight the efficaciousness of the TORO intervention, which directly engaged participants in prevention efforts through community-based participatory research methods and the use of lay heath advisors.

Behavioral adjustment in prenatally cocaine-exposed adolescents

Behavioral adjustment in prenatally cocaine-exposed adolescents

Active vaccination inhibits the acquisition of methamphetamine self-administration in rats

Active vaccination inhibits the acquisition of methamphetamine self-administration in rats