Alcohol disorders and posttraumatic stress disorder were more common in these American Indian populations than in other populations using comparable methods. Substantial comorbidity between depressive and/or anxiety and substance disorders suggests the need for greater coordination of treatment for comorbid disorders.
The results suggest that these American Indian populations had comparable, and in some cases greater, mental health service needs, compared with the general population of the United States.
This study examined the effects of the normative school transition (n= 580) during early adolescence on the self‐system and perceived school and peer social contexts of poor, black (n= 161), white (n= 146), and Latino (n= 273) youth in the public school systems of 3 eastern urban cities. The results revealed negative effects of the school transition on the affective and behavioral domains of the self‐system. These declines in self‐esteem, class preparation, and grade‐point average (GPA) were common across race/ethnicity and gender. Concurrently, the school transition was perceived to be associated with changes in the school and peer contexts. Daily hassles with the school increased, while social support and extracurricular involvement decreased over the transition. Daily hassles with peers decreased, and peer values were perceived as more antisocial. These changes in the school and peer microsystems were also common across race/ethnicity and gender. In addition, transition‐associated school and peer changes and, in particular, changes in daily hassles with the school were associated with changes in the academic dimensions of the self‐system, that is, academic efficacy expectations, class preparation, and GPA. The results are discussed within a developmental mismatch framework.
This study examined the effects of the normative school transition (n = 580) during early adolescence on the self-system and perceived school and peer social contexts of poor, black (n = 161), white (n = 146), and Latino (n = 273) youth in the public school systems of 3 eastern urban cities. The results revealed negative effects of the school transition on the affective and behavioral domains of the self-system. These declines in self-esteem, class preparation, and grade-point average (GPA) were common across race/ethnicity and gender. Concurrently, the school transition was perceived to be associated with changes in the school and peer contexts. Daily hassles with the school increased, while social support and extracurricular involvement decreased over the transition. Daily hassles with peers decreased, and peer values were perceived as more antisocial. These changes in the school and peer microsystems were also common across race/ethnicity and gender. In addition, transition-associated school and peer changes and, in particular, changes in daily hassles with the school were associated with changes in the academic dimensions of the self-system, that is, academic efficacy expectations, class preparation, and GPA. The results are discussed within a developmental mismatch framework.
Increasingly, the mental health needs of populations are measured using large-sample surveys with standardized measures and methods. Such efforts, however, rarely include sufficient number of smaller, culturally defined populations to draw defensible conclusions about their needs. Furthermore, without some adaptation, the standardized methods and measures may yield invalid results in such populations. Using a recently completed psychiatric epidemiology and services study with American Indian populations as a case example, this paper outlines issues facing epidemiologists working in such culturally diverse contexts. The issues discussed include the following: (1) persuading the scientific community and potential sponsors that work with distinct or culturally defined populations is important; (2) framing research questions and activities to meet the needs of communities; (3) defining a population of inference; (4) balancing the needs for comparability and cultural specificity; (5) maximizing scientific validity in light of the challenges in sample acquisition; and (6) developing and implementing data collection methods that uphold scientific standards but are also realistic given the context. The authors draw on their experiences--most recently in the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project (AI-SUPERPFP)--to illustrate these issues and suggest ways to address each. A goal of this paper is to challenge those invested in conducting culturally valid epidemiologic work in such populations to better articulate the nature of these efforts.
Background The epidemiology and etiology of substance use and disorder in American Indian and Alaska Native (AI/AN) communities have received increasing attention over the past 25 years and accumulating evidence provides important insights into substance use patterns in these populations. Objectives and methods We provide a descriptive sketch of the AI/AN population in the United States today, present a brief review of the literature on the epidemiology and etiology of substance use within these populations, and discuss key implications of this literature for prevention efforts. Conclusions and Scientific Significance Patterns of alcohol use and abuse in AI/AN populations are complex and vary across cultural groups, but alcohol clearly impacts both physical health and mental health within these communities. Tobacco use – and associated health consequences – is typically higher in these populations than among other US groups, although significant variation across Native communities is apparent here as with alcohol. Evidence regarding drug use and disorder is less extensive and thus less conclusive, but evidence demonstrates higher rates of use as well. Etiological explanations for substance use and disorder cut across individual characteristics (e.g., genetics) or experiences (e.g., exposure to trauma), to social contexts (e.g., family disruption), and to cultural factors (e.g., historical trauma). Protective factors likely cut across these multiple levels as well and deserve more focused attention for informing prevention efforts. The development of effective prevention strategies, built through collaboration between researchers and Native communities, drawing from the wisdom of both, is a high priority.
Developed and validated instruments for urban and culturally diverse adolescents to assess their self-reported transactions with family, peer, school, and neighborhood microsystems for the constructs of social support, daily hassles, and involvement. The sample of 998 youth were from schools in three Eastern cities with high percentages of economically disadvantaged youth. Data were collected before and after the transition to junior high school or to senior high school. Blacks constituted 26%, whites 26%, and Latinos 37% of the sample. Factor analyses confirmed and enhanced the hypothesized four-factor microsystem factor structure for support, hassles, and involvement; internal consistency and stability coefficients were consistent with these structures. In general, the microsystem factors were common across gender, ethnicity, and age. However, when group differences did occur on these demographic variables, they tended to validate the salience of microsystem specificity. In contrast to the total scores, the microsystem-specific factors yielded more meaningful and differential information with regard to demographic differences and the mediating processes across a school transition.
Substance use often begins earlier among American Indians compared to the rest of the United States, a troubling reality that puts Native youth at risk for escalating and problematic use. We need to understand more fully patterns of emergent substance use among young American Indian adolescents, risk factors associated with escalating use trajectories, and protective factors that can be parlayed into robust prevention strategies. We used growth mixture modeling with longitudinal data from middle-school students on a Northern Plains reservation (Wave 1 N=381, M age at baseline = 12.77, 45.6% female) to identify subgroups exhibiting different trajectories of cigarette, alcohol, and marijuana use. We explored how both risk (e.g., exposure to stressful events, deviant peers) and protective (e.g., positive parent-child relationships, cultural identity) factors were related to these trajectories. For all substances, most youth showed trajectories characterized by low rates of substance use (nonuser classes), but many also showed patterns characterized by high and/or escalating use. Across substances, exposure to stress, early puberty, and deviant peer relationships were associated with the more problematic patterns, while strong relationships with parents and prosocial peers were associated with nonuser classes. Our measures of emergent cultural identity were generally unrelated to substance use trajectory classes among these young adolescents. The findings point to the importance of early substance use prevention programs for American Indian youth that attenuate the impact of exposure to stressful events, redirect peer relationships, and foster positive parent influences. They also point to the need to explore more fully how cultural influences can be captured.
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