No abstract

Previous findings suggest that experiences with systems of oppression that disproportionately affect individuals based on race and neighborhood residency (e.g., systemic racism, neighborhood income disadvantage [NID]) can be associated with higher odds of developing psychological problems following traumatic events. Although race/ethnicity and NID residency are often associated, they are separate concepts that play unique roles in mental health outcomes among youth. Residents of Black, Latinx, and income‐disadvantaged communities also have an increased risk of exposure to polyvictimization and the loss of multiple loved ones. Studies have not carefully delineated the potential relations between race/ethnicity and NID residency, polyvictimization, accumulated losses, and trauma and grief outcomes in youth. We examined mediation models to investigate whether polyvictimization, the loss of multiple loved ones, and exposure to violent death were potential mechanisms through which race/ethnicity and NID would predict trauma and grief outcomes in youth. Participants (N = 429) included Black (19.9%), Latinx (36.0%), and White (27.3%) children and adolescents who were assessed through a routine baseline assessment at a trauma and grief outpatient clinic. Black youth reported significantly elevated posttraumatic stress and maladaptive grief symptoms through higher polyvictimization and violent death exposure relative to White youth, βs = .06–.12, ps <.001. Latinx identity and NID were positively and directly associated with specific domains of maladaptive grief reactions, βs = .10–.17, ps < .001. If replicated longitudinally, these findings suggest that polyvictimization and violent death exposure may be mechanisms through which Black youth develop more severe traumatic stress and grief reactions.

Objectives This study describes a pilot open trial of Multidimensional Grief Therapy, an assessment-driven, phasic individual therapy for bereaved youth. This study provides a preliminary outcome evaluation with respect to maladaptive grief reactions, post-traumatic stress symptoms, and depressive symptoms in bereaved youth. Methods The sample consisted of 65 bereaved youth (ages 6-17 years, M = 11.62, SD = 2.76; 53% female; 33.3% Hispanic, 31.8% African American/Black, 27.3% Caucasian, 6.1% mixed/biracial, 1.5% Native American). The study utilized a single-group open trial design. Youth referred to the study due to the death of a loved one completed measures of grief reactions, posttraumatic stress symptoms, and depressive symptoms. Measures were also completed following Phases I and II of the treatment. Results Youth who completed Phase I (n = 42) reported significant reductions from baseline, with large to very large effect sizes (Cohen's D range = 0.77−1.35) for all three domains of maladaptive grief, post-traumatic stress symptoms, and depressive symptoms. Youth who completed Phase II (n = 22) exhibited significant reductions from the end of Phase I, with medium to large effect sizes (range = 0.57-0.90) for two domains of maladaptive grief as well as for posttraumatic stress symptoms and depressive symptoms. Conclusions Although further evaluations using a wider array of outcomes are needed to evaluate MGT and the maintenance of treatment gains over time, the present study provides preliminary evidence supporting MGT as an individual treatment for bereaved youth experiencing maladaptive grief reactions, post-traumatic stress, and depressive symptoms.

The Active Inhibition Scale (AIS; Ayers, Sandler, & Twohey, 1998) is an 11-item, self-report measure of emotional suppression among children and adolescents. Previous research with the AIS has linked emotional suppression to several clinically significant outcomes, such as posttraumatic stress symptoms (PTSS) and suicide, among trauma-exposed and bereaved youth; however, there are no published evaluations of its psychometric properties. We examined the factor structure and criterion validity of the AIS in two samples. Sample 1 included youth (M = 12.22 years, SD = 2.96, range: 6-18 years; 55.4% female) referred to an outpatient psychology clinic specializing in childhood trauma and grief. Sample 2 included youth (M = 13.18 years, SD = 2.58, range: 8-18 years; 61.8% female) referred to a community grief counseling center. Confirmatory factor analytic results supported a one-factor solution, Cronbach's α = .94. Additionally, AIS scores correlated positively with PTSS, depression, and maladaptive grief, rs = .43-.64. Evidence of factorial invariance was found across gender, race/ethnicity, and age group. Emotional suppression scores were higher among girls compared to boys, Black and Hispanic youth compared to White youth, and older compared to younger age groups. The magnitude of correlations between AIS and symptom measure scores was comparable across groups. These results support the reliability and criterion validity of the AIS with diverse youth populations and underscore the role that emotional suppression may play in explaining group differences in mental health symptoms. Although experiencing serious adverse events may increase young people's risk for developing negative psychosocial outcomes, such as posttraumatic stress disorder (PTSD; Edwards,