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This study examined the correlates of burden of caregivers providing care to people living with HIV/AIDS in rural northern Namibia and the consequences of caregivers' burden on their physical health and mental health. A purposive sampling method was used to recruit a total of 97 primary caregivers (N = 97) in rural Namibia. We found that hunger and HIV stigma were both positively associated with caregiver burden. Caregiver burden was positively related to depression and negatively related to quality of life. The findings underscore the complex relationships between food insecurity and HIV stigma on caregiver burden and the outcomes of burden on quality of life and depressive symptoms. Policy and practice implications are also discussed.

The original thinking behind permanency planning for foster children was to secure a caregiver's intention to provide a permanent home, not to guarantee it. Little is known, however, about how intentions change after permanence or what effect this change has on post-permanency continuity of care. This study examined the mediating effects of caregivers' thoughts about ending an adoption or guardianship, and how this mechanism may be contingent on primordial and bureaucratic factors that child welfare agencies rely on to ensure family continuity after legal permanence. In 2006, a sample of 346 Illinois caregivers who finalized an adoption or guardianship between 1998 and 2002 completed surveys about child behavior problems, the adequacy of financial assistance, and thoughts about maintaining the permanency relationship. Responses were linked to administrative data that tracked continuity of care through 2012. Simple mediation and moderated mediation hypotheses of the effects of caregiver thoughts on post-permanency continuity were tested. At last observation, 8% of caregivers were no longer living with the child or stopped receiving subsidies on the child's behalf. Thoughts expressed at survey time about ending the permanency relationship mediated the effect of child behavior problems on post-permanency discontinuity rates. This indirect effect was more pronounced among distantly related kin, lone caregivers, and caregivers who felt the subsidy was inadequate to cover their expenses. Our findings suggest that post-permanency services should target a narrow segment of caregivers who express weakened permanency commitments that arise from the challenges of parenting a child with multiple behavioral problems.

Objectives: The authors systematically reviewed the outcomes and methodological quality of 24 Internet addiction (IA) treatment outcome studies in China. Method: The authors used 15 attributes from the quality of evidence scores to evaluate 24 outcome studies. These studies came from both English and Chinese academic databases from 2000 to 2010. Results: Among the 15 attributes, only sequence generation and intention-to-treat were reported by more than 50% of the 24 studies. None of the studies contained treatment adherence ratings or collateral reports. Cognitive behavior therapy combined with family therapy or group therapy emerged as possibly efficacious treatments. Conclusions: More rigorously designed studies, accompanied by transparent reporting of methods and findings are needed to identify promising IA treatments.

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Depression has been increasing rapidly and is prevalent among youth. Inadequate mental health service utilization for youth and relevant racial/ethnic disparities are a growing concern. The current study used a nationally representative database to examine racial/ethnic disparities in youth depression prevalence, mental health services utilization, and psychotropic medication receipt. The sequential examination shows that depressed minority youth (22%-30%) were not only much less likely to use specialty mental health services than depressed Caucasian and multiracial youth (40%-43%, p < .001), they were also much less likely to receive psychotropic medications (22%-30%) than their Caucasian and multiracial counterparts (38%-44%, p = .048 to <.001) when using specialty mental health services. The findings reveal possibly two levels of racial/ethnic disparities at the decision points of accessing specialty mental health services and subsequent treatment methods choice. Implications for mental health policies and practices are also discussed.