OBJECTIVE-To estimate how social support and social conflict relate to prenatal depressive symptoms and to generate a brief clinical tool to identify women at increased psychosocial risk.METHODS-This is a prospective study following 1,047 pregnant women receiving care at two university-affiliated clinics from early pregnancy through 1 year postpartum. Structured interviews were conducted in the second trimester of pregnancy. Hierarchical and logistic regressions were used to examine potential direct and interactive effects of social support and conflict on prenatal depressive symptoms measured by the Center for Epidemiologic Studies-Depression Scale.RESULTS-Thirty-three percent of the sample reported elevated levels of depressive symptoms predicted from sociodemographic factors, social support, and social conflict. Social support and conflict had independent effects on depressive symptoms although social conflict was a stronger predictor. There was a "dose-response," with each increase in interpersonal risk factor resulting in consequent risk for probable depression based on symptom reports (Center for Epidemiologic Studies-Scale greater than or equal to 16). A composite of one social support and three conflict items were identified to be used by clinicians to identify interpersonal risk factors for depression in pregnancy. Seventy-six percent of women with a composite score of three or more high-risk responses reported depressive symptoms.CONCLUSION-Increased assessment of social support and social conflict by clinicians during pregnancy can identify women who could benefit from group or individual interventions to enhance supportive and reduce negative social interactions.Pregnancy is a time of profound physical and emotional change that inherently affects interpersonal relationships. Social interactions and conflict and the individual's response to them can be crucial triggers for depression. 1,2 Social conflict can be defined as behaviors or interactions perceived as harmful, critical, and hostile and contribute to poor psychological outcome. 3-5 Interpersonal risk factors such as insufficient social support and aggravated social conflict may have profound effects on women's mental and physical health during pregnancy, 6-10 influencing pregnancy outcomes either directly or indirectly through unhealthy life style factors such as smoking or alcohol. 11-14 Among women who gave birth to low birth weight infants, women who experienced any interpersonal conflict gave birth to infants with a mean weight of 261 g lower than women without conflict. 15 There are also societal costs, including increased use of healthcare resources and lost productivity. 16 MATERIALS AND METHODSData for this study are from a larger study of young pregnant women (ages 14−25) enrolled in a randomized controlled trial aimed at promoting improved outcomes through group prenatal care. 26,27 This was a prospective study following participants from early pregnancy through 1 year postpartum. Participants were recruited from large unive...

The importance of supporting language development in preschool children from low-income families is discussed.

Empirical research and clinical resources focusing specifically on minority youth and families have increased tremendously in the last 2 decades. Despite this trend, certain groups continue to be relatively neglected. In particular, very few resources exist for understanding the unique challenges that often face biracial youth and their families. In this article, we use a nationally representative database to compare functioning in biracial youth to white adolescents and other minority adolescents. Results suggest that biracial/biethnic youth are a particularly vulnerable group in terms of self-reported delinquency, school problems, internalizing symptoms, and self-regard. As a group, they are also more likely to receive some form of psychological intervention. Given these findings and the shortcoming of clinical resources for work with this population, we provide an in-depth discussion of why biracial youth may be particularly vulnerable from a social-constructionist framework and offer several strategies based on narrative family therapy for working with biracial youngsters and their families.

Urban teens face many traumas, with implications for potential growth and distress. This study examined traumatic events, posttraumatic growth, and emotional distress over 18 months among urban adolescent girls (N = 328). Objectives were to (a) describe types of traumatic events, (b) determine how type and timing of events relate to profiles of posttraumatic growth, and (c) prospectively examine effects of event type and posttraumatic growth on short- and long-term emotional distress with controls for pre-event distress. Results indicate that type of event was related to profiles of posttraumatic growth, but not with subsequent emotional distress. When baseline emotional distress was controlled, posttraumatic growth was associated with subsequent reductions in short- and long-term emotional distress. Implications for future research and clinical practice with adolescents are addressed.