Sociodemographic and substance use characteristics associated with typologies and composition of social support networks among youth experiencing homelessness in Los Angeles, USA
Youth experiencing homelessness are a vulnerable population with increased behavioural health risks. Social networks are a consistent correlate of youths’ substance use behaviours. However, less is known about the reciprocal relationships among these constructs. This study classified youth experiencing homelessness according to their social support network type (e.g. instrumental, emotional, service) and composition (e.g. family, peers, service staff) and linked their membership in these social network classes to sociodemographic and substance use characteristics. Four waves of cross‐sectional data were collected between October 2011 and June 2013 from youth experiencing homelessness, ages 14–29, at three drop‐in centres in Los Angeles, CA (N = 1,046). This study employed latent class analysis to identify subgroups of youth experiencing homelessness according to the type and composition of their social support networks. Multinomial logistic regression analyses were then conducted to identify the sociodemographic and substance use characteristics associated with social support network class membership. Five latent classes of youths’ social support networks were identified: (a) high staff emotional and service support; (b) high home‐based peer and family emotional, service and instrumental support; (c) moderate street‐ and home‐based peer emotional support; (d) low or no support and (e) high home‐based peer and family emotional and instrumental support. Multinomial logistic regression models indicated that race/ethnicity, gender, sexual orientation, literal homelessness, former foster care experience, depression, heroin and marijuana use were significant correlates of social support network class membership. Results indicate distinct classes of social support networks among youth experiencing homelessness, with certain sociodemographic and substance use characteristics implicated in youths’ social networks.
Characteristics and Factors Associated With Intimate Partner Violence–Related Homicide Post-Release From Jail or Prison
Intimate partner violence (IPV) victimization and perpetration are common experiences among incarcerated people. Despite knowledge regarding the challenges of re-integrating post-release from jail or prison, including an increased risk of homicide victimization, there is a dearth of research focused on IPV-related homicides post-release from a correctional facility. To address this gap, the current study used 2003-2015 data from the National Violent Death Reporting System from 27 states to examine the characteristics and circumstances surrounding IPV-related homicides soon after the homicide victim was released from jail or prison. Of the 126 post-release homicides, 13.5% were related to IPV. Post-release homicides involving either a female victim or perpetrator were more likely to be IPV-related. In the case of many of the IPV-related homicides, there was evidence of prior IPV as well as potential bystanders (including formal and informal supports) who were aware of the risk for IPV escalation and possible lethality. Compared with non-IPV post-release homicides, those related to IPV were more likely to occur in the victim’s home, have been immediately preceded by a physical fight, and have occurred by means other than firearm. These findings highlight the importance of enhancing the capacity of correctional facilities and community-based services to assess for and respond to risk of IPV and IPV-related lethality for individuals leaving correctional institutions.
Asset-building and social inclusion: A qualitative analysis of families’ perspectives
Social inclusion has historically been one of the key goals of the welfare state. Over the past two decades, an increasing number of policies have aimed to promote inclusion by connecting low-income families to mainstream financial services and enabling them to save and acquire assets. Building on the concept of the “paradox of inclusion,” this article examines whether and how policies that aim to include low-income families in asset accumulation do so in ways that risk reinforcing their exclusion. The article focuses on a case study of a matched savings program in the heart of a major American city, gathering evidence through in-depth interviews with 24 clients in the program and ethnographic observations at the agency implementing the program.
The co-occurrence of adverse childhood experiences among children investigated for child maltreatment: A latent class analysis
Children investigated for maltreatment are particularly vulnerable to experiencing multiple adversities. Few studies have examined the extent to which experiences of adversity and different types of maltreatment co-occur in this most vulnerable population of children. Understanding the complex nature of childhood adversity may inform the enhanced tailoring of practices to better meet the needs of maltreated children. Using cross-sectional data from the National Survey of Child and Adolescent Well-Being II (N =5870), this study employed latent class analysis to identify subgroups of children who had experienced multiple forms of maltreatment and associated adversities among four developmental stages: birth to 23 months (infants), 2–5 (preschool age), 6–10 (school age), and 11–18 years-old (adolescents). Three latent classes were identified for infants, preschool-aged children, and adolescents, and four latent classes were identified for school-aged children. Among infants, the groups were characterized by experiences of (1) physical neglect/emotional abuse/caregiver treated violently, (2) physical neglect/household dysfunction, and (3) caregiver divorce. For preschool-aged children, the groups included (1) physical neglect/emotional abuse/caregiver treated violently, (2) physical neglect/household dysfunction, and (3) emotional abuse. Children in the school-age group clustered based on experiencing (1) physical neglect/emotional neglect and abuse/caregiver treated violently, (2) physical neglect/household dysfunction, (3) emotional abuse, and (4) emotional abuse/caregiver divorce. Finally, adolescents were grouped based on (1) physical neglect/emotional abuse/household dysfunction, (2) physical abuse/emotional abuse/household dysfunction, and (3) emotional abuse/caregiver divorce. The results indicate distinct classes of adversity experienced among children investigated for child maltreatment, with both stability across developmental periods and unique age-related vulnerabilities. Implications for practice and future research are discussed.
“And Slowly, the Integration and the Growing and the Learning”: Nuanced Notions of Integration of Bhutanese Refugees in US Cities
Policy related to refugee integration focuses on economic factors, while integration is not clearly operationalized nor is it being systematically measured and tracked in policy implementation. This study poses the question, how can local-level integration be conceptualized based on the perspectives of resettled refugees, to add nuance to policy. Using a case study approach with a nation-wide scale, data include 40 interviews and five focus groups with leaders of Bhutanese refugee-run organizations in 35 cities across the United States. Findings illustrate the importance of bonds, bridges and links in non-linear, relational integration. Findings also suggest that better access to services and resources is the responsibility of policy-makers and would lead to stronger bridges over time. This complicates existing policy and implies that resettlement programming should remain individualized and contextual from the ground level to the national level.
The Family Resilience Inventory: A Culturally Grounded Measure of Current and Family‐of‐Origin Protective Processes in Native American Families
The purpose of this article is to introduce the Family Resilience Inventory (FRI) and present findings on initial efforts to validate this measure. The FRI is designed to assess family resilience in one’s current family and in one’s family of origin, enabling the assessment of family protective factors across these generations. The development of the FRI was the result of many years of ethnographic research with Southeastern Native American tribes; yet, we believe that this scale is applicable to families of various backgrounds. Items for the FRI were derived directly from thematic analysis of qualitative data with 436 participants, resulting in two 20‐item scales. Due to missing data, eight cases were removed from the 127 participants across two tribes, resulting in an analytic sample size of 119. Conceptually, the FRI is comprised of two factors or scales measuring distinct dimensions of family resilience (i.e., resilience in one’s current family and resilience in one’s family of origin). The results of the confirmatory factor analysis supported the hypothesized two‐factor structure (X2(644) = 814.14, p = .03, X2/df = 1.10, RMSEA = .03, CFI = .97, TLI = .96). Both the subscales and the total FRI scale (α = .92) demonstrated excellent reliability. The results also provided preliminary evidence of convergent and discriminant validity. This measure fills a gap in the absence of community‐based, culturally grounded, and empirical measures of family resilience. The examination of family resilience, which may occur across generations, is an exciting new contribution of the FRI.
Autonomic and affective mediators of the relationship between mindfulness and opioid craving among chronic pain patients
Prescription opioid misuse among chronic pain patients is undergirded by self-regulatory deficits, affective distress, and opioid-cue reactivity. Dispositional mindfulness has been associated with enhanced self-regulation, lower distress, and adaptive autonomic responses following drug-cue exposure. We hypothesized that dispositional mindfulness might serve as a protective factor among opioid-treated chronic pain patients. We examined heart-rate variability (HRV) during exposure to opioid cues and depressed mood as mediators of the association between dispositional mindfulness and opioid craving. Data were obtained from a sample of chronic pain patients (N = 115) receiving long-term opioid pharmacotherapy. Participants self-reported opioid craving and depression, and HRV was measured during an opioid-cue dot-probe task. Dispositional mindfulness was significantly positively correlated with HRV, and HRV was significantly inversely associated with opioid craving. Dispositional mindfulness was significantly negatively correlated with depression, and depression was significantly positively correlated with opioid craving. Path analysis revealed significant indirect effects of dispositional mindfulness on craving through both HRV and depression. Dispositional mindfulness may buffer against opioid craving among chronic pain patients prescribed opioids; this buffering effect may be a function of improved autonomic and affective responses.
Papilledema Treated by Cranial Expansion in a 5-Year-Old Boy with Camurati-Engelmann Syndrome
“That’s My Number One Fear in Life. It’s the Police”: Examining Young Black Men’s Exposures to Trauma and Loss Resulting From Police Violence and Police Killings
Black males are disproportionately the victims of police killings in the United States, yet few studies have examined their personal narratives of trauma and bereavement resulting from police violence. Informed by critical race theory and stress and coping theory, we used a modified grounded theory approach to conduct and analyze in-depth, semistructured life history interviews with 40 young Black men (aged 18-24 years) in Baltimore, Maryland. Study participants were recruited from a GED and job readiness center serving Baltimore youth. Study results offer a nuanced understanding of the patterning and mental health consequences of police violence for young Black men. Participant disclosures of witnessing and experiencing police violence began in childhood and spanned through emerging adulthood, met Diagnostic and Statistical Manual of Mental Disorders–Fifth Edition criteria for trauma exposure, and embodied theoretical conceptualizations of racial trauma. Exposures to police violence fostered distrust of police and informed participants’ appraisals of their vulnerability to police violence across the life course. Six study participants disclosed losing loved ones to police killings. Injustice and hypervigilance accompanied grief. Implications for research, policy, and practice are discussed.
A Culturally Informed Systematic Review of Mental Health Disparities Among Adult Indigenous Men and Women of the USA: What is known?
Related to a broader context of historical oppression, Indigenous peoples of the USA are overburdened with the mental health challenges that social workers tend to treat, including post-traumatic stress disorder (PTSD), depression, suicide and substance use disorders (SUD). The purpose of this systematic review is to use the Framework of Historical Oppression, Resilience and Transcendence (FHORT) to identify empirical research on risk and protective factors related to mental health and SUD amongst these populations. This systematic review includes peer-reviewed quantitative and qualitative research articles from 1980 to 2017 focusing on the mental health of US Indigenous adults. A total of thirty-eight peer-reviewed empirical articles met inclusion criteria. Results reveal adults within Indigenous populations are at a high risk for mental health outcomes, including PTSD, depression, suicide, SUD and comorbidity across these outcomes. Underlying risk factors across outcomes included historical oppression and loss, family problems and SUD. Protective factors tended to include family and social support and engagement with tribal cultural activities. Significant variability was identified based on gender and geographic regions. Given that protective factors tended to include cultural, familial and community tenets, holistic approaches are the most promising programmes for social workers to work towards.
Coping, Discrimination, and Physical Health Conditions Among Predominantly Poor, Urban African Americans: Implications for Community-Level Health Services
African Americans and ethnic minorities experience racial discrimination in a variety of settings. Racial discrimination is a potent stressor that has been linked to psychosocial stress and poor physical health. To cope with discriminatory experiences and daily life event stressors, African Americans frequently use the concept of John Henryism (a high effort coping strategy with prolonged exposure to stress). This cross-sectional analysis explored the relationship between racism/discrimination, John Henryism, and health problems in a predominately African American sample. Data were collected through health care screenings for hypertension, diabetes, and obesity and a self-report survey to assess experiences of discrimination and use of John Henryism. Logistic and linear regression models were used to assess the relationship between the John Henryism score, racism/discrimination score, and health problems among 352 participants. John Henryism was associated with a decrease in systolic blood pressure (b = − 12.50, 95% CI = − 23.05, − 1.95) among men, after adjusting for experiences of racism/discrimination and demographic characteristics. Experiences of racism/discrimination were associated with an increase in systolic blood pressure (b = 11.23, 95% CI = 0.38, 22.09) among men, after adjusting for John Henryism and demographic characteristics. Among women, there was no association found between John Henryism and experiences of racism/discrimination with systolic blood pressure. No association was found between John Henryism and experiences of racism/discrimination with being overweight/obese in women nor men. The study found that John Henryism was positively associated with the health of men, while experiences of racism/discrimination were negatively associated with their health. Limitations of the study are discussed, and recommendations are made to guide future research exploring the concept of John Henryism as a relevant factor between stress, racial discrimination and poor health.
“On a Journey to Appreciate What My Body Does for Me”: Qualitative Results from a Positive Body Image Pilot Intervention Study
Research suggests body appreciation is related to mental, physical, and sexual health behaviors and outcomes that are relevant to social workers and public health clinicians. As such, it is imperative to develop and test interventions that aim to improve body appreciation. The current study is part of a larger pilot intervention study that utilized 3D scanning technology. During the intervention, 18–25-year-old women digitally “painted” their avatar on a computer based on a series of prompts from the researcher. The purpose of this study is to qualitatively explore how a small subsample of the participants (n = 18) experienced this innovative intervention and how they view themselves differently post-intervention. Using thematic analysis, we uncovered three themes: 1) ways of defining body image, 2) importance of body function over aesthetics, and 3) body acceptance and appreciation. This study provides support for the use of one-time individual-level interventions focused on body appreciation and functionality over appearance. Implications are discussed.
The social construction of preteen children
In 1962, philosopher Thomas Kuhn, in his book on the history of science, The Structure of Scientific Revolutions, describes how scientists are enculturated into the accepted methods, tools, conceptual categories, and ways of “doing” science that are embraced until new concepts and methods gain traction and replace the old (Kuhn, 2015). Although he argued his case with examples from the physical sciences, his thought is nonetheless relevant to the social sciences and health sciences. Kuhn’s book helps nurse scientists understand that the concepts, theories, and methodological tools of a given time period reflect and reinforce the biases of normal science. That is until anomalies are noticed that challenge prior knowledge and taken for granted assumptions of the physical or social world. A good example is seen in Philippe Aries’s work on childhood.
Mentoring Matters: An Innovative Approach to Infusing Mentorship in a Social Work Doctoral Program
Social work doctoral students must identify how to prioritize their time and how to gain the many qualifications required by the academic job market. Mentoring has long been recognized as an effective strategy for promoting academic success and degree completion in doctoral studies. This article describes three student-led initiatives in a social work doctoral program that sought to infuse mentorship throughout the program. The content of these innovative initiatives is discussed, as well as their implications for social work doctoral education.
The Potential of College Completion: How Disability Shapes Labor Market Activity Differentially by Educational Attainment and Disability Type
I conducted a descriptive analysis of how disability shapes labor market activity differentially by educational attainment and disability type using the American Community Survey, 2015 (N = 1,504,947) and linear probability models. Having a disability is associated with a decrease in the probability of labor force participation (proportion of those employed or seeking employment; ????=−0.34) and employment (proportion of those in the labor market who are employed; ????=−0.05). When differentiated by disability type, education moderates the relationship between disability and labor force participation for all disability types. However, education only moderates the relationship between disability and employment for those with cognitive-, physical-, and mobility-related disabilities (not sensory or self-care). Having a bachelor’s degree is associated with a 30.68% higher probability of labor force participation and a 26.84% higher probability of employment among those in the labor force than having some college, indicating higher education may be a pivotal intervention point. The relationships between disability and labor force participation and disability and employment vary by disability type, as does the role of education.
Expanding current understandings of epistemic injustice and dementia: Learning from stigma theory
The current paper addresses the nature of epistemic injustice as it may be experienced by persons with dementia. We describe how theoretical models of stigma align with the current model of epistemic injustice through a consideration of the concepts of ‘stereotype’, ‘prejudice’ and ‘discrimination’, shared by the two models. We draw on current understandings of dementia-related stigma to expand understandings of the epistemic injustice faced by persons with dementia. We discuss how these insights may inform the development of mechanisms to uphold the basic human right to speak, to be heard, and to be believed for persons with dementia.
Child, Family, and Case Characteristics Associated With Reentry Into Out-of-Home Care Among Children and Youth Involved With Child Protection Services
Many children and youth with child protection services (CPS) involvement enter out-of-home care. The aims of this study were to examine rates of reentry and risk factors associated with reentry into out-of-home care among children and youth involved in the child protection (reported for abuse/neglect) and youth-in-conflict (reported for behavioral issues) programs. This study used administrative data from Colorado’s Statewide Automated Child Welfare Information System, which contains information on all children and youth who enter Colorado’s CPS. Of the 14,461 children and youth in the child protection program and 2,353 children and youth in the youth-in-conflict program, 14.7% and 35.1%, respectively, reentered into out-of-home care. Families’ prior history of CPS involvement and current CPS case characteristics better explained reentry into out-of-home care than child and family demographic characteristics alone. Understanding risk factors associated with reentry into out-of-home care is critical to inform the prevention of child maltreatment recurrence and ensure the safety, permanency, and well-being of children and youth.
Adverse childhood experiences and complex health concerns among child welfare-involved children
Adverse childhood experiences (ACEs) contribute to public health concerns, as they have been linked to chronic diseases in adulthood. From the seminal ACEs study in the mid-1990s (Felitti et al., 1998) to today, the Centers for Disease Control (2016) reports well over 50 studies that link ACEs to adult health conditions such as cancer, heart disease, lung disease, and mental illness. This preponderance of evidence has prompted widespread attention to the possibility that preventing and successfully treating ACE-associated traumatic stress would greatly reduce our country’s incidence of chronic disease and the associated public health burden and cost (Danese et al., 2009). To illustrate, one study suggests that child abuse and neglect alone costs the United States $124 billion annually, with individual lifetime costs that are higher than or equal to the economic burden of diabetes and stroke (Fang, Brown, Florence, & Mercy, 2012). That child maltreatment is just one category of 10 total ACEs suggests that the total financial impact of ACEs in the United States is likely much greater and that some populations, such as children involved in child welfare, may be disproportionately affected by the negative effects of adverse childhood experiences.
Exploring the relationship between cumulative trauma and recidivism among older adults: Does race and offense history matter?
There is a dearth of knowledge on the role of cumulative trauma, stress, and minority oppression on recidivism among incarcerated elder population. The current study fills a gap in the literature by exploring the association between race, trauma, offense history, and recidivism among incarcerated elders. This study used a cross-sectional correlational design with 607 adult males aged 50 and older in a Northeastern state correctional system. Results of a series of moderation analyses revealed that drug offense history had a significant moderating effect on the relationship between trauma and recidivism. However, minority status or violent offense history was not found to be a significant moderator of the trauma and recidivism relationship. These findings suggest prevention and intervention efforts would benefit from incorporating trauma-informed approaches and principles of restorative justice that facilitate individual, family, and community healing.
Preadolescents’ Daily Peer Victimization and Perceived Social Competence: Moderating Effects of Classroom Aggression
Few studies have assessed children’s daily peer experiences, and even fewer have considered their daily self-perceptions. This daily diary study examined relations between preadolescents’ daily reports of peer victimization and perceived social competence, along with moderating effects of classroom aggression. A racially diverse sample of 182 children in 5th grade (105 boys; M age = 10.64 years; 35% White, 31% Black, 17% Hispanic, 17% other or not reported) completed daily measures of peer victimization and perceived social competence, with most children completing measures on 8 school days. Teachers completed measures of aggression for each participating pupil. Four types of peer victimization (verbal victimization, social manipulation, social rebuff, and property attacks) predicted decreased daily perceived social competence. Daily social rebuff predicted decreased daily perceived social competence beyond the effects of the other types of victimization. Classroom aggression moderated the relation of verbal victimization with perceived social competence, such that this relation was significant in classrooms with lower aggression and nonsignificant in classrooms with higher aggression. Results indicate that preadolescents’ daily self-perceptions fluctuate with daily victimization by peers, particularly with social rebuff. Findings also suggest that the impact of verbal victimization on children’s self-views could be exacerbated in classrooms that better manage peer-to-peer aggression. Accordingly, targeted interventions appear critical for children who continue to experience peer victimization in schools with highly effective aggression prevention programs.