Nonsuicidal Self-Injury, Suicide Planning, and Suicide Attempt Among High-Risk Adolescents Prior to Psychiatric Hospitalization

The purpose of this study was to understand the trajectories of nonsuicidal self-injury (NSSI) and suicide plans (SP) in the 90 days prior to inpatient hospitalization, understand the role of NSSI and SP in predicting suicide attempts (SA) on a given day, and to test the interaction between NSSI and SP in predicting same-day SA. Participants included 69 adolescents (77% female, 65% white, 77% Non-Hispanic/Latinx, Mage = 15.77 SDage = 1.00) from an inpatient psychiatric unit. Past 90 day NSSI, SP, and SA were measured using the Columbia Suicide Severity Rating Scale and Timeline Follow Back. First, mixed effect models were conducted to assess trajectories of NSSI and SP leading up to inpatient hospitalization. The odds of NSSI remained relatively stable prior to hospitalization (OR = 1.01, 95% CI [1.00,1.02]). The odds of SP increased in the 90 days prior to hospitalization (OR = 1.04, 95% CI [1.02,1.05]) with each day associated with a 4% increase in the odds of making a SP. Second, random effect models were conducted to predict the odds of same-day SA from NSSI and SP. When adolescents endorsed either NSSI (OR = 2.99, p \u3c .001) or a SP (OR = 77.13, p \u3c .001) there was elevated odds of same-day SA. However, the presence of both NSSI and SP on a given day did not increase risk of SA on that same day. For this high-risk clinical sample of suicidal adolescents who drink alcohol, odds of SP increased in the days leading up to psychiatric hospitalization, but NSSI remained stable. On days when adolescents reported NSSI or SP, they had an increased odds of same-day SA. These results underscore the importance of frequent monitoring of NSSI and SP among high-risk adolescents who drink alcohol to prevent suicide attempts

Beliefs, Perceptions, and Socialization Practices of Lesbian, Gay, and Heterosexual Adoptive Parents

Thesis advisor: Ruth McRoyThesis advisor: Summer HawkinsAdoptive parenting contributes to the dramatic growth in lesbian and gay (LG) parenting. Research on adoptive families has mostly focused on heterosexual parent families and the limited research on LG parenting has primarily emphasized child adjustment outcomes. This three-paper dissertation utilized subsamples from a large (N=1616) and recent (2012-2013) comprehensive dataset, The Modern Adoptive Families Study, designed to compare family characteristics, experiences, and adjustment outcomes across different types of adoptive families, especially families headed by sexual minority parents. The Minority Stress model is used to frame a deeper understanding of parenting processes in heterosexual and lesbian and gay parent adoptive families. This framework takes into account the potential for families, led by sexual minority parents, to encounter discrimination and suggests processes may exist within the family to help buffer interpersonal and systemic bias. Paper 1 used logistic regression to examine the associations of adoptive parents’ satisfaction with their mental health services and their pediatrician. Pediatrician satisfaction was specifically related to the parental perception of their provider’s understanding of their minority status; based on 1) adoptive family status, 2) parental sexual orientation, and 3) transracial adoption status. Overall, 51% of the sample of parents who sought mental health services reported satisfaction. Satisfaction was positively associated with being a gay father, having a higher household income, and having a child whose race was identified as Asian. Satisfaction was negatively associated with having a child older than 11 years old. Of parents who reported on their satisfaction with pediatricians, 82% of parents reported satisfaction. Having a higher household income was positively associated with respondents’ satisfaction. Paper 2 used confirmatory factor analysis (CFA) to explore how findings from two racial socialization measures compared across parental sexual orientation, in transracial adoptive families. The scales measured parental endorsement of cultural competency pertaining to race and related self-efficacy enacting racial socialization practices. In Paper 3, cultural socialization theory was used to investigate parents’ endorsement of socialization related to being raised in a same-sex headed family with two newly developed scales using exploratory factor analysis (EFA). Results of these studies will help to inform policy and practice by addressing critical questions impacting a growing number of adoptive families, especially those headed by sexual minority parents. Contributions to the literature include findings about parenting practices, perceptions, experiences, and relationship dynamics within lesbian, gay, and heterosexual adoptive parent families.Thesis (PhD) — Boston College, 2018.Submitted to: Boston College. Graduate School of Social Work.Discipline: Social Work

Parent, child, and adoption characteristics associated with post-adoption support needs

The purpose of this study is to (a) identify whether there are meaningful subgroups of families with distinct post-adoption needs and (b) determine which parent, youth, and adoption characteristics are associated with these collections of needs. Using data from the Modern Adoptive Families study, authors conducted a three-step latent class analysis with a sample of 1,414 families who rated the importance of 16 areas of parent education and support, based on their current level of need. A five-class solution best fit the data. Descriptively, the classes reflect families with low needs, families with needs related to adoption adjustment, families with adoption-specific needs, families wanting support specific to their youths\u27 special needs, and families with needs that are both adoption-specific and related to youth special needs. Results from the multinomial logistic regression model found class membership differences based on parent, youth, and adoption characteristics. These classes may help adoption professionals to recognize the types of post-adoption services different families may need and to develop targeted interventions for specific types of families

Heterosexual and sexual minority adoptive parents’ help-seeking and service satisfaction of pediatricians and mental health providers

The aim of our study was to examine the associations between heterosexual and sexual minority adoptive parents’ adoption-related help-seeking and their service satisfaction with pediatricians and mental health providers. We examined associations with (a) satisfaction with pediatricians and (b) understanding of adoption by a mental health provider among adoptive parents who sought advice for adoption-related issues using data drawn from the Modern Adoptive Families study (N = 1,419). Logistic regressions were used to examine associations with service-seeking and satisfaction with professionals’ adoption advice. About half of the sample adopted a child with either special needs at placement (55%) and/or preplacement adversity (74%), which were significantly associated with seeking adoption-related advice. Consulting pediatricians about adoption was common (78%), and 83% of those parents reported being satisfied with adoption-related advice provided by their pediatrician. About half (51%) of the parents sought mental health services, but only 41% of those parents reported having access to an adoption-competent mental health provider and 50% of those parents felt their mental health provider understood adoption. Parent sexual orientation, higher income, older child age, and having a child with special needs were positively associated with satisfaction with adoption-related advice provided by the pediatrician and having a mental health provider who understood adoption. Adopting a child with special needs at placement and an older child were positive associations of seeking adoption-related help, while parent demographics, including higher household income, were positively associated with satisfaction. Results suggest an inclusive family-centered approach to care is important