Identification and comparison of pandemic-to-symptom networks of South Korea and the United States

BackgroundThe Coronavirus (COVID-19) pandemic resulted in a dramatic increase in the prevalence of anxiety and depression globally. Although the impact on the mental health of young adults was especially strong, its underlying mechanisms remain elusive.Materials and methodsUsing a network approach, the present study investigated the putative pathways between pandemic-related factors and anxiety and depressive symptoms among young adults in South Korea and the U.S. Network analyses were conducted on cross-country data collected during the COVID-19 lockdown period (n = 1,036). Our model included depression symptoms (PHQ-9), generalized anxiety symptoms (GAD-7), and COVID-19-related factors (e.g., COVID-19-related traumatic stress, pandemic concerns, access to medical/mental health services).ResultsThe overall structure of pandemic-to-symptom networks of South Korea and the U.S. were found to be similar. In both countries, COVID-related stress and negative future anticipation (an anxiety symptom) were identified as bridging nodes between pandemic-related factors and psychological distress. In addition, worry-related symptoms (e.g., excessive worry, uncontrollable worry) were identified as key contributors in maintaining the overall pandemic-to-symptom network in both countries.ConclusionThe similar network structures and patterns observed in both countries imply that there may exist a stable relationship between the pandemic and internalizing symptoms above and beyond the sociocultural differences. The current findings provide new insights into the common potential pathway between the pandemic and internalizing symptoms in South Korea and in the U.S. and inform policymakers and mental health professionals of potential intervention targets to alleviate internalizing symptoms

Substance Use Prevention Services in Juvenile Justice and Behavioral Health: Results from a National Survey

BACKGROUND: This study examined the national availability of substance use prevention (SUP) within juvenile justice (JJ) and their primary behavioral health (BH) providers, and the relationships between the availability of SUP and agency-level measures of organizational structure, staffing, and youth characteristics. A three-stage national probability sampling process was used to select participants for a national survey that included, among other facets of community supervision (CS) and BH practices, questions on agency characteristics, youth characteristics, whether the agency/provider directly provided SUP services, and whether the agency/provider directly provided substance use and/or mental health treatment. This paper focuses on SUP services along with agency/provider and youth characteristics related to providing SUP. RESULTS: The response rate for both CS agencies (n = 195) and BH providers (n = 271) was 96%. Complex samples logistic regression initially examined univariate associations of each variable and identified candidates for a final multivariate model. Overall, only one-third of CS and BH providers reported offering SUP services, with BH providers being significantly more likely than CS agencies to provide SUP services. In addition, likelihood of SUP was significantly lower among agencies where the substance use distribution of the caseload was below the median. Controlling for master\u27s level staff and the substance use distribution, CS agencies were about 67% less likely to offer SUP when compared to BH providers. CONCLUSIONS: Given the high rates of substance use among justice-involved youth and that substance use is an established risk for several negative behaviors, outcomes, and health conditions, these findings suggest that evidence-based prevention services should likely be expanded in justice settings, and perhaps included as part of CS programs, even when youth do not initially present with SU service needs

Juvenile Justice—Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS): A Cluster Randomized Trial Targeting System-Wide Improvement in Substance Use Services

Background: The purpose of this paper is to describe the Juvenile Justice—Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS) study, a cooperative implementation science initiative involving the National Institute on Drug Abuse, six research centers, a coordinating center, and Juvenile Justice Partners representing seven US states. While the pooling of resources across centers enables a robust implementation study design involving 36 juvenile justice agencies and their behavioral health partner agencies, co-producing a study protocol that has potential to advance implementation science, meets the needs of all constituencies (funding agency, researchers, partners, study sites), and can be implemented with fidelity across the cooperative can be challenging. This paper describes (a) the study background and rationale, including the juvenile justice context and best practices for substance use disorders, (b) the selection and use of an implementation science framework to guide study design and inform selection of implementation components, and (c) the specific study design elements, including research questions, implementation interventions, measurement, and analytic plan. Methods/design: The JJ-TRIALS primary study uses a head-to-head cluster randomized trial with a phased rollout to evaluate the differential effectiveness of two conditions (Core and Enhanced) in 36 sites located in seven states. A Core strategy for promoting change is compared to an Enhanced strategy that incorporates all core strategies plus active facilitation. Target outcomes include improvements in evidence-based screening, assessment, and linkage to substance use treatment. Discussion: Contributions to implementation science are discussed as well as challenges associated with designing and deploying a complex, collaborative project. Trial registration: NCT02672150

The Influence of Adolescent Psychiatric Disorder on Young Adult Recidivism On behalf of: International Association for Correctional and Forensic Psychology can be found at: Criminal Justice and Behavior Additional services and information for The Influenc

This study examined the influence of adolescent psychiatric disorder on young adult recidivism and compared findings with earlier studies of juvenile recidivism. Logistic regression analysis examined subsequent adulthood recidivism (through age 23 years) by disorder profile, adjusting for prior offense severity and background variables, in 340 Alabama juveniles referred to juvenile justice agencies (probation and detention). youths with comorbid internalizing and disruptive behavior disorder had a sixfold increased risk for young adult recidivism compared with nondisordered counterparts. Comorbid internalizing disorder likely is a marker for the severity of a youth's disruptive behavior disorder; similarly, offending that continues into adulthood likely betokens a more serious course of offending behavior. The severity underlying disorder and offending behavior is probably the common link between them. To prevent reoffending into adulthood, the mental health needs of juvenile justice youths' internalizing and externalizing problems should be addressed

Gender Differences in Psychiatric Disorders at Juvenile Probation Intake

Objective. We identified gender differences in psychiatric disorders among youths at probation intake. Methods. We measured disorders with the Voice Diagnostic Interview Schedule for Children among 991 randomly selected youths (200 girls) at probation intake in 8 Texas counties. Logistic regression analyses predicted diagnostic clusters by gender, adjusting for demographics and offense characteristics. Results. Demographic and offense characteristics explained small but interpretable and specific variance in diagnostic profile. Girls’ rates of anxiety and affective disorders were higher than boys’ (odds ratios = 0.59 and 0.32, respectively). Girls with violent offenses, compared with other groups, were 3 to 5 times as likely to report anxiety disorders. Conclusions. Among youths with conduct problems, girls demonstrated an elevated risk for co-occurring anxiety or affective disorder

Perceived importance of substance use prevention in juvenile justice: a multi-level analysis

Abstract Background Youth under juvenile justice (JJ) supervision are at high-risk of adverse outcomes from substance use, making prevention important. Few studies have examined prevention-related attitudes of JJ employees, yet such attitudes may be important for implementing prevention programs. Attitudes toward prevention may reflect individual characteristics and organizational contexts. Methods Mixed effects regression was used to analyze data from 492 employees in 36 sites participating in the Juvenile Justice—Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS) cooperative agreement. JJ employees’ perceived importance of substance use prevention was measured. Staff-level variables included attitudes, job type, and demographic characteristics. Site-level variables focused on use of evidence-based screening tools, prevention programs, and drug testing. Results On average, JJ employees rated substance use prevention as highly important (mean = 45.9, out of 50). JJ employees generally agreed that preventing substance use was part of their agency’s responsibility (mean = 3.8 on scale ranging from 1 to 5). At the site level, 72.2% used an evidence-based screening tool, 22.2% used one or more evidence-based prevention program, and 47.2% used drug testing. Reported importance of prevention was positively associated with site-level use of screening tools and drug testing as well as staff-level attitudes regarding prevention being consistent with the agency’s mission. Conclusions The associations between screening and prevention attitudes suggest that commitment to identifying youth needs may result in greater openness to preventing substance use. Future efforts to implement substance use prevention within JJ agencies charged with supervising youth in the community may benefit from highlighting the fit between prevention and the agency’s mission

The Missing Link(age): Multilevel Contributors to Service Uptake Failure Among Youths on Community Justice Supervision.

OBJECTIVES: Youth in the juvenile justice system often do not access needed behavioral health services. We seek to determine, based on our model of the Behavioral Health Services Cascade, the prevalence of substance use Screening, Identification of Need, and Referral to and Initiation of behavioral health treatment in youth undergoing intake, and at what steps their access is most challenged. Characteristics associated with identification of needs and linkage to community services are also examined. METHODS: Data were drawn from administrative records of 33 community justice agencies in 7 states, participating in NIDA’s JJ-TRIALS initiative (N=8307 youth). We examined contributions of youth, staff, agency and county characteristics to identification of behavioral health needs and linkage to community services. RESULTS: Approximately 70% of youths were screened, and more than half were found to be in need of treatment. Among those in need of services, only about a fifth were referred to treatment, yet among those referred, 68% initiated treatment. Overall, fewer than 15% of identified youth initiated services. Multivariable multilevel regression analyses identified an array of contributors to service-related outcomes, with youth’s level of supervision among the strongest predictors. CONCLUSION: Community justice agencies appear to follow an approach that focuses identification and linkage practices on youth concerns other than behavioral health needs, although such needs contribute to re-offending. Implications for practice in behavioral health agencies are discussed. Local agencies should coordinate efforts to support communication in the referral and cross-system linkage process

The comparative effectiveness of Core versus Core+Enhanced implementation strategies in a randomized controlled trial to improve substance use treatment receipt among justice-involved youth

Abstract Background Most justice-involved youth are supervised in community settings, where assessment and linkage to substance use (SU) treatment services are inconsistent and fragmented. Only 1/3 of youth with an identified SU need receive a treatment referral and even fewer initiate services. Thus, improving identification and linkage to treatment requires coordination across juvenile justice (JJ) and behavioral health (BH) agencies. The current study examines the comparative effectiveness of two bundled implementation intervention strategies for improving SU treatment initiation, engagement, and continuing care among justice-involved youth supervised in community settings. Exploration, Preparation, Implementation, Sustainment (EPIS) served as the conceptual framework for study design and selection/timing of implementation intervention components, and the BH Services Cascade served as the conceptual and measurement framework for identifying and addressing gaps in service receipt. Methods Part of a larger Juvenile-Justice Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS) Cooperative, this study involved a multisite, cluster-randomized control trial where sites were paired then randomly assigned to receive Core (training teams on the BH Services Cascade and data-driven decision making; supporting goal selection) or Core+Enhanced (external facilitation of implementation teams) intervention components. Youth service records were collected from 20 JJ community supervision agencies (in five states) across five study phases (baseline, pre-randomization, early experiment, late experiment, maintenance). Implementation teams comprised of JJ and BH staff collaboratively identified goals along the BH Cascade and used data-driven decision-making to implement change. Results Results suggest that Core intervention components were effective at increasing service receipt over time relative to baseline, but differences between Core and Core+Enhanced conditions were non-significant. Time to service initiation was shorter among Core+Enhanced sites, and deeper Cascade penetration occurred when external facilitation (of implementation teams) was provided. Wide variation existed in the degree and nature of change across service systems. Conclusions Findings demonstrate the criticality of early EPIS phases, demonstrating that strategies provided during the formative exploration and preparation phases produced some improvement in service receipt, whereas implementation-focused activities produced incremental improvement in moving youth farther along the Cascade