Applying ecological systems theory to juvenile legal system interventions outcomes research: a measurement framework

Intervention research and development for youth in the juvenile legal system (JLS) has often focused on recidivism as the primary outcome of interest. Although recidivism is an important outcome, it is ultimately a downstream marker of success and is affected by changes in other domains of youths’ lives (e.g., family and peer relations, neighborhood safety, local and state-level policies). Thus, the present manuscript proposes the application of ecological systems theory to selecting outcomes to assess intervention effects in JLS intervention research to better capture proximal and distal influences on youth behavior. To that end, we first provide an overview of the strengths and limitations of using recidivism as an outcome measure. Next, the current application of social ecology theory to existing research on both risk and protective factors of JLS involvement is discussed, as well as existing work on assessing social-ecological domains within intervention studies. Then, a measurement framework is introduced for selecting pertinent domains of youths’ social ecologies to assess as intervention outcomes, moderators, and mediators. To facilitate this, we provide examples of concrete constructs and measures that researchers may select. We conclude with potential new avenues of research to which our proposed framework could lead, as well as potential limitations of implementing our framework

Graphic Warning Labels Elicit Affective and Thoughtful Responses from Smokers: Results of a Randomized Clinical Trial

Objective Observational research suggests that placing graphic images on cigarette warning labels can reduce smoking rates, but field studies lack experimental control. Our primary objective was to determine the psychological processes set in motion by naturalistic exposure to graphic vs. text-only warnings in a randomized clinical trial involving exposure to modified cigarette packs over a 4-week period. Theories of graphic-warning impact were tested by examining affect toward smoking, credibility of warning information, risk perceptions, quit intentions, warning label memory, and smoking risk knowledge. Methods Adults who smoked between 5 and 40 cigarettes daily (N = 293; mean age = 33.7), did not have a contra-indicated medical condition, and did not intend to quit were recruited from Philadelphia, PA and Columbus, OH. Smokers were randomly assigned to receive their own brand of cigarettes for four weeks in one of three warning conditions: text only, graphic images plus text, or graphic images with elaborated text. Results Data from 244 participants who completed the trial were analyzed in structural-equation models. The presence of graphic images (compared to text-only) caused more negative affect toward smoking, a process that indirectly influenced risk perceptions and quit intentions (e.g., image-\u3enegative affect-\u3erisk perception-\u3equit intention). Negative affect from graphic images also enhanced warning credibility including through increased scrutiny of the warnings, a process that also indirectly affected risk perceptions and quit intentions (e.g., image-\u3enegative affect-\u3erisk scrutiny-\u3ewarning credibility-\u3erisk perception-\u3equit intention). Unexpectedly, elaborated text reduced warning credibility. Finally, graphic warnings increased warning-information recall and indirectly increased smoking-risk knowledge at the end of the trial and one month later. Conclusions In the first naturalistic clinical trial conducted, graphic warning labels are more effective than text-only warnings in encouraging smokers to consider quitting and in educating them about smoking’s risks. Negative affective reactions to smoking, thinking about risks, and perceptions of credibility are mediators of their impact

Multisystemic therapy with juvenile sexual offenders : a 10.2-year follow-up to a randomized effectiveness trial

Field of study: Psychology.Charles M. Borduin, Ph.D., Thesis Supervisor."July 2017."[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI AT REQUEST OF AUTHOR.] Multisystemic Therapy for Problem Sexual Behavior (MST-PSB; Borduin, Letourneau, Henggeler, & Swenson, 2009) is a family- and community-based treatment for juvenile sexual offenders that has shown long-term efficacy in two randomized clinical trials (i.e., university-based trials). However, the long-term effectiveness (i.e., a trial conducted in a community setting) of MST-PSB has yet to be evaluated. The present study provided a 10.2-year postbaseline follow-up of 94 juvenile sexual offenders who were randomized to receive either MST-PSB or treatment-as-usual (TAU; cognitive-behavioral group therapy) in an effectiveness trial. This follow-up examined both criminal (i.e., misdemeanor and felony arrests) and noncriminal (i.e., financial and family-related civil suits) outcomes among the former participants. Between-groups analyses indicated that MST-PSB was no more effective than TAU on most criminal and noncriminal outcomes. However, those individuals who received MST-PSB were found to have been fined at a lower rate by the criminal court system than those individuals who received TAU. The results indicate that future research should examine factors (i.e., low therapist adherence to treatment, need for booster sessions, low severity of pretreatment sexual offending) that may have muted the effects of MST-PSB in the present study.Includes bibliographical references (pages 24-28)

From court to the community: improving access to evidence-based treatment for underserved youth involved in the juvenile legal system at-risk for suicide

Abstract Background Juvenile legal involved youth (JLIY) experience disproportionately high rates of suicidal and self-injurious thoughts and behaviors (SSITB). Many JLIY lack access to evidence-based treatment specifically designed to treat SSITB, thereby increasing the overall risk of suicide. The overwhelming majority of JLIY are not placed in secure facilities and almost all incarcerated youth are eventually released to the community. Consequently, SSITB are a major concern of JLIY residing in the community and it is critical that this population has access to evidence-based treatment for SSITB. Unfortunately, most community mental health providers who treat JLIY have not been trained in evidence-based interventions that are specifically designed to SSITB, which often leads to youth experiencing prolonged periods of SSITB. Training community mental health providers who serve JLIY in the detection and treatment of SSITB shows promise for decreasing the overall suicide risk for JLIY. Methods The current proposal aims to reduce SSITB among JLIY, and thus reduce mental health disparities in this vulnerable and underserved youth population, by increasing access to evidence-based treatment strategies specifically designed to treat SSITB behaviors. We will implement an agency-wide training among at least 9 distinct community mental health agencies that serve JLIY referred to treatment by a statewide court system in the Northeast. Agencies will be trained in an adapted version of the COping, Problem Solving, Enhancing life, Safety, and Parenting (COPES+) intervention. Training will be implemented via a cluster-randomized stepped wedge trial that proceeds through multiple phases. Discussion This research engages multiple systems (i.e., juvenile legal and mental health systems) serving JLIY and has the potential to directly inform treatment practices in juvenile legal and mental health systems. The current protocol has significant public health implications as the primary goals are to reduce SSITB among adolescents involved in the juvenile legal system. By implementing a training protocol with community-based providers to help them learn an evidence-based intervention, this proposal aims to reduce mental health disparities in a marginalized and underserved population. Trial registration osf.io/sq9z

Model Testing the Predictions of Hypotheses 1 and 2.

<p>W3 = Week 3; W6 = Week 6. Path coefficients for the measurement models for Risk Perceptions (Risk 1 = 1.00, Risk 2 = .88**, Risk 3 = 1.19**) and Quit Intentions (Contemplation Ladder = 1.00, 30-Day Quit Intentions = .45**, Quit Desire = .42**)</p

Participant Retention Diagram.

<p>Participant recruitment and retention over the course of the trial.</p

Placement of Experimental Warning Labels.

<p>Basic text warnings (left) were placed on the side of cigarettes packages. Graphic warning labels (center) covered approximately 50% of the front of cigarette packages and paired images with basic text statements. Elaborated text warning labels (right) also featured graphic images, but included descriptive text which explained the warning in more detail.</p

Alcohol use and alcohol use disorder differ in their genetic relationships with PTSD: A genomic structural equation modelling approach

PURPOSE: Posttraumatic Stress Disorder (PTSD) is associated with increased alcohol use and alcohol use disorder (AUD), which are all moderately heritable. Studies suggest the genetic association between PTSD and alcohol use differs from that of PTSD and AUD, but further analysis is needed. BASIC PROCEDURES: We used genomic Structural Equation Modeling (genomicSEM) to analyze summary statistics from large-scale genome-wide association studies (GWAS) of European Ancestry participants to investigate the genetic relationships between PTSD (both diagnosis and re-experiencing symptom severity) and a range of alcohol use and AUD phenotypes. MAIN FINDINGS: When we differentiated genetic factors for alcohol use and AUD we observed improved model fit relative to models with all alcohol-related indicators loading onto a single factor. The genetic correlations (rG) of PTSD were quite discrepant for the alcohol use and AUD factors. This was true when modeled as a three-correlated-factor model (PTSD-AUD rG:.36, p < .001; PTSD-alcohol use rG: -0.17, p < .001) and as a Bifactor model, in which the common and unique portions of alcohol phenotypes were pulled out into an AUD-specific factor (rG with PTSD:.40, p < .001), AU-specific factor (rG with PTSD: -0.57, p < .001), and a common alcohol factor (rG with PTSD:.16, NS). PRINCIPAL CONCLUSIONS: These results indicate the genetic architecture of alcohol use and AUD are differentially associated with PTSD. When the portions of variance unique to alcohol use and AUD are extracted, their genetic associations with PTSD vary substantially, suggesting different genetic architectures of alcohol phenotypes in people with PTSD