This article introduces a special issue on the school and life experiences of highly mobile stude... more This article introduces a special issue on the school and life experiences of highly mobile students. In it, the phenomenology of high mobility is described as well as the current state of research on subpopulations of highly mobile students. In addition, the risk and resilience framework is invoked as a general theoretical crosscurrent that cuts across the articles included in the special issue that provide novel research on environmental instability, student homelessness, foster care experiences, relocation because of war, and trauma-and violence-informed care. Lastly, areas for future research are discussed as highly mobile students remain an understudied yet important and growing population in need of empirical investigation and supportive intervention. K E Y W O R D S foster care students, homeless students, risk and resilience framework, trauma-informed care 1 | INTRODUCTION We are pleased to report that this special issue in Psychology in the Schools is devoted to featuring research on the school and life experiences of highly mobile students. Even though highly mobile students experience significant challenges to their academic success and healthy psychosocial functioning, a paucity of research exists on these displaced, often marginalized, and even traumatized student populations (Larson & Meehan, 2011; Masten et al., 2015; Miller & Bourgeois, 2013). Moreover, even less is known about protective factors and resilience in this growing yet often misunderstood population of students (Sukowski, 2016).
In 2013, the Montana Office of Public Instruction (OPI) began the process of developing systemati... more In 2013, the Montana Office of Public Instruction (OPI) began the process of developing systematic, school-based crisis intervention policies and procedures across three demonstration sites (Bitterroot Valley Education Cooperative, Prairie View Special Services Cooperative, Fort Peck Reservation) with the intent to support local school districts (e.g., technical assistance, web-based resources) in their efforts to develop, scale-up, and sustain protocols of their own across Montana. It was the hope of OPI administrators to 1) demonstrate the value and feasibility of systematic crisis intervention protocols where the majority of youth and families interface with fellow citizens and community agencies on a daily basis and 2) reduce and/or prevent youth suicide through early identification and appropriate referrals for effective intervention. The results of this demonstration project suggest that crisis intervention protocols can be implemented effectively into communities when local champions are identified to lead the effort, protocols are adapted to reflect the strengths and needs of the community, youth perspectives and endorsements are honored, and adequate time and resources are dedicated to support ongoing implementation and sustainability.
Journal of College Student Psychotherapy, Mar 31, 2010
Motivational interviewing has shown some success as an intervention for college student cigarette... more Motivational interviewing has shown some success as an intervention for college student cigarette smokers. We tested the efficacy and process of a two session motivational-interviewingbased smoking intervention compared to an assessment/information session. College student participants assigned to the motivational interviewing condition did not differ significantly from participants in the assessment/information condition on smoking outcome variables one month later. However, both groups reported significant decreases in self-reported smoking over time, suggesting that brief interventions for college student smoking can be efficacious. Consistent with theory, the motivational interviewing group reported a significant increase in self-efficacy over time and reported stronger perceptions of the therapeutic alliance after the first session compared to assessment/information participants. Cigarette smoking is the leading preventable cause of morbidity and mortality in the United States (Centers for Disease Control and Prevention, 2006). Although the overall prevalence of smoking has declined since 1991, the rate among American youths has risen since 1992 (Johnston, O'Malley, & Bachman, 1996). In fact, young Americans, particularly college students, have the highest rate of "new smoker" status (Centers for Disease Control and Prevention, 2006), and recent reports indicate that approximately 28% of college students smoke cigarettes (Weitzman, Chen, & Subramanian, 2005). Nearly one-third of college smokers began to smoke regularly at or after age 19 (American Cancer Society, 2006), suggesting the early college years might be an opportune time to impact smoking behaviors (Herman & Fahnlander, 2003). Brief interventions may aid college student smokers in successful smoking cessation (Herman & Fahnlander, 2003; Prokhorov et al., 2008), and they frequently employ a motivational interviewing style. Motivational interviewing (MI) is a client-centered therapeutic style designed to increase readiness to change by helping clients resolve ambivalence and increase motivation for change (Miller & Rollnick, 2002). The four basic principles of MI are creating empathy, increasing client efficacy, developing discrepancy, and rolling with resistance. An empathetic counseling style that creates a nonthreatening, accepting environment is fundamental to MI (Rogers, 1951; Rollnick & Miller, 1995). Self-efficacy refers to the client's confidence that he or she is able to engage in specific behaviors that are promoted in MI by focusing on the choice of the individual to implement change. An MI therapist also seeks to develop discrepancy between the problem behavior (e.g., smoking) and the client's change goals by providing feedback and reducing ambivalence toward change. In addition, a therapist using an MI style rolls with resistant verbalizations or behaviors by using reflective listening and avoids arguing with clients when they are ambivalent about or resistant to change (Miller & Rollnick, 2002). A significant body of research supports the efficacy of brief interventions and the MI style for decreasing substance use (Bien, Miller, &
There is considerable debate in the public arena and among the professional mental health communi... more There is considerable debate in the public arena and among the professional mental health community around the media's role in increasing suicide risk following exposure to suicide-themed media in youth. A recent example involves the concerning reaction to the release of Netflix's controversial hit teen-suicide drama 13 Reasons Why. This follow-up study examined the association between the release of 13 Reasons Why Season 2 (13RW2), which coincided with two celebrity suicides, and national trends in crisis-related text conversations. We implemented an interrupted time series design to examine changes in daily counts of crisis texts aggregated at the national level following two events: (1) the release of 13RW2 and (2) celebrity suicide deaths of Anthony Bourdain and Kate Spade. We also performed a sub-analysis of suicide-related crisis conversations following each event. Crisis conversation volume was 42% higher after the release of 13RW2 for 6 of the 18 days of the study period, while crisis text usage was 51% higher for 9 out of the 18 days after the publicized celebrity suicide deaths. Both the release of 13RW2 and the celebrity suicides in the summer of 2018 were followed by an abrupt, but transient rise in crisis help-seeking among adolescents. Media outlets should consider pairing suicide-themed content with crisis support services as a core best practice to reduce the risk of population-level adverse reactions to suicide portrayals or coverage.
Few studies in the Southeastern U.S. have examined county-level spatial patterning in suicide clu... more Few studies in the Southeastern U.S. have examined county-level spatial patterning in suicide clusters, and no studies have examined clustering at the census block group. The objective of this retrospective ecological study is to identify high-risk suicide clusters and characterize the community-level factors associated with suicides inside and outside spatial clusters. We used the discrete Poisson SatScan statistic to identify spatial clusters in suicide for North Carolina, 2000-2017. A suicide cluster was defined as a statistically significant cluster of suicide events. Community-level determinants were obtained from the American Community Survey, and logistic regression models were used to examine the association between community-level determinants and suicide clusters. A total of 12 statistically significant high-risk spatial clusters were identified. Clusters were also identified for specific age-demographics, including adolescents (<25), the working-age population (25 to 64), and the elderly (65>). The risk ratios of suicide varied from 1.27 to 2.05 in high-risk clusters, and spatial clustering was positively associated with being male or residence in a rural area. Multivariable logistic regression found strong associations with income, population change, and educational attainment. Our results highlight the significant geographic heterogeneity in suicide across North Carolina and the need for more research that identifies localized suicide clusters for targeted public health interventions.
Computer use in the classroom has become a popular method of instruction for many technology educ... more Computer use in the classroom has become a popular method of instruction for many technology educators. This may be due to the fact that software programs have advanced beyond the early days of drill and practice instruction. With the introduction of the graphical user interface, increased processing speed, and affordability, computer use in education has finally come of age. Software designers are now able to design multidimensional educational programs that include high quality graphics, stereo sound, and real time interaction (Bilan, 1992). One area of noticeable improvement is computer simulations. Computer simulations are software programs that either replicate or mimic real world phenomena. If implemented correctly, computer simulations can help students learn about technological events and processes that may otherwise be unattainable due to cost, feasibility, or safety. Studies have shown that computer simulators can: 1. Be equally as effective as real life, hands-on laboratory experiences in teaching students scientific concepts (Choi and Gennaro, 1987). 2. Enhance the learning achievement levels of students (Betz, 1996). 3. Enhance the problem solving skills of students (Gokhale, 1996). 4. Foster peer interaction (Bilan, 1992). The educational benefits of computer simulations for learning are promising. Some researchers even suspect that computer simulations may enhance creativity (e.g., Betz, 1996; Gokhale, 1996; Harkow, 1996), however, after an extensive review of literature, no empirical research has been found to support this claim. For this reason, the following study was conducted to compare the effect of a computer simulation activity versus a traditional handson activity on students' product creativity. Background Product Creativity in Technology Education Historically, technology educators have chosen the creation of products or projects as a means to teach technological concepts (Knoll, 1997). Olson (1973), in describing the important role projects play in the industrial arts/technology classroom, remarked, "The project represents human creative achievement with materials and ideas and results in an experience of self-fulfillment" (p. 21).
Rising suicide rates, the opioid crisis, and persisting healthcare disparities have collectively ... more Rising suicide rates, the opioid crisis, and persisting healthcare disparities have collectively created a perfect storm of factors associated with higher rates of premature death in rural communities. Unfortunately, rural communities often experience disproportionate suicide rates compared to urban settings (Fontanella et al., 2015). Moreover, the capacity of the healthcare systems in most rural communities has been in steady decline for years. This capacity problem is due, in part, to the closing of rural hospitals and clinics and workforce shortages in remote regions (Thomas et al., 2012). These workforce and clinic shortages are exacerbated by other barriers, including economic disparities (e.g., lack of insurance), geographic remoteness, inadequate transportation, and a lack of sufficient infrastructure for telehealth solutions. Acceptability of mental health services or lack thereof also acts as a barrier to effective suicide prevention in rural communities. It is not an uncommon perception in small communities that disclosing personal health information to a medical or mental health professional is unnecessary, unhelpful, or a sign of being disloyal to the family (Owens et al., 2013). Similarly, individuals from rural areas have also reported that receiving conventional mental health care signals weakness or indicates that one has spiritual flaws (Curtin et al., 2017). Easy access to lethal means, primarily firearms and dangerous medications, also makes it difficult to prevent suicide in rural regions. Between 1999 and 2019, the leading mechanism of suicide for youth aged 10-19 living in the least populous
Previous meta-analyses of psychotherapies for child and adolescent depression were limited becaus... more Previous meta-analyses of psychotherapies for child and adolescent depression were limited because of the small number of trials with direct comparisons between two treatments. A network meta-analysis, a novel approach that integrates direct and indirect evidence from randomized controlled studies, was undertaken to investigate the comparative efficacy and acceptability of psychotherapies for depression in children and adolescents. Systematic searches resulted in 52 studies (total N53805) of nine psychotherapies and four control conditions. We assessed the efficacy at post-treatment and at follow-up, as well as the acceptability (all-cause discontinuation) of psychotherapies and control conditions. At post-treatment, only interpersonal therapy (IPT) and cognitive-behavioral therapy (CBT) were significantly more effective than most control conditions (standardized mean differences, SMDs ranged from 20.47 to 20.96). Also, IPT and CBT were more beneficial than play therapy. Only psychodynamic therapy and play therapy were not significantly superior to waitlist. At follow-up, IPT and CBT were significantly more effective than most control conditions (SMDs ranged from 20.26 to 21.05), although only IPT retained this superiority at both short-term and long-term follow-up. In addition, IPT and CBT were more beneficial than problem-solving therapy. Waitlist was significantly inferior to other control conditions. With regard to acceptability, IPT and problem-solving therapy had significantly fewer all-cause discontinuations than cognitive therapy and CBT (ORs ranged from 0.06 to 0.33). These data suggest that IPT and CBT should be considered as the best available psychotherapies for depression in children and adolescents. However, several alternative psychotherapies are understudied in this age group. Waitlist may inflate the effect of psychotherapies, so that psychological placebo or treatment-as-usual may be preferable as a control condition in psychotherapy trials.
In a study of 182 undergraduates, a substantial proportion of the students in this sample reporte... more In a study of 182 undergraduates, a substantial proportion of the students in this sample reported significant symptoms of depression, yet only a minute number of them had ever sought treatment for their ailments. Further, the college men in this study appeared to be suffering to a greater extent than would be predicted based upon past epidemiological studies. The implications and limitations are reviewed, as are the suggestions for future research.
Over the past two decades , a great deal of research has been devoted to the lll understanding of... more Over the past two decades , a great deal of research has been devoted to the lll understanding of internalizing disorders in children. Internalizing disorders encompass a wide variety of problems, including depression , anxiety, social withdrawal, and somatic complaints. It has been suggested that the existence of internalizing disorders in children Vl ACKNOWLEDGMENTS I want to express my deep appreciation to Dr. Kenneth Merrell for his support and guidance throughout this thesis project. From the project's inception to the final defense , Dr. Merrell provided me with personal encouragement, solid advice, and technical support. In addition, I wish to thank Dr. Susan Crowley and Dr. Patricia Truhn for their thoughtful and insightful feedback provided during the course of the study. Furthermore, I want to extend my gratitude to Dr. Cher King and Mr. Dale Thompsen for their assistance in helping to make this a viable investigation. I would also like to thank the teachers and the staff in the elementary school, whose assistance in the data collection procedures was invaluable. The teachers and staff included Ms.
T hroughout history and across cultures, humans have sought out various psychoactive substances, ... more T hroughout history and across cultures, humans have sought out various psychoactive substances, concoctions, drinks, pills, plants, herbs, and potions to alter, improve, change, and otherwise treat what ails us. The term psychoactive refers to a substance or drug that can alter physiology, cognition, emotion, and behavior. The part of the body most affected by psychoactive substances or drugs is the central nervous system (CNS), which comprises the brain and the spinal cord. Once inside the CNS, the drug can alter biochemical interactions both within and between brain cells or neurons. These interactions, in turn, often have a powerful and rapid impact on thinking, feeling, and behaving. Drug effects are typically classified in terms of how they alter CNS functioning. For example, alcohol is classified as a CNS depressant, given that it typically slows heart rate and respiration and leads to sedation, disinhibition, and a subjective sense of euphoric intoxication. Opiate drugs, such as heroin and prescription medications like codeine, can have dramatic effects on the CNS, such as a euphoric rush, relaxation, apathy, and impaired judgment. In contrast to opiates and depressants, CNS stimulants like cocaine and amphetamines tend to produce physiological arousal, euphoria, restlessness, diminished appetite, expansive mood, agitation, and even paranoia. However, before the biochemical processes and subsequent effects can occur, drug-seeking behavior must take place. Drugseeking behavior. or the use of psychoactive substances, is the focus of this chapter.
Background: Most suicide prevention programs focus on increasing knowledge regarding the problem ... more Background: Most suicide prevention programs focus on increasing knowledge regarding the problem of suicide, yet many fail to include information on the science and application of means reduction approaches. In an attempt to address this gap in practice, the Counseling on Access to Lethal Means (CALM) program was developed to educate clinicians on the importance of means reduction interventions. Methods: In the current study, a gatekeeper CALM training was delivered to 167 resident assistants. Confidence levels regarding suicide prevention and means reduction skills were assessed at baseline, post-training, and after a 6-week follow-up. Results: Results were suggestive of medium to large training effects. Though there was a small decay of training effects at follow-up, the effects were durable when compared to baseline levels. Conclusion: Given these findings, future gatekeeper trainings should be provided more consistently to help sustain the effects and data on the implementation of CALM principles should be measured during follow-up assessments.
This article introduces a special issue on the school and life experiences of highly mobile stude... more This article introduces a special issue on the school and life experiences of highly mobile students. In it, the phenomenology of high mobility is described as well as the current state of research on subpopulations of highly mobile students. In addition, the risk and resilience framework is invoked as a general theoretical crosscurrent that cuts across the articles included in the special issue that provide novel research on environmental instability, student homelessness, foster care experiences, relocation because of war, and trauma-and violence-informed care. Lastly, areas for future research are discussed as highly mobile students remain an understudied yet important and growing population in need of empirical investigation and supportive intervention. K E Y W O R D S foster care students, homeless students, risk and resilience framework, trauma-informed care 1 | INTRODUCTION We are pleased to report that this special issue in Psychology in the Schools is devoted to featuring research on the school and life experiences of highly mobile students. Even though highly mobile students experience significant challenges to their academic success and healthy psychosocial functioning, a paucity of research exists on these displaced, often marginalized, and even traumatized student populations (Larson & Meehan, 2011; Masten et al., 2015; Miller & Bourgeois, 2013). Moreover, even less is known about protective factors and resilience in this growing yet often misunderstood population of students (Sukowski, 2016).
In 2013, the Montana Office of Public Instruction (OPI) began the process of developing systemati... more In 2013, the Montana Office of Public Instruction (OPI) began the process of developing systematic, school-based crisis intervention policies and procedures across three demonstration sites (Bitterroot Valley Education Cooperative, Prairie View Special Services Cooperative, Fort Peck Reservation) with the intent to support local school districts (e.g., technical assistance, web-based resources) in their efforts to develop, scale-up, and sustain protocols of their own across Montana. It was the hope of OPI administrators to 1) demonstrate the value and feasibility of systematic crisis intervention protocols where the majority of youth and families interface with fellow citizens and community agencies on a daily basis and 2) reduce and/or prevent youth suicide through early identification and appropriate referrals for effective intervention. The results of this demonstration project suggest that crisis intervention protocols can be implemented effectively into communities when local champions are identified to lead the effort, protocols are adapted to reflect the strengths and needs of the community, youth perspectives and endorsements are honored, and adequate time and resources are dedicated to support ongoing implementation and sustainability.
Journal of College Student Psychotherapy, Mar 31, 2010
Motivational interviewing has shown some success as an intervention for college student cigarette... more Motivational interviewing has shown some success as an intervention for college student cigarette smokers. We tested the efficacy and process of a two session motivational-interviewingbased smoking intervention compared to an assessment/information session. College student participants assigned to the motivational interviewing condition did not differ significantly from participants in the assessment/information condition on smoking outcome variables one month later. However, both groups reported significant decreases in self-reported smoking over time, suggesting that brief interventions for college student smoking can be efficacious. Consistent with theory, the motivational interviewing group reported a significant increase in self-efficacy over time and reported stronger perceptions of the therapeutic alliance after the first session compared to assessment/information participants. Cigarette smoking is the leading preventable cause of morbidity and mortality in the United States (Centers for Disease Control and Prevention, 2006). Although the overall prevalence of smoking has declined since 1991, the rate among American youths has risen since 1992 (Johnston, O'Malley, & Bachman, 1996). In fact, young Americans, particularly college students, have the highest rate of "new smoker" status (Centers for Disease Control and Prevention, 2006), and recent reports indicate that approximately 28% of college students smoke cigarettes (Weitzman, Chen, & Subramanian, 2005). Nearly one-third of college smokers began to smoke regularly at or after age 19 (American Cancer Society, 2006), suggesting the early college years might be an opportune time to impact smoking behaviors (Herman & Fahnlander, 2003). Brief interventions may aid college student smokers in successful smoking cessation (Herman & Fahnlander, 2003; Prokhorov et al., 2008), and they frequently employ a motivational interviewing style. Motivational interviewing (MI) is a client-centered therapeutic style designed to increase readiness to change by helping clients resolve ambivalence and increase motivation for change (Miller & Rollnick, 2002). The four basic principles of MI are creating empathy, increasing client efficacy, developing discrepancy, and rolling with resistance. An empathetic counseling style that creates a nonthreatening, accepting environment is fundamental to MI (Rogers, 1951; Rollnick & Miller, 1995). Self-efficacy refers to the client's confidence that he or she is able to engage in specific behaviors that are promoted in MI by focusing on the choice of the individual to implement change. An MI therapist also seeks to develop discrepancy between the problem behavior (e.g., smoking) and the client's change goals by providing feedback and reducing ambivalence toward change. In addition, a therapist using an MI style rolls with resistant verbalizations or behaviors by using reflective listening and avoids arguing with clients when they are ambivalent about or resistant to change (Miller & Rollnick, 2002). A significant body of research supports the efficacy of brief interventions and the MI style for decreasing substance use (Bien, Miller, &
There is considerable debate in the public arena and among the professional mental health communi... more There is considerable debate in the public arena and among the professional mental health community around the media's role in increasing suicide risk following exposure to suicide-themed media in youth. A recent example involves the concerning reaction to the release of Netflix's controversial hit teen-suicide drama 13 Reasons Why. This follow-up study examined the association between the release of 13 Reasons Why Season 2 (13RW2), which coincided with two celebrity suicides, and national trends in crisis-related text conversations. We implemented an interrupted time series design to examine changes in daily counts of crisis texts aggregated at the national level following two events: (1) the release of 13RW2 and (2) celebrity suicide deaths of Anthony Bourdain and Kate Spade. We also performed a sub-analysis of suicide-related crisis conversations following each event. Crisis conversation volume was 42% higher after the release of 13RW2 for 6 of the 18 days of the study period, while crisis text usage was 51% higher for 9 out of the 18 days after the publicized celebrity suicide deaths. Both the release of 13RW2 and the celebrity suicides in the summer of 2018 were followed by an abrupt, but transient rise in crisis help-seeking among adolescents. Media outlets should consider pairing suicide-themed content with crisis support services as a core best practice to reduce the risk of population-level adverse reactions to suicide portrayals or coverage.
Few studies in the Southeastern U.S. have examined county-level spatial patterning in suicide clu... more Few studies in the Southeastern U.S. have examined county-level spatial patterning in suicide clusters, and no studies have examined clustering at the census block group. The objective of this retrospective ecological study is to identify high-risk suicide clusters and characterize the community-level factors associated with suicides inside and outside spatial clusters. We used the discrete Poisson SatScan statistic to identify spatial clusters in suicide for North Carolina, 2000-2017. A suicide cluster was defined as a statistically significant cluster of suicide events. Community-level determinants were obtained from the American Community Survey, and logistic regression models were used to examine the association between community-level determinants and suicide clusters. A total of 12 statistically significant high-risk spatial clusters were identified. Clusters were also identified for specific age-demographics, including adolescents (<25), the working-age population (25 to 64), and the elderly (65>). The risk ratios of suicide varied from 1.27 to 2.05 in high-risk clusters, and spatial clustering was positively associated with being male or residence in a rural area. Multivariable logistic regression found strong associations with income, population change, and educational attainment. Our results highlight the significant geographic heterogeneity in suicide across North Carolina and the need for more research that identifies localized suicide clusters for targeted public health interventions.
Computer use in the classroom has become a popular method of instruction for many technology educ... more Computer use in the classroom has become a popular method of instruction for many technology educators. This may be due to the fact that software programs have advanced beyond the early days of drill and practice instruction. With the introduction of the graphical user interface, increased processing speed, and affordability, computer use in education has finally come of age. Software designers are now able to design multidimensional educational programs that include high quality graphics, stereo sound, and real time interaction (Bilan, 1992). One area of noticeable improvement is computer simulations. Computer simulations are software programs that either replicate or mimic real world phenomena. If implemented correctly, computer simulations can help students learn about technological events and processes that may otherwise be unattainable due to cost, feasibility, or safety. Studies have shown that computer simulators can: 1. Be equally as effective as real life, hands-on laboratory experiences in teaching students scientific concepts (Choi and Gennaro, 1987). 2. Enhance the learning achievement levels of students (Betz, 1996). 3. Enhance the problem solving skills of students (Gokhale, 1996). 4. Foster peer interaction (Bilan, 1992). The educational benefits of computer simulations for learning are promising. Some researchers even suspect that computer simulations may enhance creativity (e.g., Betz, 1996; Gokhale, 1996; Harkow, 1996), however, after an extensive review of literature, no empirical research has been found to support this claim. For this reason, the following study was conducted to compare the effect of a computer simulation activity versus a traditional handson activity on students' product creativity. Background Product Creativity in Technology Education Historically, technology educators have chosen the creation of products or projects as a means to teach technological concepts (Knoll, 1997). Olson (1973), in describing the important role projects play in the industrial arts/technology classroom, remarked, "The project represents human creative achievement with materials and ideas and results in an experience of self-fulfillment" (p. 21).
Rising suicide rates, the opioid crisis, and persisting healthcare disparities have collectively ... more Rising suicide rates, the opioid crisis, and persisting healthcare disparities have collectively created a perfect storm of factors associated with higher rates of premature death in rural communities. Unfortunately, rural communities often experience disproportionate suicide rates compared to urban settings (Fontanella et al., 2015). Moreover, the capacity of the healthcare systems in most rural communities has been in steady decline for years. This capacity problem is due, in part, to the closing of rural hospitals and clinics and workforce shortages in remote regions (Thomas et al., 2012). These workforce and clinic shortages are exacerbated by other barriers, including economic disparities (e.g., lack of insurance), geographic remoteness, inadequate transportation, and a lack of sufficient infrastructure for telehealth solutions. Acceptability of mental health services or lack thereof also acts as a barrier to effective suicide prevention in rural communities. It is not an uncommon perception in small communities that disclosing personal health information to a medical or mental health professional is unnecessary, unhelpful, or a sign of being disloyal to the family (Owens et al., 2013). Similarly, individuals from rural areas have also reported that receiving conventional mental health care signals weakness or indicates that one has spiritual flaws (Curtin et al., 2017). Easy access to lethal means, primarily firearms and dangerous medications, also makes it difficult to prevent suicide in rural regions. Between 1999 and 2019, the leading mechanism of suicide for youth aged 10-19 living in the least populous
Previous meta-analyses of psychotherapies for child and adolescent depression were limited becaus... more Previous meta-analyses of psychotherapies for child and adolescent depression were limited because of the small number of trials with direct comparisons between two treatments. A network meta-analysis, a novel approach that integrates direct and indirect evidence from randomized controlled studies, was undertaken to investigate the comparative efficacy and acceptability of psychotherapies for depression in children and adolescents. Systematic searches resulted in 52 studies (total N53805) of nine psychotherapies and four control conditions. We assessed the efficacy at post-treatment and at follow-up, as well as the acceptability (all-cause discontinuation) of psychotherapies and control conditions. At post-treatment, only interpersonal therapy (IPT) and cognitive-behavioral therapy (CBT) were significantly more effective than most control conditions (standardized mean differences, SMDs ranged from 20.47 to 20.96). Also, IPT and CBT were more beneficial than play therapy. Only psychodynamic therapy and play therapy were not significantly superior to waitlist. At follow-up, IPT and CBT were significantly more effective than most control conditions (SMDs ranged from 20.26 to 21.05), although only IPT retained this superiority at both short-term and long-term follow-up. In addition, IPT and CBT were more beneficial than problem-solving therapy. Waitlist was significantly inferior to other control conditions. With regard to acceptability, IPT and problem-solving therapy had significantly fewer all-cause discontinuations than cognitive therapy and CBT (ORs ranged from 0.06 to 0.33). These data suggest that IPT and CBT should be considered as the best available psychotherapies for depression in children and adolescents. However, several alternative psychotherapies are understudied in this age group. Waitlist may inflate the effect of psychotherapies, so that psychological placebo or treatment-as-usual may be preferable as a control condition in psychotherapy trials.
In a study of 182 undergraduates, a substantial proportion of the students in this sample reporte... more In a study of 182 undergraduates, a substantial proportion of the students in this sample reported significant symptoms of depression, yet only a minute number of them had ever sought treatment for their ailments. Further, the college men in this study appeared to be suffering to a greater extent than would be predicted based upon past epidemiological studies. The implications and limitations are reviewed, as are the suggestions for future research.
Over the past two decades , a great deal of research has been devoted to the lll understanding of... more Over the past two decades , a great deal of research has been devoted to the lll understanding of internalizing disorders in children. Internalizing disorders encompass a wide variety of problems, including depression , anxiety, social withdrawal, and somatic complaints. It has been suggested that the existence of internalizing disorders in children Vl ACKNOWLEDGMENTS I want to express my deep appreciation to Dr. Kenneth Merrell for his support and guidance throughout this thesis project. From the project's inception to the final defense , Dr. Merrell provided me with personal encouragement, solid advice, and technical support. In addition, I wish to thank Dr. Susan Crowley and Dr. Patricia Truhn for their thoughtful and insightful feedback provided during the course of the study. Furthermore, I want to extend my gratitude to Dr. Cher King and Mr. Dale Thompsen for their assistance in helping to make this a viable investigation. I would also like to thank the teachers and the staff in the elementary school, whose assistance in the data collection procedures was invaluable. The teachers and staff included Ms.
T hroughout history and across cultures, humans have sought out various psychoactive substances, ... more T hroughout history and across cultures, humans have sought out various psychoactive substances, concoctions, drinks, pills, plants, herbs, and potions to alter, improve, change, and otherwise treat what ails us. The term psychoactive refers to a substance or drug that can alter physiology, cognition, emotion, and behavior. The part of the body most affected by psychoactive substances or drugs is the central nervous system (CNS), which comprises the brain and the spinal cord. Once inside the CNS, the drug can alter biochemical interactions both within and between brain cells or neurons. These interactions, in turn, often have a powerful and rapid impact on thinking, feeling, and behaving. Drug effects are typically classified in terms of how they alter CNS functioning. For example, alcohol is classified as a CNS depressant, given that it typically slows heart rate and respiration and leads to sedation, disinhibition, and a subjective sense of euphoric intoxication. Opiate drugs, such as heroin and prescription medications like codeine, can have dramatic effects on the CNS, such as a euphoric rush, relaxation, apathy, and impaired judgment. In contrast to opiates and depressants, CNS stimulants like cocaine and amphetamines tend to produce physiological arousal, euphoria, restlessness, diminished appetite, expansive mood, agitation, and even paranoia. However, before the biochemical processes and subsequent effects can occur, drug-seeking behavior must take place. Drugseeking behavior. or the use of psychoactive substances, is the focus of this chapter.
Background: Most suicide prevention programs focus on increasing knowledge regarding the problem ... more Background: Most suicide prevention programs focus on increasing knowledge regarding the problem of suicide, yet many fail to include information on the science and application of means reduction approaches. In an attempt to address this gap in practice, the Counseling on Access to Lethal Means (CALM) program was developed to educate clinicians on the importance of means reduction interventions. Methods: In the current study, a gatekeeper CALM training was delivered to 167 resident assistants. Confidence levels regarding suicide prevention and means reduction skills were assessed at baseline, post-training, and after a 6-week follow-up. Results: Results were suggestive of medium to large training effects. Though there was a small decay of training effects at follow-up, the effects were durable when compared to baseline levels. Conclusion: Given these findings, future gatekeeper trainings should be provided more consistently to help sustain the effects and data on the implementation of CALM principles should be measured during follow-up assessments.
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