Risk and Resilience Midterm Study Guide (Terms)

Identity captial model

"Stable sense of self facilitates individuals' ability to negotiate everyday experiences by enhancing their recognition of obstacles and opportunities most relevant to them" (p. 1196). Developing a clear, committed sense of identity should contribute to well-being by strengthening individual's sense of purpose and self-direction Role of purpose in youth development: Purpose interwoven with identity provides guidance on how to work with limited resources, but also promotes well-being of the individual

Steps of evidence based practice

1. Formulating an individual/family, community, of policy-related question What is the question I am trying to answer while trying to create this intervention? 2. Systematically searching the literature Review previous strategies, interventions. 3. Appraising findings for quality and applicability identifying what worked effectively in terms of target population and outcomes and research evidence is interpreted and combined with other sources of knowledge (example: practitioner expertise, individuality, etc) 4. Applying these findings and considerations in practice and changing practices, strategies, integrate change into sustainable systems. 5. Evaluating the results Evaluate impact of EBP on outcomes, practitioner, and individual/family satisfaction, efficacy, efficiency, economic analysis, and health status and leads to improvement.

Six principles for better services

1. Multi-level service: involve service providers and informal supports at multiple ecological levels 2. Coordinated: Though different agencies (mental health, corrections, child welfare, education, recreation, etc.) share common agendas and clients, that does not mean they work well together. Better coordinated services across the lifespan of a child may help overall. 3. Continuity: Resulted in lengthy delays accessing services or the delivery of disjointed services in which each new service initiated another round of assessment. A child could literally repeat his or her story a half dozen times to service providers who lacked access to each other's files or who were compelled by agency protocols to duplicate previously completed assessments. 4. Negotiated: Systems of care influenced by the power of clients to shape service delivery. In this regard, services need to pay greater attention to privileging the voices of those who receive services. 5. Continuum of care: Continuity, as mentioned earlier, should produce seamless delivery between services. A related principle, the provision of a continuum of services from least to most intrusive, is also critical to the management of complex cases. For the most part, the management of human and financial resources among service providers tends to structure services as hierarchies based on acute need. 6. Effective: Research on programmed effectiveness has, in general, demonstrated evidence for best practices that are coordinated, ecologically complex, matched to the context in which they are delivered and offered both over time and along a continuum.

Children's mental health (statistics)

11.3% percent of U.S. children ages 2-17 are reported by their parents to have been diagnosed with emotional, behavioral, or developmental conditions ADHD is the most prevalent diagnosis among children ages 3-17 Boys are more likely to be diagnosed with depression Suicide is the second leading cause of death among children ages 12-17.

Positive outcomes

Absence of a negative outcome or alternatively measures of adjustment.

Research findings on academic diversity, peer exclusion/victimization

Academic adversity-changing the mindset itself (moving away from entity to entity to incremental) can improve children's grades: Changing mindsets can work with college students. Research on developmental math students showed that when they were given a brief opportunity to think and teach others incremental perspectives, they were more likely to persist in their math courses. 2. Peer exclusion/victimization: Students with more fixed mindsets were more likely to participate in retaliatory aggression following a peer conflict and reduced desire for forgiveness Students with growth mindsets were more likely to address the conflict with the peer to try to educate them about harm caused (proactive solutions) When compared with coping skills training, incremental interventions were more effective in reducing aggressive retaliation and increasing pro social behaviors following experience with social exclusion Incremental interventions can also reduce perceptions that the experience of peer exclusion are stressful Questions linked to mindsets: How can changing mindsets improve school outcomes without removing actual adversity? Child's interpretations of adversity determines whether adversity affects outcomes Changing mindsets can affect child's ability to take advantages of the resources available to them

Prevention

Actions that eliminate or eradicate the impact of risk factors.

Challenges of prevention

Adapting prevention/intervention: how to transfer P/I to a new community? How you do fund an prevention/intervention program?

Erik Erikson's perspective

Adolescents explore their identity and struggle to resolve conflicts between identity and role confusion. Adolescents with a strong sense of identity are more confident, more motivated, and less vulnerable to risk. Adolescents who are developing their identities or who have a weaker identity are more vulnerable to risk.

Aims and findings

Aim 1: Identity should be linked to well-being; identity commitment and purpose commitment should be linked to hope, happiness, and positive affect Aim 2: Does this finding replicate with emerging adults? Establishing a purpose serves as identity capital in adolescence and emerging adulthood (especially for those in a committed identity) Aim 3: Identity and purpose were expected to be linked to daily well-being; with greater commitment to each to be related to greater positive affect and lower negative affect, youth with more established identity reported greater emotional well-being (greater positive and lower negative affect) and mechanism by which this relationship operates is through purpose commitment.

Attachment Theory

Attachment security promotes the development of empathy (increased emotion awareness and emotion responding linked to maternal sensitivity) Researchers focused on children and incarcerated parents and found that empathy serves as a protective factor for these children (as linked to reducing aggressive peer relations).

Successful prevention

Causes of potential risk (identification of risk/ risk groups), understanding of how risk is transmitted, availability of early detection and or/treatment, and continuous evaluation of and development of preventative measures.

Different types of protective factors

Child: attributes of the child (child IQ, emotional regulation, temperament, locus of control, genotypes) Family: presence of a caregiver that provide resources (nutrition) and have positive relationship (warm, responsive) Community: neighborhood quality, number of community programs

Specific effects linked to maltreated children

Children exhibited dysregulated emotion regulation patterns and children with a history of physical abuse were rated as more aggressive and disruptive by their peers than were no maltreated children. However, this relationship was mediated by poor emotion regulation-and the tendency to perceive ambivalent and prosocial situations as hostile, suggesting that emotion regulation is necessary for successful social interaction. Emotion regulation and dysregulation may also affect academic performance by impacting children's ability to focus their attention.

How do systems limit children?

Children fall through the cracks; exclusionary practices of services and marginalized children 'adapt' or 'cope' (drift into delinquency).

Two models of cultural resilience

Clauss-Ehlers: Culturally-focused resilient adaptation: Degree to which the strengths of one's culture promotes the development of coping. Within some cultural groups, there is strong ethnic identity and that allows them to really identify with their cultural group and provide a strong protective factor. Werner: cultural resilience is linked to good developmental outcomes, recovery from trauma, competence under stress: Example: Religious affiliation in some cultures. Culture and cultural values promotes positive coping among youth from diverse backgrounds Sociocultural aspects communities contribute to resiliency (supportive communities, school experiences).

Protective factors

Conditions or attributes (skills, strengths, resources, supports or coping strategies) in individuals, families, communities or the larger society that help people deal more effectively with stressful events and mitigate or eliminate risk in families and communities.

Evidence based practice

Conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual [clients] or problem-solving approach that takes the best available scientific evidence, clinician's expertise, and [individual's] preference and values

Cumulative risk

Decreases likelihood of protective factors.

Beck's model

Depressions arises from distorted cognitions and maladaptive self-schemas (cognitive vulnerability). Schemas (stored body of knowledge that affects encoding, comprehension, and retrieval); themes of loss, inadequacy, failure, and worthlessness Dysfunctional attitudes are activated following occurrence of a negative life event which then generates specific negative thoughts about the self, world, and future Risk factors: Negative life events low self-esteem=dysfunctional attitudes Protective factors: High levels of social support, high self esteem Problems with the theory: Mixed research evidence, poor measures of cognitive vulnerabilities

Implicit theory

Describes the specific patterns and biases an individual uses when forming impressions based on a limited amount of initial information about an unfamiliar person.

Two pathways of personality traits

Direct effects: Predict academic achievement, affects homework completion, directly shape capacity for competent functioning. Indirect effects: Traits shape experiences of the environment, influence the reactions and support they evoke from others, impact interpretations of the experiences, shape capacities for dealing with stress.

Impact of cognitive skills on resilience

Early cognitive skills act as a buffer for negative life events, children with strong cognitive skills are better able to process these life events and respond more adaptively, those with high cognitive ability are more systematic, planful, reflective, and consider alternative accounts for risk or protection, and high levels of internalizing problems result from a poor ability to process information.

Why is emotional functioning so important?

Emotional functioning is important for the well-being of children Children are often prone to difficulties with emotion regulation.Particularly true for maltreated children (patterns of emotion dysregulation) Those with negative emotionality are more likely to have behavior problems, poor attention control.

Multi-level resilience framework

Environmental factors at several levels account for risk or protection (for example: neighborhood, family, individual).

U Curve

Essentially when people come here, they experience a "honeymoon phase" at first, but over time, in months 3-6, culture shock occurs and there's a lot of learning that has to be done.

Two dimensions of ethnic identity

Ethnic affirmation and sense of belonging.

Evaluation of prevention

Evaluation is the process by which results are compared with the intended objectives; assessment of how well a program is performing Evaluation should always be considered during the planning and implementation stages of a program or activity, critical in determining benefits/potential difficulties and also generate information for other purposes (bring attention to an issue and to note the impact of your particular program.)

Anxiety

Excessive fear (emotional response to real or perceived imminent threat. Anxiety (anticipation of future threat) +behavioral responses (fight, flight, freeze). a. Separation anxiety: Range of 2.8 percent to 8 percent: Often develops after a life stress, especially loss, Parental overprotection (environmental) and is a much greater risk in first-degree relatives (genetic) b. Social anxiety: 7 percent: Fear of negative evaluation (personality), maltreatment, modeling by parent (environment) and is 2-6 times greater chance in first degree relatives (genetic). Treatment: Cognitive behavioral therapy and medication (anti anxiety and antidepressant).

Findings fro the big 5 personality traits

Extraversion, neuroticism, conscientiousness, agreeableness, and openness Low neuroticism, high conscientiousness, and agreeableness and openness are closely connected to resilience. Extraversion was associated with negative outcomes and coping strategy of problem solving is associated positively with agreeableness, openness to experience, and conscientiousness and negatively with neuroticism.

Risk factors

Factors known to be associated with negative outcomes such as parental psychopathology, SES disadvantage, poverty, community violence, maltreatment, negative life events, family violence, etc.

Family based interventions

Findings suggest that a brief, preventive intervention improving maternal depressive symptoms can have enduring effects on child emotional problems that are generalizable across contexts. As there is a growing emphasis for the use of evidence-based and cost-efficient interventions that can be delivered in multiple delivery settings serving low-income families and their children, clinicians and researchers welcome evidence that interventions can promote change in multiple problem areas. The FCU appears to hold such promise.

Types of mindsets

Fixed Mindset (entity): Intelligence is a fixed trait. Growth Mindset (incremental): Intelligence is a malleable quality, a potential that can be developed.

Future research

Focus on factors that are salient in that particular life context and that affect a large number of people in that group, attend to risk factors that are malleable (can be changed), focus on factors that are enduring or exert influence throughout child's life, look at generative indices (factors that set risk or protection in cascades).

Article findings for Ungar 2008

Focused on describing how resilience needs to be considered in a cultural context. It is negotiated between "individuals and their communities with a tendency to display both homogeneity and heterogeneity" (p. 219). International Resilience Project (IRP)- 1500 youth in 14 communities across 5 continents (facing at least 3 common risks in local communities). Global and cultural aspects of resilience, different communities offer different stresses and different resources to sustain child-well-being, community themselves must decide what is "healthy", and need research on what it means to be resilient in different cultures and contexts.

Resilience across Domains

For high-risk children, positive outcomes do not generalize across domains (may do well in one aspect of functioning, but may not be doing well in other aspects of their functioning) and resilient individuals don't always exhibit their resilience across domains- they may exhibit internal distress or difficulties in their social relationships.

Setting up intervention/prevention

For multiple risk factors, use multiple strategies: support transitions, respond to (and prevent) crises, increase community involvement and support, facilitate access to effective services.

Acculturation stress hypothesis

Foreign-born adolescents experience more acculturative stress than U.S.-born adolescents, contributing to higher levels of mental health symptomatology.

Types of identity

Gender-a person's internal sense of being male, female, some combination of male and female, or neither male nor female. Social - sense of who they are based on their social group.

How to develop better services

Give more control of services to children and families Challenges: some families still won't access services (gap: what they need and what systems can provide), different organizational cultures, lack of funding for front-line providers, need to be creative.

Protective factors in urban settings

Greater awareness and better access to health services.

Ethnic identity

Has been linked to variations in children's adjustment and ethnic identity achievement- extent to which the individual has explored and achieved a secure sense of self of what it means to be a member of their own ethnic group.

5 pathways to identification

Healthcare: •Primary gateway of identification and entry into services •Almost all children come into this system to receive immunizations, well-child care •Example: Medicaid-mandates Early and Periodic Screening, Diagnostic and Treatment program (comprehensive behavioral healthcare, mental health screen, linked services) •AAP Policy Statement: Developmental surveillance, screening, and referral for infants and young children; large proportion of mental health problems are undetected by pediatricians •Barriers: lack of physician training, time constraints, avoidance of labeling young children, perceived lack of services B. Early Care and Learning: Second primary pathway; although not all children get a routine developmental screening •Variety in mandates (example: relative care vs Head Start, Title 1 preschools) •Even in programs like HS, with their screenings, some problems are under-identified or misidentified •Also, early care environments in general do not have adequate resources to meet mental health intervention C. Early Intervention and Education: •Part C of IDEA: statewide programs of early intervention, early identification, screening, assessment, referral (birth to age 3) •Little data at how effective outreach is •Focus on neurodevelopmental, physical/sensory disability •Less attention/support social/behavioral problems D. Child Welfare: •Vulnerable population with well documented mental health needs •Identification is a critical process at intake, but states are struggling with limited resources •Some states are not systematic with screening and access to services (e.g., mental health services are not integrated with health care) E. Mental Health in the Community: •5% of children receive care in community mental health facilities (focus on children with serious emotional disturbances) •Very little $$ go to children under 6 years of age •Impediments in Medicaid (problems with diagnostic labeling, difficulty in reimbursing for consultation/parent education)

Military families

Heightened risk for psychological health problems among service members, spouses and children who experience challenges of military life (dangerous conditions, deployment). FOCUS: Families Overcoming Under Stress Family Resiliency Training •Parent-only, child-only, and family sessions •Training on: stress reactions (linking them to specific communication, routines, daily activities), identifying and utilizing family strengths, guidance on child development. Children entering FOCUS had higher behavioral and emotional symptoms than the norms identified in typical children •Children more distressed when caretakers were distressed; distress was across family systems •FOCUS reduced family distress: improving family adjustment predicted reduced distress across military children •Intervention dosage was associated with reduction in distress •Distress from the military member was linked to better attendance in the FOCUS program •Lead to long-term improvement in psychological health outcomes

Key ideas of mindsets

High ability is not always linked to growth mindset. Some high ability students question own abilities when they encounter failure. Success in itself does very little boost children's desire for challenges or ability to cope with setbacks (can have the opposite effects. Praising a child's 'intelligence' can lead children to fear failure, avoid risks, doubt themselves when they fail, and cope poorly with obstacles. Child's confidence does not always lead to resiliency (easily shaken when they encounter difficulty). Changing a child's mindset can promote resilience: promoting a malleable view of personality can improve student's achievement.

Depression

Hopelessness, Persistent boredom, Low energy, Social isolation, Low self-esteem, having extreme sensitivity to rejection or failure, increased irritability, anger, or hostility, difficulty with relationships, frequent complaints of physical illness, absences from school/poor school performance. Thoughts or expressions of suicide or self-destructive behavior. Prevalence and Risk Major depression strikes 8 percent of youth ages 12 and older (2% in younger children) and more girls than boys in adolescence, equal rates in childhood. Three risk factors: Temperament/personality (negative affectivity), environmental (adverse childhood experiences, particularly multiple experiences), and genetic (two to four times more likely if first degree relative has depression).

Cultural resilience

How cultural backgrounds (values, language, customs, etc) helps people and communities overcome adversity.

Dweck's research

How students "view" themselves as learners, implicit theories about the malleability of human characteristics. View or implicit theory is likely to have a major effect on their self-belief, their motivation, and their resilience. Resilience: not only presence/absence of adversity, but also interpretations of adversity that determines outcomes.

Objective of Resilience Researchers

Identify vulnerability and protective factors that modify negative effects of adverse life events and to identify mechanisms/processes by which this occurs. In other words, what makes the child vulnerable and what provides some protection?

Youth Force

Impact of program: All of the CMs reported that involvement in YF increased their self-confidence,not only in relation community organizing skills and competencies but also more generally. Participants also described transferring the skills and confidence they developed in YF to other contexts of their lives, a major area being school. Youth community organizing programs can influence a range of youth development outcomes, including the development of skills, knowledge, civic engagement, empowerment, and positive changes in self-concept. Moreover, youth reported transferring the competencies they developed in YF into other areas of their lives, particularly in school,attributing increased class participation, greater accountability,and improved relationships with teachers to their experiences in YF.

Immigrant paradox

In which the second generation (U.S. born) has been found to be at a higher risk for mental health concerns, such as depression, anxiety, substance abuse, eating disorders, and suicidal ideation and behavior, compared with the first generation (foreign born), although some studies indicate a different trend with the first generation at a greater risk for mental health problems.

Services (roles)

Include working on shelter, clothing, counseling, but also structures (organizations that ensure safety and relationships (attachments with peers, friends, and communities) All are considered resources for children/youth and the role of services: address risks, treat disorder and provide access to resources that support child well-being.

Effective characteristics of prevention

Increase protective factors, clearly defined, appropriate to target population, starts early, makes best use of resources

Key terms of evidence based practice

Individual/family preferences and culture guide and inform the delivery of treatments and services, practitioner, research, and individual/family work together in order to identify what works, for whom, and under what condition (individualized care), ensures that the treatments and services, when used as intended will have the most effective outcomes as demonstrated by the research and ensures that programs with proven success will be more widely disseminated and will benefit a greater number of people.

Specific Tactics of Prevention

Information campaigns (educating the public about how to cut down on certain risk factors through use of posters, flyers, etc), street outreach (sending outreach specialists into a designated area), community outreach (similar to street outreach, but done more often and in a group setting with the use of presentations and lectures) peer education (people who are members of your target population go into the community and act as positive role models), counseling (peer, one on one health counseling) and direct action (working on specific policy or program to reach the target population).

Findings of Flouri et al. (2010)

Investigated role of non-verbal cognitive ability on cumulative risk and NVCA moderated the role of risk when it comes to emotional arousal. When children had low cognitive ability, emotional arousal was strongly related to problem behavior and cognitive ability (e.g., cognitive flexibility, problem-solving aptitude)-provides a buffering effect over adversity. Main findings: multiple negative life events predicted emotional arousal which then predicted greater problem behaviors. The effect was reduced for those at higher levels of cognitive ability.

Is prevention better than cure?

It is better to try to keep a bad thing from happening than it is to fix the bad thing once it has happened.

Enculturation

Learning about your own heritage culture, learn about their own culture through experience, observation, and instruction.

Acculturation

Learning new culture, adopting cultural traits, and social patterns.

Barriers to using EBP

Limited access, critique, and skills to apply data, practitioners who may be interested in EBP do not have the knowledge to use EBP, lack of confidence/skill to use EBP, feelings like research is difficult to read/understand, and difficult to apply to practice, lack of acceptance of EBP, failure to communicate across groups (example: researchers informing practice, effectively involving a target population in decision-making), research on issue is not always available, insufficient training on how to use EBP, and how do you deal with complex social, family, and cultural contexts?

Where is EBP used?

Medicine (e.g. Nursing) Some research shows that a lot of nurses rely on information from other nurses and they aren't using research to support their practice Children's mental health, early care settings, health care, juvenile justice system, schools.

Who should be involved in developing prevention/intervention strategies?

Members of the community: increases public support, gives you a better sense of what the local resources are, better at targeting how to change community norms, and values (leading to long lasting change) Members of your target population: helps to establish trust, gives a better understanding of what the target needs, increases awareness of future program Practitioners should be involved in both the intervention and prevention.

3 interventions

Mental health consultants- who screen and identify serious problems, provide intervention, or train others to implement interventions Use a variety of techniques: play therapy, crisis intervention, counseling for families. Comprehensive family support is critical with a continuum of services (day treatment, out-and in-patient services, wraparound services).

Community caring collaboration

Model: The "bridging model" develops trust-based relationships between high-risk mothers with the health system and its multiple resources. Community members with advanced training provide the support and care linkages that are critical for family success. Impact of program: Innovative models of collaborative care impact the health of vulnerable mothers and their children working toward a marked decrease in health related disparities.

Risk factors in rural settings

Much more vulnerable to death due to injuries, more likely to use tobacco and other substances, at greater risk for obesity and other health concerns, poor access to health care, and large percentage living in deep poverty (27%).

Links to key themes

Navigation Community Reach: Services must be a part of the community, allow children/families to determine what services they need, also give a voice to participants accessing the services One-stop shopping: Integrate services (clustering), involves making services accessible (co-location) A Door is Back in: Fluid integration back into their communities (do not trap them into the system), give opportunities for joint activities to navigate between systems. What are we doing in terms of helping these children navigate back into the community? Negotiation Less is More: Fewer service providers that are involved (get to individually know children well and better advocate); could work as teams. Unknown, but not Unknowable: Cultivate cultural awareness, put aside bias, avoid making assumptions. Something to Shout About: Give more power to statements children make about themselves, effective case planning that provides for children's own uniqueness.

Themes (Navigation and Negotiation)

Navigation- how do children navigate or access the resources they need. Negotiation- how do children travel through systems of resources available to them.

Assumptions of low vs. high risk

Need to be careful of 'presumption' of risk conditions Key point: need to be careful when assuming particular groups are at high or low risk (example: immigrants).

Underlying Processes

Need to determine the casual antecedents; both vulnerability or resilience.

Categories of mental health

Neurodevelopmental Disorders: Autism spectrum disorder and attention deficit hyperactivity disorder Depressive and Bipolar Disorder Persistent Depressive Disorder (Dysthymia), bipolar disorder, and disruptive mood dysregulation disorder Anxiety disorders: Selective mutism, specific phobia, separation anxiety, social anxiety, panic disorder, agoraphobia, generalized Anxiety Disruptive, Impulse Control, and Conduct Disorders: Oppositional Defiant Disorder, intermittent explosive disorder, and conduct disorders Trauma and Stressor-Related Disorders: Reactive Attachment Disorder, disinhibited social engagement Disorder, and PTSD Feeding and Eating Disorders: Anorexia Nervosa, bulimia nervosa and binge-eating disorder

Conduct Disorder

Pattern of behavior in which the basic rights of others or societal norms and rules are violated. Behaviors fall into four categories: Aggression to people/animals, destruction of property, deceitfulness or theft, and serious violation of the rules. Three subtypes Childhood onset (prior to age 10), adolescent subtype (no symptoms prior to age 10), and unspecified (not enough information to determine onset) Risk added if symptoms reflect limited prosocial emotions (lack of remorse, empathy, concern about performance, or affect)

Risk factors in urban settings

Poor infrastructure, under resourced-institutions, inadequate drinking water, poor housing (few rent protections, crowded conditions), and large percentage living in deep poverty (22%).

Population, high risk strategy

Population strategy: Directed at the whole population irrespective of individual risk levels, directed towards socioeconomic, behavioral and lifestyle changes, related to organization and community development Examples: work on public awareness, change level of services, change policies/laws, build coalitions with other groups. High-risk strategy: Bring care to individual at special risk, identify individuals at high risk (try to change individual behavior) Examples: provide individual support or mentoring, incentives/disincentives, make program accessible to target population.

Resilience

Positive outcomes in the context of adversity; dynamic process that results from ongoing transactions between child and their environment.

Positive schemas

Positive schemas (Keyfitz, Lumley, Hennig, & Dozois, 2013): Having positive core beliefs that guide interpretation of the world (filters), more specific than a broad positive viewpoint, highlights specific positive beliefs about yourself Links to depression: Evidence that depression is negatively related to positive cognitive constructs, may have difficulty in processing positive events Links to anxiety: Evidence that low levels of positive cognitions regarding coping self-efficacy and control is related to vulnerability to anxiety disorders Links to resilience: Positive states facilitate resilience, at least help to maintain a neutral emotional state Findings in the article: Positive schemas contribute to prediction of depression and resilience, not as strongly to anxiety Lacking positive schemas stronger predictor than negative schemas for depression in youth Positive schemas can act as a protective factor Implications? Positive schemas could be a protective factor (linked to resilience) as well as a risk factor (lack of positive schemas).

Levels of prevention

Primary prevention/ Universal Prevention: Actions taken before onset of risk (removes possibility of risk emerging), health promotion (example: positive health), work on specific protective factors/processes, cost beneficial to everyone in the population Secondary prevention/Selective Prevention: Work on emerging symptoms, halts progress of risk, works on diagnosis and treatment, provides protection of risk to others in the community, and cost beneficial to subgroup of people who are at a high risk Tertiary prevention/ Indicated Prevention: Aimed at reducing risk from difficulties that are emerging (diagnosed), rehabilitative focus, and applied to groups who have early symptoms (or are susceptible to the risk) Newer level: Primordial prevention: Prevention of the emergence or development of risk factors in countries or population groups in which they have not appeared, efforts for discouraging children from adopting harmful activities/lifestyles, usually done through education

Levels of intervention

Primary: Core of the intervention, available to all the participants experiencing risk, very proactive and tries to access most of the people that are experiencing a risk, 80% of kids are targeted with primary types of intervention strategies. Secondary: Targeted group intervention (moderate intensity to activities), short term, and 15% of kids are targeted with secondary types of intervention strategies. Tertiary Intensive individual intervention, longest in duration, and 5% of kids are targeted with tertiary types of intervention strategies.

Links between adjustment and EI, findings

Protection vs Risk: Protection= Strong ethnic identity promotes good adaptation (promotes effects) Risk=Weak ethnic identity creates risk for lower levels of adaptation (vulnerability effects) Ethnic identity can confer risk/protection in context of specific risk (like school)

Protective factors for children who are high-risk

Protective factors in high-risk children may not be effective especially in context of other risk factors (example: protective factors diminish in neighborhoods with high poverty rates). Protective factors do not generalize across levels of risk, BUT sometimes they do.

Biopsychosocial model

Psychosocial factors can cause a biological fact by predisposing the individual child to different risk factors Considers biological, social, and psychological factors in understanding mental health and need to examine the multiple influences that impact/influence health as well as individual's perception plays a role in their health and their decisions regarding health.

Identity

Qualities, beliefs, personality, looks, and/or expressions that make a person (self-identity) or group (particular social category or social group)

Art therapy intervention

Research has demonstrated that siblings of children undergoing HSCT are at risk for developing psychosocial problems such as post traumatic stress, anxiety, and low self-esteem. This study examined psychosocial changes in siblings (N= 30) of pediatric HSCT recipients. These siblings participated in an art therapy intervention session 1 week, 1 month, and 3 months after their siblings' HSCT procedure. Results showed improvements in sibling psychosocial functioning associated with participation in the art therapy interventions. Compared to a control group (n= 10), the intervention group (n= 20) showed lower levels of post traumatic stress symptoms at the final session.

Interactive vs Group Analyses

Researchers are focused on interaction effects (differences by age, gender, and ethnicity); want to compare across groups. Researchers should look at specific groups and what makes a difference for at-risk children; move away from comparative analyses to examine critical processes for youth from specific backgrounds.

Four propositions of the International Resilience Project

Resilience has global as well as culturally and contextually aspects: 32 domains that are relevant (Table 2; cultural identification, perceived social equity, having goals and aspirations) Aspects of resilience exert differing amounts of influence over a child's life depending on the specific culture and context in which resilience is realized: Equivalence of same aspect of resilience across cultures Aspects of children's lives that contribute to resilience are related to one another in patterns that reflect a child's culture and context: Aspects of resilience are linked thematically How tensions between individuals and their cultures and contexts are resolved will affect the way aspects of resilience are grouped together: Seven tensions that are critical (Table 3, e.g., access to materials, power and control)

Resilience from a resource perspective (challenges)

Resilience is highly dependent on structural conditions, relationships, and access and is a result of both personal capacities and social, cultural assets Challenges: Lack of comprehensive study of patterns of service utilization, large number of children move "chaotically" between services, role of families in traveling through systems (families filter the services children receive), and some services unintentionally provide for more effective ways to access deviancy.

Science of Resilience

Resilience is like a scale with a fulcrum on it and there are things on both sides of the scale (experiences of both good and bad) and our genes determine where the fulcrum is positioned at the start. and certain genes make a child more sensitive to the effects of maltreatment. The fulcrum may start towards one side and that makes a big difference in terms of how these events affect things positively or negatively.

Stability and key elements linked to resilience

Resilience is not an all-or-nothing phenomenon, risk, careful about relying on stereotypes to determine what is high risk, positive outcomes need to examine the issue in specific domains or across several domains.

Implications

Resilience is not exclusively a quality of a person or context, can be a consequence of person's interpretation of adversities, improving resilience is possible even with adults, and need to develop mindsets that represent challenges as things that they can take on and overcome with time and effort.

Vanderbilt-Adriance and Shaw (2008) Key Concepts

Resilience, as a global construct, appears to be rare at the highest levels of risk, and that resilience may benefit from a narrower conceptualization focusing on specific outcomes at specific time points in development. The implication of this conclusion for future research and intervention efforts is then discussed.

Intervention

Response to an identified impairment It is measurable (goals are clear of that intervention and progress towards those goals can be measured), replicable (the method or program is structured and documented clearly enough that someone other than yourself could replicate it), successful (not only gets good results, but also is more likely to achieve goals over other programs [evidence based]), and fits the target audience (best practices).

Protective factors in rural settings

Schools may be better resourced and communities are smaller.

CPS: Career Option

See video.

Vulnerability

Situations where there is a high level of risk to children as the basic psychological needs are not being met.

Hopelessness Theory of Depression

Some individuals exhibit a more depressive, inferential style of thinking 3 types of negative inferences made: Causal inferences (inferences about why event occurred aka attributions) Inferred consequences (what will result from the event) Self inferences (inferences about self respect to the event)

Charles Hunt perspective on trauma and resilience

That resilience is one of the most important traits to have, is critical to their happiness and success, & can be learned.

Immigrant optimism hypothesis

The notion that foreign-born adolescents experience greater optimism that buffers against mental health symptoms.

Trends and future directions

Trends in the data: Depending on the sample, number of risks, and number/type of outcomes, rates of positive outcomes can differ widely. Need to be cautious in generalizing across levels of risk. Studies show that resilience fluctuates within and across development (global resilience is very rare.) Future directions: Need to focus decreasing overall exposure to risk (limits to amount of risk that can be overcome) in intervention and prevention, need to look at the developmental perspective (especially periods of transition), need to investigate effects of cumulative protective factors, Process through which protective factors have influence. What are the rates of resilience within and across groups? How do genetics play a role in resilience?

Personality traits

Typical patterns of behaving, thinking, and feeling, are likely to be another source of resilience.

Goals of research when studying resilience

Understanding child development, helps with prevention and intervention efforts, guide policy and social programs, researchers have to inform the research, literature, and accurately report findings to relevant groups (public health, media).

Deculturation

Unlearning about original culture, causes loss/abandonment of culture.

Response Sets

Ways that individuals respond to their depressive symptoms determines severity and duration of depression Three response styles: Rumination-thoughts and behaviors that focus attention inward which intensifies/prolongs depressive symptoms Problem-solving-actively trying to change the situation, but are hindered by depressive symptoms Distraction-attempting to engage in positive reinforcing activities to divert attention from symptoms Risk factors: Gender, adolescent stressors Protective factors: Social support, effective strategies Problems with the theory: Research on rumination is strong, research on the other two styles is weak (mixed results), few studies done with young children

Suicide prevention program

We compared youth mortality rates across time between counties that implemented GLS-funded gatekeeper training sessions (the most frequently implemented suicide prevention strategy among grantees) and a set of matched counties in which no GLS-funded training occurred. A rich set of background characteristics, including preintervention mortality rates, was accounted for with a combination of propensity score-based techniques. We also analyzed closely related outcomes that we did not expect to be affected by GLS as control outcomes. Results: Counties implementing GLS training had significantly lower suicide rates among the population aged 10 to 24 years the year after GLS training than similar counties that did not implement GLS training (1.33 fewer deaths per 100 000; P= .02). Simultaneously, we found no significant difference in terms of adult suicide mortality rates or nonsuicide youth mortality the year after the implementation. Conclusions: These results support the existence of an important reduction in youth suicide rates resulting from the implementation of GLS suicide prevention programming.