School‐Based Mental Health and Behavioral Programs for Low‐Income,Urban Youth: A Systematic and Meta‐Analytic Review

[Clin Psychol Sci Prac 18: 372–390, 2011] A systematic and meta‐analytic review was conducted of the effectiveness of school‐based mental health and behavioral programs for low‐income, urban youth. Applying criteria from an earlier systematic review ( Rones & Hoagwood, 2000 ) of such programs for all populations indicated substantially fewer effective programs for low‐income, urban youth. The meta‐analysis similarly failed to indicate effects of the typical program on primary outcomes. Effectiveness was evident, however, for programs that targeted internalizing problems or had a broader socio‐emotional focus and those delivered to all youth (i.e., universal). In contrast, negative effects were apparent for programs that targeted externalizing problems and were delivered selectively to youth with existing problems. Distinctive characteristics of low‐income, urban schools and nonschool environments are emphasized as potential explanations for the findings.     

Socioenvironmental conditions and nutritional status in urban and rural schoolchildren

We analyzed the nutritional status of urban and rural schoolchildren from Mendoza (Argentina), but avoided rural and urban categorization by generating subpopulations as a function of their socioenvironmental characteristics. We transformed weight and height data into z‐scores using the CDC/NCHS growth charts; defined underweight, stunting, and wasting by z‐scores of less than −2 SD; and calculated overweight and obesity, according to the cutoff proposed by the International Obesity Task Force. Socioenvironmental characteristics included housing, public services, parental resources, and farming practices; we processed these variables by categorical principal‐component analysis. The two first axes defined four subgroups of schoolchildren: three of these were associated with urban characteristics, while the remaining subgroup was considered rural. Nutritional status differed across groups, whereas overweight was similar among the groups and obesity higher in urban middle‐income children. Urban differences were manifested mainly as underweight, but rural children exhibited the greatest stunting and wasting. Thus, the negative effects of environment on nutritional status in children are not restricted to poor periurban and rural areas, though these are indeed unfavorable environments for growth: some urban families provide children with sufficient quantity and diversity of foods to expose them to obesity. By contrast, the more affluent urban families would appear to have greater possibilities for allowing their children to adopt a healthy life‐style. Although the causes of differences in nutritional status between middle‐ and high‐income urban groups are not clear, these determinants probably involve economic as well as educational influences. Am. J. Hum. Biol., 2008. © 2008 Wiley‐Liss, Inc.     

How neighborhoods matter for rural and urban children's language and cognitive development at kindergarten and Grade 4

The authors took a population‐based approach to testing how commonly studied neighborhood socioeconomic conditions are associated with the language and cognitive outcomes of residentially stable rural and urban children tracked from kindergarten (ages 5–6) to Grade 4 (ages 9–10). Child‐level kindergarten Early Development Instrument (EDI) data were probabilistically linked to scores on Grade 4's Foundation Skills Assessment (FSA), 4 years later, and to socioeconomic data describing the children's residential neighborhoods. Multilevel analyses were performed for a study population of 5,022 children residing in 105 neighborhoods across British Columbia, Canada: 635 children in 20 rural neighborhoods and 4,825 children in 85 urban neighborhoods. Concentrated immigration consistently predicted better child outcomes. Moreover, the determinants of children's language and cognitive outcomes analyzed cross‐sectionally differed from the determinants of outcomes analyzed longitudinally. Furthermore, there were notable differences in the extent of the relationship between neighborhood socioeconomic conditions and rural and urban children's outcomes over time. © 2010 Wiley Periodicals, Inc.     

Changing contexts? The effects of a primary prevention program on classroom levels of peer relational and physical victimization

Whereas school‐based prevention programs often target deficits in individual children's social skills in order to limit their aggression or exposure to peer victimization, there is increasing evidence that school‐wide and classroom‐level factors can also affect the success of these programs. This short‐term longitudinal study involved 432 elementary school students from 44 classrooms in 17 urban schools. We investigated whether classroom characteristics (average levels of social competence, emotional problems, and behavioral problems) and school‐wide characteristics (proportion of children on income assistance and implementation of a peer victimization prevention program—the Walk away, Ignore, Talk, and Seek help [W.I.T.S.] program) experienced in Grade 1 influences changes in children's reports of relational and physical victimization at the end of Grade 2. Findings showed that classroom levels of emotional problems predicted increases in relational victimization (beyond individual differences in emotional and behavioral problems). Classroom levels of behavioral problems predicted reports of increases in physical victimization (beyond individual differences). Classroom levels of social competence also interacted with individual levels of emotional problems such that children with higher levels of emotional problems in classes with more socially competent children reported more relational and physical victimization. Higher school levels of poverty and lack of program involvement also predicted higher levels of physical victimization, beyond individual and classroom effects. The capacity of the W.I.T.S. program to influence classroom level characteristics and the moderating effects of school poverty on victimization were also assessed. © 2003 Wiley Periodicals, Inc. J Comm Psychol 31: 397–418, 2003.     

Communitarianism and youth empowerment: Motivation for participation in a community‐based substance abuse prevention coalition

In recent years, collaborative efforts between universities and community‐based coalitions have helped develop prevention–intervention efforts to decrease the prevalence of drug and alcohol use among youth in low‐income, majority–minority urban areas.  One theory often employed to understand the efficacy of community member involvement is McMillian and Chavis's (1986) sense of community (SOC) model. This model posits how 4 main tenants (i.e., sense of belonging, emotional connection, needs fulfillment, and influence) lead to increased empowerment. The present study examines how individual SOC affected substance abuse coalition members’ (N = 17) motivations for serving on a coalition. Findings explore how all four tenants of McMillian and Chavis's (1986) model influenced community members’ involvement in the coalition, which have implications for prevention, policy, and further research.     

Urban–rural contrasts in the physical fitness of school children in Oaxaca,Mexico

The physical fitness of school children resident in an urban colonia and in a rural indigenous community in Oaxaca, southern Mexico, was compared. Two measures of performance‐related fitness (standing long jump, 35‐yard dash [32 m]) and four measures of health‐related fitness (grip strength, sit and reach, timed sit‐ups, distance run) were taken on 355 rural (175 boys, 184 girls) and 324 urban (163 boys, 161 girls) school children, 6–13 years of age. Urban children were significantly taller and heavier than rural children. Absolute grip strength did not consistently differ between rural and urban children, but when adjusted for age and body size, strength was greater in rural children. Explosive power (standing long jump) and abdominal strength and endurance (timed sit‐ups) were better in urban than in rural children without and with adjustment for age and body size. Urban–rural differences in running speed (dash) and flexibility (sit and reach) varied by age group and sex. Younger rural children and older urban girls performed better in the distance run, whereas older rural and urban boys did not differ in endurance. The size advantage of urban children does not necessarily translate into better levels of performance‐ and health‐related physical fitness. The observed differences may be related to activity habits associated with school physical education and lifestyle in the respective communities. Am. J. Hum. Biol. 15:800–813, 2003. © 2003 Wiley‐Liss, Inc.     

Children's work,earnings, and nutrition in urban Mexican shantytowns

For many children living in conditions of urban poverty, earning money can provide additional resources to them and their families, and this raises interesting questions about the potential biological consequences (costs and benefits) of children's work in ‘modern’ settings. This study uses time allocation, ethnographic, dietary, and anthropometric data collected with 96 urban Mexican shantytown children (aged 8–12 years) and their older and younger siblings (aged 1–18 years) to test hypotheses related to the effects of children's cash earning and cash contributions to their households for their own and their sibs' nutritional status. Regression models show that children's contributions to household income and the time they allocate to working outside the home makes no difference to their own or their younger siblings' nutritional status assessed anthropometrically. Dietary quality, based on food recalls, is worse in working than non‐working children, even taking household income into account. Children's allocation of time to work and their cash contributions to the household do however significantly improve the weight of their older siblings, especially sisters. This suggests children's work in urban ecologies might have different constraints and opportunities for their own and siblings' growth and nutrition than typically observed in subsistence settings. Am. J. Hum. Biol. 2010. © 2009 Wiley‐Liss, Inc.     

Characteristics of Emotionally Disturbed Children Referred to Day-Treatment,Special-Class,Outpatient, and Assessment Services

We examined characteristics differentiating 68 emotionally disturbed 6- to 12-year-old children referred to one of four treatment programs: day treatment, segregated class, outpatient treatment, or assessment only. We expected that children in the more intrusive programs (i.e., day treatment and special class) would be characterized by more severe emotional problems than would be children in the less intrusive treatment programs. Measures of children's emotional adjustment, family functioning, academic achievement, self-concept, and attending behavior in the classroom were administered prior to admission of children into their respective program. A multivariate analysis of variance was calculated on the 28 dependent measures administered in the study and failed to show significant group differences. Moreover, on most measures the results for all four groups did not deviate significantly from normal limits as indicated in the test administration manuals. We discuss possible reasons for these unexpected results and their implications.     

Psychopathology in 7‐year‐old children: Differences in maternal and paternal ratings and the genetic epidemiology

The assessment of children's psychopathology is often based on parental report. Earlier studies have suggested that rater bias can affect the estimates of genetic, shared environmental and unique environmental influences on differences between children. The availability of a large dataset of maternal as well as paternal ratings of psychopathology in 7‐year old children enabled (i) the analysis of informant effects on these assessments, and (ii) to obtain more reliable estimates of the genetic and non‐genetic effects. DSM‐oriented measures of affective, anxiety, somatic, attention‐deficit/hyperactivity, oppositional‐defiant, conduct, and obsessive‐compulsive problems were rated for 12,310 twin pairs from the Netherlands Twin Register by mothers (N = 12,085) and fathers (N = 8,516). The effects of genetic and non‐genetic effects were estimated on the common and rater‐specific variance. For all scales, mean scores on maternal ratings exceeded paternal ratings. Parents largely agreed on the ranking of their child's problems (r 0.60–0.75). The heritability was estimated over 55% for maternal and paternal ratings for all scales, except for conduct problems (44–46%). Unbiased shared environmental influences, i.e., on the common variance, were significant for affective (13%), oppositional (13%), and conduct problems (37%). In clinical settings, different cutoffs for (sub)clinical scores could be applied to paternal and maternal ratings of their child's psychopathology. Only for conduct problems, shared environmental and genetic influences explain an equal amount in differences between children. For the other scales, genetic factors explain the majority of the variance, especially for the common part that is free of rater bias. © 2016 The Authors. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics Published by Wiley Periodicals, Inc.     

Young Jamaicans' attitudes toward mental illness: Experimental and demographic factors associated with social distance and stigmatizing opinions

Two large‐scale studies assessed the nature and correlates of young Jamaicans' attitudes toward mental illness. In study 1, students viewed a videotaped job interview for a teacher whose history was manipulated to include a history of mental illness, or not. Students desired significantly less social distance (i.e., more contact) with the “normal” confederate, followed by those with a mental illness history. The putative cause of the mental illness (biomedical vs. psychosocial) made no difference. Study 2, a survey study, revealed the presence of negative attitudes toward people with mental illness and several demographic (age, gender, social class, and rural vs. urban location) differences. Implications of the results for community public health, education, and stigma‐reduction programs, as well as a comparison with research on stigma and attitudes toward mental illness in American culture, are discussed. © 2006 Wiley Periodicals, Inc.     

Emotional Understanding: A Comparison of Physically Maltreating and Nonmaltreating Mother-Child Dyads

Investigated emotional understanding in 22 physically maltreating mothers and their children and a matched control group to determine the ways in which a maltreating relationship may interfere with children's emotional development. Findings indicated that, when compared to controls, maltreating mothers were less likely to engage in discussion reflective of emotional understanding (e.g., causes and consequences of emotion) and maltreated children demonstrated lower levels of emotional understanding. Further, significant relations emerged between maternal behavior (e.g., discussion of emotion) and children's emotional understanding skills. Findings are discussed from the functionalist approach to emotional development, emphasizing the importance of social context in the development of children's emotional understanding skills. Potential clinical applications are also considered.     

Autonomic nervous system functioning in early childhood: Responses to cognitive and negatively valenced emotional challenges

Although autonomic nervous system (ANS) functioning is “context-dependent,” few studies examined children's normative sympathetic and parasympathetic autonomic responses to distinct challenges in early childhood years. Examining children's ANS responsivity to distinct challenges is important for understanding normative autonomic responses toward everyday life stressors and identifying paradigms that effectively elicit a “stress response.” We examined children's (N = 278) sympathetic (preejection period [PEP]) and parasympathetic (respiratory sinus arrhythmia [RSA]) responses to cognitive (i.e., problem-solving and cognitive control) and negatively valenced emotional (i.e., blocked goal and unfairness) challenges in preschool, kindergarten, and grade 1. Children, on average, demonstrated parasympathetic inhibition (RSA withdrawal) in response to all challenges but the magnitude of these responses depended on the task. Children showed sympathetic activation (PEP shortening) toward the problem-solving task at each assessment and there was no sample-level change in the magnitude of this response over time. Children showed greater sympathetic responsivity toward the cognitive control task over time, with evidence for a sympathetic activation response only in grade 1. Children experienced sympathetic inhibition (PEP lengthening) toward the unfairness tasks but did not experience significant sympathetic responsivity toward the blocked goal tasks. Parasympathetic responsivity to most challenges were modestly stable but there was no stability in sympathetic responsivity across time.     

Measuring behavior change in young children receiving intensive school‐based mental health services

An innovative urban school‐based mental health program was developed to treat the subset of elementary school‐referred children who are experiencing severe emotional and behavioral difficulties. The program served a group of 201 students and their families, referred from 15 elementary schools through a large urban school district in Ohio (K through fifth grade). The children in the sample are predominantly African‐American (N = 157, 78.1%), and male (N = 154, 76.6%), with an average age at admission of 9.23 years (SD = 1.75). Parents and teachers provided behavioral rating data using a standardized psychiatric assessment instrument (i.e., the Devereux Scales of Mental Disorders—DSMD). Results showed that at intake 68.7% of children scored above the clinical cutoff score of 60 on the conduct disorder subscale of the DSMD, with more than 40.8% of youth scoring 70 or higher. On the depression subscale 55.7% scored above the cutoff score, with slightly less than a third (30.8%) scoring 70 or higher. Hierarchical linear modeling (HLM) was used to measure longitudinal behavior change. Children evidenced statistically significant reductions in conduct disordered behavior ( p < .01), attention deficit/hyperactivity ( p < .05), and depressive symptomatology ( p < .01) over the course of approximately 1 year. © 2003 Wiley Periodicals, Inc. J Comm Psychol 31: 629–639, 2003.     

COMMUNITY SETTING‐SPECIFIC AND SERVICE‐SEEKING STIGMA TOWARD CHILDREN WITH EMOTIONAL AND BEHAVIORAL DISORDERS AND THEIR FAMILIES

This study investigates the stigma associated with mental health service seeking and community settings among children with emotional and behavioral disorders (EBD) and their parents living in rural areas. Parents (n = 185) rated stigma toward children with EBD and their families in school contexts significantly higher than the other community settings, and they rated stigma related to the context of church significantly lower than the others, with neighborhood and workplace falling in between. Stigma in each of these settings was a significant predictor of perceived service‐seeking stigma. These findings suggest the need for further examination of stigma toward children with EBD and their families in community settings and for additional research investigating service‐seeking stigma and its relationship to service‐seeking behavior and use.     

Reynolds adolescent depression scale‐second edition: a reliable and useful instrument

The authors conducted two studies to address issues of the dimensionality, scale reliability, and psychometric properties of scores on the Reynolds Adolescent Depression Scale‐Second Edition (RADS‐2; Reynolds, 2002 ) in samples of adolescent psychiatric inpatients. In Study 1 (N=262), they used bifactor analysis to further evaluate the general and specific components of the RADS‐2. In Study 2 (N=196), they used confirmatory factor analysis to evaluate the fit of a 1‐factor model, the original 4‐factor model, a second‐order model, and a bifactor model to a new sample data. In both studies, the total RADS‐2 and content‐specific subscale scores showed acceptable estimates of reliability (i.e., scale reliability estimates >.80). Estimates of concurrent validity were also examined. Scores of the RADS‐2 total and content‐specific subscale scores were useful in differentiating between the responses of youth with mood disorder diagnoses and those with other primary psychiatric disorder diagnoses. The authors also conducted correlation analyses to identify potential correlates for the total RADS‐2 scale and the proposed subscale scores. © 2010 Wiley Periodicals, Inc. J Clin Psychol 66:1–22, 2010.     

Is there a selective rural–urban migration in respect to height and weight?

Height and weight were examined in rural–urban premigrants from heavily depopulating regions in the countryside. The analysis involved children, 5.75–8.74 years, from rural schools in two rural districts in Poland, Bystrzyca K?odzka and Pińczów, in 1978. Migrants were identified while reexamining the children in the same schools 10 years later, i.e., in 1988, and by using information from local census registers. The premigrants from the villages of K?odzka Pińczów and Pinczow districts do not differ in height and weight when compared to the total population of rural children examined in each district. The comparison of height and weight in premigrants and nonmigrants in groups homogeneous for SES of the children's families indicates that if the SES of rural families is very low, individuals smaller in size tend to remain in the rural areas. When SES of the rural population improves, migration of the young seems to be random in respect to height and weight.     

Air pollution and children's respiratory health – gaps in the global evidence

There is now convincing evidence that air pollution, especially the particulate matter (PM) fraction, adversely affects children's health. In general, the health effects of traffic‐derived PM are well described in children living in high‐income countries. Conversely, studies into the health effects of PM from biomass and solid fuels are limited to children in lower‐income countries. As PM from different combustion sources have components in common (e.g. elemental black carbon) – are we able to extrapolate from the research performed in different countries under different exposure conditions? Using lung function growth and vulnerability to infection as examples of health effects of global significance to children, this review addresses the question whether high‐income‐country research into air pollution can inform effects of pollution in low‐income countries and vice versa. Cite this as: J. Grigg, Clinical & Experimental Allergy, 2011 (41) 1072–1075.     

What's in a blush? Physiological blushing reveals narcissistic children's social‐evaluative concerns

Physiological responses can reveal emotional states that individuals are unwilling to admit to others. Here, we studied what blushing reveals about the emotional states of narcissistic children. Narcissistic children (i.e., those high on the personality trait of narcissism) have a pervasive sense of grandiosity. We theorized that narcissistic children are so invested in their sense of grandiosity that even modest praise can make them feel depreciated. Because narcissistic children may not admit this feeling to others, we measured their physiological blushing: an involuntary reddening of the face that occurs when individuals anticipate being depreciated. Unlike other emotional expressions, blushing cannot be faked. Children (N = 105, ages 7–12) completed the Childhood Narcissism Scale and were then invited to sing a song on stage. They were randomly assigned to receive inflated praise (e.g., “You sang incredibly well!”), modest praise (“You sang well!”), or no praise for their performance. Blushing was recorded using photoplethysmography and temperature sensing. Afterward, children were asked how much they thought they had blushed. As predicted, narcissistic children—unlike nonnarcissistic children—blushed when they received modest praise, not when they received inflated praise. Specifically, they showed increased blood volume pulse (i.e., fast changes in blood volume with each heartbeat). Strikingly, when asked, narcissistic children denied blushing, perhaps to hide their vulnerabilities. Thus, blushing revealed social‐evaluative concerns that narcissistic children wished to keep private.     

The relation between common sleep problems and emotional and behavioral problems among 2- and 3-year-olds in the context of known risk factors for psychopathology

The contribution of sleep problems to emotional and behavioral problems among young children within the context of known risk factors for psychopathology was examined. Data on 2- and 3-year-olds, representative of Canadian children without a chronic illness, from three cross-sectional cohorts of the Canadian National Longitudinal Study of Child and Youth were analysed ( n  = 2996, 2822, and 3050). The person most knowledgeable (PMK), usually the mother, provided information about her child, herself, and her family. Predictors included: child health status and temperament; parenting and PMK depressive symptomatology; family demographics (e.g., marital status, income) and functioning. Child sleep problems included night waking and bedtime resistance. Both internalizing/emotional (i.e., anxiety) and externalizing/behavioral problems (i.e., hyperactivity, aggression) were examined. Adjusting for other known risk factors, child sleep problems accounted for a small, but significant, independent proportion of the variance in internalizing and externalizing problems. Structural equation models examining the pathways linking risk factors to sleep problems and emotional and behavioral problems were a good fit of the data. Results were replicated on two additional cross-sectional samples. The relation between sleep problems and emotional and behavioral problems is independent of other commonly identified risk factors. Among young children, sleep problems are as strong a correlate of child emotional and behavioral problems as PMK depressive symptomatology, a well-established risk factor for child psychopathology. Adverse parenting and PMK symptomatology, along with difficult temperament all contribute to both sleep problems and emotional and behavioral problems. Children's sleep problems appear to exacerbate emotional and behavioral problems.     

Network ties and mean lies: a relational approach to relational aggression

The current study considers how the structure of peer networks facilitates or constrains children's opportunities to engage in relationally aggressive behaviors such as social exclusion and rumor spreading. Specifically, the influence of two network features, centrality and density, on relational aggression are explored using grade‐level behavioral and social network data collected on a demographically diverse sample of 144 third through eighth grade urban elementary school students. As hypothesized, these network features influenced levels of teacher‐rated and peer‐nominated relational aggression beyond the effects of demographic characteristics (i.e., gender and grade). Results revealed that relational aggression is influenced not only by who children are, but also by where they are located in the peer context. Implications for future research and intervention are offered. © 2009 Wiley Periodicals, Inc.