This article reports on the development of two measures relating to historical trauma among American Indian people: The Historical Loss Scale and The Historical Loss Associated Symptoms Scale. ...Measurement characteristics including frequencies, internal reliability, and confirmatory factor analyses were calculated based on 143 American Indian adult parents of children aged 10 through 12 years who are part of an ongoing longitudinal study of American Indian families in the upper Midwest. Results indicate both scales have high internal reliability. Frequencies indicate that the current generation of American Indian adults have frequent thoughts pertaining to historical losses and that they associate these losses with negative feelings. Two factors of the Historical Loss Associated Symptoms Scale indicate one anxiety/depression component and one anger/avoidance component. The results are discussed in terms of future research and theory pertaining to historical trauma among American Indian people.
This article seeks to understand to what extent cultural engagement and substance use risk factors influence families' decisions to participate, and ultimately complete, a culturally grounded ...substance use prevention program. Using data from a 14-week culturally oriented family-based substance use prevention program, we examine predictors of successful recruitment and retention of American Indian youth and their caregivers. Guided by the theoretical model for developing culturally specific preventions, the community-based approach to recruitment resulted in 85.6% of eligible families from two American Indian communities agreeing to participate in the randomized controlled trial. After completion of baseline surveys, 57.3% of the intervention selected families initiated participation in the program sessions and 67.8% of these families completed participation in the program. We used logistic regression to analyze two different models: one that predicted whether invited families chose to participate and whether participating families attended eight or more sessions. Important predictors of participation in the intervention program included single-caregiver households, youth Indigenous language and cultural identity, youth early substance use initiation, and household substance use exposure. Overall, results from this study highlight the importance of fully engaged community research partnerships for multi-session family-based interventions, while identifying potential challenges to program recruitment and participation.
The study investigates change in occurrences for mental and substance abuse children between early and mid-adolescence among a group of indigenous adolescents. Findings show a dramatic increase in ...occurrence rates for substance abuse disorder and conduct disorder, and a mental health crisis on indigenous reservations and reserves indicating a need for immediate policy change to address the mental health disparities associated with rural reservation life.
We examined the longitudinal measurement properties and predictive utility of the Center for Epidemiologic Studies Depression Scale (CES-D) from early to late adolescence among a sample of North ...American Indigenous youths. Participants were 632 North American Indigenous adolescents (n = 632; 50.3% girls; M age at baseline = 11.11 years) participating in an 8-year, 8-wave longitudinal study. Via in-person interviews, participants completed the CES-D at Waves 1, 3, 5, and 7, and the major depressive disorder (MDD) module of the Diagnostic Interview Schedule for Children at Waves 1, 4, 6, and 8. Confirmatory factor analyses indicated that responses to the CES-D were similarly explained by 2-, 3-, and 4-factor models, as well as a 1-factor model with correlations between the error variances for the positively worded items. Longitudinal measurement equivalence analyses indicated full structural (i.e., factor structure), metric (i.e., factor loadings), and scalar (i.e., observed item intercepts) equivalence for each factor structure. Substantive analyses showed that the CES-D was significantly associated with MDD both concurrently and prospectively, although these effects were smaller than might be expected. Finally, the CES-D negative affect and somatic complaints subscales were the strongest and most consistent predictors of MDD. Among our sample of North American Indigenous youths, the measurement properties of the CES-D were stable from early to late adolescence. Moreover, somatic difficulties and depressed affect were the strongest predictors of MDD.
Indigenous communities lack representation in psychiatric epidemiology despite disproportionate exposure to risk factors. We document the cumulative and 12-month prevalence of psychiatric disorders ...across the early life course among a sample of Indigenous young adults and compare prospective and retrospective reporting of lifetime mental disorders. This community-based participatory research includes data from 735 Indigenous people from 8 reservations/reserves. Personal interviews were conducted between 2002–2010 and 2017–2018 totaling 9 waves; diagnostic assessments of DSM-IV-TR alcohol abuse/dependence, marijuana use/dependence, other substance abuse/dependence, generalized anxiety disorder, major depressive disorder, dysthymic disorder, and attention deficit/hyperactivity disorder occurred at waves 1 (mean age = 11.1 years), 4 (mean age = 14.3 years), 6 (mean age = 16.2 years), 8 (mean age = 18.3 years), and 9 (mean age = 26.3 years). Cumulative lifetime psychiatric disorders reached 77.3% and lifetime comorbidity 56.4% by wave 9. Past-year prevalence and comorbidity at wave 9 were 28.7% and 6.7%, respectively. Substance use disorders (SUDs) were most common with peak past-year prevalence observed when participants were on average 16.3 years old then declining thereafter. Trends in early life course psychiatric disorders in this study with Indigenous participants highlight cultural variations in psychiatric epidemiology including surprisingly low rates of internalizing disorders in the face of risk factors, disproportionately high rates of early-onset and lifetime SUD, and lower rates of past-year SUD in early adulthood compared with prior research.
This study compares participation in deviant subsistence strategies, street victimization, and lifetime prevalence of five mental disorders (conduct disorder, major depressive disorder, ...post-traumatic stress disorder, alcohol abuse, and drug abuse) among heterosexual males and females (n = 366) and gay, lesbian, and bisexual (n = 63) homeless and runaway adolescents from the first wave of a longitudinal study of homeless youth in four Midwestern states. The results indicate that gay, lesbian, and bisexual adolescents were more likely to have been physically and sexually abused by caretakers, were more likely to engage in risky survival strategies when on their own (including survival sex), were more likely to be physically and sexually victimized when on the streets, and were more likely to meet criteria for mental disorder than were their heterosexual counterparts.
This study investigated internalizing and externalizing symptoms as potential mediators of the relationship between perceived discrimination and early substance abuse among 195 American Indian 5 ...through 8 graders from three reservations that share a common culture (e.g., language, spiritual beliefs, and traditional practices) in the upper Midwest. The findings indicated that, although perceived discrimination contributed significantly to internalizing symptoms among the adolescents, internalizing symptoms were unrelated to early substance abuse. Rather, the effects of perceived discrimination on early substance abuse were mediated by adolescent anger and delinquent behaviors. The results are discussed in terms of the consequences of perceived discrimination on the development of American Indian early adolescents.
Objective
Our objective was to investigate change in prevalence rates for mental and substance abuse disorders between early adolescence and young adulthood in a cohort of indigenous adolescents who ...participated in an 8-year panel study.
Method
The data are from a lagged, sequential study of 671 indigenous adolescents (Wave 1) from a single culture in the Northern Midwest USA and Canada. At Wave 1 (mean age 11.3 years, Wave 4 (mean age 14.3 years), Wave 6 (mean age 16.2 years), and at Wave 8 (mean age 18.3 years) the tribally enrolled adolescents completed a computer-assisted personal interview that included DISC-R assessment for 11 diagnoses. Our yearly retention rates by diagnostic wave were: Wave 2, 94.7 %; Wave 4, 87.7 %; Wave 6, 88.0 %; Wave 8, 78.5 %.
Results
The findings show a dramatic increase in lifetime prevalence rates for substance use disorders. By young adulthood, over half had met criteria of substance abuse or dependence disorder. Also at young adulthood, 58.2 % had met lifetime criteria of a single substance use or mental disorder and 37.2 % for two or more substance use or mental disorders. The results are compared to other indigenous diagnostic studies and to the general population.
Conclusions
A mental health crisis exists within the indigenous populations that participated in this study. Innovations within current mental health service systems are needed to address the unmet demand of adolescents and families.
Objective: To examine street victimization and posttraumatic stress symptoms among urban homeless adolescents and to test whether emotional numbing and avoidance represent distinct posttraumatic ...stress disorder (PTSD) symptom clusters. Method: Structured, private interviews were conducted with homeless adolescents (N = 374) in the Seattle metropolitan area (95% response rate) from 1995 to 1998. Results: Eighty-three percent of street youths were physically and/or sexually victimized after leaving home. Approximately 18% of these youths met research criteria for PTSD. Results from a confirmatory factor analysis suggest that disaggregating symptoms of avoidance from symptoms of emotional numbing provides a better fit of the data than the current DSM-IV model in which these symptoms are combined in one factor. Conclusions: Sexual and physical victimization are serious threats for homeless adolescents, and those who are victimized are at risk for PTSD. Results challenge the belief that symptoms of avoidance and numbing represent one unified cluster in this population.
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