This paper describes an empirical approach to assessing pediatric residents' attitudes, knowledge and skills in primary care behavioral health. Outcomes from that assessment approach are presented from two pediatric residency training programs in the northeastern United States. Thirty-six pediatric residents completed attitudes, knowledge and skills surveys. The survey was developed to align with the American Academy of Pediatrics’ Policy Statement in 2009 citing aspirational competencies for pediatricians in primary care behavioral health. This alignment addressed both learner variables (attitudes, knowledge, and skills) as well as clinical presentations (ADHD, anxiety, depression, and suicide) highlighted in the policy statement. The survey specifically inquired about self-reported confidence and comfort in managing behavioral health concerns using evidence-based practice parameters (attitudes and knowledge) and their measured ability to deliver evidence-based care in response to clinical vignettes (skills). Findings largely revealed no statistically significant differences in attitudes, knowledge or skills between interns and upper-level residents. Training programs can use the approach described in this paper and the assessment instrument with some possible modifications to monitor annual progress and evaluate any changes in didactic and clinical training.

År 2015 drabbades Europa av en stor flyktingkris, däribland Sverige, där många ensamkommande flyktingar från framförallt Syrien och Afghanistan flydde till Sverige för att söka skydd. Syftet med denna studie är att undersöka de syriska ensamkommande flyktingarnas upplevelse av sin integrationsprocess i Sverige och vad som kan ha varit försvårande för integrationen. Vi har använt oss av kvalitativa intervjuer där vi utgick från en given intervjuguide. Vårt urval har varit syriska ensamkommande flyktingar, som var mellan 16-22 när de kom till Sverige 2015 och senare. De teoretiska utgångspunkterna har varit Aaron Antonovskys teori om känsla av sammanhang (KASAM), Erving Goffmans teori om stigma, samt stämplingsteorin. Resultatet visade på att de syriska ensamkommande flyktingarnas tid i Sverige har varit svår med många utmaningar. Det framgår att sociala förbindelser är mycket viktiga för de unga ensamkommande, eftersom det i sin tur påverkar den sociala hälsan och upplevt välbefinnande. För att kunna skaffa sig kontakter måste man behärska det svenska språket, men även andra faktorer var avgörande för om man kunde integreras i samhället. / In 2015, Europe was hit by a major refugee crisis, including Sweden, where many unaccompanied refugees from mainly Syria and Afghanistan fled to Sweden to seek protection. The purpose of this study is to investigate the Syrian unaccompanied refugees' experience of their integration process in Sweden and what may have made integration difficult. We have used qualitative interviews where we started from a given interview guide. Our sample has been unaccompanied Syrian refugees, who were between 16-22 when they came to Sweden in 2015 and later. The theoretical starting points have been Aaron Antonovsky's theory of sense of coherence (KASAM), Erving Goffman's theory of stigma, and the labeling theory. The results showed that the Syrian unaccompanied refugees' time in Sweden has been difficult with many challenges. It appears that social connections are very important for the young unaccompanied minors, as this in turn affects social health and perceived well-being. In order to make contacts, one must master the Swedish language, but other factors were also decisive for whether one could be integrated into society.

The Alcohol Use Disorder Identification Test (AUDIT) is a brief screening instrument for assessing alcohol use problems among adults. This instrument is widely used and continued evaluation of its psychometric performance is needed. Reliability and validity are the primary psychometric characteristics of interest when evaluating psychological instruments. The focus of the present study is on reliability, which reflects the consistency or repeatability of the scores produced by a given instrument. Using meta-analytic methods, results showed that approximately 65% of previously published studies using the AUDIT did not appropriately report reliability estimates. Among the remaining studies, weighted reliability estimate centered on .81 (SD = .07) suggesting that the AUDIT generally produces scores of adequate reliability for most research purposes. Multiple regression equations showed that, among a variety of sample and methodological characteristics, the standard deviation of scores was the only statistically significant predictor of the variability in AUDIT score reliability estimates.

EMS personnel were examined for Post Traumatic Stress symptoms and the usefulness of Critical Incident Stress Debriefing (CISD) using the Los Angeles Symptom Checklist (LASC) and a demographics questionnaire. This study revealed that women in this group show higher PTSD symptoms than male coworkers. Level of Training (LOT) of the EMS provider did not demonstrate a significant difference in whether a provider developed PTSD. EMS personnel receiving debriefing actually suffered greater levels of PTSD than those that did not receive debriefing. And 16% of EMS providers in this study suffered from PTSD, while approximately 20% suffered from partial PTSD or PTSS. The results suggest that there are high levels of PTSD within the EMS community, especially in women. This study also suggests that CISD does not help with PTSD symptoms and may actually worsen them.

The purpose of this study was to analyze gender, race, substance abuse programs such as Drug Abuse Resistance Education (D.A.R.E.), parents, and peers and their ability to influence or predict adolescents and their decisions to use marijuana. All of the variables used for this study came from secondhand data collected by Esbensen and Osgood (1999), Gang Resistance Education and Training (G.R.E.A.T.). The analysis revealed that males are more likely to have ever used marijuana, that mixed race adolescents have a higher rate than other races to have ever used marijuana, that when adolescents complete the substance abuse program, D.A.R.E. have a lower rate than those who did not complete the program, adolescents are less likely to have ever used marijuana when their parents know where they are, and adolescents are more likely to have ever used marijuana when they have friends who use marijuana.

The purpose of this study was to explore the relationship between alcohol, tobacco, and marijuana use among teenagers. This study examined three research questions: (1) Is there a relationship between demographic characteristics (i.e., sex and race), the attitudinal variable (attachment to family), and the admitted use of marijuana, alcohol, and tobacco among teenagers? (2) Is there a relationship between the use of marijuana by teenagers and the use of tobacco by teenagers? (3) Is there a relationship between the use of marijuana by teenagers and the use of alcohol by teenagers? The data used for this paper were from the Evaluation of the Gang Resistance Education and Training Program research project (Esbensen, 2003). The analysis found that the frequency of teenage alcohol use had the strongest correlation with the use of marijuana. The frequency of teenage tobacco use was also found to have a significant correlation to marijuana use.

Every year in the United States approximately 30,000 people commit suicide including approximately 1,100 college students. Furthermore, heavy alcohol consumption is prevalent on many college campuses and has been linked to suicidal behavior. The present study was conducted to examine suicidal ideation and reasons for living in college students with varying levels of risk for alcohol related problems. Undergraduate students (n = 161) were administered a survey to assess demographics, suicide ideation status, reasons for living, and the participant's level of risk for alcohol related problems. Results indicated that suicide ideators are significantly more likely than non-ideators to be at risk for alcohol related problems. Also, women were significantly more likely to be suicide ideators and endorse more reasons for living. The results of this study may be used to identify groups who are at an increased risk for suicide, as well as to implement more efficient intervention and prevention programs on the collegiate level.

Coleridge's usual use of opium was through laudanum, a mixture of opium and alcohol. This thesis presents the history of and criticism regarding the poet's use of laudanum and the physical and emotional consequences the drug held for him and his writing career.

The theory of shattered assumptions proposes that experiencing traumatic events can change how people view themselves and the world. Most adults experience a traumatic event during their lifetime, and some subsequently develop post-traumatic stress disorder (PTSD). However, the current conceptualization of trauma (i.e., Criterion A PTSD) may be too narrow to adequately capture the range of potentially traumatizing events that People of Color experience, including racial discrimination and neighborhood disadvantage. This study investigated the association of racial discrimination and neighborhood disadvantage with core beliefs about the world being safe and predictable (i.e., world assumptions) among a sample of Black, Latine, and Asian young adults. Multi-step analyses of covariance tested associations between racial discrimination and neighborhood disadvantage with world assumptions and whether these held in the context of other traumatic exposures. Results indicated that racial discrimination negatively impacted world assumptions among Asian young adults only and this effect remained in the context of trauma. In addition, low neighborhood support negatively impacted world assumptions across all racial groups and neighborhood violence negatively impacted world assumptions among Latine young adults only; however, this effect did not remain in the context of trauma. This study indicates it is worthwhile to consider other adverse events in the conceptualization of trauma, such as racial discrimination and neighborhood disadvantage, that may impact world assumptions and contribute to subsequent post-trauma psychopathology.

This research study quantifies and describes suicide among South Asian Americans (SAAs), an emerging population that are underrepresented group in suicide research. The purpose of this study was to examine key characteristics of suicide deaths among SAAs. Data were employed from DuPage County, IL, a county with a large SAA population. Following federal recommendations for disaggregating Asian American data at a granular level, four SAA researchers used name recognition to identify all SAA cases classified as suicide in the DuPage County coroner’s database from 2001 to 2017 (N = 38). Coroner’s reports were analyzed for contextual details and correlating factors specific to each suicide. Overall, 76.3% of victims were male and 45.0% were married. An analysis of the coroner reports established that 71.1% of decedents showed behavioral disorders that were predisposing risk factors for suicide including mental health diagnoses (57.9%), and a reported prior suicide attempt (21.1%). Among these decedents only 34.2% had received any prior psychiatric care. Significant errors in racial classification of SAAs, lead to a gross undercount of SAA deaths by suicide with 55% of South Asian suicides assigned to a different race or ethnic group. Future studies must increase the scope of this research to other geographic locations with high concentrations of SAAs and examine the risk factors for suicide among SAAs, one of the fastest growing ethnic populations in the U.S.