This Q methodology study focused on those intrinsic attributes that successful African American men who had adverse childhood experiences attributed to their success. Using the purposeful and snowball sampling recruitment process, forty-two successful African American men participated in this research project. Five distinct factors were identified and labeled as, Factor 1: The Godly Working Men, Factor 2: The Competitive Men, Factor 3: The Charismatic Men, Factor 4: The Expectation Driven Men, and Factor 5: The Proud African American Men. The main findings were that respectful African American boys who are taught to understand who they are spiritually, be proud of their racial history, have a sound sense of purpose, and a desire to work hard are tooled to become successful African American men. The findings in this study support the wealth of research regarding strength-based youth development approaches, such as the Positive Youth Development’s 40 Developmental Assets framework. The six top intrinsic attributes that the participants in this research project ranked as most contributing to their success were 1) faith and trust in God, 2) desire to learn and understand how to apply the word of God to their life, 3) being respectful of others, 4) having a sense of purpose and value for life, 5) pride in racial identity and history, and 6) the ability to work hard and do their best. However, the intrinsic attributes relating to spirituality and pride in racial identity and history are not explicitly identified within the internal assets of the Positive Youth Development’s 40 Developmental Assets framework. For this framework to be meaningful for African Americans, the pride in racial identity and history attribute should be added to the positive identity group and a new group should be included to account for the two spirituality attributes. This study provided evidence that African American men from adverse backgrounds have voices and want to share their experiences to help other young people overcome and be successful. It is highly recommended that additional study be conducted on the impacts that extrinsic and intrinsic attribute have to the success of African American men.

Introduction. La notion d'" embodiment " propose que chaque humain est à la fois un être social ainsi que biologique, intégrant le monde dans lequel il/elle vit. Nous faisons l'hypothèse que la position socioéconomique pendant l'enfance peut être biologiquement incorporée, conduisant à la production des inégalités sociales de santé entre les sous-groupes de population. La charge allostatique (CA) est un concept qui tente de capturer l'usure physiologique globale du corps liée à l'activation répétée des mécanismes physiologiques compensatoires en cas d'exposition à des stress chroniques. La CA pourrait permettre une meilleure compréhension des voies biologiques qui jouent un rôle potentiel dans la construction du gradient social de santé des adultes. Objectif. Pour explorer l'hypothèse d'incorporation biologique, nous avons examiné les voies de médiation entre les adversités psychosociales et la position socioéconomique précoces et la CA à 44 ans. Nous avons également confronté l'indice de CA à une mesure multidimensionnelle de santé latente à 50 ans. Méthodes. Les données sont issues de la cohorte Britannique de naissance de 1958 (n=18 000). La CA a été construite avec les données de l'enquête biomédicale conduite à 44 ans, comme une mesure physiologique synthétique, multi-système, à l'aide de 14 biomarqueurs représentant les systèmes neuroendocrinien, métabolique, immunitaire / inflammatoire et cardiorespiratoire. Résultats. L'ensemble de nos résultats suggèrent que la CA pourrait être un indice approprié pour capturer partiellement la dimension biologique des processus d'embodiment. Discussion. Comprendre comment l'environnement affecte notre santé en se " glissant sous la peau " et pénétrant dans les cellules, les organes et les systèmes physiologiques de notre corps est un principe clé dans la recherche en santé publique. Promouvoir le recueil de marqueurs biologiques dans des grandes études prospectives et représentatives est crucial pour continuer la recherche sur ce sujet. Les études de réplication pourraient faire partie des futures perspectives de recherche, pour comparer entre populations avec des contextes culturels différents pour observer si un index de CA peut être considéré comme "universel ". / Introduction. The notion of embodiment proposes that every human being is both a social and a biological organism that incorporates the world in which (s)he lives. It has been hypothesized that early life socioeconomic position (SEP) can be biologically embedded, potentially leading to the production of health inequalities across population groups. Allostatic load (AL) is a concept that intends to capture the overall physiological wear-and-tear of the body triggered by the repeated activation of compensatory physiological mechanisms as a response to chronic stress. AL could allow a better understanding of the potential biological pathways playing a role in the construction of the social gradient in adult health. Objective. To explore the biological embedding hypothesis, we examined the mediating pathways between early SEP and early adverse psychosocial experiences and higher AL at 44 years. We also confronted an AL index with a latent multidimensional and integrative measure of health status at 50y. Methods. Data are from the 1958 British birth cohort (n=18 000) follow-up to age 50. AL was operationalized using data from the biomedical survey collected at age 44 on 14 parameters representing the neuroendocrine, metabolic, immune-inflammatory and cardiovascular systems. Results. Overall, our results suggest that AL could be a suitable index to partially capture the biological dimensions of embodiment processes. Discussion. Understanding how human environments affect our health by 'getting under the skin' and penetrating the cells, organs and physiological systems of our bodies is a key tenet in public health research. Promoting the collection of biological markers in large representative and prospective studies is crucial to continue to investigate on this topic. Replication studies could be part of the future research perspectives, to compare with other cultural context and to observe if an AL index can be 'universal'.

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Syftet med studien var att undersöka hur känsla av sammanhang (KASAM) påverkas i vuxenlivet hos individer som farit illa i barndomen. Tidigare forskning tydliggör vilken omfattande problematik det kan vara. Vidare undersöker studien betydelsen av vändpunkter och motståndskraft för posttraumatiskt växande. Den kvalitativa metoden består av sex semistrukturerade intervjuer. Den kvantitativa metoden innefattar en webbenkät där 101 respondenter deltog. Antonovskys KASAM tillsammans med Mays existentialism och Honneths erkännandeteori lägger grunden för studiens teoretiska ansats. Resultatet visar att en förlust av grundtillit och egenvärde i barndomen leder till en svag känsla av sammanhang. Urvalsgruppens KASAM-värden var avsevärt lägre än normalbefolkningens, dock med hög meningsfullhet. I vuxenlivet tycks det viktigt att ta igen barndomens förluster. Samtalsstöd med ett salutogent synsätt kan kompensera för denna förlust. Det tillsammans med meningsskapande processer kan leda till posttraumatiskt växande. / The aim of this study was to examine how sense of coherence (SOC) is affected in adulthood in people who have suffered from adverse childhood experiences. Previous research indicate on how comprehensive of a problem this is. We also wanted to examine the impact of turning points and resilience for posttraumatic growth. The qualitative method consists of six semi- structured interviews. The quantitative method is composed of a web survey in which 101 respondents participated. Antonovsky's SOC together with May's existentialism and Honneth's theory of recognition lays the foundation for the study's theoretical approach. The result shows that a loss of basic trust and intrinsic value in childhood leads to a low sense of coherence. Participants SOC values was significantly lower than the normal population, however they scored high on meaningfulness. In adulthood it seems important to reclaim these losses from childhood. Different types of counseling with a salutogenic approach can make up for that loss. This, together with meaning-making, can lead to posttraumatic growth.

Survivors of complex childhood trauma (CCT) tend to develop distinctive mental health challenges later on in adulthood, which may be exacerbated by the ongoing coronavirus pandemic. CCT survivors often struggle with self-regulation, making it difficult to tolerate the distress associated with “gold-standard” trauma-processing therapies for survivors of single-incident and adult-onset trauma. Yoga can enhance self-regulation, through physical movements, breathing techniques, meditative focus, and ethical guidelines of behaviour. This dissertation encompasses the creation of a new approach for teaching yoga to trauma survivors, called TIME yoga. This approach is based on a neuropsychological understanding of the bio-psycho-social alterations that CCT survivors undergo. Chapter 1 details the methods employed in this series of dissertation studies. A randomized controlled trial (RCT) was conducted with 26 adult survivors of CCT. Mental health, emotional functioning, resilience, and cognitive functioning were assessed via subjective and objective measures at two time points (i.e., pre- and post- participation in the online yoga program or waitlist). Chapter 2 is a retrospective and cross-sectional study describing survivors’ pre-intervention psychological and cognitive functioning during the pandemic, and evaluating the impact of trauma at particular developmental stages. Regression analyses revealed particular implications of adolescent and young-childhood trauma. Chapter 3 presents a manual of TIME yoga and feasibility data from the initial RCT, supporting both feasibility and safety of the program. Chapter 4 underscores yoga-related improvements in depressive symptoms, interoceptive awareness, and executive functioning. Using both repeated-measures ANOVAs and clinically meaningful indicators of change, this study illustrates how TIME yoga effectively improved survivors’ self-regulation during the global health crisis. Future directions for program development and evaluation are discussed. / Graduate / 2023-04-11

Today’s elementary school students face myriad traumatic issues including poverty, violence, physical and emotional abuse, homelessness, and parental substance abuse. These adverse childhood experiences are responsible for an increased risk of academic failure and behavioral problems in childhood, adolescence, and into adulthood. Social-emotional learning (SEL) programs, provided through school and community partnerships, attempt to address these needs in both school-based and out-of-school-time (OST) learning settings. The purpose of this action research study was to examine one northern California-based nonprofit organization’s OST SEL program for third through fifth grade students and determine actions and interventions for greater program effectiveness. Students, parent/guardians, site administrators, school-staff, and community members engaged in focus groups, completed surveys, participated in validation groups, and acted as research associates throughout the iterative plan, act, observe, reflect action research cycle conducted during the winter of 2020. Qualitative data from focus group meetings included identified themes from authenticated and coded transcripts while quantitative data included descriptive statistical analysis of pre-program and end-of-program surveys. As the lead researcher for the study, I worked with action research participants to make program modifications and identify new actions for program improvement. Based on themes and data trends, as well as the application of self-determination theory’s basic psychological needs theory, findings demonstrate that student self-management skills improved during the 4-week action research cycle, as did their sense of autonomy, competence, and relatedness. At the same time, findings suggest additional growth opportunities in the areas of responsible decision-making and program improvement through development and implementation of integrated and universal SEL supports in classrooms, schools, families, and the larger community. Linking the literature to these findings, recommendations for future action research cycles include age and developmental considerations regarding instruction and application of responsible decision-making skills, and integration of all five SEL competencies for greater harmonization of emotion and thought. To that end, the nonprofit organization’s educational design team and I have begun redesigning the curriculum. Program modifications address child development of perceptual and higher-level memory and cognitive skills, and intentional integration of instruction and practice in all five SEL competencies throughout each program module. Teaching, combined with real-time application of planning and decision-making skills, will include opportunities for active role-playing, adult guidance, and experiences in which students learn and grow from mistakes. In addition to student program modifications to build responsible decision-making skills, literature supports the call for universal SEL in the form of partnerships between schools, families, and community organizations for resource coordination resulting in more positive youth outcomes. Again working with the educational design team, the nonprofit organization and I have taken initial steps to establish a city wellness task force, bringing together a diverse group of stakeholders to partner in wellness for children and families in the community. We also continue to iterate as we develop a community of practice for educators, focused on building SEL knowledge and practice. By focusing on continuous improvement through an ongoing action research process, this study not only serves as an opportunity to celebrate successes, but highlight growth opportunities to advance the work of the northern California-based nonprofit organization and its programs. Utilizing study findings in combination with supporting literature, we are taking immediate action towards more positive outcomes for those we serve. This study also provides tools and guidance for other community partners in their design and implementation of effective SEL programs for the social and emotional well-being of elementary school students and families, and the communities in which they live.

Abstract Adverse Childhood Experiences and Trauma-Informed Schools: Restorative Practices for Social and Emotional Behavior Issues in Education by Heather Easterling The purpose of this study was to determine whether factors in school climate and culture and the educator's role in evaluating adverse childhood experiences (ACEs), trauma-informed situations, and disruptive classroom behaviors, enable a school to generate interventions needed to help students succeed. This qualitative study evaluated the ACEs and the relationships traumatic incidents had on disruptive classroom behaviors that teachers experienced with students. Although there is emerging research regarding ACEs and trauma-informed schools, there are multiple factors that facilitate the relationship between ACEs and disruptive classroom experiences. Data collection strategies included the use of interview procedures and document review. This evidence was gathered from teachers who provided their experiences with disruptive classroom behaviors and their experiences with behavior intervention programs such as RTI2B (Response to Instruction and Intervention for Behavior) and trauma-informed practices. Analysis of data occurred in three phases: (a) categorization based on emergent themes from the interviews, (b) constructing the explanation in narrative form, and (c) re-examination of the collected data concerning discipline referrals, school climate surveys, and attendance surveys. This research study provided insight into experiences teachers had with disruptive classroom behaviors. The experiences showed implementation of trauma-informed practices, a positive behavior program, and the need for a support system for teachers to be able to better reach students who have experienced ACEs that are related to disruptive classroom behaviors. The results revealed that there were direct factors that determined that the relationship between ACEs and trauma were consistent with disruptive classroom behaviors.

Prior research suggests a greater degree of suicidality and self-harm behavior in those involved with criminal justice and forensic mental health systems. Such individuals also evidence increased exposure to early childhood adversity, which is often associated with suicide risk. Other significant predictors of suicidality have been noted within forensic populations, however, including indicators of specific psychopathology and situational and demographic factors. These populations present with overlapping risk factors that remain underexamined. In the current study, 182 persons residing in secure forensic psychiatric care following incidents of illegal and aggressive behavior were evaluated. Adverse childhood experiences and other empirically derived potential predictors of suicide attempts and self-harm were examined via binomial logistic regression. Findings indicate frequent experiences of early adversity across participants, and that a combination of race, individual adverse childhood experiences, number of biological children, and diagnoses of either posttraumatic stress disorder or borderline personality disorder were significant predictors of suicide attempts, self-harm behavior, and first hospitalization resulting from a suicide attempt. Clinical and research implications are discussed.

Trauma-informed care is a relatively new construct in K-12 education, and districts across the United States are seeking avenues to meet the needs of their students. The COVID-19 pandemic elevated the need for districts to develop appropriate supports to address student and adult trauma. Traumatic events can affect a child’s mental, physical, social-emotional, and/or spiritual well-being (Substance Abuse and Mental Health Service Administration, 2011). Furthermore, children with an elevated risk of trauma may not be able to access these supports outside of the school setting (Baweja et al., 2015). Therefore, educational systems need to develop trauma-informed care models for schools that furnish a sense of safety and community so that students receive the necessary support. This evaluation aimed to identify how the moderating factors of district administrators, site administrators, climate and culture, and teacher capacity affect trauma-informed care via a multi-tiered system of support (MTSS) framework. It included a specific focus on Tier 1, universal access, to improve timely support for students. This formative program evaluation explored the impact of the moderating factors through the viewpoint of a newly created conceptual framework. I used qualitative and quantitative data sources to explore the multiple aspects of the phenomenon. The ARTIC-45 provided descriptive statistics about educators’ attitudes toward trauma-informed care. The observational data and analysis of the Panorama Education social-emotional learning (SEL) survey that assessed 3rd-12th students social-emotional well-being provided character to the evaluation. The data analysis yielded inconsistent results. The observational data strongly indicated a trauma-informed environment in which students were given clear expectations and engaged in positive reciprocal interactions with peers and adults. The ARTIC-45 data showed that administrators, teachers, and support staff responded favorably to trauma-informed care approaches. Though statistical significance could not be obtained due to the sample size constraint of being too small, the data provided context to the other data sources. For example, teacher capacity could not be quantified, but the data provided context to the overall staff capacity. The review of the archival and current SEL survey data showed that favorability among domains varied by site and grade level. The variations in students' social-emotional favorability can be related to their lived experiences and it is important to track over time to monitor how experiences, expressions, and feelings change over time. Students' perspectives regarding themselves and their environment differed from the observational data. This indicates that educators should not solely rely on observational data to determine students’ social-emotional well-being. Furthermore, an SEL survey can be used as a tool to understand students’ well-being and thus provide them with timely support. The evaluation determined that district administration, site administration, climate and culture and staff capacity can positively impact a multi-tiered, trauma-informed care environment. In these settings, student behavior and social-emotional well-being is viewed in a healing-centered manner. Districts can create a multi-tiered, trauma-sensitive culture and provide support to enhance teachers’ capacity to implement trauma-informed care, take advantage of administrative influence, develop community partnerships, and create a culture that is open to systematic change.

Children and adolescents in low- and middle-income countries (LMIC) suffer heightened vulnerability for the development of mental health conditions which is exacerbated due to enduring socioemotional, economic, and biological risk factors. The constellation of co-occurring adverse childhood experiences (ACEs; e.g. poverty, maltreatment, household dysfunction, exposure to violence) confer heightened vulnerability for the development of mental health disorders that may persist into adulthood. Although the mechanisms for transmission from one generation to the next has not yet been fully elucidated, contemporary evidence has converged primarily on maternal mental health as a key mediator between childhood exposure to ACEs, and the subsequent mental health of her children. Access to mental health assessment or treatment resources in Kenya are limited or non-existent. Due to the heightened risk for intergenerational transmission of mental health problems across generations, with support from the World Health Organization and key stakeholders in Kenya, the development of task-sharing approaches to address the unmet psychological needs of children and mothers has been advocated for. Task-sharing involves the rational redistribution of mental health care tasks from higher cadres of mental health professionals to non-specialized community health care workers in order to increase the capacity for, and access to, mental health services across Kenya. This dissertation seeks to explore: 1) the development of a partnership between the Africa Mental Health Research and Training Foundation and McMaster University to explore the use of task-sharing in the development of a technology-supported assessment for common mental disorders in children and adolescents; 2) the validity and reliability of the newly developed International Mobile Assessment for Children and Teens (IMPACT) administered by non-specialized community health workers when compared to a gold-standard assessment, the MINI-KID, when administered by trained psychology graduate students, and finally; 3) the association between maternal exposure ACEs and the subsequent mental health of her children, mediated by maternal mental health. The first study outlines the process of the development of the IMPACT using a novel blending of emic-etic approaches, and the practical evaluation of the IMPACT by ten local community health workers. Results from this study demonstrated the demand for, and utility of, the IMPACT and outlined the practical considerations of conducting field work of this nature. The second study examined the diagnostic agreement (e.g. validity) of mental health conditions in Kenyan school children (n=189) between the IMPACT and the MINI-KID. The results of this study demonstrated relatively high agreement between the diagnosis of common mental disorders in children between the IMPACT and the MINI-KID. The third study explores the relationship between ACEs (Y-VACS) of mothers (n=149) and the socioemotional wellbeing of her children (e.g. internalizing and externalizing problems; CBCL), mediated by maternal mental health (CBCL). The results of this study demonstrate the association between maternal ACEs and child internalizing and externalizing behaviours, mediated by maternal mental health and moderated by maternal education. Collectively, the results of these dissertation studies support the use of task-sharing approaches for the assessment of common mental disorders in children and adolescents, by non-specialized community health workers and that the transmission of mental health problems between generations is associated with a multitude of complex and inter-related factors (e.g. maternal ACEs and maternal mental health), exacerbated by chronic and co-occurring adversity. Additionally, the results of these studies demonstrated the need for further research that prioritizes the equitable accessibility interventions that target the mental health related-sequelae experienced by maternal-child dyads exposed to chronic and enduring adversity in LMIC. / Dissertation / Doctor of Philosophy (PhD) / Children who grow up in circumstances of chronic poverty and adversity suffer heightened risk for mental health problems as they grow up. This is especially true of children who live in low- and middle-income countries, where children are more likely to experience chronic and co-occurring forms of adversity. Access to mental health services in these contexts are limited or non-existent, conferring heightened vulnerability for mental health problems that may persist across the lifespan. The risk for mental health problems can be transmitted across generations. Although it is not fully understood how mental health problems can be transmitted from a mother to a child, one commonly studied mechanism is the role of maternal adversity and maternal mental health. Because the barriers to mental health care are abundant, the needs of children and mothers with mental health problems are frequently left unmet. The World Health Organization proposes a task-sharing solution, whereby less specialized community health care workers are trained to provide services to improve access to assessment and treatment in low income countries. Using data collected in rural Kenya, this dissertation seeks to explore: 1) the development of a partnership between the Africa Mental Health Research and Training Foundation and McMaster University with the aim of working together to create mental health assessment for children, using a task-sharing approach, 2) to compare the results of the novel mental health assessment to a gold-standard, and 3) to evaluate maternal adversity, maternal mental health, and the transmission of mental health problems between mothers and children in Kenya. Collectively, the results of this dissertation demonstrate that utilizing a task-sharing model for the development of a mental health assessment for use by community health workers is a valid method for assessing and diagnosing mental health problems in children, and that the transmission of mental health problems across generations is associated complex factors (e.g. maternal exposure to adversity and maternal mental health) as a result of exposure to chronic and enduring adversity in LMIC.