<p dir="ltr">Background: Racial discrimination has been consistently associated with risk for alcohol use outcomes among racial/ethnic minority groups. This is particularly concerning given that engagement in alcohol use during adolescence has significant downstream effects on an individual's health into adulthood. Understanding factors that influence the relationship between racial discrimination and alcohol outcomes are needed to better understand the risk pathway and to identify malleable targets for interventions to reduce alcohol use among racial/ethnic minority adolescents. One potential candidate is emotion regulation as there is evidence that exposure to discrimination is associated with emotion regulation difficulties, and that emotion regulation difficulties are associated with alcohol outcomes. It is also plausible that emotion regulation is an external factor that strengthens or weakens to direct association between racial discrimination and alcohol use. Thus, the current study examined difficulties in emotion regulation (as measured by the State Difficulties in Emotion Regulation, S-DERS) as a mediator and moderator separately on the relationship between racial discrimination related stress (RDRS) and alcohol outcomes (i.e., use, quantity, frequency, alcohol use disorder, binge drinking, high intensity alcohol use) and risk for problems associated with substance use. To better understand the nuances within the emotion regulation construct, this study also examined the four subscales of the S-DERS (e.g., difficulties in nonacceptance, modulation, lack of awareness, lack of clarity) in a parallel mediation and moderation model to account for each domain’s unique effect on the racial discrimination-alcohol pathway. Methods: 714 self-identifying racial/ethnic minority adolescents aged 10-19 years old (62.9% male, mean age 16.21 years old, 58.1% African American/Black, 19% American, 9.9% Hispanic/Latino, 9.7% Asian American/Pacific Islander, 1.3% Middle Eastern/North African) completed an online questionnaire that included measures assessing experiences of racial discrimination related stress, state difficulties in emotion regulation, and alcohol outcomes. Results: Findings indicated a significant indirect effect of RDRS on alcohol outcomes through total state difficulties in emotion regulation (past year use b = 0.002, p <0.001; frequency b = 0.005, p <0.001; quantity b = 0.003, p <0.001; alcohol use disorder b = 0.056, p <0.001; binge drinking b = 0.004, p <0.001; high intensity alcohol use b = 0.003, p <0.001; risk for problems associated with substance use b = 0.007, p <0.001). When examining the subscales of emotion regulation, a significant indirect effect was found for difficulties in modulation within the relationship between RDRS and past year use, quantity, frequency, alcohol use disorder, binge drinking, and high-intensity alcohol use, but not for risk for problems associated with substance use. There were no significant indirect effects observed for the other subscales of emotion regulation. Additionally, when examining whether S-DERS or the S-DERS subscales moderated the relationship between RDRS and alcohol outcomes, no significant effects were found. Conclusion: These findings expand our understanding on potential mechanisms that underlie the racial discrimination-alcohol risk pathway among racial/ethnic minority adolescents, which may in turn help clarify the multifaceted nature of emotion regulation. As such, findings suggest that a unique effect was found for difficulties in modulation of emotions when accounting for the other domains of emotion regulation when examining the RDRS and alcohol outcomes relationship. Given that this study was cross-sectional, additional research utilizing a prospective study design can build off the current findings to confirm the proposed temporal pathway between RDRS, emotion regulation, and alcohol use outcomes. Moreover, findings suggest that difficulties in modulation and emotion regulation may be important constructs to include within treatments aimed at reducing alcohol use and prevention efforts among racial/ethnic minority adolescents experiencing racial discrimination related distress.</p>

This quasi-experimental study compared family formation and perceived partner support among pregnant adolescents in a prenatal care program. Participants were assigned to either an intervention group utilizing centering pregnancy (CP) prenatal care and case management, or to a comparison group receiving case management only. Partners were invited to participate in CP group sessions. This study included 173 predominantly minority pregnant adolescents ages 15–18 years who were enrolled in a prenatal program and followed one month postpartum. Family formation included living and relationship arrangements. Perceived partner support included six domains of perceived social provisions. Data were collected through participants’ self-reports using computer-assisted self-interviews. Changes in family formation and perceptions of partner support from baseline to postpartum did not differ between intervention and comparison groups. Male partners who attended at least one CP session were perceived as more supportive at both the beginning and end of the program than partners who did not attend any sessions. After combining groups, pregnant adolescents reported a significant shift in family formation and increased monetary support from partners from baseline to postpartum. Partner support is important for ensuring positive pregnancy outcomes. Additional strategies are needed to engage young fathers who do not readily provide support during pregnancy.

This student-centered analysis of caring in three academically promising, low-income public high schools in Texas used an instrumental case study design (Stake, 1998) to investigate students' perceptions and experiences of receiving care in high school. The analysis also examined the teacher and administrator practices that contributed to students' experience of receiving care, and considered the resources that supported the adults' caring practice at the three schools. Archival data consisting of open-ended interviews with students, teachers, administrators, and school staff were analyzed qualitatively. Results suggest that caring should be evaluated in context. In the high school context students experience care through having their teachers' and administrators’ help and support with academics. Results also suggest that students experience caring through teacher and administrator behaviors and attitudes that respond to their developmental needs. That is, they experience care when adults at school establish a style and pattern of interaction similar to "authoritative parenting" (Baumrind, 1987). Recognition from adults in the school is very important for high school students, and especially salient for low-income and minority adolescents who often receive negative and discriminatory feedback from the community. / text

Despite the developmental and clinical importance of body image during the pre-adolescent and adolescent years, there remains a dearth of information on the body image experiences of immigrant children and adolescents. This thesis represents a purposeful attempt to examine body image experiences among immigrant and ethnic minority children and adolescents in Canada and the United States (US). Specifically, the thesis integrates multiple methods (scoping reviews, qualitative interpretive description, quantitative multi-level modeling) and samples (clinical and population-based samples) to systematically contribute to the academic literature focusing on body image experiences among immigrant and ethnic minority children and adolescents in Canada and the US. Consisting of four conceptually related studies, this thesis makes the following methodological and conceptual contributions to epidemiological and clinical research and practice. First, the results from all four studies point to the need to develop standardized approaches for identifying and classifying immigrant and ethnic-minority children and adolescents. This will substantially increase the field’s ability to systematically characterize the nature and magnitude of body image dissatisfaction, body image distortion, and their associated outcomes among immigrant and ethnic minority children and adolescents. In addition, this systematic classification has the potential to inform the development or adaptation of universal and targeted preventative intervention strategies. Second, Study’s 1 and 2 demonstrate a clear need to further examine the constructs and experiences of acculturation and acculturative stress in relation to the body image experiences of immigrant and ethnic minority children and adolescents. The literature is unclear with respect to whether or not immigrant adolescents’ adoption of the values, behaviours and ideals of the Canadian or US culture increases their risk for body image concerns. On the other hand, we are also unclear as to whether or not immigrant adolescents’ retaining of the values, behaviours and ideals of their culture of origin may offer protection from poor body image experiences. Similarly, we are unclear about whether—and to what extent—stress as a result of adolescents’ acculturative experiences (i.e. acculturative stress) influence the onset or pervasiveness of body image concerns. Greater understanding about these constructs and processes and the extent to which they are implicated in the body image experiences among immigrant children and adolescents has the potential to inform culturally competent and targeted intervention approaches. Results from Study 3 indicate that immigrant adolescents have body image and appearance-related concerns that extend beyond what has typically been found among non-immigrant adolescents. More specifically, immigrant adolescents are concerned about the appearance of their skin (texture, complexion), their hair, their teeth, as well as other bodily features. It would be prudent for future researchers and clinicians to consider this information in relation to measuring, classifying and addressing body image dissatisfaction among immigrant adolescents. Finally, Study 4 demonstrates that females and first generation immigrants with body image dissatisfaction are at significantly elevated risk for body image distortion. This suggests that the assessment and intervention for body image dissatisfaction—particularly among females—soon after the migratory experience may play an important role in reducing body image distortion experiences. Taken together, the findings of this thesis strengthen the body image field by demonstrating that there are several unique aspects about being an immigrant that can influence adolescents’ body image experiences; and therefore, should be considered from a conceptual and methodological standpoint in future research and implementation of body image interventions. / Dissertation / Doctor of Philosophy (PhD) / Body image dissatisfaction and body image distortion have been linked to serious psychological outcomes, including depression and eating disorders. Yet, we know very little about the nature of these experiences among immigrant and ethnic minority children and adolescents. This thesis uses qualitative and quantitative methods, as well as general population and clinical samples to investigate body image dissatisfaction and body image distortion among immigrant and ethnic minority children and adolescents in Canada and the United States. Results provide important information that can inform the development of preventative interventions targeting body image dissatisfaction and body image distortion among immigrant and non-immigrant children and adolescents.