Resilience & Prevention Flashcards
Child adversity is mostly conceptualized as
yes/no
ACES
Most common ACEs
Abuse: physical, emotional, sexual
Neglect: physical, emotional
Household dysfunction: mental illness , incarcerated relative, abuse toward parent, substance abuse, divorce
Cumulative risk score
“Lumper” way of measuring ACEs - summing different adversities to represent total # of adversities experienced by an individual. Dominant approach.
CONS: Doesn’t ID risk mechanism, no rationale for choosing/summing adversities, unlikely assumptions
Single adversity approach
“Splitter” way of measuring ACEs - focus on one ACE or examine independent effects of multiple ACEs
PRO: ID pathways
CONS: ignores co-occurrence
Dimensional theoretical approaches
Variation of “splitter”. Group ACEs together based on how they might impact outcome
Example: harshness & unpredictability
DMAP
Dimensional Model of Adversity & Psychopathology
1. Deprivation & threat
2. Deprivation & threat -> psychopathology risk
3. Deprivation & threat -> same outcomes, NOT different
Primary prevention
Universal level
Secondary prevention
Selected level - individuals
Tertiary prevention
Indicated level - already have disorder, prevent further deterioration
Primary prevention / George Albee
Lack-of-provider issue & community psych -> mental health through community as a whole
H. Kraemer types of risk factors for maltreatment
- Fixed markers (won’t change)
- Variable markers (changes by increasing or decreasing)
- Causal risk factors (can change)
Broader risk factors of maltreatment
- Poverty
- Aggregation of risk factors
- Importance of cumulative risk
Costello et al., poverty study
1500 youth ages 9-13, followed 4 years
1/4 Native American
Casino opened - 14% moved out of poverty, fewer psychopathological symptoms
Resilience history
Started out with studies around SCHIZOPHRENIA, pre-morbid competence: knowing who would get disorder. Studied offspring of schizophrenics and observed MULTIFINALITY
What is resilience?
Pattern of positive adaption in the context of significant adversity
(NOT invulnerability and NOT ego-resiliency)
2 judgements of resilience
- Doing okay in life
- but what does that mean? Do you need to be HAPPY?
- Serious threat to adaptation
- stressful life events
- independent? controllable? trauma?
- what counts?
Kauai Study
~700 Hawaiian children born in 1955, data collected longitudinally from prenatal to adulthood
Childhood: ~30% classified as “high risk” based on 4 risk factors
1. Pre/perinatal stress
2. Chronic poverty
3. Chronic interparental conflict
4. Parental psychopathology
2/3 of high risk group had problems, but other 1/3 didn’t.
Why did 1/3 of high-risk Kauai study not develop issues?
Resilience & differed in
1. easy temperament
2. good problem-solving skills
3. positive self-concept
4. social support - mentors!
FAST track: Motivation
Conduct problems are stable/persistent, high societal cost
Early onset group is @ highest risk
Test developmental theories
FAST track design
Early, comprehensive, long-lasting
4 sites, 56 schools
Randomized to interventions vs control by school
High-risk, screening process
- Top 10% on aggression in kindergarten
FAST TRACK Universal intervention for youth example
Classroom-based: PATHS - Promoting Alternative Thinking Strategies
FAST TRACK indicated intervention for high-risk youth examples:
- Parenting groups
- Child social-skill groups
- Mentoring
- Academic tutoring
- Home visits
- Peer pairing
FAST track outcome data
Modest reductions in conduct disorder diagnosis
Positive effects on parenting, social competence, and early behavior problems
FAST track stands for what?
Families and schools together
