The First Americans Have Much to Teach Us

Journal of the American Academy of Child and Adolescent Psychiatry (Impact Factor: 6.35). 08/2008; 47(8):843-4. DOI: 10.1097/CHI.0b013e318179a087
Source: PubMed
  • Journal of the American Academy of Child and Adolescent Psychiatry 07/2009; 48(6):585-6. DOI:10.1097/CHI.0b013e3181a1f575 · 6.35 Impact Factor
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    ABSTRACT: Stress process and life-course models of mental distress emphasize socio-cultural and historical processes that influence stress exposure and the impact of stress on mental health outcomes. Drawing from these theoretical orientations as well as concepts from the historical trauma literature, we examine the effects of culturally relevant and more generalized sources of stress on distress among North American Indigenous adults, and tests for the potential cumulative and interactive effects of stress on distress across the life-course via self-reported early childhood and adult/contemporary stressors. Results of OLS regression analyses reveal positive, significant associations between general stressors and distress as well as culturally-meaningful stressors and distress. In addition, we found evidence of the accumulating and interactive impact of stress on psychological distress.
    07/2011; 1(2):124-136. DOI:10.1177/2156869311414919
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    ABSTRACT: To evaluate the efficacy of a paraprofessional-delivered, home-visiting intervention among young, reservation-based American Indian (AI) mothers on parenting knowledge, involvement, and maternal and infant outcomes. From 2002 to 2004, expectant AI women aged 12 to 22 years (n = 167) were randomized (1:1) to one of two paraprofessional-delivered, home-visiting interventions: the 25-visit "Family Spirit" intervention addressing prenatal and newborn care and maternal life skills (treatment) or a 23-visit breast-feeding/nutrition education intervention (active control). The interventions began during pregnancy and continued to 6 months postpartum. Mothers and children were evaluated at baseline and 2, 6, and 12 months postpartum. Primary outcomes included changes in mothers' parenting knowledge and involvement. Secondary outcomes included infants' social and emotional behavior; the home environment; and mothers' stress, social support, depression, and substance use. Participants were mostly teenaged, first-time, unmarried mothers living in reservation communities. At 6 and 12 months postpartum, treatment mothers compared with control mothers had greater parenting knowledge gains, 13.5 (p < .0001) and 13.9 (p < .0001) points higher, respectively (100-point scale). At 12 months postpartum, treatment mothers reported their infants to have significantly lower scores on the externalizing domain (beta = -.17, p < .05) and less separation distress in the internalizing domain (beta = -.17, p < .05). No between-group differences were found for maternal involvement, home environment, or mothers' stress, social support, depression, or substance use. This study supports the efficacy of the paraprofessional-delivered Family Spirit home-visiting intervention for young AI mothers on maternal knowledge and infant behavior outcomes. A longer, larger study is needed to replicate results and evaluate the durability of child behavior outcomes.
    Journal of the American Academy of Child and Adolescent Psychiatry 07/2009; 48(6):591-601. DOI:10.1097/CHI.0b013e3181a0ab86 · 6.35 Impact Factor


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