Trace Kershaw

Yale-New Haven Hospital, New Haven, Connecticut, United States

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Publications (177)468.6 Total impact

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    ABSTRACT: There is a critical need to examine protective and risk factors of anxiety and depressive symptoms among people living with HIV in order to improve quality of life. Structural equation modeling was used to examine the associations between HIV-related shame, sexual abuse-related shame, posttraumatic growth, and anxiety and depressive symptoms among a cohort of 225 heterosexual women and men who have sex with men (MSM) living with HIV who have experienced childhood sexual abuse (CSA). Higher sexual abuse-related shame was related to more anxiety and depressive symptoms for heterosexual women. Higher posttraumatic growth predicted less anxiety symptoms for only heterosexual women. Higher posttraumatic growth predicted less depressive symptoms for heterosexual women and MSM, but the magnitude of this effect was stronger for heterosexual women than MSM. Psychosocial interventions may need to be tailored to meet the specific needs of heterosexual women and MSM living with HIV and CSA.
    Full-text · Article · Feb 2016 · AIDS and Behavior
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    Tiara C. Willie · Adeya Powell · Trace Kershaw
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    ABSTRACT: Adolescent and young mothers transitioning from pregnancy to postpartum need to maintain an optimal quality of life. Stress and exposure to violence (e.g., intimate partner violence (IPV), nonpartner violence) are predictors of poor quality of life for adult women; however, these associations remain understudied among adolescent and young mothers in urban areas. Guided by the social ecological model, the current study created a latent variable, urban social stress, to examine the impact of the urban social environment (i.e., stressful life events, discrimination, family stress, and neighborhood problems) on the quality of life of adolescent and young mothers during both pregnancy and postpartum. The current study is a secondary data analysis of a prospective cohort study of 296 expectant young mothers recruited at obstetrics and gynecology clinics. Results from structural equation and multigroup models found that higher urban social stress predicted lower mental and physical quality of life during pregnancy, but these associations were significantly stronger for IPV-exposed and nonpartner violence-exposed mothers. In the postpartum period, higher urban social stress predicted lower mental and physical quality of life, but these associations were significantly stronger for IPV-unexposed and nonpartner violence-exposed mothers. Stress reduction programs need to help adolescent and young mothers in urban areas develop stress management skills specific to urban social stress. Pregnancy and parenting programs need to be tailored to the specific needs of young mothers in urban areas by becoming sensitive to the role of IPV and nonpartner violence in these young women’s lives.
    Full-text · Article · Jan 2016 · Journal of Urban Health
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    ABSTRACT: Objective: To assess the risk for neurodevelopmental delays for children of mothers who were obese (≥200 pounds) prior to pregnancy, and to characterize delays associated with maternal obesity among children referred to and found eligible to receive Early Intervention Program services. Methods: We conducted a retrospective cohort study (N = 541,816) using a population-based New York City data warehouse with linked birth and Early Intervention data. Risks for children suspected of a delay and 'significantly delayed', with two moderate or one severe delay, were calculated. Among the group of children eligible by delay for Early Intervention, analyses assessed risk for being identified with a moderate-to-severe delay across each of five functional domains as well as risks for multiple delays. Results: Children of mothers who were obese were more likely to be suspected of a delay (adjusted RR 1.19 [CI 1.15-1.22]) and borderline association for 'significantly delayed' (adjusted RR 1.01 [CI 1.00-1.02). Among children eligible by delay, children of mothers who were obese evidenced an increased risk for moderate-to-severe cognitive (adjusted RR 1.04 [CI 1.02-1.07]) and physical (adjusted RR 1.04 [CI 1.01-1.08]) delays and for global developmental delay (adjusted RR 1.05 [CI 1.01-1.08]). Conclusion: Maternal obesity is associated with increased risk of developmental delay in offspring. Among children with moderate or severe delays, maternal obesity is associated with increased risk of cognitive and physical delays as well as with increased risk for global developmental delay. While causation remains uncertain, this adds to the growing body of research reporting an association between maternal obesity and neurodevelopmental delays in offspring.
    No preview · Article · Dec 2015 · Maternal and Child Health Journal
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    ABSTRACT: Objectives: We compared an evidence-based model of group prenatal care to traditional individual prenatal care on birth, neonatal, and reproductive health outcomes. Methods: We performed a multisite cluster randomized controlled trial in 14 health centers in New York City (2008-2012). We analyzed 1148 pregnant women aged 14 to 21 years, at less than 24 weeks of gestation, and not at high obstetrical risk. We assessed outcomes via medical records and surveys. Results: In intention-to-treat analyses, women at intervention sites were significantly less likely to have infants small for gestational age (< 10th percentile; 11.0% vs 15.8%; odds ratio = 0.66; 95% confidence interval = 0.44, 0.99). In as-treated analyses, women with more group visits had better outcomes, including small for gestational age, gestational age, birth weight, days in neonatal intensive care unit, rapid repeat pregnancy, condom use, and unprotected sex (P = .030 to < .001). There were no associated risks. Conclusions: CenteringPregnancy Plus group prenatal care resulted in more favorable birth, neonatal, and reproductive outcomes. Successful translation of clinical innovations to enhance care, improve outcomes, and reduce cost requires strategies that facilitate patient adherence and support organizational change. (Am J Public Health. Published online ahead of print December 21, 2015: e1-e7. doi:10.2105/AJPH.2015.302960).
    No preview · Article · Dec 2015 · American Journal of Public Health
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    ABSTRACT: Purpose: Group models of prenatal care continue to grow in popularity. However, little is known about how group composition (similarity or diversity between members of groups) relates to care-related outcomes. The current investigation aimed to explore associations between prenatal care group composition with patient satisfaction, engagement, and group attendance among young, urban women of color. Methods: Data were drawn from two studies conducted in New Haven and Atlanta (2001-2004; n = 557) and New York City (2008-2011; n = 375) designed to evaluate group prenatal care among young, urban women of color. Women aged 14 to 25 were assigned to group prenatal care and completed surveys during their second and third trimesters of pregnancy. Group attendance was recorded. Data were merged and analyzed guided by the Group Actor-Partner Interdependence Model using multilevel regression. Analyses explored composition in terms of age, race, ethnicity, and language. Main findings: Women in groups with others more diverse in age reported greater patient engagement and, in turn, attended more group sessions, b(se) = -0.01(0.01); p = .04. Conclusion: The composition of prenatal care groups seems to be associated with young women's engagement in care, ultimately relating to the number of group prenatal care sessions they attend. Creating groups diverse in age may be particularly beneficial for young, urban women of color, who have unique pregnancy needs and experiences. Future research is needed to test the generalizability of these exploratory findings.
    No preview · Article · Nov 2015 · Women s Health Issues
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    ABSTRACT: Background: Transitioning into parenthood can be difficult for adolescent parents who experienced violence victimization. Previous research has shown that experiences of child abuse and intimate partner violence (IPV) can impact parenting. Although one in five children experience polyvictimization, experiencing multiple types of violence victimization (e.g., IPV, stranger violence, family violence, peer violence), the impact of polyvictimization among adolescent and young couples has been unexplored. The current study examined patterns of polyvictimization for adolescent and young parents; and its association with parenting behaviors and involvement. Methods: Data were collected from 592 expectant adolescents and their partners (N = 296 couples) between 2007 and 2011 as part of a longitudinal study. Participants were recruited at obstetrics and gynecology clinics and an ultrasound clinic in four university-affiliated hospitals. At baseline, participants provided data on violence victimization and sociodemographics. Parenting outcomes were reported at 6 months postpartum. Results: Results from two latent class analyses showed three-class models for both women and men, with latent classes being described by the probabilities of the polyvictimization. The classes of women were: (1) No Violence; (2) Stranger Violence/Prior IPV; and the (3) Prior IPV /Peer Violence. The classes of men were: (1) No Violence; (2) Prior IPV; and (3) High Polyvictimization. Results from ANOVAs revealed that men in the High Polyvictimization class were less likely to be involved in raising the child (p = 0.004) and had more negative parenting experiences at postpartum (p = 0.002). Women in Prior IPV/Peer Violence class were more likely to have negative parenting experiences (p = 0.005), and low partner involvement in parenting (p = 0.01). Conclusions: Polyvictimization plays an important role in how adolescent parents transition into parenthood. Policy and intervention development should be sensitive to the intersection between polyvictimization and parenting, particularly among adolescents.
    No preview · Conference Paper · Nov 2015
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    ABSTRACT: Background: Polyvictimization, experiencing multiple forms of victimization (e.g., intimate partner violence (IPV), family violence, peer violence, stranger violence), has been strongly associated with mental health problems among adolescents. However, very little research has examined the impact of polyvictimization on sexual health. The current study examined patterns of polyvictimization for females and males; and their association with sexual risk and psychosocial outcomes. Methods: Data were collected from 592 pregnant adolescents and their partners(N = 296 couples) between 2007 and 2011 as part of a longitudinal study. During baseline interviews, participants provided data on victimization, sexual risk, and psychosocial outcomes. Results: Latent class analyses showed three-class models for both females and males. Females’ classes were: No Violence; Stranger Violence/Prior IPV; and Prior IPV/Peer Violence; while, males’ classes were: No Violence; Prior IPV; and High Polyvictimization. ANOVAs revealed that females in the Stranger Violence/Prior IPV class reported less condom use in the past six months(F=6.00,p=0.003) and communicated more about HIV with their partner(F=3.83,p=0.02) than the No Violence class. Females in the Prior IPV/Peer Violence reported lower condom use self-efficacy(F=6.38,p=0.002) and less positive attitudes about condoms(F=3.26,p=0.03) than the Stranger Violence/Prior IPV class. Males in the High Polyvictimization class reported less condom use in the past six months(F=3.27,p=0.03) then the No Violence and Prior IPV class. Males in the Prior IPV class reported more HIV risks(F=8.81,p<0.001) than the No Violence class. Conclusions: Polyvictimization impacts the sexual health of adolescents. It may be useful for HIV/STI interventions to identify and address experiences of polyvictimization among adolescent couples.
    No preview · Conference Paper · Nov 2015
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    ABSTRACT: Young expecting parents face a great deal of challenges as they transition into parenthood. This paper sought to identify racial and gender differences in the relationship between general discrimination, neighborhood problems, neighborhood cohesion, and social support on the depressive and stress symptoms among young expecting couples. Results indicated perceived general discrimination and less social support was associated with increased stress and depression. More neighborhood problems were related to increased depression and more neighborhood cohesion was related to less stress. Moderator analyses showed that the influence of general discrimination and stress was stronger for women than men. In addition, neighborhood cohesion was protective on stress for Blacks and Whites but not for Hispanics. These results indicate the need to address the broader social context for young expectant couples.
    Full-text · Article · Oct 2015 · Journal of Child and Family Studies
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    ABSTRACT: Background: Psychoeducational interventions, tested for efficacy in randomized clinical trials, are seldom implemented in clinical practice where cancer survivors and their family caregivers can benefit from them. Objective: This study examined the effectiveness of the FOCUS Program on cancer survivors' and their family caregivers' outcomes when implemented at a Cancer Support Community (CSC) affiliate by agency social workers. Study aims were to (1) test effects of the program on survivor and caregiver outcomes as a unit and (2) determine program feasibility in terms of enrollment, retention, intervention fidelity, and satisfaction. Methods: A preintervention and postintervention pilot effectiveness study was conducted with 34 cancer survivor-caregiver dyads (ie, pairs). The FOCUS Program, originally delivered by nurses in dyads' homes, was modified to a small-group format and delivered by CSC social workers. The primary outcome was quality of life (QOL). Intermediary outcomes were benefits of illness/caregiving, communication, support, and self-efficacy. Analyses included repeated-measures analysis of variance. Results: Dyads had significant improvements in total QOL; physical, emotional, and functional QOL; benefits of illness; and self-efficacy. Effect sizes were similar to prior randomized clinical trial findings. Although dyads were difficult to recruit (enrollment, 60%), both retention (92%) and intervention fidelity (94%) were high. Conclusions: It was possible to implement the FOCUS Program at a CSC affiliate by agency staff, obtain positive intervention effects, and maintain intervention fidelity. Implications for practice: Researchers and clinicians need to collaborate to implement more evidence-based interventions in practice settings for cancer survivors and their family caregivers.
    Full-text · Article · Oct 2015 · Cancer nursing
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    ABSTRACT: Background: The challenges of advanced cancer have health implications for patients and their family caregivers from diagnosis through end of life. The nature of the patient/caregiver experience suggests that their mental and physical health may be interdependent, but limited empirical evidence exists. Purpose: This study used social cognitive theory as a framework to investigate individual and interpersonal influences on patients' and their family caregivers' mental health, physical health, and self-efficacy as individuals to manage the challenges of advanced disease over time. Methods: Patients and caregivers (484 patient-caregiver dyads) completed surveys at baseline, 3 and 6 months. Longitudinal dyadic analysis techniques were used to examine (i) the influence that patients and caregivers had on their own mental health, physical health, and self-efficacy (actor effects) and (ii) the influence that they had on each other's health outcomes (partner effects). We also examined the influence of self-efficacy on mental and physical health over time. Results: Consistent with our hypotheses, each person's mental health, physical health, and self-efficacy had significant effects on their own outcomes over time (actor effects). Patients and caregivers influenced one another's mental and physical health (partner effects), but not their self-efficacy. In addition, patients and caregivers with higher self-efficacy had better mental health, and their partners had better physical health. Conclusions: Patients' and caregivers' mental and physical health were interdependent. Each person's cancer-related self-efficacy influenced their own mental and physical health. However, a person's self-efficacy did not influence the other person's self-efficacy.
    Full-text · Article · Oct 2015 · Annals of Behavioral Medicine
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    ABSTRACT: Social networking technologies are influential among men who have sex with men (MSM) and may be an important strategy for HIV prevention. We conducted focus groups with HIV positive and negative participants. Almost all participants used social networking sites to meet new friends and sexual partners. The main obstacle to effective HIV prevention campaigns in social networking platforms was stigmatization based on homosexuality as well as HIV status. Persistent stigma associated with HIV status and disclosure was cited as a top reason for avoiding HIV-related conversations while meeting new partners using social technologies. Further, social networking sites have different social etiquettes and rules that may increase HIV risk by discouraging HIV status disclosure. Overall, successful interventions for MSM using social networking technologies must consider aspects of privacy, stigma, and social norms in order to enact HIV reduction among MSM.
    No preview · Article · Aug 2015 · AIDS education and prevention: official publication of the International Society for AIDS Education
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    ABSTRACT: Mental health issues often become apparent as adolescents emerge into young adulthood. The use of mental health services is low among adolescents and young adults, and use is particularly low among minorities. In this study, we examine mental health utilization among diverse young parenting couples. The sample consisted of 296 couples. We used the social-personal framework to examine personal, family, partner relationship, and environmental predictors for using mental health services. We used the Actor-Partner Interdependence Model to assess actor and partner effects on mental health utilization. We also examined moderator effects for gender and internalizing and externalizing behaviors. We found that being female, being White, higher income, more conduct problems, and less anxious romantic attachment predicted mental health utilization. Significant moderator effects included depression × gender, depression × medical insurance, and stress × Latino. Implications for community mental health practice include conducting mental health assessments during medical visits and systematic mental health follow-up for individuals and couples with identified mental health and support needs. Future research should include married couples and the spouse's influence on mental health use and examine relevant parenting factors that may also predict mental health utilization among couples.
    Full-text · Article · Jul 2015 · American Journal of Community Psychology
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    ABSTRACT: Social network and area level characteristics have been linked to substance use. We used snowball sampling to recruit 90 predominantly African American emerging adult men who provided typical locations visited (n=510). We used generalized estimating equations to examine social network and area level predictors of substance use. Lower social network quality was associated with days of marijuana use (B=-0.0037, p<0.0001) and problem alcohol use (B=-0.0050, p=0.0181). The influence of area characteristics on substance use differed between risky and non-risky spaces. Peer and area influences are important for substance use among men, and may differ for high and low risk places. Copyright © 2015 Elsevier Ltd. All rights reserved.
    No preview · Article · Jul 2015 · Health & Place
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    ABSTRACT: To investigate whether group prenatal care [Centering Pregnancy Plus (CP+)] impacts pregnancy weight gain and postpartum weight loss trajectories, and to determine whether prenatal depression and distress might mediate these trajectories. Secondary analysis of a cluster-randomized trial of CP+ in 14 Community Health Centers and hospitals in New York City. Participants were pregnant women aged 14-21 (N=984). Medical record review and four structured interviews were conducted: second and third trimester, 6- and 12-months postpartum. Longitudinal mixed modeling was utilized to evaluate weight change trajectories in control and intervention groups. Prenatal distress and depression were also assessed to examine their impact on weight change. There were no significant differences between intervention and control groups in baseline demographics. Thirty five percent of participants were overweight or obese and more than 50% had excessive weight gain by Institute of Medicine standards. CP+ was associated with improved weight trajectories compared to controls (p<0.0001): women at clinical sites randomized to group prenatal care gained less weight during pregnancy and lost more weight post-partum. This effect was sustained among women who were categorized as obese based on pre-pregnancy body mass index (p<0.01). Prenatal depression and distress were significantly associated with higher antepartum weight gain and postpartum weight retention. Women with the highest levels of depression and prenatal distress exhibited the greatest positive impact of group prenatal care on weight trajectories during pregnancy and through 12-months postpartum. Group prenatal care has a significant impact on weight gain trajectories in pregnancy and postpartum. The intervention also appeared to mitigate the effects of depression and prenatal distress on antepartum weight gain and postpartum weight retention. Targeted efforts are needed during and after pregnancy to improve weight gain trajectories and overall health. Copyright © 2015 Elsevier Inc. All rights reserved.
    No preview · Article · Jul 2015 · American journal of obstetrics and gynecology
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    ABSTRACT: To examine differences in healthcare service utilization among patients with advanced cancer participating in a nurse-led psychoeducational intervention. . Secondary analysis of trial data. . Four Michigan cancer centers. . 484 patients with advanced cancer. . Patients were randomized to three groups. Study arm (brief, extensive, or control), ED visitation (one or more times versus none), inpatient hospitalizations (one or more times versus none), and covariates. . No significant differences in ED visits or inpatient hospitalizations were observed among study arms. ED visits were more frequent for patients with lung or colorectal cancer, more comorbidities, and lower baseline QOL. Baseline QOL was associated with inpatient hospitalizations in the adjusted analysis. . The psychoeducational intervention, either in brief or extensive format, is unlikely to increase healthcare service utilization. . Efficacious nurse-led psychoeducational interventions to improve QOL do not place undue burdens on the healthcare system and may improve care. .
    No preview · Article · Jul 2015 · Oncology Nursing Forum
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    ABSTRACT: To determine whether prenatal depressive symptoms are associated with postpartum sexual risk among young, urban women of color. Participants completed surveys during their second trimester of pregnancy and at 1 year postpartum. Depressive symptoms were measured using the Center for Epidemiologic Studies-Depression Scale, excluding somatic items because women were pregnant. Logistic and linear regression models adjusted for known predictors of sexual risk and baseline outcome variables were used to assess whether prenatal depressive symptoms make an independent contribution to sexual risk over time. Fourteen community health centers and hospitals in New York City. The participants included 757 predominantly black and Latina (91%, n = 692) pregnant teens and young women aged 14-21 years. The main outcome measures were number of sex partners, condom use, exposure to high-risk sex partners, diagnosis of a sexually transmitted disease, and repeat pregnancy. High levels of prenatal depressive symptoms were significantly associated with increased number of sex partners (β = 0.17; standard error, 0.08), decreased condom use (β = -7.16; standard error, 3.08), and greater likelihood of having had sex with a high-risk partner (odds ratio = 1.84; 95% confidence interval, 1.26-2.70), and repeat pregnancy (odds ratio = 1.72; 95% confidence interval, 1.09-2.72), among participants who were sexually active (all P < .05). Prenatal depressive symptoms were not associated with whether participants engaged in postpartum sexual activity or sexually transmitted disease incidence. Screening and treatment for depression should be available routinely to women at risk for antenatal depression. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
    No preview · Article · May 2015 · Journal of Pediatric and Adolescent Gynecology
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    ABSTRACT: When examining older adults' health behaviors and psychological health, it is important to consider the social context. The purpose of this study was to examine in older adult marriages whether each spouse's physical activity predicted changes in their own (actor effects) and their partner's (partner effects) depressive symptoms. Gender differences were also examined. Each spouse within 1260 married couples (at baseline) in the Cardiovascular Health Study completed self-report measures at wave 1 (1989-1990), wave 3 (1992-1993), and wave 7 (1996-1997). Dyadic path analyses were performed. Husbands' physical activity significantly predicted own decreased depressive symptoms (actor effect). For both spouses, own physical activity did not significantly predict the spouse's depressive symptoms (partner effects). However, husbands' physical activity and depressive symptoms predicted wives' physical activity and depressive symptoms (partner effects), respectively. Depressive symptoms did not predict physical activity. Findings suggest that husbands' physical activity is particularly influential for older married couples' psychological health.
    No preview · Article · Apr 2015 · Annals of Behavioral Medicine
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    ABSTRACT: Alcohol, tobacco and other drug use (ATOD) among adolescent and young adult couples during prenatal and postnatal periods is a significant public health problem, and couples may mutually influence each others' ATOD behaviors. The current study investigated romantic partner influences on ATOD among adolescent and young adult couples during pregnancy and postnatal periods. Participants were 296 young couples in the second or third trimester of pregnancy recruited from OBGYN clinics between July 2007 and February 2011. Participants completed questionnaires at prenatal, 6 months postnatal, and 12 months postnatal periods. Dyadic data analysis was conducted to assess the stability and interdependence of male and female ATOD over time. Male partner cigarette and marijuana use in the prenatal period significantly predicted female cigarette and marijuana use at 6 months postnatal (b = 0.14, P < 0.01; b = 0.11, P < 0.05, respectively). Male partner marijuana use at 6 months postnatal also significantly predicted female marijuana use at 12 months postnatal (b = 0.11, P < 0.05). Additionally, significant positive correlations were found for partner alcohol and marijuana at pre-pregnancy and 6 months postnatal, and partner cigarette use at pre-pregnancy, 6 months and 12 months postnatal. Partner ATOD among young fathers, particularly during the prenatal period, may play an important role in subsequent ATOD among young mothers during postnatal periods. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
    No preview · Article · Apr 2015 · Journal of Public Health
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    ABSTRACT: This mixed-methods investigation combines a quantitative survey, focus groups, and in-depth interviews to examine sexual risk behaviors and HIV status disclosure among HIV-positive hijras (male-to-female transgender people) and HIV-positive men who have sex with men (MSM) in Chennai and Mumbai, India. From the survey results, the authors found a relatively high prevalence of inconsistent condom use for anal sex with male partners—about one-fifth to almost one-half, depending on the type of partner (regular, casual) and sexual role (receptive, insertive). One-quarter of MSM and two-fifths of hijras reported having disclosed their HIV status to their male regular partner. The qualitative data helped in understanding social and structural factors that created barriers to disclosure of HIV status and to condom use. Disclosure was not uniformly followed by safer sex, and nondisclosure did not always lead to unprotected sex. Implications for practice and policies and potential interventions are discussed.
    Full-text · Article · Mar 2015 · Journal of HIV/AIDS & Social Services
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    ABSTRACT: Objective Deficits in emotion expression skills have been associated with alcohol and substance use, but the mechanisms through which these associations occur are not well understood. The current study investigated (a) associations between emotion expression and substance use (i.e., alcohol, cigarettes, and marijuana) in newly parenting adolescents and young adults and (b) whether symptoms of depression and stress mediate these associations in young mothers and fathers.Methods Participants recruited from obstetrics and gynecology clinics completed the Center for Epidemiological Studies-Depression Scale, Perceived Stress Scale, Emotion Expression Scale for Children, and substance use items.ResultsPath analysis indicated that lower emotion expression at 6 months postpartum was significantly associated with more alcohol and marijuana use at 12 months postpartum for males but not females. Also among males, stress levels at 6 months postpartum partially mediated associations between emotion expression and alcohol and marijuana use at 12 months postpartum.Conclusions Findings suggest that poor emotion expression skills are related to more substance use in young fathers, and levels of stress may partially account for this association.
    No preview · Article · Mar 2015 · Journal of Clinical Psychology

Publication Stats

4k Citations
468.60 Total Impact Points

Institutions

  • 2003-2015
    • Yale-New Haven Hospital
      • Department of Pathology
      New Haven, Connecticut, United States
    • Yale University
      • Center for Interdisciplinary Research on AIDS (CIRA)
      New Haven, Connecticut, United States
  • 2014
    • Drexel University
      Filadelfia, Pennsylvania, United States
  • 2010-2012
    • Duke University
      • Department of Medicine
      Durham, North Carolina, United States
  • 2008
    • Florida International University
      Miami, Florida, United States
  • 2007
    • Harvard University
      Cambridge, Massachusetts, United States
    • University of Connecticut
      • Department of Psychology
      Storrs, Connecticut, United States
  • 2006
    • Concordia University–Ann Arbor
      Ann Arbor, Michigan, United States
    • Centers for Disease Control and Prevention
      Атланта, Michigan, United States
  • 2000-2003
    • Wayne State University
      • College of Nursing
      Detroit, Michigan, United States
  • 2002
    • Karmanos Cancer Institute
      Detroit, Michigan, United States
  • 2001-2002
    • University of New Haven
      New Haven, Connecticut, United States