Virginia Gil-Rivas - US grants

[unreadable] DESCRIPTION (provided by applicant): The proposed study will examine the combined effects of trauma exposure and posttraumatic stress disorder (PTSD) on primary treatment outcomes among individuals with comorbid substance use disorders (SUDs) and severe mental illness (SMI) with attention to gender differences. Further analyses of a longitudinal sample of 400 individuals receiving services at 11 residential treatment programs will be conducted. The specific aims of this study include: 1a) to determine whether trauma exposure is associated with primary treatment outcomes at the 6- and 12-month follow-ups; 1b) to examine whether the association between trauma exposure and treatment outcomes is mediated by the presence of PTSD; to determine if the association between PTSD and treatment outcomes is mediated by changes in trauma related symptoms and psychological distress; 2) examine whether the participation in specific treatment services mediate and/or moderate the relationship between trauma exposure/PTSD and treatment outcomes; and 3) to examine whether the patterns of association identified for each of these aims differ by gender. Regression models based on the generalized estimating equations approach will be employed to examine the longitudinal relationship between the variables of interest. Several methodological strengths of the proposed study provide a unique opportunity to address gaps in the literature. Specifically: 1) the use of structured clinical interviews to diagnose SUDs, SMI, and PTSD according to DSM-IV criteria; 2) repeated assessment of the variables of interest; 3) a sample of individuals receiving concurrent substance abuse and mental health services; and 4) the inclusion of sufficient males and females to allow for simultaneous gender comparisons. In sum, the findings of the present study can aid in the development of treatment interventions that better address the needs of individuals with multiple comorbid disorders. [unreadable] [unreadable] [unreadable]

[unreadable] DESCRIPTION (provided by applicant): The long-range objectives are to identify (1) mechanisms by which children adjust in the aftermath of disaster, and (2) strategies for intervention to foster successful adaptation. With a primary goal of furthering understanding of the role of the caregiver-child relationship (CCR) in post-disaster adjustment, this study will assess children (7 to 9 year olds) and caregivers evacuated as a result of Hurricane Katrina at two time points and will serve as the initial step in a longitudinal effort. This work has important health implications, given the enormous impact of the hurricane on those directly exposed and the ongoing adversities they continue to face. Exposure to major stressors places children at risk for emotional, behavioral, and academic difficulties, though children also vary considerably in their adaptation subsequent to such events. Enhancing understanding of the impact of the hurricane on children, and factors that influence their adjustment, can guide policy, practice, and intervention to best meet the diverse needs of children and families post-disaster. A short-term longitudinal approach, with 2 data collections separated by 6 to 8 months, will be used. Four hundred families impacted by the hurricane will be recruited, and children (ages 7-9 years) will be the focus. Primary caregivers will complete multiple indicators of child adjustment and measures regarding caregiving and contextual variables. Children will complete self-reports of emotions, experiences, and resources thought to be relevant to adjustment post-disaster. The specific aims of this study are: (1) examine the contribution of child characteristics and resources to adjustment 6 and 12 months post-hurricane; (2) investigate the extent to which caregiver resources and other post-hurricane contextual factors predict the quality of the CCR 6 and 12 months post-disaster; and (3) test a model predicting that the CCR will mediate the association between disaster and post-hurricane contextual factors, and children's adjustment. [unreadable] [unreadable] [unreadable]

[unreadable] DESCRIPTION (provided by applicant): The long-range objectives are to identify (1) mechanisms by which children adjust in the aftermath of disaster, and (2) strategies for intervention to foster successful adaptation. With a primary goal of furthering understanding of the role of the caregiver-child relationship (CCR) in post-disaster adjustment, this study will assess children (7 to 9 year olds) and caregivers evacuated as a result of Hurricane Katrina at two time points and will serve as the initial step in a longitudinal effort. This work has important health implications, given the enormous impact of the hurricane on those directly exposed and the ongoing adversities they continue to face. Exposure to major stressors places children at risk for emotional, behavioral, and academic difficulties, though children also vary considerably in their adaptation subsequent to such events. Enhancing understanding of the impact of the hurricane on children, and factors that influence their adjustment, can guide policy, practice, and intervention to best meet the diverse needs of children and families post-disaster. A short-term longitudinal approach, with 2 data collections separated by 6 to 8 months, will be used. Four hundred families impacted by the hurricane will be recruited, and children (ages 7-9 years) will be the focus. Primary caregivers will complete multiple indicators of child adjustment and measures regarding caregiving and contextual variables. Children will complete self-reports of emotions, experiences, and resources thought to be relevant to adjustment post-disaster. The specific aims of this study are: (1) examine the contribution of child characteristics and resources to adjustment 6 and 12 months post-hurricane; (2) investigate the extent to which caregiver resources and other post-hurricane contextual factors predict the quality of the CCR 6 and 12 months post-disaster; and (3) test a model predicting that the CCR will mediate the association between disaster and post-hurricane contextual factors, and children's adjustment. [unreadable] [unreadable] [unreadable]