Reducing Internalizing Symptoms Among High-Risk, Hispanic Adolescents: Mediators of a Preventive Family Intervention
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Familias Unidas is a family-focused preventive intervention that has been found to reduce drug use and sexual risk behaviors among Hispanic adolescents. In some trials, Familias Unidas has also been found to be efficacious in reducing adolescent internalizing symptoms (i.e., depressive and anxiety symptoms), even though the intervention did not specifically target internalizing symptoms. This study examines potential mediators or mechanisms by which Familias Unidas influences internalizing symptoms, specifically the role of intervention-targeted improvements in parent-adolescent communication and reductions in youth externalizing behaviors. A total of 213 Hispanic eighth grade students with a history of externalizing behavior problems and their primary caregivers were recruited from the public school system. Participants, with a mean age of 13.8 years, were randomized into the Familias Unidas intervention or community practice control condition and assessed at baseline, 6, 18, and 30 months post-baseline. A cascading mediation model was tested in which the Familias Unidas intervention was hypothesized to decrease adolescent internalizing symptoms through two mediators: improvements in parent-adolescent communication leading to decreases in externalizing behaviors. Findings show that the intervention had significant direct effects on youth internalizing symptoms at 30 months post-baseline. In addition, the cascading mediation model was supported in which the Familias Unidas intervention predicted significant improvements in parent-adolescent communication at 6 months, subsequently decreasing externalizing behaviors at 18 months, and ultimately reducing youth internalizing symptoms at 30 months post-baseline. Implications for prevention interventions are discussed.
KeywordsAdolescent Prevention Internalizing symptoms Family Hispanic
Compliance with Ethical Standards
This study involved analyses of data from a randomized controlled trial funded by the National Institute on Drug Abuse Grant No. R01-DA017462—Hilda Pantin, Principal Investigator. The analyses were also supported by the National Institute of Mental Health grant number R01-MH040859)—C. Hendricks Brown, Principal Investigator.
Conflict of Interest
The authors declare that they have no conflict of interest.
This study was approved by the University of Miami’s Human Subjects Research Board and the Miami-Dade County Schools’ Research Board. All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.
Informed consent was obtained from parents of all youth in this trial. Voluntary informed assent was obtained from all youth in this trial.
- Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Routledge AcademicGoogle Scholar
- DeVore, E. R., & Ginsburg, K. R. (2005). The protective effects of good parenting on adolescents. Current Opinions in Pediatrics, 17, 46–5.Google Scholar
- Ingoldsby, E.M., Kohl, G.O., McMahon, R.J., Lengua, L. & the Conduct Disorders Prevention Research Group. (2006). Conduct problems, depressive symptomatology and their co-occurring presentation in childhood as predictors of adjustment in early adolescence. Journal of Abnormal Child Psychology, 34, 603–21.Google Scholar
- Muthén, L. K., & Muthén, B. O. (1998–2012). Mplus User’s Guide (7th ed.). Los Angeles, CA: Muthén & Muthén.Google Scholar
- National Research Council/ Institute of Medicine. (2009). Preventing mental, emotional, and behavioral disorders among young people: Progress and possibilities. Committee on the Prevention of Mental Disorders and Substance Abuse among Children, Youth, and Young Adults: Research Advances and Promising Interventions. In O.’. C. Mary Ellen, B. Thomas, & K. E. Warner (Eds.), Board on Children, Youth, and Families, Division of Behavioral and Social Sciences and Education. Washington, DC: National Academies Press.Google Scholar
- Patterson, G. R., Reid, J., & Dishion, T. (1992). A social interactional approach: Antisocial boys (Vol. 4). Eugene, OR: Castalia.Google Scholar
- Perrino, T., Pantin, H., Prado, G., Huang, S., Brincks, A., Howe, G., & Brown, C. H. (2014). Preventing internalizing symptoms among Hispanic adolescents: a synthesis across Familias Unidas trials. Prevention Science, 15, 917–28.Google Scholar
- Perrino, T., Pantin, H., Huang, S., Brincks, A., Brown, C.H., & Prado, G. (2015). Reducing the risk of internalizing symptoms among high-risk Hispanic youth through a family intervention: A randomized controlled trial. Family Process. Epub ahead of printGoogle Scholar
- Prado, G., Pantin, H., Briones, E., Schwartz, S., Feaster, D., Huang, S., & Szapocznik, J. (2007). A randomized controlled trial of a parent-centered intervention in preventing substance use and HIV risk behaviors in Hispanic adolescents. Journal of Consulting & Clinical Psychology, 75, 914–26.CrossRefGoogle Scholar
- Prado, G., Cordova, D., Huang, S., Estrada, Y., Rosen, A., Bacio, G. A., & McCollister, K. (2012a). The efficacy of Familias Unidas on drug and alcohol outcomes for Hispanic delinquent youth: Main effects and interaction effects by parental stress and social support. Drug and Alcohol Dependence, 125S, S18–25.Google Scholar
- Prado, G., Pantin, H., Huang, S., Cordova, D., Tapia, M., Velazquez, M. R., & Estrada, Y. (2012b). Effects of a family intervention in reducing HIV risk behaviors among high-risk Hispanic adolescents: a randomized controlled trial. Archives of Pediatrics and Adolescent Medicine, 166, 127–33.Google Scholar
- Quay, H. C., & Peterson, D. R. (1993). The Revised Behavior Problem Checklist: Manual. Odessa, FL: Psychological Assessment Resources.Google Scholar
- Reef, J., Diamantopoulou, S., van Meurs, I., Verhulst, F. C., & van der Ende, J. (2011). Developmental trajectories of child adolescent externalizing behavior and adult DSM-IV disorder: a longitudinal study. Social Psychiatry and Psychiatric Epidemiology, 46, 1233–41.CrossRefPubMedPubMedCentralGoogle Scholar
- Szapocznik, J., & Coatsworth, J. D. (1999). An ecodevelopmental framework for organizing the influences on drug abuse: a developmental model of risk and protection. In M. D. Glantz & C. R. Hartel (Eds.), Drug abuse: origins & interventions (pp. 331–336). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
- Trudeau, L., Spoth, R., Mason, W.A., Randall, G.K., Redmond, C., & Schainker, L. (2015). Effects of adolescent universal substance misuse preventive interventions on young adult depression symptoms: Mediational model. Journal of Abnormal Psychology, Epub Ahead of printGoogle Scholar
- Zhou, Q., Sandler, I. N., Millsap, R. E., Wolchik, S. A., & Dawson- McClure, S. R. (2008). Mother–child relationship quality and effective discipline as mediators of the 6-year effects of the New Beginnings Program for children from divorced families. Journal of Consulting and Clinical Psychology, 76, 579–94.CrossRefPubMedGoogle Scholar