Risk and resilience among youth of caregivers living with HIV (January 2023-present): As a developmental period, adolescence is associated with normative increases in risk taking, sensation seeking, autonomy from parents, and focus on peer relationships. For many adolescents, these changes are associated with positive psychosocial adjustment; however, some adolescents experience increases in psychological symptoms and social difficulties. Less is known about family processes that confer risk or resilience for positive outcomes, particularly among adolescents of parents living with HIV who often experience challenges specific to HIV (e.g., stigma, decreased access to care) and among families who experience health disparities and are minoritized. The current study addresses these gaps by examining youth neurocognitive and psychosocial processes among adolescents of parents living with HIV. Aims are to (a) identify risk and resilience factors among youth and within the family system that are associated with youth psychological symptoms and positive adjustment, and (b) examine whether child-specific factors moderate the relation between family functioning and youth psychological symptoms and positive adjustment. This comprehensive battery will permit identification of youth at risk for negative psychosocial outcomes and characterize youth and family functioning among adolescents of parents living with HIV. Findings also will have implications for resilience from psychological symptoms and inform efforts to attenuate health disparities through identification of intervention targets and prevention strategies.
Coping Power Program (May 2010-present): Adaptations of evidence-based practice in community settings have received little attention. This issue is particularly problematic among low income, urban youth, who are at risk for emotional and behavioral difficulties likely stemming from contextual circumstances, and who have limited access to effective intervention services. For this project, we conduct school-based assessments evaluating (a) neurodevelopmental and contextual factors that may predict intervention outcomes; and (b) an adapted version of the Coping Power program, a cognitive-behavioral intervention shown to reduce behavior problems among children. Children are assessed pre- and post-intervention using a well-validated battery of neurodevelopmental (e.g., memory, verbal abilities) and contextual (e.g., peer, neighborhood) measures. Youth participate in the group-based Coping Power program, designed to teach anger management, learn perspective-taking and social problem-solving techniques, and make improvements toward social goals. We aim to evaluate adaptation of this intervention to better address challenges among diverse youth, identify children at risk for continued challenges, and determine predictors of intervention outcomes.
Resilience and Health Outcomes among Youth (June 2021-present): Youth who reside in low-income, urban communities are at increased risk of adverse childhood events (ACEs; e.g., family conflict, maltreatment, community violence, family psychological or legal difficulties). Exposure to such stressors leads to a variety of outcomes, including emotional or behavioral problems, as well as resilience, or thriving despite adversity. We use existing data from the Child and Adolescent Resilience Study who presented for their yearly well visit. To examine multifinality (i.e., multiple outcomes from ACEs), EPIC medical data will be coded. Analyses examine whether resilience moderates relations among ACEs and both caregiver-reported and EPIC-derived indices of psychosocial outcomes. The second component includes collecting and analyzing data about child functioning in the domains of physical, cognitive, and emotional health, and contextual processes. This extension will allow evaluation of different questions regarding risk and resilience among families in contextually disadvantaged and under-resourced communities where ACE levels are elevated.
Neuropsychological and Biological Factors Associated with Risk and Resilience for Cognitive Decline (March 2020-present): Alzheimer’s disease, Alzheimer’s disease-related dementias (AD/ADRD), and mild cognitive impairment (MCI) represent enormous public health concerns. The putative etiological processes, risk factors, correlates, phenotypic presentations, and trajectories associated with AD are heterogeneous. This project leverages two large-scale, prospective data sets of participants from the National Alzheimer’s Coordinating Center, a sample drawn from 39 National Institute on Aging-funded AD Centers, and the Framingham Heart Study, an epidemiological, community-dwelling sample. The goals are to identify neuropsychological profiles in both data sets across multiple time points; to consider prospective stability and transitions of profile membership that might indicate risk for cognitive decline or resilience (i.e., attenuated decline despite membership in a risk profile); to test whether biological or psychosocial processes are associated with such stability or transitions; and to determine profiles most associated with risk for neuropsychological decline and subsequent diagnoses of AD and MCI. The proposed project will include parallel analyses of Caucasian and ethnic minority participants to assess potential health disparities.
The Child Health & Behavior Study Phases I and II (Dec. 2003-present): The Child Health and Behavior Study was an NIMH-funded prospective project that examines how factors specific to the child (e.g., temperament, cognitive abilities) interact with aspects of the child’s many contexts (e.g., family, peers, neighborhood) to influence emotional and social adjustment among low income, urban families living in Philadelphia. The project focuses on the roles of prefrontal, limbic, and peer-child interactional processes as predictors of conduct problems and depressive symptoms.