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. Given the public health significance of youth behavior problems and dearth of effective interventions among underserved and contextually disadvantaged groups, findings can address a critical gap regarding effective dissemination and implementation of evidence-based practice in the community.

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. Nevertheless, little research examines relations among ACEs and these disparate outcomes among youth. Such knowledge could inform our understanding of risk and resilience among youth residing in low-income, urban communities, as well as facilitate identification of youth at risk for negative long-term sequelae. We will use existing data from the Child Resilience Study (PI: Ashleigh Hall, DO; N = 425; 6-11 years old; 79% Black; 21% Hispanic; 52% female, 48% male) and Adolescent Resilience Study (N = 450; M = 14.9 years old, range = 12.1-18.9 years; 55% female; 72.5% African American; 21.1% Hispanic) who presented for their yearly well visit. To examine multifinality (i.e., multiple outcomes from ACEs), EPIC medical data will be coded. Analyses will examine whether resilience moderates relations among ACEs and both caregiver-reported and EPIC-derived indices of psychosocial outcomes. Given that the existing data largely involved screening questionnaires, 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. Findings will have implications for identification of children at differential risk for psychosocial difficulties during a critical developmental period and in settings where intervention may be more effective.

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 and are associated with significant neuropsychological impairment, problematic interpersonal functioning, psychiatric morbidity, and mortality. The putative etiological processes, risk factors, correlates, phenotypic presentations, and trajectories associated with AD are heterogeneous. Previous research has used latent class analysis, a person-centered statistical technique, to classify dementia patients diagnosed with AD and vascular dementia, as well as patients with MCI, into profiles on the basis of neuropsychological test performance. However, the factors that might underlie changes in neuropsychological profile membership over time have not been thoroughly researched. Further characterization of individuals at risk for emergent dementia using person-centered statistical techniques analyzing both cross-sectional and longitudinal profiles, along with an investigation of the biological and psychosocial factors that underlie group membership, could improve prognostic decision-making and inform prevention and intervention efforts to attenuate long-term risk and associated sequelae. 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 in risk factors, course, and outcomes among ethnic minority individuals, and to examine the complex interplay among neuropsychological, biological, and psychosocial factors that contribute to the pathogenesis of AD, ADRD, and MCI using multiple levels of analysis. Findings may guide AD/MCI assessment, prevention, and intervention efforts and address well-known health disparities in AD/ADRD among ethnic minority individuals.

The Child Health & Behavior Study Phases I and II (Dec. 2003-present)

The Child Health and Behavior Study, directed by Dr. Deborah Drabick, is 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.