Contextual factors and anxiety in minority and European American youth presenting for treatment across two urban university clinics

Abstract

The current study compared ethnic minority and European Americanclinically-referred anxious youth (N = 686; 2–19 years) on internalizing symptoms (i.e., primary anxiety and comorbid depression) and neighborhood context. Data were provided from multiple informants including youth, parents, and teachers. Internalizing symptoms were measured by the Multidimensional Anxiety Scale for Children, Child Depression Inventory, Child Behavior Checklist and Teacher Report Form. Diagnoses were based on the Anxiety Disorders Interview Schedule for Children. Neighborhood context was measured using Census tract data (i.e., owner-occupied housing, education level, poverty level, and median home value). Ethnic minority and European American youth showed differential patterns of diagnosis and severity of anxiety disorders. Ethnic minority youth lived in more disadvantaged neighborhoods. Ethnicity and neighborhood context appear to have an additive influence on internalizing symptoms in clinically-referred anxious youth. Implications for evidence-based treatments are discussed.

Are Inner Context Factors Related to Implementation Outcomes in Cognitive-Behavioral Therapy for Youth Anxiety?

“…As reported previously (Beidas et al, 2012), the RM-ANOVA demonstrated that there was a main effect of time such that therapist adherence ( F (2, 222) = 100.21, p < .001) and skill ( F (2, 222) = 79.90, p <.001) improved after receiving the training and consultation package.…”

“…This is curious given that these individuals sought out this type of specialty training and reported that they either currently or planned to treat anxious youth in the future. This may be potentially due to difficulty identifying “pure” anxiety cases in community settings (Beidas et al, 2012; Ehrenreich-May et al, 2010; Southam-Gerow, Silverman, & Kendall, 2006). …”

“…Given that no significant differences between the three conditions were identified on therapist fidelity, we chose to collapse across training conditions in our analyses (see Beidas et al, 2012). …”

Barriers to and Facilitators in the Implementation of Cognitive-Behavioral Therapy for Youth Anxiety in the Community

“…Empirical findings support this perception, given that comorbidity rates are often high across psychological disorders, particularly for anxiety disorders (33,34). Compared with youths in the general population, anxious youths in the community often present with multiple comorbid diagnoses, lower socioeconomic status, and a background from more disadvantaged neighborhoods (23,35,36). Therefore, future training and consultation for providers working in community settings should include practical tips on how to address issues relevant for youths from urban communities.…”

Sociodemographic characteristics of youth in a trauma focused‐cognitive behavioral therapy effectiveness trial in the city of Philadelphia

“…We included the following neighborhood socioeconomic indicators in our analyses: the percentage of individuals living below the poverty level, the percentage of individuals over the age of 25 with only a high school education/equivalent or less, the median household income, and the percentage of owner‐occupied housing units. These indicators are frequently used in studies examining neighborhood context and were chosen specifically in other investigations examining SES and psychopathology (Beidas et al, ; Stockdale et al, ; U.S. Census Bureau, ).…”