Parents and families play an important role in insulating youth against high-risk sexual behavior... more Parents and families play an important role in insulating youth against high-risk sexual behavior (e.g., more partners, non-condom use) and have become an important focus of adolescent HIV prevention programs. Although adaptive parenting practices help protect youth, maladaptive practices may place them at greater risk. Parents with psychiatric disorders are more likely to display greater criticism and hostility in their communication and also display more disorganized parenting strategies with less parental monitoring. These maladaptive behaviors suggest that parental psychopathology is an important background factor to consider when implementing family based prevention programs. Examining parental psychopathology is especially relevant given recent evidence from meta-analyses of general parenting interventions that suggests parents with mental health problems may not respond as well as their peers to parent-training interventions. Strengthening Today’s Youth Life Experiences (Proj...
Desigualdades en la salud reproductiva: enfoque sobre la planificación familiar y la prevención e... more Desigualdades en la salud reproductiva: enfoque sobre la planificación familiar y la prevención entre las mujeres pertenecientes a minorías y las adolescentes ABSTRACT Minority women and adolescent females of all races and ethnicities are disproportionately affected by unintended pregnancy in the United States. Adolescents also experience an additional proportion of the burden compared to other age groups, as 82% of pregnancies among women 19 years old and younger are unintended. Moreover, minority and adolescent mothers are at increased risk for having preterm deliveries, low birth weight infants, and other complications. Unintended pregnancy continues to be an important public health problem in the United States, and prevention through family planning is urgently needed. This review presents an overview of the US demographics for unintended pregnancy among both minority and adolescent women and identifies current and past efforts to reduce unintended pregnancy, specifically among minority and adolescent females, through contraception and familyplanning programs.
Journal of Consulting and Clinical Psychology, 2010
Objective: To examine the relationship between psychiatric disorders and sexual behaviors among a... more Objective: To examine the relationship between psychiatric disorders and sexual behaviors among adolescents receiving mental health treatment. Adolescents in mental health treatment have been found to have higher rates of HIV risk behavior than their peers, but data concerning the relationship between psychopathology and risk are inconsistent and limited. Method: Eight hundred and forty adolescents (56% female, 58% African American,
The study examined the efficacy of family-based and adolescent-only HIV prevention programs in de... more The study examined the efficacy of family-based and adolescent-only HIV prevention programs in decreasing HIV risk and improving parental monitoring and sexual communication among youths in mental health treatment. A randomized controlled trial (RCT) with 721 adolescents (ages 13-18 years) and their caregivers from mental health settings in three U.S. cities were randomly assigned to one of three theory-based, structured group interventions: family-based HIV prevention, adolescent-only HIV prevention, and adolescent-only health promotion. Interventions were delivered during an all-day workshop. Assessments were completed at baseline and three months postintervention. Compared with those in the health intervention, adolescents in the HIV prevention interventions reported fewer unsafe sex acts (adjusted rate ratio=.49, p=.01), greater condom use (adjusted relative change=59%, p=.01), and greater likelihood of avoiding sex (adjusted odds ratio=1.44, p=.05). They also showed improved HIV knowledge (p<.01) and self-efficacy (p<.05). The family-based intervention, compared with the other interventions, produced significant improvements in parent-teen sexual communication (p<.01), parental monitoring (p<.01), and parental permissiveness (p=.05). This RCT found that the HIV prevention interventions reduced sexual risk behavior over three months in a large, diverse sample of youths in mental health treatment and that the family-based intervention improved parental monitoring and communication with teens about sex. These interventions show promise.
The purpose of this study was to examine the effectiveness of evidence-based recruitment and rete... more The purpose of this study was to examine the effectiveness of evidence-based recruitment and retention strategies for a longitudinal, family-based HIV prevention intervention study targeting adolescents in psychiatric care by (1) determining consent rate (recruitment), rate of participation at the first intervention session (retention), and follow-up attendance rate (retention); and (2) examining socio-demographic factors, family-level processes, sexual risk-related indices, and
To assess the associations of sexual risk behavior with psychiatric impairment and individual, pe... more To assess the associations of sexual risk behavior with psychiatric impairment and individual, peer, and partner attitudes among adolescents receiving mental health treatment. Adolescents (N=893, 56% female, 67% African American) completed assessments of psychiatric impairment, rejection sensitivity, peer norms, HIV knowledge, perceived vulnerability, self-efficacy and condom use intentions. Two structural equation models were used to test the study hypotheses; one for sexually active youth and one for non-active youth. For non-active youth, psychiatric impairment influenced self-efficacy and condom use intentions via peer norms, rejection sensitivity, and perceived vulnerability. Among the sexually active youth, sexual risk was related to impairment and previous condom use. These results suggest that individual, peer, and partner factors are related to impairment and to sexual risk attitudes, but depend on previous sexual experience.
High risk sexual behaviour, alcohol and drug use, and mental health problems combine to yield hig... more High risk sexual behaviour, alcohol and drug use, and mental health problems combine to yield high levels of HIV-risk behaviour among adolescents with mental health problems. In South Africa, little research has been conducted on parental perspectives of HIV-risk among this population. We conducted a series of focus group discussions with 28 mothers of adolescents receiving services at two mental health clinics in South Africa to identify, from their perspectives, the key community problems facing their children. Participants indicated that HIV remained a serious threat to their adolescent children's well-being, in addition to substance abuse, early sexual debut, and teenage pregnancy. These social problems were mentioned as external to their household dynamics, and thus seemingly beyond the purview of the parent-adolescent relationship. These data have implications for the design of family-based interventions to ameliorate the factors associated with HIV-risk among youth receiving mental health services.
The relationship between perceived maternal control and depression was examined in 111 urban adol... more The relationship between perceived maternal control and depression was examined in 111 urban adolescent girls seeking psychological services at an outpatient mental health center in the Midwest. This study sought to clarify inconsistent findings in earlier research linking parental control and adolescent depression by examining urban girls with mental health problems and by testing ethnic background as a moderator of the general relationship. Data were collected using self-administered questionnaires of adolescent girls' depressive symptoms, and perceptions of their mothers' parenting styles. Analyses did not detect a significant association between maternal control and depression in the combined sample of adolescent girls; however, findings were moderated by the ethnicity of the girls. Once ethnicity was included, no relation between control and depression was found for Caucasian and Latina girls, but high control was linked to less depression among African American girls. These findings highlight the importance of ethnicity and gender in child rearing and adolescent depression and stress the need for more culturally sensitive conceptualizations of depression.
This study examined the utility of cognitive and behavioral constructs (AIDS information, motivat... more This study examined the utility of cognitive and behavioral constructs (AIDS information, motivation, and behavioral skills) in explaining sexual risk taking among 172 12-20-year-old ethnically diverse urban youths in outpatient psychiatric care. Structural equation modeling revealed only moderate support for the model, explaining low to moderate levels of variance in global sexual risk taking. The amount of explained variance improved when age was included as a predictor in the model. Findings shed light on the contribution of AIDS information, motivation, and behavioral skills to risky sexual behavior among teens receiving outpatient psychiatric care. Results suggest that cognitive and behavioral factors alone may not explain sexual risk taking among teens whose cognitive and emotional deficits (e.g., impaired judgment, poor reality testing, affect dysregulation) interfere with HIV preventive behavior. The most powerful explanatory model will likely include a combination of cognitive, behavioral, developmental, social (e.g., family), and personal (e.g., psychopathology) risk mechanisms.
This study investigated the relationship between parent-teen sexual communication, discussion of ... more This study investigated the relationship between parent-teen sexual communication, discussion of condoms, and condom use among adolescents in mental health treatment. Adolescents with a history of sexual intercourse and their parents completed questionnaires assessing adolescent sexual risk behavior, sexual communication, and discussion of sexual topics. Greater condom use by adolescents was associated with parent-adolescent condom discussion but was not associated with openness in sexual communication. Seventy-six percent of adolescents reported that parents had discussed condoms with them and these discussions were significantly associated with protected sexual acts. In a logistic regression, accounting for age, gender, race, and psychiatric diagnosis teens that discussed condoms with their parent were more likely to report condom use at last sex. Increasing direct communication about condoms may be an important step in increasing adolescent's safer sex behavior. Mental health disorders and family distress may make such discussions challenging but are not an insurmountable barrier to direct discussions about condoms.
Journal of correctional health care : the official journal of the National Commission on Correctional Health Care, 2015
This study evaluates the prevalence of mental/emotional distress and its specific correlates amon... more This study evaluates the prevalence of mental/emotional distress and its specific correlates among people living with HIV/AIDS (PLWHA) in 20 jail systems across the United States. Of the 878 PLWHA jail detainees, 52% had high levels of mental/emotional distress, defined by the composite Addiction Severity Index score. High mental/emotional distress was found to be associated with the inmate living in a city with lower income inequality, lower health ranking, and higher degree of danger. Proximate variables included being female, bisexual orientation, poorer physical health, and increased severity of substance abuse. Inmates in jails with accredited health services and those satisfied with family support had lower mental/emotional distress scores. These findings indicate the need for expanded mental health assessment of PLWHAs entering jail.
Parents and families play an important role in insulating youth against high-risk sexual behavior... more Parents and families play an important role in insulating youth against high-risk sexual behavior (e.g., more partners, non-condom use) and have become an important focus of adolescent HIV prevention programs. Although adaptive parenting practices help protect youth, maladaptive practices may place them at greater risk. Parents with psychiatric disorders are more likely to display greater criticism and hostility in their communication and also display more disorganized parenting strategies with less parental monitoring. These maladaptive behaviors suggest that parental psychopathology is an important background factor to consider when implementing family based prevention programs. Examining parental psychopathology is especially relevant given recent evidence from meta-analyses of general parenting interventions that suggests parents with mental health problems may not respond as well as their peers to parent-training interventions. Strengthening Today’s Youth Life Experiences (Proj...
Desigualdades en la salud reproductiva: enfoque sobre la planificación familiar y la prevención e... more Desigualdades en la salud reproductiva: enfoque sobre la planificación familiar y la prevención entre las mujeres pertenecientes a minorías y las adolescentes ABSTRACT Minority women and adolescent females of all races and ethnicities are disproportionately affected by unintended pregnancy in the United States. Adolescents also experience an additional proportion of the burden compared to other age groups, as 82% of pregnancies among women 19 years old and younger are unintended. Moreover, minority and adolescent mothers are at increased risk for having preterm deliveries, low birth weight infants, and other complications. Unintended pregnancy continues to be an important public health problem in the United States, and prevention through family planning is urgently needed. This review presents an overview of the US demographics for unintended pregnancy among both minority and adolescent women and identifies current and past efforts to reduce unintended pregnancy, specifically among minority and adolescent females, through contraception and familyplanning programs.
Journal of Consulting and Clinical Psychology, 2010
Objective: To examine the relationship between psychiatric disorders and sexual behaviors among a... more Objective: To examine the relationship between psychiatric disorders and sexual behaviors among adolescents receiving mental health treatment. Adolescents in mental health treatment have been found to have higher rates of HIV risk behavior than their peers, but data concerning the relationship between psychopathology and risk are inconsistent and limited. Method: Eight hundred and forty adolescents (56% female, 58% African American,
The study examined the efficacy of family-based and adolescent-only HIV prevention programs in de... more The study examined the efficacy of family-based and adolescent-only HIV prevention programs in decreasing HIV risk and improving parental monitoring and sexual communication among youths in mental health treatment. A randomized controlled trial (RCT) with 721 adolescents (ages 13-18 years) and their caregivers from mental health settings in three U.S. cities were randomly assigned to one of three theory-based, structured group interventions: family-based HIV prevention, adolescent-only HIV prevention, and adolescent-only health promotion. Interventions were delivered during an all-day workshop. Assessments were completed at baseline and three months postintervention. Compared with those in the health intervention, adolescents in the HIV prevention interventions reported fewer unsafe sex acts (adjusted rate ratio=.49, p=.01), greater condom use (adjusted relative change=59%, p=.01), and greater likelihood of avoiding sex (adjusted odds ratio=1.44, p=.05). They also showed improved HIV knowledge (p<.01) and self-efficacy (p<.05). The family-based intervention, compared with the other interventions, produced significant improvements in parent-teen sexual communication (p<.01), parental monitoring (p<.01), and parental permissiveness (p=.05). This RCT found that the HIV prevention interventions reduced sexual risk behavior over three months in a large, diverse sample of youths in mental health treatment and that the family-based intervention improved parental monitoring and communication with teens about sex. These interventions show promise.
The purpose of this study was to examine the effectiveness of evidence-based recruitment and rete... more The purpose of this study was to examine the effectiveness of evidence-based recruitment and retention strategies for a longitudinal, family-based HIV prevention intervention study targeting adolescents in psychiatric care by (1) determining consent rate (recruitment), rate of participation at the first intervention session (retention), and follow-up attendance rate (retention); and (2) examining socio-demographic factors, family-level processes, sexual risk-related indices, and
To assess the associations of sexual risk behavior with psychiatric impairment and individual, pe... more To assess the associations of sexual risk behavior with psychiatric impairment and individual, peer, and partner attitudes among adolescents receiving mental health treatment. Adolescents (N=893, 56% female, 67% African American) completed assessments of psychiatric impairment, rejection sensitivity, peer norms, HIV knowledge, perceived vulnerability, self-efficacy and condom use intentions. Two structural equation models were used to test the study hypotheses; one for sexually active youth and one for non-active youth. For non-active youth, psychiatric impairment influenced self-efficacy and condom use intentions via peer norms, rejection sensitivity, and perceived vulnerability. Among the sexually active youth, sexual risk was related to impairment and previous condom use. These results suggest that individual, peer, and partner factors are related to impairment and to sexual risk attitudes, but depend on previous sexual experience.
High risk sexual behaviour, alcohol and drug use, and mental health problems combine to yield hig... more High risk sexual behaviour, alcohol and drug use, and mental health problems combine to yield high levels of HIV-risk behaviour among adolescents with mental health problems. In South Africa, little research has been conducted on parental perspectives of HIV-risk among this population. We conducted a series of focus group discussions with 28 mothers of adolescents receiving services at two mental health clinics in South Africa to identify, from their perspectives, the key community problems facing their children. Participants indicated that HIV remained a serious threat to their adolescent children's well-being, in addition to substance abuse, early sexual debut, and teenage pregnancy. These social problems were mentioned as external to their household dynamics, and thus seemingly beyond the purview of the parent-adolescent relationship. These data have implications for the design of family-based interventions to ameliorate the factors associated with HIV-risk among youth receiving mental health services.
The relationship between perceived maternal control and depression was examined in 111 urban adol... more The relationship between perceived maternal control and depression was examined in 111 urban adolescent girls seeking psychological services at an outpatient mental health center in the Midwest. This study sought to clarify inconsistent findings in earlier research linking parental control and adolescent depression by examining urban girls with mental health problems and by testing ethnic background as a moderator of the general relationship. Data were collected using self-administered questionnaires of adolescent girls' depressive symptoms, and perceptions of their mothers' parenting styles. Analyses did not detect a significant association between maternal control and depression in the combined sample of adolescent girls; however, findings were moderated by the ethnicity of the girls. Once ethnicity was included, no relation between control and depression was found for Caucasian and Latina girls, but high control was linked to less depression among African American girls. These findings highlight the importance of ethnicity and gender in child rearing and adolescent depression and stress the need for more culturally sensitive conceptualizations of depression.
This study examined the utility of cognitive and behavioral constructs (AIDS information, motivat... more This study examined the utility of cognitive and behavioral constructs (AIDS information, motivation, and behavioral skills) in explaining sexual risk taking among 172 12-20-year-old ethnically diverse urban youths in outpatient psychiatric care. Structural equation modeling revealed only moderate support for the model, explaining low to moderate levels of variance in global sexual risk taking. The amount of explained variance improved when age was included as a predictor in the model. Findings shed light on the contribution of AIDS information, motivation, and behavioral skills to risky sexual behavior among teens receiving outpatient psychiatric care. Results suggest that cognitive and behavioral factors alone may not explain sexual risk taking among teens whose cognitive and emotional deficits (e.g., impaired judgment, poor reality testing, affect dysregulation) interfere with HIV preventive behavior. The most powerful explanatory model will likely include a combination of cognitive, behavioral, developmental, social (e.g., family), and personal (e.g., psychopathology) risk mechanisms.
This study investigated the relationship between parent-teen sexual communication, discussion of ... more This study investigated the relationship between parent-teen sexual communication, discussion of condoms, and condom use among adolescents in mental health treatment. Adolescents with a history of sexual intercourse and their parents completed questionnaires assessing adolescent sexual risk behavior, sexual communication, and discussion of sexual topics. Greater condom use by adolescents was associated with parent-adolescent condom discussion but was not associated with openness in sexual communication. Seventy-six percent of adolescents reported that parents had discussed condoms with them and these discussions were significantly associated with protected sexual acts. In a logistic regression, accounting for age, gender, race, and psychiatric diagnosis teens that discussed condoms with their parent were more likely to report condom use at last sex. Increasing direct communication about condoms may be an important step in increasing adolescent's safer sex behavior. Mental health disorders and family distress may make such discussions challenging but are not an insurmountable barrier to direct discussions about condoms.
Journal of correctional health care : the official journal of the National Commission on Correctional Health Care, 2015
This study evaluates the prevalence of mental/emotional distress and its specific correlates amon... more This study evaluates the prevalence of mental/emotional distress and its specific correlates among people living with HIV/AIDS (PLWHA) in 20 jail systems across the United States. Of the 878 PLWHA jail detainees, 52% had high levels of mental/emotional distress, defined by the composite Addiction Severity Index score. High mental/emotional distress was found to be associated with the inmate living in a city with lower income inequality, lower health ranking, and higher degree of danger. Proximate variables included being female, bisexual orientation, poorer physical health, and increased severity of substance abuse. Inmates in jails with accredited health services and those satisfied with family support had lower mental/emotional distress scores. These findings indicate the need for expanded mental health assessment of PLWHAs entering jail.
Uploads
Papers by Geri Donenberg