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Project Title
Chicago Adolescent
Risk and Evaluation Study (CARES)
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Investigators:
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Geri Donenberg, PI; Roberta Paikoff, Co-I; Fred
Bryant, Co-I
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Key Personnel:
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Andrea Boyd, PhD; Erin Emerson, MA; Gloria Coleman,
MA
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Funding Sources:
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National Institute of Mental
Health; Warren Wright Adolescent Center; Northwestern Memorial Hospital’s
Intramural Grants Program
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Collaborators:
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Children’s Memorial Hospital, Cook County Hospital
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Adolescents are among the fastest growing population at risk for HIV/AIDS, and teens in psychiatric care at especially high risk. CARES explores HIV/AIDS risk determinants among 346 ethnically diverse teenagers seeking outpatient mental health services. Study aims are to (a) determine rates of risky sexual behavior and drug use among youth in psychiatric care and compare these rates to rates among teens in the general population; (b) test and compare the utility of two theoretical models in explaining HIV-risk -- the Information-Motivation-Behavior model (Fisher & Fisher, 1992) and a social-personal model (Donenberg & Pao, 2003); and (c) test and compare the two models for theoretically important subgroups of youth (internalizing, externalizing, substance abusing). In a final integrative analysis, we will develop a profile for youth at greatest HIV-risk based on the strongest predictors from both theoretical models. Teens and parents are recruited from four outpatient mental health clinics and they are interviewed at baseline, 6- and 12-months. Family members complete a combination of interviews and questionnaires to assess HIV/AIDS information, motivation, and behavioral skills, and teens' personal attributes, relationship concerns, and risky sexual behavior and substance use. Family context is examined via two structured videotaped interaction tasks and questionnaires, and adolescent psychopathology and substance abuse are evaluated via questionnaires and a structured diagnostic interview. We are using multiple methods to predict HIV-risk behavior (i.e., sexual risk taking and substance use).
The long-term significance of the research is to guide the development of specially targeted HIV prevention programs for youths in psychiatric care. HIV prevention programs are most effective when they are tailored to specific population needs. HIV/AIDS risk determinants identified in this study will be used to develop specially targeted programs for teens with mental health problems. Where interventions are effective in a clinical setting, they may be applied to teens with mental health problems in school-based settings.
* Currently CARES is in its final stage of completion. Closed to enrollment, the study is in the process of collecting 12 month follow-up data for enrolled youths.
Summary of Research
Findings
Published Manuscripts
Donenberg, G., Emerson, E., Bryant, F., Wilson , H., & Weber-Shifrin, E. (2001). Understanding AIDS-risk behavior among adolescents in psychiatric care: Links to psychopathology and peer relationships. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 642-653.
Donenberg, G., Wilson, H., Emerson, E., & Bryant, F. (2002). Holding the line with a watchful eye: The impact of perceived parental monitoring and parental permissiveness on risky sexual behavior among adolescents in outpatient psychiatric service. AIDS Education and Prevention, 14, 138-157.
Donenberg, G. R. & Pao, M. (2003). Understanding HIV/AIDS: Psychosocial and psychiatric issues. Contemporary Psychiatry, 2(7), 1-7.
Donenberg, G., Bryant, F., Wilson, H., & Emerson, E. (2003). Tracing the roots of Early Sexual Debut Among Adolescents in Psychiatric Care. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 594-608.
Donenberg, G. R. & Pao, M. (2004). HIV/AIDS prevention and intervention: Youth and psychiatric illness. Contemporary Psychiatry, 2(10), 1-6.
Wilson, H., & Donenberg, G. R. (2004). Quality of parent communication about sex and its relationship to risky sexual behavior among adolescents in psychiatric care. Journal of Child Psychology and Psychiatry, 45, 387-395.
Donenberg, G., Moss, R., Emerson, E., Wilson , H., Bryant, F., Coleman, G., & Clark, S. (2005). Applying a Cognitive-Behavioral Model of HIV-Risk to Youths in Psychiatric Care. AIDS Education and Prevention, 17, 200-216.
Donenberg, G. R. & Pao, M. (2005). Youths and HIV/AIDS: Psychiatry's role in a changing epidemic. Journal of the American Academy of Child & Adolescent Psychiatry, 44, 728-747.
Donenberg, G., Emerson, E., Bryant, F. & King, S. (2006). Does substance use moderate the effects of parents and peers on risky sexual behaviour? AIDS Care, 18(3), 194-200.
Mustanski, B., Donenberg, G., & Emerson, E. (2006). I can use a condom, I just don't: The importance of motivation to prevent HIV in adolescent seeking psychiatric care. AIDS and Behavior.
Donenberg, G., Paikoff, R., & Pequegnat, W. (2006). Introduction to the special issue on Families and HIV: First Generation Prevention Programs. Journal of Pediatric Psychology, 41. 869-873.
Malow, R., Rosenberg, R., Donenberg, G., & Dévieux, J. (2006). Interventions and Patterns of Risk in Adolescent HIV/AIDS Prevention. American Journal of Infectious Diseases, 2, 80-89.
Brady, S., & Donenberg, G. (2006). Violence exposure predicts adolescent engagement in substance use and sexual risk taking. Journal of the American Academy of Child and Adolescent Psychiatry, XXX
Jordan, K., & Donenberg, G. R., (2006). Child and Adolescent Psychiatry and HIV/AIDS. Current Opinions in Pediatrics, 18, 545-550.
Under Review
Nappi, C. M., Donenberg, G. R., & McBride, C. K. (under review). HIV/AIDS Communication among Adolescents in Psychiatric Care and their Parents: Beware of the “Scare Tactic.”
Lampe, R., McBride, C. K., & Donenberg, G. R. (under review). Sensation Seeking as a Correlate of Risky Sexual Behavior Among Adolescents in Psychiatric Care.
Donenberg, G., Bryant, F., Emerson, E., & Kapungu, C. (under review). To Use or Not to Use Condoms: Pathways to Safe versus Risky Sexual Behavior Among Adolescents in Psychiatric Care.
Presentations
Mustanski, B., Donenberg, G., & Boyd, A. (July, 2006). Problem behaviors syndrome in adolescents seeking mental health services: The interacting role of sensation seeking and parenting behaviors. Presented at the annual NIMH Research Conference on the Role of Families in Preventing and Adapting to HIV/AIDS, San Juan , Puerto Rico .
Donenberg, G., Mustanski, B., & Emerson, E. (March, 2006). Can parental monitoring and control protect high sensation seeking youths from risky sexual behavior? Paper presented as part of a symposium at the annual meeting of the Society for Research on Adolescence. San Francisco , CA .
Wilson, H., Donenberg, G., & Lavigne, J. (October, 2005). Parent Communication, Partner Negotiation, and Risky Sex in Treatment-Seeking Adolescents. Presented at the annual meeting of the American Academy of Child and Adolescent Psychiatry, Toronto , Canada .
Donenberg, G. (April, 2005). Does drug use moderate the effects of parents and peers on risky sex? Paper presented at the meeting of the International AIDS Impact Conference, Capetown , South Africa .
Brady, S. & Donenberg, G. (April, 2005). Violence exposure predicts adolescent engagement in substance use and sexual risk taking. Paper presented at the meeting of the International AIDS Impact Conference, Capetown , South Africa .
Mustanski, B., Donenberg, G., & Emerson, E. (April, 2005). Testing cognitive and behavioral mechanisms in HIV risk behavior among troubled youths. Paper presented at the meeting of the International AIDS Impact Conference, Capetown , South Africa .
Wilson, H. W., Emerson, E., Nappi, C., & Donenberg, G. R. (July, 2004). The big talk: What kind of parent-teen communication is most relevant for reducing HIV-risk among youth in psychiatric care? Presented at the XV International AIDS Conference, Bangkok Thailand .
Donenberg, G. (July, 2004). Parents enhancing HIV prevention among adolescents. Invited paper at the annual NIMH Research Conference on the Role of Families in Preventing and Adapting to HIV/AIDS, Atlanta , GA.
Lampe, R., Nappi, C., McBride, C., Emerson, E., Donenberg, G., & Wright, T. (October, 2003). Sensation seeking and risky sex among adolescents in psychiatric care. Presented at the Annual Meeting of the American Academy of Child and Adolescent Psychiatry, Miami , Florida .
Wilson, H. W., Emerson, E. & Donenberg, G. (July, 2003). Do parent-teen conversations about sex make a difference? Presented at the annual NIMH Research Conference on the Role of Families in Preventing and Adapting to HIV/AIDS, Washington , DC .
Nappi, C. M., Lampe, R. C., Roebuck, M. S., Emerson, E., Wilson, H. W., McBride, C. K., & Donenberg, G. (July, 2003). Transmission or prevention: Assessing the content of HIV-related communication between adolescents and their parents. Presented at the annual NIMH Research Conference on the Role of Families in Preventing and Adapting to HIV/AIDS, Washington , DC .
Coleman, G., Byndum, D., & Donenberg, G. (July, 2003). C.A.R.E.S. – Recruitment and tracking – What works?. Presented at the annual NIMH Research Conference on the Role of Families in Preventing and Adapting to HIV/AIDS, Washington , DC .
Boyd, A., Barve, C., & Donenberg, G. (July, 2003). Effects of parent perception of parent-teen conflict and perceived vulnerability on parent-teen dialogue about sex. Presented at the annual NIMH Research Conference on the Role of Families in Preventing and Adapting to HIV/AIDS, Washington , DC .
Moss, R. & Donenberg, G. (April, 2003). The Information-Motivation-Behavioral Skills Model (IMB) of HIV-risk: Its application to youth in psychiatric care. Poster presented at the Biennial Meeting of the Society for Research on Child Development, Tampa , Florida .
Donenberg, G. R. (July, 2002). Social and Personal Factors Related to Early Sexual Debut Among Adolescents in Psychiatric Care. Presented at the annual NIMH Research Conference on the Role of Families in Preventing and Adapting to HIV/AIDS, Miami , Fl.
Barve, C., Boyd, A., Wilson, H., & Donenberg, G. (July, 2002). Observed conflict discussions between parents and troubled teens: Links to HIV risk? Presented at the annual NIMH Research Conference on the Role of Families in Preventing and Adapting to HIV/AIDS, Miami , Florida .
Emerson, E., Wilson, H., & Donenberg, G. (July, 2002). Risking her health or her boyfriend: The role of parents and partners in troubled girls' condom use. Presented at the annual NIMH Research Conference on the Role of Families in Preventing and Adapting to HIV/AIDS, Miami , Florida .
McBride, C., & Donenberg, G. (July, 2002). Predicting risky sexual behavior among youth in psychiatric care: Problem behavior and family variables. Presented at the annual NIMH Research Conference on the Role of Families in Preventing and Adapting to HIV/AIDS, Miami , Florida .
Donenberg, G. (July, 2001). Mental health aspects of HIV. Presented at the NIMH Research Conference on the Role of Families in Preventing and Adapting to HIV/AIDS, Los Angeles , CA .
Wilson, H., Emerson, E., & Donenberg, G. (July, 2001). Do Relationships Matter in Adolescent HIV-Risk? Presented at the annual NIMH Research Conference on the Role of Families in Preventing and Adapting to HIV/AIDS, Los Angeles , CA
Donenberg, G. R., Bryant, F., & Emerson, E. (July, 2000). Do relationship maintenance concerns mediate the link between family disengagement and AIDS-risk behavior among clinically disturbed adolescents? Presented at the NIMH Research Conference on the Role of Families in Preventing and Adapting to HIV/AIDS, Chicago , Illinois .
Finkelstein, J., Emerson, E., & Donenberg, G. R. (July, 2000). Parental monitoring and adolescent gender as predictors of AIDS-risk behaviors in youth seeking mental health treatment. Presented at the annual NIMH Research Conference on the Role of Families in Preventing and Adapting to HIV/AIDS, Chicago , Illinois .
Wilson , H., Weber-Shifrin, E., & Donenberg, G. R. (July, 2000). Parent-adolescent communication about sex and parental monitoring as predictors of sexual risk-taking among mentally ill youth. Presented at the NIMH Research Conference on the Role of Families in Preventing and Adapting to HIV/AIDS, Chicago , Illinois .
Donenberg, G., & Emerson, E. (July, 1999). AIDS-risk behavior and family functioning in clinically disturbed youth. Presented at the NIMH Research Conference on the Role of Families in Preventing and Adapting to HIV/AIDS, Philadelphia , PA.
Wilson, H., Donenberg, G., & Emerson, E. (March, 2000). Parent-adolescent interactions and teenagers' risky sexual behavior. Presented at the meeting of the Society for Research on Adolescence, Chicago , Illinois .
Donenberg, G., & Emerson, E. (October, 1999). HIV Risk in Mentally Ill Adolescents: The Role of Families, Peers, and Psychopathology. Paper presented at the workshop, Settings and Situations: Emerging HIV/STD Risk in Children and Youth, sponsored by the NIMH Center for Mental Health Research on AIDS.
Donenberg, G., & Emerson, E. (June, 1999). AIDS-risk behavior among clinically disturbed youth: Links to externalizing and internalizing problems. Presented at the bi-annual meeting of the International Society for Research in Child and Adolescent Psychopathology, Barcelona , Spain . |
