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Leveraging Scientific Advances to Strengthen the Implementation, Evaluation, and Impacts of Intervention Programs for Children Experiencing Early Life Adversity

Award Date: 01/2024
PI: Danielle Roubinov, PhD
Adversity exposure in childhood is one of the most significant predictors of poor health and development. Early trauma impacts children’s stress-sensitive biological systems, resulting in “wear and tear” on the body, with effects that may persist across the life course. With partners from the UNC Child Medical Evaluation Program ( and Center for Child and Family Health (, this project will deliver an evidence-based intervention to children and their families who have been exposed to adversity. Before and after treatment, we will collect non-invasive measures of children’s stress functioning to understand how treatments may “repair” the biological harms of adversity exposure and explore factors that make some children more likely to respond to treatment.

mother talking to upset childSupporting Healthy Individuals through Nurturing Environments

Award Date: 12/2023
PI: Danielle Roubinov, PhD
Children whose parents were exposed to severe trauma – including sexual violence – are at elevated risk for posttraumatic stress disorder. Current research on trauma is narrowly siloed into two categories: 1) research on adult trauma exposure and its effects on adult mental health 2) research on child trauma exposure and its effects on child mental health. Scarce research bridges these two literatures to examine how exposure to parental trauma impacts parenting and mental health risk in offspring. The present study will recruit 100 mother-child dyads consisting of an adult woman who received emergency care after sexual assault and her offspring ages 8-14 years. Families will be followed for 6 months and will provide data on parent and child mental health, coping, parenting, and other aspects of the family environment. Results will be used to identify modifiable risk factors for youth mental health problems after caregivers are exposed to traumatic stress and develop prevention and intervention programs.

school counselor talking with teenage girl in a libraryCharacterizing the Nature and Scope of School-Based Behavioral Health across the 10 Health Resources and Services Administration (HRSA) Regions in the US

Award Date: 10/2023
PI: Nate Sowa, MD, PhD; Danielle Roubinov, PhD
School-based behavioral health (SBBH) has been proposed as a strategy to address the inadequate supply of youth mental health services; however, little is known about the characteristics and workforce of statewide SBBH programs and variations across the U.S. The purpose of this project is to explore the following characteristics of SBBH across 10 HRSA-defined regions in the US: presence/absence, how care is delivered (in-person, virtual, hybrid), by whom (psychologists, psychiatrists, LCSWs), and funding source(s).

female doctor talking to female teenager in examination roomImplementing and Evaluating a New Evidence-Based Intervention for Youth Anxiety and Depression into a Pediatric Primary Care Setting

Award Date: 09/2023
PI: Danielle Roubinov, PhD
Child and adolescent mood and anxiety disorders are common and there is a shortage of trained mental health care providers who can provide care. Brief, research-backed programs that are delivered in primary care settings can increase access to effective services. A brief intervention may be a “stand alone” approach to treating symptoms, or may the first step before more intensive care is delivered. First Approach Skills Training (FAST) is a suite of brief interventions that have been adapted from longer evidence-based programs to treat pediatric anxiety and depression. In partnership with two UNC pediatric primary care clinics we are conducting a proof-of-concept study to test the feasibilty and preliminary effects of FAST for anxiety (FAST-A) and depression (FAST-D). Results will be used to refine and expand FAST programs to other settings within and outside of UNC.

Learn more information about the FAST program.

Does Social Motivation in Adolescence Differentially Predict the Impact of Childhood Threat Exposure on Developing Suicidal Thoughts and Behaviors?

Award Date: 09/2023
PI: Andrea Pelletier-Baldelli, PhD
Childhood threat exposure (e.g., family/community violence) is a key risk factor for developing suicidal thoughts and behaviors; yet, not all adolescents with childhood threat exposure develop these symptoms. Disruptions to social motivation – the motivations driving the desire and effort to socially interact – may play a role in differentiating suicide risk. The current study will identify whether maladaptive social motivation presentations during adolescence moderate the link between childhood threat exposure and suicidal thoughts/behaviors in an effort to improve risk identification and mechanistic targets for interventions.

Autistic Adults and other Stakeholders Engage Together – Suicide Prevention

Award Date: 08/2022
PI: Shari Jager-Hyman, PhD; Danielle Roubinov, PhD
Suicide is the second leading cause of death among young people. Autistic individuals are at elevated risk for experiencing suicidal ideation and are more likely to die by suicide as compared to the general population. This multi-site cluster radnomized controlled trial compares the effectiveness of two tailored approaches to suicide prevention among autistic youth: SPI-A delivered in a single encounter and SPI-A+, a multi-component intervention.

Learn more information about this project.