What works better? 1-year outcomes of an effectiveness trial comparing online, telehealth, and group-based formats of a military parenting program.

OBJECTIVE: The present study, conducted with a population of military families, examined the comparative effectiveness of three program formats of Adaptive Parenting Tools (ADAPT), a parenting program for families of school-aged children in which a National Guard or Reserve (NG/R) parent had returned from deployment to the post-9/11 conflicts. Despite well-documented need, parenting programs for NG/R families are scarce and often inaccessible. We predicted that both facilitator-delivered conditions (i.e., in-person group; individual telehealth) would result in stronger improvements in observed parenting than assignment to the online self-directed condition. We further proposed a noninferiority hypothesis wherein no significant difference would be detected between telehealth and group conditions. METHOD: Families (N = 244; 87% Caucasian) were recruited from NG/R units in two midwestern states. Families (with a 5-12-year-old child) were randomized to one of three conditions: in-person multifamily group, individual telehealth, or an online, self-directed condition. The intervention was delivered using the same content across conditions, over 14 weeks (group, telehealth conditions) or 12 modules (online condition); either or both parents could participate. RESULTS: Intent-to-treat analyses supported both hypotheses: families in both in-person group and telehealth conditions showed significant improvements to observed parenting at 1-year postbaseline compared with those assigned to the self-directed online condition. CONCLUSIONS: This is the first study to demonstrate that in-person group and telehealth parenting programs are equally effective and that both are superior to a self-directed online program. Limitations include differences between the session lengths in each format, as well as greater attrition in the in-person format. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Replication and extension of the military family stress model: The after deployment adaptive parenting tools ADAPT4U study.

The military family stress (MFS) model conceptualizes that wartime deployments and post-traumatic stress disorder (PTSD) symptoms are associated with couple, parenting, and child adjustment difficulties. The aim of this study was to replicate and extend the military family stress model by examining the associations among deployment length, PTSD symptoms, marital functioning, parenting practices, and child adjustment in a replication sample of both National Guard and Reserve (NG/R) as well as active-duty service member families. The MFS model is extended to test whether these relationships vary between mothers and fathers. The sample included 208 families enrolled in a randomized controlled trial of a parenting program for military families (94.4% of fathers and 21.6% of mothers were deployed). Replicating the MFS model, we specified parenting, marital quality, and child adjustment as latent variables and conducted multi-group structural equation models. Parenting practices were positively associated with marital quality and child adjustment. PTSD symptoms were negatively associated with marital quality. The indirect effect from PTSD symptoms to parenting practices through marital quality was marginally significant. The indirect effect from marital quality to child adjustment through parenting practices was significant. There were no significant gender differences between the two structural models. This study provides empirical support for the MFS model. Results demonstrate that deployment-related stressors are significantly associated with parent and family functioning. Parenting programs for military families might effectively target similar risk processes among both mothers and fathers.

Linking observing and nonreactivity mindfulness to parenting: Moderated direct and indirect effects via inhibitory control.

To disentangle the effects of key dimensions of dispositional mindfulness on parenting, the present study tests the hypotheses that parental Nonreactivity moderates the association between Observing and effective parenting behaviors, and that parental inhibitory control mediates the relationship between Observing and parenting depending on levels of Nonreactivity. The sample consists of 294 fathers (95.9% deployed) and 313 mothers (81.5% nondeployed) from 336 military families with a child aged between 4 and 13 years at baseline. Parents reported Observing and Nonreactivity at baseline using the Five Facet Mindfulness Questionnaire and completed a computerized Go/No-Go task for assessing inhibitory control at baseline and 1-year follow-up. Families completed a series of in-home interaction tasks at baseline and 2-year follow-up, and effective parenting behaviors were observed and coded using a theory-driven, empirically validated coding system. Results showed that when fathers reported low Nonreactivity, the association between Observing and effective parenting behaviors 2 years later was negative, but this association became positive when fathers reported high Nonreactivity. Fathers' Observing was associated with decreased inhibitory control 1 year later when they reported low (vs. high) Nonreactivity, whereas mothers' Observing was associated with increased inhibitory control 1 year later when they reported high (vs. low) Nonreactivity. The hypothesized effect of inhibitory control as a mediator was not found. Understanding specificity in the effects of dispositional mindfulness dimensions on parenting behaviors will drive effective and efficient designs of mindful parenting interventions. Future research should use dismantling experimental designs to test the synergistic effects of Observing and Nonreactivity in parents. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Emotion socialization profiles in military parents: Associations with post-traumatic stress disorder.

Military families face many difficulties, including a parent deploying to a warzone and the subsequent risk of returning with symptoms of posttraumatic stress disorder (PTSD). Symptoms of PTSD are associated with parenting difficulties; however, little is known about how PTSD symptoms may be associated with emotion socialization (ES), a set of processes crucial to children's emotional well-being. This project investigated observed ES behaviors in deployed and non-deployed parents in a sample of 224 predominantly White, non-Hispanic National Guard/Reserve (NG/R) families with deployed fathers, non-deployed mothers, and a child between the ages of 4 and 13. Parents completed self-report questionnaires and families engaged in videotaped parent-child discussions, which were coded for three types of ES behaviors. Latent profile analyses of the coded behaviors identified five profiles of parental ES: Balanced/Supportive, Balanced/Limited Expression, Unsupportive/Distressed, Unsupportive/Positive, and Involved/Emotive/Angry. Multinomial logistic regressions of each parent's profile membership on fathers' PTSD symptoms revealed no significant associations, while additional analyses including additional family factors revealed that greater father PTSD symptoms were associated with a greater likelihood of mothers being in the Balanced/Supportive profile compared to the Balanced/Limited Expression profile, particularly when children displayed average to low levels of emotion during discussion tasks. No other significant associations with PTSD symptoms were detected. Overall, in contrast to the hypotheses, the majority of these findings indicated that PTSD symptoms did not play a significant role in parental ES behaviors.

Parental efficacy after a military parenting program: A dyadic latent growth model.

Parental efficacy is an important aspect of parenting and a key outcome in many parenting programs. However, most studies focus on mothers, and less is known about the relationship between coparents' parental efficacy over time following intervention, and how parental distress can impact parental efficacy. The current study (N = 271 heterosexual couples; 162 intervention and 109 control) used a dyadic latent growth model to explore the dependence structure of parental efficacy between couples 2 years after assignment to a military parenting program, After Deployment, Adaptive Parenting Tools or a control condition. Results revealed a significant intervention effect, with both mothers and fathers in the intervention group exhibiting quadratic changes over 2 years, while the control group remained relatively stable. Notably, mothers' baseline emotional distress and fathers' deployment length emerged as predictors in understanding parental efficacy improvement over time. This research underscores the importance of adopting a family systems perspective and considering emotional distress and environmental stressors in designing targeted interventions to support military families and enhance overall well-being.

Five-year fidelity assessment of an evidence-based parenting program (GenerationPMTO): inter-rater reliability following international implementation.

BACKGROUND: Implementing evidence-based programs in community service settings introduces the challenge of ensuring sustained fidelity to the original program. We employ a fidelity measure based on direct observation of practitioners' competence and adherence to the evidence-based parenting program (EBPP) GenerationPMTO following installation in national and international sites. Fidelity monitoring is crucial, especially when the program purveyor transfers administration of the program to the community as was done in this case. In previous studies, the Fidelity of Implementation rating system (FIMP) was used to evaluate practitioners' fidelity to the GenerationPMTO intervention in six countries following implementation showing high levels of adherence up to 17 years post certification. Other studies showed FIMP to have predictive validity. The present study provides inter-rater reliability data for this fidelity tool across teams of the purveyor, Implementation Sciences International, Inc./ISII, and national and international sites over a five-year period. METHODS: Data assess inter-rater reliability in terms of percent agreement and intraclass correlation (ICC) for the purveyor's two fidelity teams and the fidelity teams in seven implementation sites. RESULTS: Results report stable good to excellent levels of inter-rater reliability and ICCs as well as good attendance at fidelity meetings for all fidelity teams. CONCLUSIONS: This observational method of assessing fidelity post implementation is a promising approach to enable EBPPs to be transferred safely from purveyors to communities while maintaining reliable fidelity to the intervention.

The Impact of Parent Torture and Family Functioning on Youth Adjustment in War-Affected Families: A Path Analysis Describing Intergenerational Trauma and the Family System.

The direct exposure to physical or psychological trauma from torture or war leads to well-documented individual health consequences. Less understood are the inclusive and intergenerational effects of war trauma on family systems and youth adjustment. The purpose was to examine mechanisms in war-affected families that explained the significant emotional and behavioral consequences of intergenerational trauma in youth through the use of multiple methods. Quantitative assessments of maternal and paternal caregivers and youth characterized associations between parent torture, parent mental health distress, parent physical health problems, family functioning, and youth adjustment. Narrative statements further contextualized processes through which the trauma of a parent impacted youth and family systems. The research was conducted in partnership with local, refugee-serving community-based organizations. The study sample included parents and youth in 96 Karen families, originating from Burma in Southeast Asia, who had been resettled to the United States through the U.S. Refugee Admissions Program. Path analysis results indicated that parent torture (ß = -0.173) had statistically significant negative direct effects on youth adjustment. Parent torture had a negative indirect effect on youth adjustment through the mental health (ß = -0.345) and physical health problems of parents (ß = -0.305), and youth gender (ß = 0.126) and trauma exposure of youth (ß = -0.048). Family functioning type demonstrated a positive direct effect on youth adjustment (ß = 0.449). Family type had an indirect effect on youth adjustment through youth gender (ß = 0.142), youth trauma exposure (ß = -0.165), parent physical health problems (ß = -0.202), and parent mental health (ß = 0.509). The current study developed and tested the first model of intergenerational trauma's effects on the adjustment of Karen refugee youth. Results emphasize that individual recovery from torture must be accompanied by adjunct interventions focused on family systems and youth adjustment, to holistically address intergenerational sequala of trauma.

Emotion Regulation Difficulties in Military Fathers Magnify Their Benefit from a Parenting Program.

Military service members who were exposed to combat-related traumatic events may exhibit emotion regulation problems, which can compromise emotion-related parenting practices (ERPPs). After Deployment, Adaptive Parenting Tools (ADAPT) is a preventive intervention developed for military families to improve parenting behaviors, including ERPPs. Parental emotion regulation difficulties may affect parents' responses to this parenting program. Thus, this study aimed to use a baseline target moderated mediation design to examine the intent-to-treat (ITT) effect of the ADAPT program on deployed fathers' emotion-related parenting practices (ERPPs) at the 1-year follow-up as well as the moderation and mediation effect of fathers' emotion regulation difficulties. The sample consisted of 181 deployed fathers and their 4-13-year-old children. At both baseline and 1 year, fathers' ERPPs (i.e., positive engagement, withdrawal avoidance, reactivity-coercion, and distress avoidance) were observed during a series of structured parent-child interaction tasks. Results of path analyses showed no ITT effects on fathers' ERPPs, but emotion regulation difficulties significantly moderated ITT effects on distress avoidance. Fathers with higher levels of emotion regulation difficulties at baseline showed decreases in distress avoidance behaviors at 1 year if randomized to the intervention condition. Emotion regulation difficulties also significantly mediated the program's effect on reductions in reactivity coercion for fathers with high levels of emotion regulation difficulties at baseline. These findings highlight parental emotion regulation as a key baseline target of the ADAPT program and provide insight into how and for whom a parenting program improves parenting practices.

Intensity of Grandparent Caregiving, Health, and Well-Being in Cultural Context: A Systematic Review.

BACKGROUND AND OBJECTIVES: Grandparents are key resources in grandchildren care globally. However, mixed findings indicated that multiple role engagement may enhance well-being and bring demands on grandparent caregivers in different contexts. This systematic review examines the association between the intensity of grandparent caregiving and their health and well-being (i.e., physical, mental, cognitive, and life satisfaction) by continent and country/region. RESEARCH DESIGN AND METHODS: Systematic searches were conducted in 4 databases. Peer-reviewed articles with quantitative designs published between 1990 and November 2021 were identified. A rigorous selection process was followed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The studies were critically appraised, and their results were narratively synthesized. RESULTS: Sixty-five articles from 29 countries/regions were included. Findings suggested a concave curvilinear relationship between the intensity of grandparent caregiving and their health and well-being, with the optimal caregiving intensity varying across sociocultural contexts. In Europe, Oceania, the Middle East, and South America, providing supplementary or occasional care seems beneficial for grandparents' health and well-being, especially supporting dual-earner families. In East Asia, economic resources appear to buffer the adverse effect of primary care on grandparents' well-being. In the United States, findings vary across ethnicity/race. DISCUSSION AND IMPLICATIONS: Collectively, the intensity of grandparent caregiving, health, and well-being is complicated by grandparents' roles in the family and cultural differences. Acknowledging the bidirectional relationship between well-being and grandparents' capacity for providing care, the well-being as outcome is a limitation. Despite so, this systematic review calls for culturally-tailored family programs to support grandparent caregiving.

The ADAPT Parenting Intervention Benefits Combat Exposed Fathers Genetically Susceptible to Problem Drinking.

Testing a vantage sensitivity model from differential susceptibility theory (DST), we examined a G × E × I hypothesis; that is, whether a military parenting intervention program (I) might buffer a G × E susceptibility for military deployed fathers exposed to deployment combat stress and trauma. We hypothesized that combat stress (E, referring to the natural environmental factor) would lead to increases in problem drinking, and that the effect of problem drinking would be amplified by genetic predisposition (G) for drinking reward systems, substance use, and addictive behaviors (i.e., differential vulnerability). Providing a preventive intervention designed to improve post-deployment family environments (I, vantage sensitivity) is hypothesized to buffer the negative impacts of combat exposure and genetic susceptibility. The sample included 185 post-deployed military fathers who consented to genotyping, from a larger sample of 294 fathers enrolled in a randomized effectiveness trial of the After Deployment Adaptive Parenting Tools (ADAPT) intervention. Trauma-exposed military fathers at genetic susceptibility for problem drinking assigned to the ADAPT intervention reported significantly more reductions in risky drinking compared with fathers at genetic susceptibility assigned to the control group, with a small effect size for the G × E × I interaction (d = .2). Trial Registration. The ADAPT trial is registered at the US National Institutes of Health ( ClinicalTrials.gov ) # NCT03522610.

Mental health, risk and resilience among refugee families in Europe.

Refugee children and families are at high risk of developing mental health conditions. The objective of this systematic review was to examine the current empirical literature on refugee mental health in Europe with a focus on children and families. A systematic search was conducted between January 2022 to June 2022 in PsychInfo, CINAHIL and PubMed. The search produced 2385 results and 62 articles met the selection criteria. Results showed that children had high rates of trauma exposure and were at higher risk of psychopathology than their host peers. Post-migration stressors impact mental health outcomes in adolescents and adults. However, most studies were self-report and cross-sectional and there were very few studies on refugee parenting or dyadic relationships.

Effectiveness of GenerationPMTO to Promote Parenting and Child Adjustment: A Meta-Analytic Review.

GenerationPMTO is a theory- and evidence-based behavioral parenting program widely implemented in the past three decades. This systematic review and meta-analysis examined the effectiveness of twenty GenerationPMTO studies on parenting and child adjustment among 3893 families in six countries. Hedges' g from studies with pretest-posttest-controlled designs were computed and robust variance estimation (RVE) was used to deal with the effect size dependency. Results showed that GenerationPMTO significantly promoted parenting and child adjustment with moderate to high levels of heterogeneity. Specifically, GenerationPMTO improved parental discipline, parenting monitoring, skill encouragement, child externalizing problems, and child internalizing problems. Subgroup analyses revealed several important moderators, including type of comparison group, measurement, informant, risk of bias, etc. Intervention effects were quite robust across countries and multiple demographic characteristics. No publication bias across studies for parenting and child adjustment was detected. The revised Cochrane risk of bias for randomized trials (RoB 2) procedure was used to assess risk of bias within the included studies. Some studies showed a higher level of risk due to problems with the randomization process, missing data, low measurement quality, and reporting bias. Due to lack of data, we did not examine intervention effects on parental mental health or couple relationship quality. Future studies should test mediation models to understand the mechanisms of change and to identify moderators in order to understand the high levels of heterogeneity in GenerationPMTO studies.

Parenting Interventions for Refugees and Forcibly Displaced Families: A Systematic Review.

Globally, an estimated 79.5 million individuals have been displaced, nearly 40% of whom are children. Parenting interventions may have the potential to improve outcomes for displaced families. To investigate this, we conducted a systematic review to identify the types of caregiver or parenting interventions that have been evaluated among displaced families, to assess their efficacy across a range of contexts, and to describe their cultural and contextual adaptations. The review followed PRISMA guidelines. At stage one, all articles describing caregiver/parenting interventions for forcibly displaced families were included to provide a scoping review of the state of the literature. At stage two, only randomized controlled trials (RCTs) and quasi-experimental designs were included, allowing for quantitative analysis of program effects. A total of 30 articles (24 studies) were identified in stage one. 95.8% of these articles were published in the past 10 years. Of these, 14 articles (10 studies) used an RCT or quasi-experimental design to assess program efficacy or effectiveness. Relative to control groups, those assigned to caregiving programs showed significant, beneficial effects across the domains of parenting behaviors and attitudes, child psychosocial and developmental outcomes, and parent mental health. Cultural adaptations and recruitment and engagement strategies are described. The evidence base for caregiving programs for displaced families has expanded in recent years but remains limited. Caregiving/parenting programs show promise for reducing the negative effects of forced displacement on families, but future studies are needed to understand which programs show the greatest potential for scalability.

Inhibitory Control Moderates the Intervention Effects of a Preventive Parenting Program on Posttraumatic Stress Disorder Symptoms Among Male Service Members.

Military servicemembers face substantial challenges due to war-related trauma exposure, including posttraumatic stress disorder (PTSD). Individuals with deficits in inhibitory control (IC) may have an increased risk of developing PTSD due to a reduced ability to regulate their cognitive responses to and disengage from trauma-related stimuli. After Deployment, Adaptive Parenting Tools (ADAPT) is a mindfulness-infused parenting program for military families that has also been found to have crossover effects on parental mental health. The present study examined whether fathers' IC at baseline affected their response to this emotional skills-focused intervention and further influenced their PTSD symptoms 1 year later. The sample included 282 male National Guard and Reserve (NG/R) service members who had recently been deployed to Iraq or Afghanistan. Fathers were randomly assigned to either the ADAPT program or a control condition, with IC measured at baseline and PTSD symptoms measured at baseline and 1-year follow-up. Intent-to-treat analyses revealed no significant main effect of the intervention on fathers' PTSD symptoms. However, fathers' IC moderated intervention effects on PTSD symptoms, f2 = 0.03. The intervention had more beneficial effects on reducing fathers' PTSD symptoms for participants with low IC at baseline. These findings are consistent with compensatory effects in the risk moderation hypothesis, which suggests that prevention or intervention programs are more effective for high-risk subgroups.

International psychological research addressing the early phase of the COVID-19 pandemic: A rapid scoping review and implications for global psychology.

In March 2020, the World Health Organization (WHO) declared COVID-19 a global pandemic. Given that keeping abreast of international perspectives and research results is of particular importance for such massive global emergencies, we employed a scoping review methodology to rapidly map the field of international psychological research addressing this important early phase of the pandemic. We included a total of 79 studies, with data mostly collected between March and June 2020. This review aimed to systematically identify and map the nature and scope of international studies examining psychological aspects of the unfolding COVID-19 pandemic. We mapped key research themes, subfields of psychology, the nature and extent of international research collaboration, data methods employed, and challenges and enablers faced by psychological researchers in the early stages of the pandemic. Among the wide range of themes covered, mental health and social behaviours were the key themes. Most studies were in clinical/health psychology and social psychology. Network analyses revealed how authors collaborated and to what extent the studies were international. Europe and the United States were often at the centre of international collaboration. The predominant study design was cross-sectional and online with quantitative analyses. We also summarised author reported critical challenges and enablers for international psychological research during the COVID pandemic, and conclude with implications for the field of psychology.

Psychological implications of the COVID-19 pandemic around the world: Introduction to the special issue.

Although psychological researchers have long studied the implications of major crises, the outbreak and spread of the COVID-19 pandemic have confronted the global community of psychologists and psychological researchers with new challenges. This special issue contributes to the growing empirical literature on the immediate psychological implications of the COVID-19 pandemic. We present and discuss diverse work from authors that followed our call for papers in May 2020, shortly after the World Health Organisation declared COVID-19 a global pandemic. The studies focus on the early phases of the pandemic by addressing (a) implications of the pandemic for psychological well-being and mental health, (b) psychological effects of lockdown scenarios as well as (c) individual compliance with COVID-19 prevention and intervention measures. We conclude by highlighting the need for new research efforts, with a special focus on low- and middle-income regions, international research collaborations and cross-cultural research designs.

A Conversion Crosswalk for the UCLA PTSD Reaction Index: Translating DSM-IV to DSM-5.

The use of patient-reported measures in assessing mental health symptoms is common in both the research and clinical fields. With regard to assessing posttraumatic stress symptoms, there are specific versions of measures designed for child and adolescent populations in accordance with the fourth and fifth editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV and DSM-5, respectively). Different clinical thresholds, numbers of items, and score ranges may present obstacles for clinicians and researchers attempting to compare self-report ratings across different versions of a measure. The current study aimed to produce a score conversion crosswalk between two child/adolescent self-report measures of posttraumatic stress disorder (PTSD): the UCLA PTSD Reaction Index for DSM-IV (RI-IV) and DSM-5 (RI-5). Using item response theory (IRT), we calibrated both measures separately to derive scaled scores. The discrimination parameters ranged from 0.57 to 2.08 (SE = 0.09-0.17) for RI-IV and from 0.73 to 2.11 for RI-5 (SE = 0.07-0.13). The scaled scores were connected with equipercentile linking. Total scores based on common items between the two measures were used as anchors to enhance the linking results. A total of 1,486 children and adolescents completed the measure: 571 respondents filled out the RI-IV and 915 respondents filled out the RI-5. The results allow linked scores to be compared to establish recommended clinical cutoffs and help elucidate the implications of changes in the diagnostic criteria for the measurement of self-reported PTSD symptoms in children and adolescents.

Development and Preliminary Validation of the University of Minnesota's Traumatic Stress Screen for Children and Adolescents (TSSCA).

Child and adolescent exposure to potential trauma experiences is pervasive. Given the prevalence, deleterious mental and physical effects, and economic cost of trauma exposure, child- and family-service systems are adopting trauma-informed approaches, including practices like trauma screening. Although a number of trauma-focused screening and assessment measures exist for youth, the majority are lengthy and inappropriate for universal administration. This study describes the development and preliminary validation of the Traumatic Stress Screen for Children and Adolescents (TSSCA), a six-item screening measure for trauma exposure and traumatic stress symptoms. Using two samples of youth presenting at community practice settings (n1 = 134, n2 = 137), reliability, discriminative validity, and criterion-related validity were calculated for the TSSCA. Results support the TSSCA as an empirically derived, reliable, and valid screening measure for exposure to trauma and symptoms of traumatic stress for youth ages 7 to 18.

Mechanisms Explaining the Relationship Between Maternal Torture Exposure and Youth Adjustment In Resettled Refugees: A Pilot Examination of Generational Trauma Through Moderated Mediation.

The intergenerational effects of trauma resulting from torture and war are complex and multi-faceted and have important implications for the family system. The current study aimed to identify key relationships between refugee maternal caregiver exposure to torture, mental health, and physical health with maternal-reported youth adjustment. Ninety-six Karen maternal caregivers originating from Burma and resettled in the United States participated in a cross-sectional, explanatory mixed methods study. Maternal mental health distress was found to mediate the relationship betweenmaternal torture experiences and youth adjustment, R2 = .357. Physical health problems was found to moderate the degree to which mental health distress mediated the relationship between torture and war trauma experiences and youth adjustment, R2 = .409. The current study is significant in that it enhances our mechanistic understanding of factors relevant to the intergenerational effects of trauma within families where maternal caregivers experienced trauma from torture and/or war.