Depressed mood and environmental mastery as potential pathways linking family relationship quality and disease self-management for African Americans with hypertension.

African Americans are at significantly greater risk of hypertension and worse cardiovascular outcomes than other racialized groups, yet hypertension intervention effects remain limited. Thus, it is necessary to understand the potential mechanisms whereby interventions may be more effectively targeted to improve health. Supported by prior research evidence and guided by the Biobehavioral Family Model, this study examined associations between family relationship quality, psychological wellbeing, and self-management behaviors for African Americans with hypertension. Data were pooled from three Midlife Development in the U.S. projects, resulting in a sample of 317 African Americans (63.4% female, Mage  = 53.32) with self-reported high blood pressure in the past 12 months. We tested four cross-sectional multiple mediator models, with depressed mood and environmental mastery mediating associations between family strain and exercise, smoking, problematic alcohol use, and stress-eating. Environmental mastery mediated the association between greater family strain and decreased odds of achieving recommended exercise levels; greater odds of reporting problematic alcohol use; and greater stress-eating. Though family strain was associated with depressed mood in each model, this variable did not serve as an indirect pathway to self-management behaviors. Family strain, and the potential pathway identified via environmental mastery, may be a meaningful predictor of disease self-management for African Americans with hypertension. Longitudinal studies are needed to examine directionality and to support intervention trials for improving self-management and hypertension outcomes.

Impact of the COVID-19 Pandemic on Parent, Child, and Family Functioning.

To quantify the impact of the COVID-19 pandemic and public health interventions on parent and child mental health and family relationships, we examined change in individual and family functioning in a sample of parents enrolled in a prevention trial; we examined change before the pandemic (2017-2019) when children were an average of 7 years old to the first months after the imposition of widespread public health interventions in the United States (2020) with paired t tests and HLM models. We examined moderation by parent gender, education, family income, and coparenting conflict. We found large deteriorations from before the pandemic to the first months of the pandemic in child internalizing and externalizing problems and parent depression, and a moderate decline in coparenting quality. Smaller changes were found for parent anxiety and parenting quality. Mothers and families with lower levels of income were at particular risk for deterioration in well-being. Results indicate a need for widespread family support and intervention to prevent potential family "scarring," that is, prolonged, intertwined individual mental health and family relationship problems.

Para cuantificar el efecto de la pandemia de la COVID-19 y de las intervenciones de salud pública en la salud mental de los padres y los niños y en las relaciones familiares, analizamos los cambios en el funcionamiento individual y familiar en una muestra de padres inscriptos en un ensayo de prevención; estudiamos el cambio antes de la pandemia (2017-2019) cuando los niños tenían un promedio de 7 años hasta los primeros meses después de la imposición de las intervenciones generalizadas de salud pública en los Estados Unidos (2020) con pruebas t apareadas y modelos lineales jerárquicos. Analizamos la moderación por género, educación, ingresos familiares y conflicto de cocrianza de los padres. Hallamos grandes deterioros desde antes de la pandemia hasta los primeros meses de la pandemia en problemas de interiorización y exteriorización de los niños y depresión de los padres, y una disminución moderada de la calidad de la cocrianza. También encontramos cambios más pequeños en la ansiedad de los padres y la calidad de la crianza. Las madres y las familias con niveles más bajos de ingresos estuvieron en riesgo particular de deterioro del bienestar. Los resultados indican la necesidad de apoyo familiar generalizado y de intervenciones para prevenir posibles «secuelas¼ familiares, p. ej.: salud mental individual interconectada y prolongada y problemas en las relaciones familiares.

Adolescent Attachment: A Social Relations Perspective on Family Relations.

While attachment at an early age is almost exclusively determined by parental behavior, variation in the quality of attachment in adolescence seems strong to be influenced by the complex interplay between the adolescent's internal working model and its environment. To unravel the different sources of variance in adolescent attachment relationships we applied the Social Relations Model. Two parents and two adolescents from 70 relatively well-functioning families reported on their attachment relationships within a family context. In this study, attachment was conceptualized by two different dimensions of attachment, namely anxiety (for being abandoned) and avoidance (of intimacy). Our findings suggest adolescents experience little attachment anxiety throughout adolescence, but they report significantly more attachment avoidance toward their parents. The variance in the quality of adolescents' attachment relationships was mainly determined by characteristics of the adolescent and the unique adjustments they make to the attachment figure.

Si bien el apego en los primeros años de vida está casi exclusivamente determinado por la conducta de los padres, la variación de la calidad del apego en la adolescencia parece significativamente influenciada por la interacción compleja entre el modelo de funcionamiento interno del adolescente y su entorno. Para descifrar las diferentes fuentes de varianza en las relaciones de apego de los adolescentes, aplicamos el modelo de relaciones sociales. Dos padres y dos adolescentes de 70 familias con un funcionamiento relativamente bueno informaron sobre sus relaciones de apego dentro de un contexto familiar. En este estudio, el apego se conceptualizó mediante dos aspectos diferentes del apego, por ejemplo, la ansiedad (por ser abandonado) y la evitación (de la intimidad). Nuestros resultados sugieren que los adolescentes sufren poca ansiedad por el apego durante la adolescencia, pero informan una evitación del apego más significativa hacia sus padres. La varianza en la calidad de las relaciones de apego de los adolescentes estuvo determinada principalmente por las características del adolescente y por las adaptaciones únicas que hace a la figura de apego.

Development and Validation of the Family Relationship Assessment Scale in Korean College Students' Families.

The nature of family relationships is a critical measure for healthcare professionals who work with families. In particular, non-Western cultural groups display a higher level of collectivism that emphasizes relationships between family members. This paper reports the development and psychometric testing of a new scale, the Korean Family Relationship Assessment Scale (FRAS). Using DeVellis' Guidelines in Scale Development, a pool of 40 items was created after a review of the literature, followed by an assessment for content validity by six experts. Both exploratory and confirmatory factor analyses were conducted with data from a sample of 217 Korean family triads (father, mother, and college-aged offspring) (N = 651). The final evaluation yielded three factors with 15 items: family support, family conflict, and family togetherness. Since the FRAS demonstrated good internal consistency and validity, it would be able to facilitate research on the relationships between family support, conflict, togetherness, and health. Applying this new instrument in theory-based research may contribute to knowledge about the role of the family in the health and well-being of family members within a Korean context. For clinical practice, this culturally sensitive and valid instrument has the potential to measure changes in family relationships after family therapy or interventions.

La índole de las relaciones familiares es una medida fundamental para los profesionales de la salud que trabajan con familias. En particular, los grupos culturales no occidentales muestran un nivel más alto de colectivismo que enfatiza las relaciones entre los miembros de la familia. Este artículo informa el desarrollo y la evaluación psicométrica de una nueva escala, la Escala de Evaluación de las Relaciones Familiares Coreanas (Korean Family Relationship Assessment Scale, FRAS). Utilizando las pautas de DeVellis en el desarrollo de escalas, se creó un grupo de 40 elementos después de una revisión de la bibliografía, seguido de una evaluación de la validez del contenido por parte de seis especialistas. Se realizaron análisis factoriales exploratorios y confirmatorios con datos de una muestra de 217 triadas de familias coreanas (padre, madre e hijos en edad universitaria) (N = 651). La evaluación final arrojó tres factores con 15 elementos: apoyo familiar, conflicto familiar y unión familiar. Como la FRAS demostró buena coherencia y validez interna, podría facilitar la investigación sobre las relaciones entre el apoyo, el conflicto, la unión y la salud de la familia. La aplicación de este nuevo instrumento en la investigación basada en la teoría puede incrementar el conocimiento acerca del papel de la familia en la salud y el bienestar de los miembros de la familia dentro de un contexto coreano. Para la práctica clínica, este instrumento culturalmente sensible y válido tiene el potencial de medir los cambios en las relaciones familiares después de la terapia o las intervenciones familiares.

Patterns of Interactions Between Youth and Resident Stepmothers: A Latent Class Analysis.

Stepparent-child relationships are a core pillar of stepfamily functioning and well-being. Stepparents can take on a variety of roles in the lives of their stepchildren, ranging from de facto parents to distant acquaintances. There remain important opportunities to explore specific interactional patterns between youth and stepparents, particularly resident stepmothers. Drawing from a family systems perspective, the purpose of the current study is to explore patterns of youth-stepmother interaction across recreational, personal, academic, and disciplinary domains of family life. Latent class analysis is conducted using a representative sample of 295 youth (mean age: 15.82 years, SD = 1.63; 41% female; 65% non-Hispanic White) residing in father-stepmother households who have living nonresident mothers at Wave I of the National Longitudinal Study of Adolescent to Adult Health. The optimal latent class solution yielded four interactional patterns, labeled versatile and involved (21%), inactive (12%), casually connected (17%), and academically oriented (50%). The latent classes are also contrasted with respect to stepfamily relationship quality, youth well-being, and socio-demographic characteristics. Foremost, the results illustrate significant variability in the patterns of interactions between youth and their resident stepmothers, which could be attributed to youths' varying autonomy-seeking efforts and other complex family dynamics. Consistent with a family systems perspective, associations between youth-stepmother interactional patterns and family and youth outcomes highlight the importance of the relationship between youth and their resident stepmothers. Importantly, not all interactional patterns differed significantly across outcomes, suggesting that no one pattern is universally optimal in father-stepmother families with adolescent children.

Las relaciones entre padrastros, madrastras e hijastros son un pilar fundamental del funcionamiento y el bienestar de las familias ensambladas. Los padrastros y las madrastras pueden asumir diversos roles en las vidas de sus hijastros, desde padres de hecho a personas con una relación distante. Quedan importantes oportunidades de analizar patrones interactivos específicos entre los jóvenes y los padrastros y madrastras, particularmente las madrastras residentes. Basándonos en una perspectiva de sistemas familiares, el propósito del presente estudio es analizar patrones de interacción entre los jóvenes y las madrastras en ámbitos recreativos, personales, académicos y disciplinarios de la vida familiar. Se realiza un análisis de clases latentes utilizando una muestra representativa de 295 jóvenes (edad promedio: 15.82 años, desviación típica = 1.63; 41 % de sexo femenino; 65 % raza blanca no hispana) que viven en hogares conformados por el padre y la madrastra, y que tienen madres vivas no residentes en la fase I del "Estudio Longitudinal Nacional de Salud de Adolescentes a Adultos" (National Longitudinal Study of Adolescent to Adult Health). La solución óptima de clase latente arrojó cuatro patrones interactivos llamados adaptables e interesados (21 %), inactivos (12 %), conectados ocasionalmente (17 %), y orientados académicamente (50 %). Las clases latentes también se contrastan con respecto a la calidad de la relación de la familia ensamblada, el bienestar de los jóvenes y las características sociodemográficas. Principalmente, los resultados ilustran la variabilidad significativa en los patrones de interacciones entre los jóvenes y sus madrastras residentes, que podrían atribuirse a los distintos esfuerzos de búsqueda de autonomía por parte de los jóvenes y a otras dinámicas familiares complejas. De acuerdo con una perspectiva de sistemas familiares, las asociaciones entre los patrones interactivos entre los jóvenes y las madrastras y los resultados de las familias y los jóvenes destacan la importancia de la relación entre los jóvenes y sus madrastras residentes. Cabe señalar que no todos los patrones interactivos difirieron considerablemente entre los resultados, lo cual sugiere que ningún patrón es óptimo a nivel universal en las familias de padres y madrastras con hijos adolescentes.

Distributive Justice in Family Relations.

The aim of this paper is to highlight the important contribution of the lens of distributive justice to an understanding of family relations. Existent justice research in the family tends to focus on specific family relations: spouses, parents and young children, elderly parents and adult children, with most research addressing the division of labor between spouses. We seek to go beyond the specific family relations in order to highlight justice-related themes that are common across family relations. We elaborate upon three claims. First, we show that while the ideal of equality underpins justice in contemporary Western societies, actual distribution practices across family relations are characterized by persistent inequality. Second, although the gap between the ideal of equality and unequal distribution practices may create a sense of injustice among family members, we show why this is not necessarily the case. Third, we elaborate upon the positive and negative consequences that result from feelings of justice or injustice across family relations. We conclude by discussing the interweaving of love and justice in the family.

El objetivo de este artículo es destacar la importante contribución de la perspectiva de la justicia distributiva para comprender las relaciones familiares. Las investigaciones existentes sobre la justicia en la familia tienden a centrarse en relaciones familiares específicas: cónyuges, padres e hijos pequeños, padres ancianos e hijos adultos; y la mayor parte de estas investigaciones abordan la división del trabajo entre los cónyuges. Intentamos ir más allá de las relaciones familiares específicas a fin de destacar temas relacionados con la justicia que son comunes entre las relaciones familiares. Nosotros ampliamos tres afirmaciones. Primero, demostramos que si bien el ideal de igualdad apoya la justicia en las sociedades occidentales contemporáneas, las prácticas actuales de distribución entre las relaciones familiares se caracterizan por la desigualdad constante. Segundo, aunque la brecha entre el ideal de igualdad y las prácticas de distribución desigual puede generar una sensación de injusticia entre los miembros de la familia, demostramos por qué esto no necesariamente es así. Tercero, señalamos las consecuencias positivas y negativas que resultan de los sentimientos de justicia o injusticia entre las relaciones familiares. Finalizamos con una discusión alrededor de la interrelación entre amor y justicia en la familia.

The Critical Need to Recognize That Families Matter for Adult Health: A Systematic Review of the Literature.

A systemic approach to researching families and health should capture the complex network within which family members are embedded, including multiple family relationships and larger systems of health care. However, much of the families and health research focused on adult family members has focused solely on intimate partnerships, usually the marital relationship. This neglects the remainder of the powerfully influencing family relationships adults retain, and may increasingly focus on as they age. We conducted a systematic review of the families and adult health literature, retaining 72 articles which were subsequently thematically coded to highlight main foci of this area of research. Results highlight six themes, which include family relationship quality, family composition, behavioral factors in health and health care, psychophysiological mediators, caregiving, and aging health. Findings support an underrepresentation of family members, other than the intimate partner, in research on adult health.

Un enfoque sistémico de la investigación sobre las familias y la salud debería captar la red compleja dentro de la cual están insertados los familiares, incluidas las relaciones entre varias familias y los sistemas más amplios de asistencia sanitaria. Sin embargo, gran parte de la investigación sobre las familias y la salud centrada en los familiares adultos se ha concentrado únicamente en las relaciones íntimas, generalmente en las relaciones conyugales. Esto desatiende el resto de las relaciones familiares fuertemente influyentes que lo adultos conservan, y en las que posiblemente se centren cada vez más a medida que envejecen. Realizamos un análisis sistemático de la bibliografía sobre las familias y la salud de los adultos, y conservamos 72 artículos que posteriormente se codificaron temáticamente para destacar los ejes principales de esta área de investigación. Los resultados recalcan seis temas, entre los cuales se encuentran: la calidad de las relaciones familiares, la composición familiar, los factores conductuales en la salud y la asistencia sanitaria, los mediadores psicofisiológicos, el cuidado, y la salud en la vejez. Los resultados respaldan una subrepresentación de los familiares aparte de la pareja íntima en las investigaciones sobre la salud de los adultos.

The Role of Parents in Emerging Adults' Psychological Well-Being: A Person-Oriented Approach.

The purpose of this study was to gain an overview of Spanish emerging adults' family relationships and their link with psychological well-being and psychological distress. The sample comprised 1502 undergraduate students (903 women and 599 men) aged between 18 and 29 (M = 20.32 and SD = 2.13), recruited from two universities in Spain. A cluster analysis identified three groups of families based on the centrality of five family variables: parental involvement, parental support for autonomy, parental warmth, behavioral control, and psychological control. The three groups or clusters were labeled high-quality family relationships (HQ), intermediate-quality family relationships (IQ), and low-quality family relationships (LQ). Women were overrepresented in the HQ cluster, whereas men were overrepresented in the IQ cluster. Moreover, emerging adults who perceived better family relationships (high levels of parental involvement, parental support for autonomy and parental warmth, and low levels of behavioral and psychological control) were found to have a higher level of psychological adjustment. Thus, our results indicate that family plays a key role in the psychological well-being of emerging adults. The discussion focuses on the implications of this finding for the parent-child relationship, and explores how it extends our knowledge about family relationships during emerging adulthood.

El propósito de este estudio fue obtener una visión de conjunto de las relaciones familiares de los adultos emergentes españoles y su vínculo con el bienestar psicológico y el distrés psicológico. La muestra estuvo compuesta por 1502 alumnos universitarios (903 mujeres y 599 hombres) de entre 18 y 29 años (M = 20.32 y SD = 2.13), convocados de dos universidades de España. Un análisis de grupos identificó a tres grupos de familias basándose en la centralidad de cinco variables familiares: participación de los padres, fomento de la autonomía por parte de los padres, calidez de los padres, control del comportamiento y control psicológico. Los tres grupos o agrupaciones se clasificaron como relaciones familiares de alta calidad (AC), relaciones familiares de calidad intermedia (CI) y relaciones familiares de baja calidad (BC). Las mujeres estuvieron sobrerrepresentadas en el grupo de AC, mientras que los hombres estuvieron sobrerrepresentados en el grupo de CI. Además, se descubrió que los adultos emergentes que percibieron mejores relaciones familiares (niveles altos de participación de los padres, fomento de la autonomía por parte de los padres y calidez de los padres, y niveles bajos de control conductual y psicológico) tuvieron un nivel más alto de adaptación psicológica. Por lo tanto, nuestros resultados indican que la familia desempeña un papel clave en el bienestar psicológico de los adultos emergentes. El debate se centra en las consecuencias que tiene este resultado para la relación entre padres e hijos, y analiza cómo amplía nuestro conocimiento acerca de las relaciones familiares durante la adultez emergente.

Home Environment and Self-Efficacy Beliefs among Native American, African American, and Latino Adolescents.

Context helps determine what individuals experience in the settings they inhabit. Context also helps determine the likelihood that those experiences will promote adaptive development. Theory suggests likely interplay between various aspects of home context and development of ideas about self that influence patterns of development for children. This study addressed relations between two aspects of home life (companionship and investment, modeling and encouragement) and three types of self-efficacy beliefs (enlisting social resources, independent learning, self-regulatory behavior) considered important for long-term adaptive functioning. The study focused on three groups of minority adolescents (Native American, African American, Latino). Relations were examined using regression models that also included four aspects of household risk that often hinder the development of self-efficacy. Although findings varied somewhat across the three groups, significant relations emerged between the two domains of home life examined and self-efficacy beliefs in all three groups, even controlling for overall household risk. Companionship and investment appeared particularly relevant for African American adolescents, while modeling and encouragement appeared particularly relevant for Native American adolescents. Both were relevant for Latino adolescents.

El contexto ayuda a determinar lo que las personas viven en los entornos que habitan. El contexto también ayuda a determinar la probabilidad de que esas experiencias promuevan el desarrollo adaptativo. La teoría sugiere una probable interacción entre varios aspectos del contexto hogareño y el desarrollo de ideas acerca del yo que influyen en los patrones de desarrollo de los niños. Este estudio abordó las relaciones entre dos aspectos de la vida hogareña (compañerismo e inversión, modelado y fomento) y tres tipos de creencias de autoeficacia (designación de recursos sociales, aprendizaje independiente, comportamiento autorregulado) consideradas importantes para el funcionamiento adaptativo a largo plazo. El estudio se centró en tres grupos de adolescentes de grupos minoritarios (nativo americanos, afroamericanos, latinos). Se analizaron las relaciones usando modelos de regresión que también incluyeron cuatro aspectos de riesgo doméstico que generalmente obstaculizan el desarrollo de la autoeficacia. Aunque los resultados variaron un poco en los tres grupos, surgieron relaciones significativas entre los dos ámbitos de la vida hogareña analizados y las creencias de autoeficacia en los tres grupos, aún teniendo en cuenta el riesgo doméstico general. El compañerismo y la inversión parecieron particularmente relevantes en los adolescentes afroamericanos, mientras que el modelado y el fomento parecieron particularmenete relevantes en los adolescentes nativo americanos. Ambos fueron relevantes en los adolescentes latinos.

Stepfamily Relationship Quality and Children's Internalizing and Externalizing Problems.

The stepfamily literature is replete with between-group analyses by which youth residing in stepfamilies are compared to youth in other family structures across indicators of adjustment and well-being. Few longitudinal studies examine variation in stepfamily functioning to identify factors that promote the positive adjustment of stepchildren over time. Using a longitudinal sample of 191 stepchildren (56% female, mean age = 11.3 years), the current study examines the association between the relationship quality of three central stepfamily dyads (stepparent-child, parent-child, and stepcouple) and children's internalizing and externalizing problems concurrently and over time. Results from path analyses indicate that higher levels of parent-child affective quality are associated with lower levels of children's concurrent internalizing and externalizing problems at Wave 1. Higher levels of stepparent-child affective quality are associated with decreases in children's internalizing and externalizing problems at Wave 2 (6 months beyond baseline), even after controlling for children's internalizing and externalizing problems at Wave 1 and other covariates. The stepcouple relationship was not directly linked to youth outcomes. Our findings provide implications for future research and practice.

Clinical Guidelines for Working With Stepfamilies: What Family, Couple, Individual, and Child Therapists Need to Know.

This article draws on four decades of research and clinical practice to delineate guidelines for evidence-informed, clinically sound work with stepfamilies for couple, family, individual adult, and child therapists. Few clinicians receive adequate training in working with the intense and often complex dynamics created by stepfamily structure and history. This is despite the fact that stepfamilies are a fundamentally different family form that occurs world-wide. As a result many clinicians rely on their training in first-time family models. This is not only often unhelpful, but all too often inadvertently destructive. The article integrates a large body of increasingly sophisticated research about stepfamilies with the author's four decades of clinical practice with stepfamily relationships. It describes the ways in which stepfamilies are different from first-time families. It delineates the dynamics of five major challenges stepfamily structure creates: (1) Insider/outsider positions are intense and they are fixed. (2) Children struggle with losses, loyalty binds, and change. (3) Issues of parenting, stepparenting, and discipline often divide the couple. (4) Stepcouples must build a new family culture while navigating previously established family cultures. (5) Ex-spouses (other parents outside the household) are part of the family. Some available data are shared on the impact of cultural and legal differences on these challenges. A three-level model of clinical intervention is presented: Psychoeducational, Interpersonal, and Intrapsychic/Intergenerational Family-of-Origin. The article describes some "easy wrong turns" for well-meaning therapists and lists some general clinical guidelines for working with stepfamily relationships.

The Meaning of the Sperm Donor for Heterosexual Couples: Confirming the Position of the Father.

In the literature, relatively little attention has been paid to the meaning of donor involvement in the intimate couple dyad. The current study aimed to enrich our understanding of couples' meaning-making regarding the anonymous sperm donor and how they dealt with the donor involvement. Semi-structured interviews were conducted with nine couples, who had at least one child conceived through sperm donation. Our thematic analysis showed that the donor conception was seen as a different path to create a normal family. Once the family was formed, most couples avoided talking about the donor because it was perceived as disrupting men's growing confidence in their position as father. Participants tried to confirm the position of the father to protect the family relationships. Uncertainties about how they were perceived as parents showed the continuing dominance of genetic ties within our social discourse. Participants also dealt with reminders of the donor in their daily life. Overall, they tried to manage the space taken up by the donor and to protect the position of the father. We relate our findings to literature on topic avoidance and shared obliviousness in families. For counseling practice, it could be useful to explore couples' meaning-making about the donor as this seemed to serve family functioning.

Relationship Education for Incarcerated Adults.

As relationship education (RE) programs become more widely implemented, it is important to measure and document the changes associated with RE for diverse audiences. Also, researchers have been challenged to examine the impact of RE with more disadvantaged groups. While we are seeing an increase in this area, only three studies have examined RE with an incarcerated sample. These previous studies examined only those currently in a relationship and focused primarily on couple functioning. The aim of this study was to expand the existing literature by examining RE with a broader sample of incarcerated adults, regardless of current relationship status, and to expand our understanding of its association with outcomes beyond the couple domain by also including measures of individual and parental functioning. In addition, we examined whether change from pre- to posttest was moderated by individual characteristics. Using a sample of incarcerated adults (N = 122), the study found positive change in three domains of functioning (couple, individual, and parental). Specifically, results indicated change on five of the eight outcome variables examined. Overall, we found both similarities and differences among program participants on changes from pre- to posttest. For the majority of outcomes, the positive change from pre- to posttest emerged regardless of individual characteristics.

Looking for solutions: gender differences in relationship and parenting challenges among low-income, young parents.

The need for parenting and relationship strengthening programs is important among low-income minority parents where the burden of relational and parental stressors contributes to relationship dissolution. We examine these stressors among young parents. Data were collected from four focus groups (N = 35) with young parents. Data were audio-recorded and transcribed. Inductive coding was used to generate themes and codes, and analysis was completed using NVivo. Relationship and parenting challenges, values, and areas of need were the three major themes that emerged. Women's relationship challenges were family interference and unbalanced parenting, and men reported feeling disrespected and having limited finances. Common relationship challenges for women and men were family interference and unbalanced parenting. Both genders valued trust, communication, and honesty in relationships. Areas of need for women and men included: improving communication and understanding the impact of negative relationships on current relationships. Parenting challenges for women were unbalanced parenting, child safety, and feeling unprepared to parent; men reported limited finances. Both genders valued quality time with child to instill family morals. Areas of need for women and men included learning child discipline techniques and increasing knowledge about child development. Finally, women and men have relationship and parenting similarities and differences. Young parents are interested in learning how to improve relationships and co-parent to reduce relationship distress, which could reduce risk behaviors and improve child outcomes.

Relationships, environment, and the brain: how emerging research is changing what we know about the impact of families on human development.

Recent research is providing family therapists with new information about the complex interaction between an individual's biological makeup and his/her social and physical environment. Family and social relationships, particularly during sensitive periods early in life, can affect a child's biological foundation. Additionally, stress during the early years can have a lasting effect on an individual's physical and mental health and contribute to the onset of severe mental illness. Community programs have been developed to intervene early with families who have an at-risk child to prevent or minimize the onset of mental illness including providing partnerships with at-risk mothers of infants to shape attachment relationships. Programs are also developing individual and family interventions to prevent the onset of psychosis. Practicing family therapists can incorporate emerging neuroscience and early intervention research and leverage the growing base of community programs to enhance the effectiveness and sustainability of mental health outcomes for clients. Additionally, family therapy education programs should broaden student training to incorporate the growing body of information about how family relationships affect individual mental health development.

Association of metabolic score for insulin resistance and its 6-year change with incident type 2 diabetes mellitus.

BACKGROUND: The evidence for the association between metabolic score for insulin resistance (METS-IR) and type 2 diabetes mellitus (T2DM) is limited. We aimed to explore the association of METS-IR and its 6-year change with risk of incident T2DM in a rural Chinese population. METHODS: We analyzed data for 12 107 participants (mean age 50.48 years). A Cox proportional-hazard model was used to estimate the association of METS-IR with incident T2DM by using hazard ratios (HRs) and 95% confidence intervals (CIs); a logistic regression model was used to assess the association of 6-year METS-IR change with incident T2DM by using odds ratios (ORs) and 95% CIs. We used subgroup analyses of the association of METS-IR and its 6-year change with incident T2DM by sex, age, and baseline fasting plasma glucose (FPG) level as well as restricted cubic splines to describe the dose-response association. RESULTS: The association of METS-IR and 6-year METS-IR change with incident T2DM was significant (per SD unit increase: HR = 1.80, 95% CI: 1.60-2.02 for METS-IR, OR = 1.42, 95% CI: 1.28-1.57 and OR = 1.59, 95% CI: 1.44-1.76 for relative and absolute METS-IR change). The significant association remained on subgroup analyses by sex, age, and baseline FPG level. Dose-response analysis demonstrated that the probability of incident T2DM was significantly increased with increasing METS-IR and 6-year METS-IR change. CONCLUSIONS: Increased METS-IR and 6-year METS-IR change were positively associated with risk of incident T2DM in a rural Chinese population. METS-IR may be a vital indicator for identifying T2DM.