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1.
J Interpers Violence ; : 8862605241271418, 2024 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-39229869

RESUMO

In Asia, rates of interpersonal violence are increasing, with significant regional disparities. However, long-term, continental-scale research considering regional differences across the Asia regions is limited. Guided by the ecological model, we examined five ecological risk factors (low life satisfaction/happiness, economic hardship, neighborhood disadvantage, patriarchal values, and religiosity) associated with perceptions of justification of interpersonal violence (i.e., intimate partner violence [IPV] against wife, child physical abuse, and violence against others) in five regions in Asia (i.e., East, West, Central, South, and Southeast). Using the World Values Survey (n = 32,307), a multigroup multiple regression model was used with robust maximum likelihood estimation using Mplus ver. 8. In the entire Asia sample model, perceptions of justifiability of IPV against wife were positively associated with low life satisfaction/happiness; economic hardship; neighborhood disadvantage; and patriarchal values, while they were negatively associated with religiosity. Perceptions of justifiability of child abuse were positively associated with low life satisfaction/happiness; neighborhood disadvantage; and patriarchal values, while they were negatively associated with economic hardship and religiosity. Perceptions of justifiability of violence against others were positively associated with economic hardship and neighborhood disadvantage, while they were negatively associated with religiosity. Each region presented unique risk factor associations. Considering the high rates of interpersonal violence in Asia, understanding the risk factors associated with perceptions of justifying specific types of interpersonal violence can provide an initial insight into preventing violence in Asia. Further, as many Asians dwelling outside Asian regions are still influenced by their culture, religion, language, and norms of the region of origin, the study findings may shed light on future studies to consider in the interpersonal violence literature.

2.
Child Abuse Negl ; 154: 106942, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39079321

RESUMO

BACKGROUND: Despite a large body of evidence linking the impact of trauma, parenting, and child maltreatment recidivism, current child welfare services often do not target maternal trauma and post-traumatic stress disorder (PTSD). Moreover, there is little evidence that traditional family preservation services (FPS) lower the rates of repeat incidences of child abuse and neglect. The novel intervention, Parenting-STAIR (P-STAIR), seeks to address maternal mental health and parenting skills in order to reduce punitive parenting behaviors. OBJECTIVE: This study analyzes the effects of P-STAIR on child maltreatment risk. PARTICIPANTS AND SETTING: P-STAIR was administered to 112 child welfare-involved mothers in New York City (NYC). The mothers were between 18 and 52 years old (M = 31.1, SD = 6.6) and were referred from 4 child welfare preventive service agencies in NYC. METHODS: To evaluate change over time in indicators of maltreatment risk, two-tailed paired sample t-tests compared 1) pre- and post-treatment scores and 2) pre-treatment and 3-month follow-up scores. RESULTS: Among the 71 mothers who completed treatment, significant improvements from baseline to post-assessment and pre- to 3-month follow-up were observed across total scores on the CTSPC and the AAPI-2. Improvements were evident in nonviolent disciple, psychological aggression, expectations, empathy, and parent-child family roles at both the post-assessment and 3-month follow-up which are proximal outcomes of P-STAIR (CTSPC: pre-post nonviolent disciple d = 0.70; pre-post psychological aggression d = 0.34; pre-follow-up nonviolent disciple d = 0.42; pre-follow-up psychological aggression d = 0.36; AAPI-2; pre-post expectations d = 0.31; pre-post empathy d = 0.39; pre-post parent-child roles d = 0.47; pre-follow-up expectations d = 0.33; pre-follow-up empathy d = 0.42; pre-follow-up parent-child roles d = 0.66). CONCLUSIONS: The improvement in indicators of maltreatment risk demonstrates promising support for the utility of P-STAIR within the child welfare system.


Assuntos
Maus-Tratos Infantis , Poder Familiar , Humanos , Maus-Tratos Infantis/prevenção & controle , Maus-Tratos Infantis/psicologia , Feminino , Poder Familiar/psicologia , Projetos Piloto , Adulto , Criança , Fatores de Risco , Adulto Jovem , Adolescente , Cidade de Nova Iorque , Mães/psicologia , Pessoa de Meia-Idade , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/prevenção & controle , Masculino , Serviços de Proteção Infantil
3.
Soc Sci Med ; 355: 117096, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39002197

RESUMO

OBJECTIVES: This study uses the bioecological model of human development and person-centered methods to describe the underlying patterns of risk and their association with bullying perpetration and victimization among U.S. children. METHODS: Using the National Survey of Children's Health, this study (n = 7319) explored the underlying patterns of risks across six domains (i.e., individual, family, school, neighborhood, economic, and socio-cultural) associated with bullying perpetration and victimization among U.S. elementary school children. RESULTS: Latent Class Analysis uncovered four patterns of risks. The low risks group (72.4%) showed the lowest rates of bullying perpetration (24.6%) and victimization (57.2%). The individual and environmental risks group (15.3%) presented moderate levels of bullying perpetration (31.8%) and victimization (67.1%). The family risks group (8.3%) showed moderate levels of bullying perpetration (35.9%) and victimization (66.0%). High risks group (4.0%) presented exceptionally high rates of bullying perpetration (59.1%) and victimization (87.3%). CONCLUSION: Results suggest rates of bullying perpetration and victimization differed across the four patterns of risks. Understanding the sources of risk may be critical to alleviate bullying perpetration and victimization among children. IMPLICATION: Findings suggest that child bullying should be approached with customized treatment considering their pattern of risk exposure.


Assuntos
Bullying , Vítimas de Crime , Humanos , Bullying/estatística & dados numéricos , Bullying/psicologia , Criança , Vítimas de Crime/estatística & dados numéricos , Vítimas de Crime/psicologia , Masculino , Feminino , Estados Unidos/epidemiologia , Fatores de Risco , Inquéritos e Questionários
4.
Stress Health ; 40(4): e3371, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38183368

RESUMO

Using a stress process lens, this paper considers the interrelationship between individual and family-level stress exposures and military spouse resources, including problem-solving appraisals and problem-solving support (PSS), and their associations with posttraumatic stress symptoms (PTSS) among both partners in military marital dyads. The study employs data from the Millennium Cohort Family Study, a longitudinal survey of married military dyads, with an initial panel of 9,872 spouses enroled from 2011 to 2013. A structural equation model explored the associations between service member and spouse childhood maltreatment exposure, nonmilitary and military stressors, as well as interactions with spouse resources on self-reported PTSS among both service member (SM) and spouse (SP). Among our findings, spouse childhood maltreatment muted later self-reported problem-solving appraisal and support. Spouse resources, in turn, had both protective (problem-solving appraisal) and promotive (problem-solving support) effects on PTSS for both service members and spouses. These findings emphasise the central role of spouses in military families, as more psychological resources among spouses appeared to buffer against the deleterious effects of stress exposure on both their own and their partners mental health.


Assuntos
Militares , Resolução de Problemas , Apoio Social , Cônjuges , Transtornos de Estresse Pós-Traumáticos , Humanos , Cônjuges/psicologia , Militares/psicologia , Feminino , Masculino , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto , Estudos Longitudinais , Estresse Psicológico/psicologia , Pessoa de Meia-Idade
5.
Fam Process ; 63(1): 299-314, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37051805

RESUMO

This study examines whether married service member perceptions of positive or negative communication moderate the relationship between how frequently they communicate home during a deployment and their mental distress. Participants included 382 married service members who completed surveys regarding their marital relationships, communication, and mental health while on a non-combat deployment. Though marital satisfaction was not significantly associated with service member reports of their mental distress, perceptions of negative (ß = 4.32, SE = 0.59, p < 0.001) and positive communication (ß = -1.32, SE = 0.57, p < 0.05) were. Further, significant interactions between frequency of communication and the perception of negative (ß = 0.54, SE = 0.13, p < 0.001) and positive (ß = 0.17, SE = 0.07, p < 0.01) communication suggest positive communication may be protective for service members while frequent, negative communication can exacerbate distress. Findings highlight the importance of engaging families in planning and skill building to support healthy communication across the deployment cycle.


Assuntos
Transtornos Mentais , Militares , Humanos , Casamento , Militares/psicologia , Saúde Mental , Comunicação
6.
J Racial Ethn Health Disparities ; 11(2): 669-684, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36952121

RESUMO

OBJECTIVE: To explore the social determinants of mental health (SDoMH) by race/ethnicity in a sample with equal access to healthcare. Using an adaptation of the World Health Organization's SDoMH Framework, this secondary analysis examines the socio-economic factors that make up the SDoMH by race/ethnicity. METHOD: This paper employed configurational comparative methods (CCMs) to analyze various racial/ethnic subsets from quantitative survey data from (N = 327) active-duty Army wives. Data was collected in 2012 by Walter Reed Army Institute of Research. RESULTS: Initial exploratory analysis revealed the highest-scoring factors for each racial/ethnic subgroup: non-Hispanic Black: employment and a history of adverse childhood events (ACEs); Hispanic: living off post and a recent childbirth; junior enlisted non-Hispanic White: high work-family conflict and ACEs; non-Hispanic other race: high work-family conflict and not having a military history. Final analysis showed four models consistently explained clinically significant depression symptoms and four models consistently explained the absence of clinical depression symptoms, providing a solution for each racial/ethnic minority group (non-Hispanic Black, Hispanic, junior enlisted non-Hispanic White, and non-Hispanic other). DISCUSSION: These findings highlight that Army wives are not a monolithic group, despite their collective exposure to military-specific stressors. These findings also highlight the potential for applying configurational approaches to gain new insights into mental health outcomes for social science and clinical researchers.


Assuntos
Etnicidade , Militares , Humanos , Estados Unidos , Criança , Saúde Mental , Determinantes Sociais da Saúde , Cônjuges , Grupos Minoritários
7.
JAMA Netw Open ; 6(12): e2349098, 2023 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-38127345

RESUMO

Importance: Despite the availability of several empirically supported trauma-focused interventions, retention in posttraumatic stress disorder (PTSD) psychotherapy is poor. Preliminary efficacy data shows that brief, family-based interventions may improve treatment retention in a veteran's individual PTSD treatment, although whether this occurs in routine clinical practice is not established. Objective: To characterize receipt of family therapy among veterans diagnosed with PTSD and evaluate whether participation in family therapy is associated with an increased likelihood of completing individual trauma-focused treatment. Design, Setting, and Participants: This retrospective cohort study used the Veterans Health Administration (VHA) Informatics and Computing Infrastructure to extract electronic health record data of participants. All participants were US veterans diagnosed with PTSD between October 1, 2015, and December 31, 2019, who attended at least 1 individual trauma-focused treatment session. Statistical analysis was performed from May to August 2023. Exposures: Receipt of any family psychotherapy and subtype of family-based psychotherapy. Main Outcomes and Measures: Minimally adequate individual trauma-focused treatment completion (ie, 8 or more sessions of trauma-focused treatment in a 6-month period). Results: Among a total of 1 516 887 US veterans with VHA patient data included in the study, 58 653 (3.9%) received any family therapy; 334 645 (23.5%) were Black, 1 006 168 (70.5%) were White, and 86 176 (6.0%) were other race; 1 322 592 (87.2%) were male; 1 201 902 (79.9%) lived in urban areas; and the mean (SD) age at first individual psychotherapy appointment was 52.7 (15.9) years. Among the 58 653 veterans (3.9%) who received any family therapy, 36 913 (62.9%) received undefined family therapy only, 15 528 (26.5%) received trauma-informed cognitive-behavioral conjoint therapy (CBCT) only, 5210 (8.9%) received integrative behavioral couples therapy (IBCT) only, and 282 (0.5%) received behavioral family therapy (BFT) only. Compared with receiving no family therapy, the odds of completing individual PTSD treatment were 7% higher for veterans who also received CBCT (OR, 1.07 [95% CI, 1.01-1.13]) and 68% higher for veterans received undefined family therapy (OR, 1.68 [95% CI, 1.63-1.74]). However, compared with receiving no family therapy care, veterans had 26% lower odds of completing individual PTSD treatment if they were also receiving IBCT (OR, 0.74 [95% CI, 0.66-0.82]). Conclusions and Relevance: In this cohort study of US veterans, family-based psychotherapies were found to differ substantially in their associations with individual PTSD psychotherapy retention. These findings highlight potential benefits of concurrently providing family-based therapy with individual PTSD treatment but also the need for careful clinical attention to the balance between family-based therapies and individual PTSD treatment.


Assuntos
Veteranos , Masculino , Humanos , Pessoa de Meia-Idade , Feminino , Estudos de Coortes , Estudos Retrospectivos , Psicoterapia , Terapia Familiar
8.
J Trauma Stress ; 36(5): 943-954, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37467117

RESUMO

Disparities in posttraumatic stress symptoms (PTSS) have been observed among military service members (SMs) and spouses (SPs) compared to their civilian peers, but exposure to military stressors does not adequately explain observed differences. Using a stress process framework, this study considered the associations between early and recent military and nonmilitary stressors and PTSS among SMs and SPs. We analyzed data from 3,314 SM-SP dyads in the Millennium Cohort and Millennium Cohort Family Studies. Accounting for covariates, multiple linear regression and dominance analyses were employed to consider the effects of SM and SP childhood maltreatment, recent nonmilitary stressors (e.g., financial difficulties), and recent military stressors (e.g., deployment) on their own and their partner's self-reported PTSS. For both SMs and SPs, childhood maltreatment was the strongest predictor of their own PTSS, followed by nonmilitary stressors. Couple crossover dynamics were evident as SP maltreatment and nonmilitary stressors significantly predicted SM PTSS, and SM maltreatment predicted SP PTSS. Maltreatment also multiplied the effects of SM, product term B = 0.92, p = .031, and SP, product term B = 0.75, p = .004, nonmilitary stressors. The findings emphasize the essential role of exposure to early adversity in understanding PTSS among SMs and SPs, as childhood maltreatment strongly predicted PTSS and exacerbated the effects of other stressors on PTSS. Providers should assess for early adversity among both SMs and SPs and consider the provision of services at the couple level given the potential for the transmission of stress within couples.

9.
J Child Fam Stud ; 32(2): 481-497, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36685737

RESUMO

Trauma exposure and post-traumatic stress disorder (PTSD) impact emotional and physical well-being, social functioning, and parent-child relationship quality. The effect of parental trauma on parenting and child maltreatment is often overlooked by current child welfare (CW) services. The novel intervention, Parenting-STAIR, was created to address maternal mental health, parenting skills, and child well-being outcomes. Parenting-STAIR is a combination of Skills Training in Affective and Interpersonal Regulation (STAIR) Narrative Therapy and Parent-Child Care (PC-CARE). This open pilot study aimed to examine the feasibility and preliminary impact of Parenting-STAIR in reducing maternal PTSD and increasing positive parenting skills for mothers and families involved in the child welfare system. Parenting-STAIR was delivered to 111 mothers receiving family preservation services in New York City. Of these, 70 completed treatment; statistical and clinically significant changes were observed for maternal PTSD and depression as well as in parenting stress, parenting skills, and child behaviors. These findings provide encouraging initial evidence for the feasibility and impact of this novel PTSD intervention. An evaluation of maltreatment recidivism is needed, as well as implementation of a randomized controlled trial to establish efficacy of the intervention.

10.
Am J Orthopsychiatry ; 93(6): 557-565, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-30024178

RESUMO

Military-connected youths are a vulnerable population exposed to a unique set of stressors, which may put them at increased risk for adverse mental and behavioral health outcomes, compared to their civilian counterparts. Among military-connected adolescents, emotional and instrumental parentification are mechanisms hypothesized to account for negative outcomes, including substance use. However, parentification may be protective in some cultures and has not been examined in the military population. Data were drawn from 1,441 7th-, 9th-, and 11th-graders who had a parent in the military and completed the 2013 California Healthy Kids Survey. Latent class analysis was used to examine patterns of instrumental parentification indicators among military-connected youths and associated patterns of substance use. Military-connected students in the high parentification class were significantly less likely to be in the frequent polysubstance using class (odds ratio = 0.376, 95% confidence interval [0.180, 0.782]). Findings suggest that experiences of instrumental parentification, including having more responsibilities at home, being more independent, and being able to solve problems better than peers, may be protective. For military-connected youths, these skills, developed in the context of their families, may translate to better coping with other stressful situations. Professionals may be able to build on these strengths and develop adaptive coping strategies to support military-connected youths in managing the stressors of wartime military life. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Assuntos
Militares , Transtornos Relacionados ao Uso de Substâncias , Humanos , Adolescente , Militares/psicologia , Pais/psicologia , Adaptação Psicológica , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Inquéritos Epidemiológicos
11.
Child Maltreat ; 28(2): 209-220, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-35427204

RESUMO

Military families are exposed to a unique constellation of risk factors, which may impact maltreatment outcomes. The present study examined prospective relationships between demographic, health, birth-related, and military-specific risk factors identified prior to a child's birth on their risk for maltreatment in the first two years of life. Data from the Millennium Cohort Study, Department of Defense (DoD) operational records and Family Advocacy Program data on met-criteria maltreatment, and Birth and Infant Health Research program data on suspected maltreatment were linked for 9076 service member parents. Discrete time survival analysis showed that preterm birth increased risk of maltreatment while parents' older age, physical health, and service in the Navy or Air Force decreased risk. Building on DoD's New Parent Support Program, findings suggest the need for universal and targeted prevention efforts, beginning during pregnancy, which limit or eliminate risk factors for maltreatment in military families.


Assuntos
Maus-Tratos Infantis , Família Militar , Nascimento Prematuro , Criança , Lactente , Gravidez , Feminino , Humanos , Recém-Nascido , Estudos de Coortes , Estudos Prospectivos , Maus-Tratos Infantis/prevenção & controle , Fatores de Risco
12.
Trials ; 23(1): 432, 2022 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-35606818

RESUMO

BACKGROUND: Child maltreatment recidivism substantially increases the likelihood of adverse life outcomes, but there is little evidence that family preservation services are effective at reducing recidivism. Mothers in child welfare have very high rates of trauma exposure; maternal post-traumatic stress disorder (PTSD) is an intervention target that has the potential to reduce abuse and neglect. The Safe Mothers, Safe Children (SMSC) intervention program involves the delivery of an innovative combination of interventions, including Skills Training in Affective and Interpersonal Regulation (STAIR) and Parent-Child Interaction Therapy (PCIT). The combined intervention, Parenting-STAIR (P-STAIR), targets maternal PTSD and comorbid depression symptoms to reduce the adverse effects of PTSD on parenting, improve positive parenting skills, and prevent maltreatment recidivism. METHODS: This study is a two-arm randomized controlled trial: P-STAIR (23 sessions) versus supportive counseling (23 sessions). Participants are mothers receiving child welfare family preservation services (FPS), with a child in the age range of 1-8 years old and meeting diagnostic criteria for PTSD (with/without depression). Clinical assessment occurs at pre-treatment (baseline), two in-treatment assessments (mid-assessment #1 after module 9 and mid-assessment #2 after module 15), post-treatment, and at a 6-month follow-up. Recidivism will be measured using the New York State Child Welfare Registry (NYSCWR). We will enroll a total of 220 participants over 4 years: half (N = 110) randomly assigned to the P-STAIR condition and half (N = 110) to the supportive counseling condition. DISCUSSION: This is the first RCT to investigate the efficacy of P-STAIR. The findings for the trial have the potential to contribute to the expansion of evidence-based practices for maternal PTSD, maltreatment, and child welfare.


Assuntos
Maus-Tratos Infantis , Relações Mãe-Filho , Reincidência , Transtornos de Estresse Pós-Traumáticos , Criança , Maus-Tratos Infantis/prevenção & controle , Maus-Tratos Infantis/psicologia , Serviços de Proteção Infantil , Pré-Escolar , Feminino , Humanos , Lactente , Relações Mãe-Filho/psicologia , Mães/psicologia , New York , Poder Familiar/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Reincidência/prevenção & controle , Transtornos de Estresse Pós-Traumáticos/complicações , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/prevenção & controle , Transtornos de Estresse Pós-Traumáticos/terapia
13.
Front Psychol ; 13: 948474, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36600698

RESUMO

Introduction: Military-connected students in public schools face a unique set of stressors that may impact their wellbeing and academic functioning. Methods: Twenty-four youth in the 7th to 12th grades who had an active-duty parent (mother or father) serving in the U.S. Armed Forces were interviewed. Participants completed a qualitative interview while actively completing a Life History Calendar (LHC) to mark deployment and family military service milestones and discuss how they impacted the youth respondent. This study used Qualitative Comparative Analysis (QCA) to explore the interplay and combination of specific stressors related to relocation and deployment experiences among adolescents, and to determine key factors associated with maladaptive outcomes. Results: The results of the QCA analysis identified bullying experiences and negative experiences with other military-connected youth as conditions that are associated with maladaptive coping. Discussion: Chronic and acute stressors in adolescence are established risk factors for mental, emotional, and behavioral problems in the short and long-term including suicidality, substance use and abuse, and substance use disorders. Through qualitative inquiry we were able to identify specific contextual details related to maladaptive coping that can be used to further refine areas of focus for research, prevention, and interventions for military-connected adolescents.

14.
J Interpers Violence ; 37(15-16): NP13497-NP13517, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-33832357

RESUMO

Military spouses are an understudied population with respect to intimate partner violence (IPV) perpetration. Due to the unique demands of service members' jobs, military couples are documented to experience particular individual, couple, and family-level risk factors that may lead to IPV perpetration. Using the frustration-aggression hypothesis and considering the possibility of mutual violence, we examined (a) the direct effects of stressful events, marital discord, and work-family conflict on IPV perpetration among military spouses and (b) the indirect effect of anger arousal between stressful events, marital discord, and work-family conflict on IPV perpetration. This study is a secondary analysis of data drawn from a survey of army spouses conducted by the Walter Reed Army Institute of Research in 2012. The sample consists of 314 female spouses of active-duty members (white 75%, enlisted 80%). After controlling for covariates (including spouse race, rank, household size, age, living distance from military installation), the direct effects of marital discord and anger on IPV perpetration were statistically significant. Also, the direct effects of marital discord and work-family conflict on anger were significant. The path model demonstrated that the indirect effects of marital discord and work-family conflict on IPV perpetration via anger were significant. Finally, most physical and verbal violence was reported to occur in the form of mutual violence with their partners. Study findings suggest that the pathway of risk factors impacting IPV might differ depending on the sources of stress. The Family Advocacy Program, military social work practitioners, and other behavioral health providers should consider domains of risk and provide support to military spouses that is specifically tailored to these risk factors. Furthermore, considering the mediating role of anger arousal in the relationship between marital discord, work-family conflict and IPV, programs to address anger might be helpful to reduce IPV among military spouse perpetrators.


Assuntos
Violência por Parceiro Íntimo , Militares , Ira , Feminino , Humanos , Fatores de Risco , Cônjuges , Violência
15.
Am J Orthopsychiatry ; 91(6): 789-799, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34351195

RESUMO

OBJECTIVE: Guided by a resilience framework, this study examines the accumulation of risk and protective factors, as well as the potential buffering effects of protective factors on mental distress among female military spouses. BACKGROUND: Most research with this population has focused on individual risk factors affecting military spouses. Less frequently have the effects of cumulative risk, risk factors not specifically associated with military service, or protective factors been examined, though there is evidence for their importance. METHOD: This study used secondary survey data from 334 female Army spouses collected in 2012 as part of the Land Combat Study 2. Cumulative risk and protective factor scores as well as scores within risk (intrapersonal, family, and military-specific) and protective (individual and environmental) factor domains were calculated. Four structural equation models were run to examine main and interaction effects on mental distress, a latent variable representing depression, anxiety, and trauma symptoms. RESULTS: In cumulative risk and protective factor models, cumulative risk was directly, positively associated with mental distress. This relationship was moderated by cumulative protection. In domain-specific models, only family risk was directly associated with mental distress. This relationship was moderated by environmental protective factors. CONCLUSION: Findings indicate mental distress among military spouses is associated with exposure to cumulative risk and attenuated by the presence of certain domains of protective factors. Family risk factors including marital distress and work-family conflict may be particularly pernicious stressors, but informal and structural supports may be important targets for prevention and intervention efforts. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Militares , Cônjuges , Ansiedade , Feminino , Humanos , Casamento , Fatores de Proteção , Estresse Psicológico
16.
J Fam Psychol ; 35(1): 33-43, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32437203

RESUMO

The current study examined patterns of risk and protective factors among military families and associations with mental health diagnoses among U.S. Army spouses. Spouses (N = 3,036) completed a survey of family psychosocial fitness, which informed protective factors including coping, family cohesion, and social support. Survey results were linked with Department of Defense archival data, which provided information on military-specific risks, including relocation, deployments, and reunification, as well as mental health care diagnoses. The three-step method of latent profile analysis identified six profiles, suggesting significant heterogeneity in military families with respect to their access to resources and exposure to risk. The largest profile of families (40.48% of the sample) had limited risk exposure and considerable strengths. Variability in risk and protection across profiles was associated with statistically significant differences in the prevalence of mental health diagnoses among spouses (χ² = 108.968, df = 5, p < .001). The highest prevalence of mental health diagnoses among Army spouses (41.2%) was observed in the profile with the lowest levels of protective factors. Findings point to the importance of evaluating both concurrent risk and protective factors. Increasing access to resources may be a fruitful avenue for prevention among military families that are struggling. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Transtornos Mentais/epidemiologia , Família Militar/psicologia , Resiliência Psicológica , Cônjuges/psicologia , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Militares/psicologia , Fatores de Risco , Inquéritos e Questionários , Estados Unidos/epidemiologia , Adulto Jovem
17.
Fam Process ; 60(2): 507-522, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-32981035

RESUMO

The present study aimed to describe patterns of risk and protective factors affecting U.S. Army families and their association with mental health diagnoses among military-connected children. Wartime military service is associated with increased adverse outcomes for military-connected youth, but few studies have explored the impact of concurrent risk and access to protective factors. Using big data methods to link existing datasets, protective factors (e.g., marital and family functioning) were drawn from a voluntary survey completed by 1,630 US Army spouses. Risk factors (e.g., parent mental health, family moves, deployment) were drawn from Department of Defense (DoD) archival data. Rates of mental health diagnoses among youth were derived from DoD healthcare records. Using the three-step method of latent profile analysis, five profiles emerged with variability across risk and protective factors. The largest group (40% of the sample) had considerable protective factors and limited risk exposure. Statistically significant differences in the prevalence of mental health diagnoses among military-connected youth were observed across profiles (χ2  = 30.067, df = 4, p < .001), with the highest rates (31.1% and 30.5%) observed in the two profiles with the lowest protective factors. Findings suggest most military families are faring well and highlight the importance of a thorough assessment that evaluates both the stressors military families face and the strengths they possess.


el presente estudio tuvo como finalidad describir los patrones de riesgo y los factores protectores que afectan a las familias del Ejército de los Estados Unidos y su asociación con los diagnósticos de salud mental entre niños relacionados con los militares. El servicio militar en tiempos de guerra está asociado con mayores consecuencias adversas para los jóvenes relacionados con los militares, pero pocos estudios han analizado el efecto del riesgo simultáneo y el acceso a los factores protectores. Utilizando métodos de datos masivos para conectar conjuntos de datos existentes, se extrajeron los factores protectores (p. ej.: funcionamiento familiar y conyugal) de una encuesta voluntaria contestada por 1630 cónyuges de militares del Ejército de los Estados Unidos. Los factores de riesgo (p. ej.: la salud mental de los padres, las mudanzas familiares, las comisiones) se obtuvieron de los datos de archivo del Departamento de Defensa (DoD). Los índices de los diagnósticos de salud mental entre los jóvenes se extrajeron de los expedientes de asistencia sanitaria del DoD. Utilizando el método de tres pasos del análisis de perfiles latentes, surgieron cinco perfiles con variabilidad entre los factores de riesgo y los factores protectores. El grupo más grande (el 40% de la muestra) tuvo factores protectores considerables y una exposición a riesgos limitada. Se observaron diferencias estadísticamente significativas en la prevalencia de diagnósticos de salud mental entre los jóvenes relacionados con los militares en los perfiles (χ2 = 30.067, df = 4, p < .001), y los índices más altos (31.1% and 30.5%) se observaron en los 2 perfiles con factores protectores más bajos.Los resultados sugieren que la mayoría de las familias militares se encuentran bien y destacan la importancia de una evaluación exhaustiva que evalúe tanto los factores desencadenantes de estrés que enfrentan las familias de militares como las fortalezas que poseen.


Assuntos
Família Militar , Militares , Adolescente , Criança , Humanos , Avaliação de Resultados em Cuidados de Saúde , Fatores de Risco , Cônjuges
18.
Mil Behav Health ; 8(1): 74-85, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32884854

RESUMO

The purpose of the present study is to explore the psychometric properties of the U.S. Army's Family Global Assessment Tool (GAT), which assesses the psychosocial fitness of Army families. With data from 1,692 Army spouses, we examined the structure, reliability and validity of the GAT, using confirmatory factor analysis (CFA) and two validity studies. Fifty-three items and 9 factors were retained following CFA. This model provided a good fit, and scales demonstrated strong internal consistency. Bivariate correlations and results from a theoretically driven model provide preliminary evidence of validity. Findings support the usefulness of the GAT for measuring psychosocial fitness of Army spouses.

19.
J Sch Health ; 87(8): 575-583, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28691176

RESUMO

BACKGROUND: Risky sexual behaviors put adolescents at increased risk of adverse outcomes. Parents, school-based adults, and peers play important roles in influencing these sex intentions. METHODS: This work explored the influence of parent-child sex communication on adolescent attitudes, perceived norms, and intentions to have sex, including the moderating role of social support from school-based adults, in a sample of 21,731 adolescents in California. RESULTS: Although increased parent-child sex communication was associated with intentions to have sex, it also exhibited protective effects, increasing abstinence attitudes among youth that led to decreased intention directly and via support from school-based adults. CONCLUSIONS: Although many factors influencing sexual behaviors are largely intrapersonal, these findings indicate the importance of an ecological approach to reducing adolescent sexual risk behaviors through engagement of parents and increased school connectedness.


Assuntos
Comportamento do Adolescente/psicologia , Relações Interpessoais , Relações Pais-Filho , Comportamento Sexual/psicologia , Adolescente , Feminino , Humanos , Masculino , Apego ao Objeto , Grupo Associado
20.
Public Health Rep ; 132(1): 85-92, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28005474

RESUMO

OBJECTIVES: Although many service members successfully cope with exposure to stress and traumatic experiences, others have symptoms of depression, posttraumatic stress disorder (PTSD), and anxiety; contextual factors may account for the variability in outcomes from these experiences. This work sought to understand mechanisms through which social support influences the mental health of service members and whether dyadic functioning mediates this relationship. METHODS: We collected cross-sectional data as part of a larger study conducted in 2013; 321 military personnel who had at least 1 deployment were included in these analyses. Surveys were completed online; we collected data on demographic characteristics, social support, mental health measures (depression, PTSD, and anxiety), and dyadic functioning. We performed process modeling through mediation analysis. RESULTS: The direct effects of social support on the mental health of military personnel were limited; however, across all types of support networks, greater social support was significantly associated with better dyadic functioning. Dyadic functioning mediated the relationships between social support and depression/PTSD only when social support came from nonmilitary friends or family; dyadic functioning mediated social support and anxiety only when support came from family. We found no indirect effects of support from military peers or military leaders. CONCLUSION: Findings here highlight the need to continue to explore ways in which social support, particularly from family and nonmilitary-connected peers, can bolster healthy intimate partner relationships and, in turn, improve the well-being of military service members who are deployed.


Assuntos
Transtornos Mentais/diagnóstico , Saúde Mental , Militares/psicologia , Apoio Social , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Adulto Jovem
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