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1.
Prev Sci ; 25(1): 137-154, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37837520

RESUMEN

This systematic review critically evaluates 21 grandparent-focused prevention programs designed to benefit grandparent caregivers or target grandparent caregivers as agents of change for grandchild development. These grandparent programs were published in 35 peer-reviewed articles in the last 31 years. For each program, we described the phase of development of program (i.e., feasibility, pilot, and efficacy), delivery characteristics, and adaptations of existing evidence-based programs to meet the needs of grandparent caregivers in diverse sociocultural backgrounds. For programs tested under a controlled trial design, we evaluated core components and preliminary effects on targeted outcomes. Most studies targeted grandparents who served as primary or custodial caregivers in the USA, while limited studies targeted supplementary grandparent caregivers. Thirteen programs which were evaluated using pretest-posttest designs demonstrated feasibility and acceptability of the grandparent programs. Moreover, eight programs which were evaluated using randomized-controlled trials (RCTs; 5 pilot and 3 full-scale efficacy trials) demonstrated promising outcomes. Additionally, we identified six core components and 17 specific elements in eight programs evaluated using RCT designs. Overall, we provide a comprehensive critique of this body of literature as well as directions for future studies, including the need to develop programing tailored to grandparent caregivers with unique needs.


Asunto(s)
Abuelos , Humanos , Cuidadores , Familia
2.
Prev Sci ; 25(5): 786-797, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38795235

RESUMEN

Over a 12-year period, this study examined the effects of the Family Check-Up preventive intervention model on both observed and self-reported parenting behaviors of mothers and fathers as well as how those parenting behaviors were associated with young adult antisocial behavior. Teachers identified 641 early adolescent youth from school settings to be at elevated risk for the development of externalizing behavior and/or substance use. These youth and their families were randomly assigned to the Family Check-Up intervention model (consisting of an adaptive, multi-tiered model of support, including a school-based family resource room, the Family Check-Up, and targeted follow-up services) or a control condition. Using an intent-to-treat approach, the Family Check-Up intervention model positively impacted mothers' observed parenting approximately 5 years later in middle adolescence but was not associated with changes in fathers' observed or self-reported parenting. Mothers' observed adaptive parenting and fathers' self-reported adaptive parenting in middle adolescence were associated with lower risk for young adult antisocial behavior. The cascading effects of brief, family-focused interventions are discussed along with implications for the measurement of parenting in mothers and fathers in the context of preventive intervention trials.


Asunto(s)
Responsabilidad Parental , Humanos , Femenino , Masculino , Adolescente , Estudios Longitudinales , Autoinforme , Trastorno de Personalidad Antisocial/prevención & control , Madres/psicología , Adulto Joven , Adulto , Padre/psicología
3.
Prev Sci ; 2024 Sep 16.
Artículo en Inglés | MEDLINE | ID: mdl-39285084

RESUMEN

Parenting programs aim to improve parenting quality, which may, in turn, support various aspects of child development, including behavior and mental health. However, parenting interventions show considerable heterogeneity in response patterns across different families, demonstrating that they are not one-size-fits-all programs. This variability points to a need for greater understanding of which families benefit most from these interventions and how to improve response among those who do not. Following this literature gap, this study employed a person-centered approach to identify different parenting profiles associated with heterogeneity in treatment responses to a family-based prevention interventions adapted for military families. This study used data from a randomized controlled trial of the ADAPT intervention for 336 US military families in which at least one parent had deployed to war. Latent profile analyses revealed three unobserved parenting profiles among mothers and fathers, reflecting High positive, Moderate positive, and Coercive parenting styles. Latent transition analysis (LTA) suggested that the ADAPT program led to improvements in parenting, particularly among mothers who began the program with moderate or typical levels of parenting skills, and that these positive changes in parenting may help to decrease child externalizing problems. For fathers, the ADAPT program was most effective in preventing declines in positive parenting among those with initially typical levels of positive parenting. Overall, study findings demonstrate considerable heterogeneity in parenting behavior among a sample of military families that is associated with variability in parent responses to the evidence-based parenting program.

4.
Prev Sci ; 24(2): 237-248, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-34333734

RESUMEN

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.


Asunto(s)
Regulación Emocional , Personal Militar , Humanos , Preescolar , Niño , Adolescente , Masculino , Femenino , Personal Militar/psicología , Responsabilidad Parental/psicología , Emociones/fisiología , Padre/psicología , Madres/psicología
5.
Telemed J E Health ; 29(7): 1001-1013, 2023 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-36472470

RESUMEN

Introduction: The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led to the rapid adoption of telehealth to provide HIV care and treatment. However, limited information exists about the feasibility, acceptability, and efficacy of telehealth interventions at different points of the HIV care continuum. Methods: A systematic search was conducted of Ovid MEDLINE, PsycINFO, and CINAHL databases to synthesize evidence regarding the feasibility, acceptability, and efficacy of videoconferencing and video-based interventions for HIV testing and treatment in adult populations. Seventeen articles published through July 2021 were included in the review. We used descriptive methods to analyze data, and findings were reported using frequencies and percentages. Results: Findings show that videoconferencing and video-based interventions are generally feasible and acceptable. Videoconferencing is effective in improving adherence to HIV treatment and in promoting HIV testing. In addition, video-based interventions were effective in promoting HIV testing, treatment initiation, and adherence to medication. Both modalities enhanced linkage and retention in treatment for HIV-positive patients. Conclusions: Video-based and videoconferencing interventions are beneficial in HIV testing and treatment. However, the scarcity of primary studies employing these telehealth modalities means that there is a need for more research in these areas. Also, reviewed studies suffered from several limitations, including reliance on subjective measures, lack of standardized ways of evaluating acceptability and feasibility, use of small sample sizes, and short follow-up durations. In addition, there was less representation of studies from resource-limited settings disproportionately affected by HIV and AIDS. Thus, future research should focus on addressing these challenges.


Asunto(s)
COVID-19 , Infecciones por VIH , Telemedicina , Humanos , Adulto , Estudios de Factibilidad , COVID-19/diagnóstico , SARS-CoV-2 , Telemedicina/métodos , Prueba de VIH , Infecciones por VIH/diagnóstico , Infecciones por VIH/tratamiento farmacológico
6.
Prev Sci ; 23(7): 1308-1320, 2022 10.
Artículo en Inglés | MEDLINE | ID: mdl-35486296

RESUMEN

Current evidence-based prevention programming targeting child externalizing problems demonstrates modest overall effect sizes and is largely ineffective for a sizable proportion of youth who participate. However, our understanding of the youth and family characteristics associated with response to specific programming is quite limited. The current study used child and family risk profiles as predictors of response trajectories to the Early Risers conduct problem preventive intervention. A sample of 240 kindergarten-aged youth displaying elevated school-based aggression were randomized by school to either the Early Risers intervention or a control condition. Using a number of child and family risk variables, a latent profile analysis produced a solution consisting of five unique risk profiles. Three low and mixed risk profiles were associated with a limited response to the intervention. One high-risk profile characterized by maladaptive parenting and elevated child externalizing demonstrated notably improved trajectories of externalizing behavior over a 3-year period relative to the control condition. Another high-risk profile characterized by inconsistent discipline, high parental distress, and elevated child internalizing and externalizing symptoms seemed to have positive developmental trends disrupted by the intervention relative to the control condition, potentially consistent with an iatrogenic effect relative to the control condition. The study results support continued efforts to use broader risk profiles to examine heterogeneity in response to preventive interventions and, with replication, will have implications for intervention tailoring.


Asunto(s)
Problema de Conducta , Adolescente , Anciano , Agresión , Niño , Humanos , Responsabilidad Parental , Padres , Instituciones Académicas
7.
Adm Policy Ment Health ; 49(2): 312-325, 2022 03.
Artículo en Inglés | MEDLINE | ID: mdl-34529202

RESUMEN

Primary care has increasingly adopted integrated behavioral health (IBH) practices to enhance overall care. The IBH Cross-Model Framework clarifies the core processes and structures of IBH, but little is known about how practices vary in the implementation of these processes and structures. This study aimed to describe clusters of clinics using the IBH Cross-Model Framework for a large sample of primary care clinics, as well as contextual variables associated with differences in implementation. Primary care clinics (N = 102) in Minnesota reported their level of implementation across 18 different components of IBH via the site self-assessment (SSA). The components were mapped to all five principles and four of the nine structures of the IBH Cross-Model Framework. latent class analysis was used to identify unique clusters of IBH components from the SSA across the IBH Cross-Model Framework's processes and structures. Latent classes were then regressed onto context variables. A four-class model was determined to be the best fit: Low IBH (39.6%), Structural IBH (7.9%), Partial IBH (29.4%), and Strong IBH (23.1%). Partial IBH clinics were more urban than the other three classes, lower in SES risk than Structural IBH clinics, and located in smaller organizations than Strong IBH clinics. There were no differences between classes in race/ethnicity of the clinic area or practice size. Four groups of IBH implementation were identified representing unique profiles of integration. These clusters may represent patterns of community-based implementation of IBH that indicate easier and more challenging aspects of IBH implementation.


Asunto(s)
Prestación Integrada de Atención de Salud , Psiquiatría , Instituciones de Atención Ambulatoria , Humanos , Análisis de Clases Latentes , Atención Primaria de Salud
8.
Dev Psychopathol ; 32(5): 1838-1853, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33427169

RESUMEN

Utilizing a large (N = 739), ancestrally homogenous sample, the current study aimed to better understand biological risk processes involved in the development of depressive symptoms in maltreated, African American children age 8-12 years. Maltreatment was independently coded from Child Protective Services records and maternal report. Self-reported depressive symptoms were attained in the context of a week-long, summer research camp. DNA was acquired from buccal cell or saliva samples and genotyped for nine polymorphisms in four hypothalamic-pituitary-adrenal (HPA)-axis-related genes: FKBP5, NR3C1, NR3C2, and CRHR1. Salivary cortisol samples were collected each morning (9 a.m.) and late afternoon (4 p.m.) throughout the week to assess HPA functioning. Results revealed that experiences of maltreatment beginning prior to age 5 were most predictive of depressive symptoms, whereas maltreatment onset after age 5 was most predictive of HPA axis dysregulation (blunted daytime cortisol patterns). Multigenic risk did not relate to HPA functioning, nor did it moderate the relationship between maltreatment and HPA activity. There was no mediation of the relationship between maltreatment and depressive symptoms by HPA dysfunction. Results are interpreted through a developmental psychopathology lens, emphasizing the principle of equifinality while carefully appraising racial differences. Implications for future research, particularly the need for longitudinal studies, and important methodological considerations are discussed.


Asunto(s)
Depresión , Sistema Hipotálamo-Hipofisario , Adolescente , Negro o Afroamericano , Niño , Humanos , Hidrocortisona , Sistema Hipófiso-Suprarrenal , Saliva
9.
J Res Adolesc ; 30(2): 372-388, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-31539179

RESUMEN

The current study utilized a person-centered approach to explore how self-regulatory profiles relate to conduct problems in an ethnically diverse sample of 197 adolescents referred to juvenile diversion programming. Utilizing a multidomain, multimethod battery of self-regulation indicators, three common profiles emerged in a latent profile analysis. The profiles represented an Adaptive group, a Cognitively Inflexible group, and an Emotionally Dysregulated group. Group membership was associated with severity and type of conduct problems as well as callous and unemotional traits. The Adaptive group demonstrated lower severity conduct problems when compared to the other groups. The Emotionally Dysregulated group was more likely to commit violent offenses and demonstrated higher levels of some callous and unemotional traits than youth characterized by cognitive inflexibility.


Asunto(s)
Regulación Emocional , Delincuencia Juvenil/psicología , Problema de Conducta/psicología , Autocontrol , Adolescente , Femenino , Humanos , Conducta Impulsiva , Masculino , Factores de Riesgo , Asunción de Riesgos , Encuestas y Cuestionarios
10.
Subst Abus ; 41(4): 437-450, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31809653

RESUMEN

BACKGROUND: Valid assessment of adolescent substance use is important in both research and clinical applications. However, the optimal approach to assessing adolescent use remains controversial, particularly with regard to the use of parent-reported measures. Methods: Using a systematic review of existing literature, we sought to evaluate the utility of parent measures of adolescent alcohol and cannabis use by examining their correspondence with self-report measures. Furthermore, we investigated study-related variables that may be associated with differing levels of parent-child correspondence. Relevant articles were identified using a systematic search across multiple databases. Results: The review revealed generally poor agreement between parent and adolescent reports of alcohol and cannabis use. Parents consistently underestimated use and problems associated with use when compared with adolescents. Community-based (versus clinical) samples, reporting regarding alcohol (versus cannabis), and reporting problems associated with use (versus reports of use/nonuse) were each associated with lower levels of parent-child agreement. Conclusions: Recommendations for the optimal use of parent measures of adolescent substance use are provided.


Asunto(s)
Conducta del Adolescente , Cannabis , Trastornos Relacionados con Sustancias , Adolescente , Humanos , Padres , Autoinforme
11.
Prev Sci ; 20(1): 56-67, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-29644545

RESUMEN

Parenting programs are an effective strategy to prevent multiple risky outcomes during adolescence. However, these programs usually enroll one caregiver and have low attendance. This study evaluated the preliminary results, cost, and satisfaction of adaptive recruitment and parenting interventions for immigrant Latino families. A mixed methods study was conducted integrating a pre-post design with embedded qualitative and process evaluations. Fifteen immigrant Latino families with an adolescent child aged 10-14 were recruited. Two-caregiver families received a home visit to increase enrollment of both caregivers. All families participated in an adaptive parenting program that included group sessions and a one-to-one component (online videos plus follow-up telephone calls) for those who did not attend the group sessions. The intervention addressed positive parenting practices using a strengths-based framework. Primary outcomes were the proportion of two-parent families recruited and intervention participation. Secondary outcomes were change in parenting self-efficacy, practices, fidelity, costs, and satisfaction. Participants completed questionnaires and interaction tasks before and after participating in the intervention. In addition, participants and program facilitators completed individual interviews to assess satisfaction with the program components. Overall, 23 parents participated in the intervention; 73% of two-parent families enrolled with both parents. Most participants completed 75% or more of the intervention. Fathers were more likely to use the one-to-one component of the intervention than mothers (p = .038). Participants were satisfied with program modifications. In sum, adaptive recruitment and parenting interventions achieved high father enrollment and high participation. These findings warrant further evaluation in randomized trials.


Asunto(s)
Emigrantes e Inmigrantes , Familia , Hispánicos o Latinos , Responsabilidad Parental , Adolescente , Niño , Humanos , Entrevistas como Asunto , Selección de Paciente , Medicina de Precisión , Investigación Cualitativa
12.
J Early Adolesc ; 38(9): 1322-1343, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-30555201

RESUMEN

The current study investigated the mechanisms through which a parenting intervention for military families fosters positive peer adjustment in children. A sample of 336 families with a history of parental deployment enrolled in a randomized controlled trial of the After Deployment Adaptive Parenting Tools (ADAPT) preventive intervention. ADAPT is a 14-week preventive intervention designed to strengthen parenting in military families. The intervention was associated with improvements in mother's and father's parental locus of control (i.e., a more internal locus of control) at a 6-month follow-up assessment while controlling for baseline levels. Mothers' parental locus of control was positively associated with improvements in children's peer adjustment 12 months following the intervention while controlling for baseline peer adjustment. A significant indirect effect revealed that participation in ADAPT resulted in improved 12-month peer adjustment by improving mothers' parental locus of control. Implications for supporting youth resilience to stressors associated with deployment are discussed.

13.
J Clin Child Adolesc Psychol ; 45(4): 495-509, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-25256135

RESUMEN

The development of adaptive treatment strategies (ATS) represents the next step in innovating conduct problems prevention programs within a juvenile diversion context. Toward this goal, we present the theoretical rationale, associated methods, and anticipated challenges for a feasibility pilot study in preparation for implementing a full-scale SMART (i.e., sequential, multiple assignment, randomized trial) for conduct problems prevention. The role of a SMART design in constructing ATS is presented. The SMART feasibility pilot study includes a sample of 100 youth (13-17 years of age) identified by law enforcement as early stage offenders and referred for precourt juvenile diversion programming. Prior data on the sample population detail a high level of ethnic diversity and approximately equal representations of both genders. Within the SMART, youth and their families are first randomly assigned to one of two different brief-type evidence-based prevention programs, featuring parent-focused behavioral management or youth-focused strengths-building components. Youth who do not respond sufficiently to brief first-stage programming will be randomly assigned a second time to either an extended parent- or youth-focused second-stage programming. Measures of proximal intervention response and measures of potential candidate tailoring variables for developing ATS within this sample are detailed. Results of the described pilot study will include information regarding feasibility and acceptability of the SMART design. This information will be used to refine a subsequent full-scale SMART. The use of a SMART to develop ATS for prevention will increase the efficiency and effectiveness of prevention programing for youth with developing conduct problems.


Asunto(s)
Conducta del Adolescente/psicología , Trastorno de la Conducta/prevención & control , Trastorno de la Conducta/psicología , Delincuencia Juvenil/prevención & control , Delincuencia Juvenil/psicología , Adolescente , Trastorno de la Conducta/diagnóstico , Estudios de Factibilidad , Femenino , Humanos , Masculino , Proyectos Piloto
14.
J Prim Prev ; 35(5): 321-37, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25037843

RESUMEN

Parent-focused preventive interventions for youth conduct problems are efficacious when offered in different models of delivery (e.g., individual in-home, group center-based). However, we know little about the characteristics of parents associated with a positive response to a particular model of delivery. We randomly assigned the parents of an ethnically diverse sample of kindergarten through second grade students (n = 246) displaying elevated levels of aggression to parent-focused program delivery models emphasizing receiving services in a community center largely with groups (Center; n = 121) or receiving services via an individualized in-home strategy (Outreach; n = 125). In both delivery models, parents received parent skills training and goal setting/case management/referrals over an average of 16 months. Structural equation modeling revealed a significant interaction between parental well-being at baseline and intervention delivery model in predicting parenting efficacy at year 2, while controlling for baseline levels of parenting efficacy. Within the Outreach model, parents with lower levels of well-being as reported at baseline appeared to show greater improvements in parenting efficacy than parents with higher levels of well-being. Within the Center model, parental well-being did not predict parenting efficacy outcomes. The strong response of low well-being parents within the Outreach model suggests that this may be the preferred model for these parents. These findings provide support for further investigation into tailoring delivery model of parent-focused preventive interventions using parental well-being in order to improve parenting outcomes.


Asunto(s)
Trastorno de la Conducta/prevención & control , Educación no Profesional , Modelos Educacionales , Responsabilidad Parental , Padres/psicología , Servicios de Salud Escolar , Adulto , Niño , Femenino , Frustación , Humanos , Masculino , Evaluación de Resultado en la Atención de Salud , Autoimagen , Apoyo Social , Factores Socioeconómicos , Estrés Psicológico
15.
Res Child Adolesc Psychopathol ; 52(1): 141-154, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37458901

RESUMEN

This study revisits the association between coercive parent-adolescent interactions and adolescent externalizing behaviors. Specifically, we investigate the moment-to-moment coercive exchanges between parents and adolescents and how these dynamic processes map to the long-term development of substance use and antisocial behavior from middle adolescence to early adulthood. We collected videotaped observations with 794 adolescents (ages 16-17 years) and their parents during interactions and coded their real-time behavioral exchanges. State Space Grid analyses were used to measure the proportion of time in which each parent-adolescent dyad engaged in the Dyadic Coercion region as an indicator of rigidity in dyadic coercion. We also measured adolescents' substance use and antisocial behavior at ages 16-17, ages 18-19, and ages 21-22. The enduring impact of parent-adolescent coercive interaction on substance use and antisocial behavior was tested using categorical latent growth curve models and path models. Adolescents with more coercive interactions with parents showed higher rates of increase in alcohol use and higher levels of antisocial behavior through early adulthood. The findings highlight the unique contribution of using intensive data to understand coercive interactions on a micro-timescale and how these dynamics influence long-term development in externalizing behaviors. Implications for intervention studies are discussed.


Asunto(s)
Coerción , Trastornos Relacionados con Sustancias , Adolescente , Humanos , Adulto , Trastorno de Personalidad Antisocial , Padres , Consumo de Bebidas Alcohólicas , Trastornos Relacionados con Sustancias/epidemiología
16.
BMC Prim Care ; 25(1): 302, 2024 Aug 14.
Artículo en Inglés | MEDLINE | ID: mdl-39143518

RESUMEN

BACKGROUND: People with diabetes, vascular disease, and asthma often struggle to maintain stability in their chronic health conditions, particularly those in rural areas, living in poverty, or racially or ethnically minoritized populations. These groups can experience inequities in healthcare, where one group of people has fewer or lower-quality resources than others. Integrating behavioral healthcare services into primary care holds promise in helping the primary care team better manage patients' conditions, but it involves changing the way care is delivered in a clinic in multiple ways. Some clinics are more successful than others in fully integrating behavioral health models as shown by previous research conducted by our team identifying four patterns of implementation: Low, Structural, Partial, and Strong. Little is known about how this variation in integration may be related to chronic disease management and if IBH could be a strategy to reduce healthcare inequities. This study explores potential relationships between IBH implementation variation and chronic disease management in the context of healthcare inequities. METHODS: Building on a previously published latent class analysis of 102 primary care clinics in Minnesota, we used multiple regression to establish relationships between IBH latent class and healthcare inequities in chronic disease management, and then structural equation modeling to examine how IBH latent class may moderate those healthcare inequities. RESULTS: Contrary to our hypotheses, and demonstrating the complexity of the research question, clinics with better chronic disease management were more likely to be Low IBH rather than any other level of integration. Strong and Structural IBH clinics demonstrated better chronic disease management as race in the clinic's location became more White. CONCLUSIONS: IBH may result in improved care, though it may not be sufficient to resolve healthcare inequities; it appears that IBH may be more effective when fewer social determinants of health are present. Clinics with Low IBH may not be motivated to engage in this practice change for chronic disease management and may need to be provided other reasons to do so. Larger systemic and policy changes are likely required that specifically target the mechanisms of healthcare inequities.


Asunto(s)
Disparidades en Atención de Salud , Atención Primaria de Salud , Humanos , Enfermedad Crónica/terapia , Atención Primaria de Salud/organización & administración , Prestación Integrada de Atención de Salud/organización & administración , Minnesota , Manejo de la Enfermedad , Análisis de Clases Latentes , Femenino
17.
Behav Ther ; 55(2): 248-262, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38418038

RESUMEN

To support families and reduce the burden of child mental, emotional, and behavioral problems, evidence-based parenting interventions must remain effective in real-world service delivery contexts. The purpose of the current study was to evaluate the effectiveness of the GenerationPMTO (GenPMTO) intervention during sustained implementation in the Michigan public mental health system using a single-arm open trial (pre-post) design. We also examined potential predictors of treatment response. A multilevel analysis framework was utilized to evaluate data from 365 caregivers who completed GenPMTO treatment. Results revealed significant positive improvements from pretest to posttest in all four outcome domains (i.e., parenting confidence, parenting practices, caregiver depressive symptoms, child behavior problems). When compared to group-based GenPMTO delivery, the individual delivery format was associated with significantly greater improvements in overall effective parenting practices, as well as in the subdomain of skill encouragement. Caregiver gender, caregiver educational level, and child age were all implicated as predictors of GenPMTO outcomes. These findings add to the literature by supporting the effectiveness of the GenPMTO intervention when fully integrated into mental health care practice and can inform continued efforts to provide families with evidence-based services in community settings.


Asunto(s)
Salud Mental , Problema de Conducta , Niño , Humanos , Responsabilidad Parental/psicología , Emociones , Cuidadores/psicología
18.
Clin Child Psychol Psychiatry ; 27(3): 524-537, 2022 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34962833

RESUMEN

INTRODUCTION: Parents and adolescents often have conflict. Previous research has been inconsistent regarding the association between some parent behaviors during this conflict and adolescent symptoms. This study examines parents' behaviors during a conflict resolution discussion in a clinical sample, and the relationship between parents' behaviors and adolescents' depression and anxiety symptoms. METHODS: Depression and anxiety symptoms were self-reported by 22 adolescents of ages 13-17 who were diagnosed with depression. They also participated in an observed conflict resolution task with one parent. Using observationally coded data, we utilized two linear multiple regressions to assess how parent and adolescent emotion-related behaviors related to adolescents' depression and anxiety symptoms. RESULTS: Adolescents' conflict behaviors were not associated with their psychopathology symptoms. Parent conflict behaviors of support and withdrawal were both negatively associated with adolescent depression and anxiety, with parent contempt marginally associated with adolescent depression. CONCLUSIONS: In this clinical sample, parents of adolescents with low mood or anxiety demonstrated some reduced negative parenting behaviors (i.e., contempt and withdrawal), but also reduced positive parenting behavior (i.e., support). The results suggest that when some negative parenting behaviors are reduced, this may inadvertently reinforce depressive behaviors. The results also indicate the importance of increasing supportive parent behaviors.


Asunto(s)
Conducta del Adolescente , Padres , Adolescente , Ansiedad , Emociones , Humanos , Relaciones Padres-Hijo , Responsabilidad Parental
19.
J Affect Disord ; 295: 771-780, 2021 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-34517251

RESUMEN

BACKGROUND: Previous COVID-19 pandemic research has focused on assessing the severity of psychological responses to pandemic-related stressors. Little is understood about (a) resilience as a mental health protective factor during these stressors, and (b) whether families from Eastern and Western cultures cope differently. This study examines how individual resilience and family resilience moderate the associations between pandemic-related stressors and symptoms of depression, anxiety, and stress in two culturally distinct regions. METHODS: A total of 1,039 adults (442 from Minnesota, United States, and 597 from Hong Kong) living with at least one family member completed an online survey about COVID-19-related experiences, mental health, individual resilience and family resilience from May 20 to June 30, 2020. Predictors of depression, anxiety, and stress symptoms were examined separately using hierarchical regression analyses. RESULTS: In both regions, pandemic-related stressors predicted higher symptoms of depression, anxiety, and stress. Individual resilience and two domains of family resilience were associated with positive mental health. In Minnesota, higher levels of individual resilience buffered the negative relationship between pandemic-related stressors and depressive symptoms; higher levels of family communication and problem solving also buffered the negative relationship between pandemic-related stressors and stress symptoms. In Hong Kong, higher family-level positive outlook magnified the negative relationship between pandemic-related stressors and anxiety symptoms. CONCLUSIONS: Individual and family resilience is protective against the adverse psychological effects of pandemic stressors, but they vary across cultures and as exposure to pandemic-related stressors increases.


Asunto(s)
COVID-19 , Resiliencia Psicológica , Adulto , Depresión/epidemiología , Salud de la Familia , Hong Kong/epidemiología , Humanos , Salud Mental , Minnesota/epidemiología , Pandemias , SARS-CoV-2 , Estados Unidos
20.
J Marital Fam Ther ; 46(1): 15-29, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31081952

RESUMEN

Anger-related problems have been documented among post-deployed service members who returned home, posing risks to their well-being and increasing distress in their families. Trait mindfulness (acting with awareness, nonjudging, and nonreactivity) has been associated with lower self-reported anger. Using actor-partner interdependence models, we tested the association between trait mindfulness and parental anger observed in parent-child and couple interactions. The sample consisted of 155 dyads of male National Guard/Reserve members who had been recently deployed and returned, and their female non-deployed partners. Results showed that fathers' and mothers' nonreactivity was negatively associated with their own observed anger, indicating that parents who reported higher nonreactivity exhibited lower anger. Mothers' nonreactivity was also negatively associated with observed fathers' anger in the same family such that fathers exhibited lower anger when their female partner reported higher nonreactivity. Nonreactivity facilitates emotion regulation and its cultivation may reduce anger in post-deployed military families.


Asunto(s)
Ira/fisiología , Regulación Emocional/fisiología , Relaciones Familiares , Familia Militar , Personal Militar , Atención Plena , Personalidad/fisiología , Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Relaciones Padres-Hijo , Adulto Joven
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