Preventing child mental health problems through parenting interventions in Southeastern Europe (RISE): Protocol for a multi-country cluster randomized factorial study.

BACKGROUND: Child mental health problems continue to be a major global concern, especially in low- and middle-income countries (LMICs). Parenting interventions have been shown to be effective for reducing child behavior problems in high-income countries, with emerging evidence supporting similar effects in LMICs. However, there remain substantial barriers to scaling up evidence-based interventions due to limited human and financial resources in such countries. METHODS: This protocol is for a multi-center cluster randomized factorial trial of an evidence-based parenting intervention, Parenting for Lifelong Health for Young Children, for families with children ages 2-9 years with subclinical levels of behavior problems in three Southeastern European countries, Republic of Moldova, North Macedonia, and Romania (8 conditions, 48 clusters, 864 families, 108 per condition). The trial will test three intervention components: length (5 vs. 10 sessions), engagement (basic vs. enhanced package), and fidelity (on-demand vs. structured supervision). Primary outcomes are child aggressive behavior, dysfunctional parenting, and positive parenting. Analyses will examine the main effect and cost-effectiveness of each component, as well as potential interaction effects between components, in order to identify the most optimal combination of program components. DISCUSSION: This study is the first factorial experiment of a parenting program in LMICs. Findings will inform the subsequent testing of the optimized program in a multisite randomized controlled trial in 2021. TRIAL REGISTRATION: NCT03865485 registered in ClinicalTrials.gov on March 5, 2019.

[Victims of Acts of Violence during the Procedure of the Victim Reparation Law - Characteristics of the Affected, Acts, Perpetrators and Predictors for the Period Until Claim of Help Provided by Law]. / Opfer von Gewalttaten im Verfahren nach dem Opferentschädigungsgesetz.

AIM OF THE STUDY: Coping with psychological trauma plays a central role in victims of acts of violence. The Victim Reparation Law (in German: Opferentschädigungsgesetz, OEG) provides services for the reparation of participation. To further improve the care of the affected persons, the characteristics of the victims were determined in relation to the acts and the perpetrators. METHOD: 312 OEG-files of adult victims were sighted. On the basis of a system of categories, demographic data, trauma specific and health-related characteristics of the victims, relevant characteristics of the perpetrators and the violence, as well as predictors for the time difference between the violent act and the application were determined. RESULTS: Mostly women (71%) were affected by acts of violence. 49% of the affected persons suffered from physical and 87% from psychological impairment (64% of these from a posttraumatic stress disorder). 55% of the acts of violence were sex crimes, 47% were bodily injuries and in 44% additional psychological abuse existed. The perpetrators were often connected to the victims. 42% of the offenses concerned domestic violence. Time difference between the act of violence and the request for help which is provided by law variated between 0 and 52 years. 50% made use of help within one year, further 15.2% within five years. In 34.3% of cases, time difference was longer than 5 years. In case of serial and severe traumatizations, depression and close connections between victim and perpetrator help provided by law was called for only late. CONCLUSION: Many victims of acts of violence acts are psychologically traumatized. In order to prevent a traumatization from becoming a permanent health disorder, the offering of early evidence-based specialist or psychological acute therapy (e. g., in trauma outpatient clinics) ought to be optimized.

[Minor Victims of Violent Acts in the Context of the Victim Reparation Law]. / Minderjährige Opfer von Gewalttaten im Verfahren des Opferentschädigungsgesetzes.

Objective: A descriptive analysis of victim compensation applications for children and adolescents as well as sociodemographic and trauma-specific information concerning victims and perpetrators. Method: We did analysis of 100 victim-compensation application files based on a self-developed category system. Results: The files included solely interpersonal trauma, 59 % of which are type II trauma. The most frequent form is sexual violence. The perpetrators stem mostly from children's homes or peripherals. 79 % of the victims received a diagnosis of a mental disorder, most often posttraumatic stress disorder. Conclusions: Sexually abused children and adolescents make up the majority of the target population in OEG-related trauma outpatient units. Such outpatient units should therefore offer a specific expertise in treating sexually abused children and adolescents.

[Differences in relationship quality and dyadic coping for attachment-related couple types]. / Unterschiede in der Partnerschaftsqualität und im dyadischen Coping bei verschiedenen bindungsbezogenen Paartypen.

Attachment is associated with important relationship characteristics. Based on partners' scores of attachment dimensions anxiety and avoidance a cluster analysis with 304 couples was conducted and it was examined whether attachment-related couple types differ in self-reported relationship quality and dyadic coping. 3 couple types were identified: secure couples (N=114, both partners with low scores on anxiety and avoidance), fearful-avoidant couples (N=62, both partners with higher scores on both attachment dimensions than secure couples) and mixed-couples (N=128, men with higher anxiety scores than women). Secure couples reported better relationship quality as well as more positive and less negative dyadic coping compared to fearful-avoidant and mixed couples. Findings are discussed regarding the inclusion of partners' attachment characteristics in diagnostics and marital therapy.

Fear of progression in partners of chronically ill patients.

Fear of progression (FoP) is one of the most prevalent symptoms in cancer patients. This chronic disease does not only have a profound impact on patients, but also on their spouses. The aim of this study was to evaluate the psychometric properties of a spouse FoP questionnaire (FoP-Q-SF/P) in 227 partners of chronically ill patients (breast cancer, prostate cancer, and diabetes mellitus) in Germany. Estimates of reliability were high (α = 0.88). The original one-factor structure of the FoP-Q-SF for patients was replicated. We used the Hamilton Anxiety and Depression Scale, Impact of Event Scale-revised, Short Form-8 Health Survey, Quality of Marriage Index, Partnership Questionnaire, and Dyadic Coping Inventory to validate the FoP-Q-SF/P. Significant positive correlations were found for anxiety, hyperarousal and intrusion (r > .61) as well as for depression and avoidance (r > .51). Partners of patients with cancer reported significantly higher levels of FoP than did partners of patients with diabetes mellitus. The FoP-Q-SF/P is a reliable and valid instrument that can be recommended for further use in research and clinical care.

Perceived impact of socially anxious behaviors on individuals' lives in Western and East Asian countries.

The current study compared the predicted social and career impact of socially withdrawn and reticent behaviors among participants from Western and East Asian countries. Three hundred sixty-one college students from 5 Western countries and 455 students from 3 East Asian countries read hypothetical vignettes describing socially withdrawn and shy behaviors versus socially outgoing and confident behaviors. Participants then answered questions following each vignette indicating the extent to which they would expect the subject of the vignette to be socially liked and to succeed in their career. Participants also completed measures of their own social anxiety and quality of life. The results indicated significant vignette-by-country interactions in that the difference in perceived social and career impact between shy and outgoing vignettes was smaller among participants from East Asian countries than from Western countries. In addition, significant negative correlations were shown between personal level of shyness and experienced quality of life for participants from both groups of countries, but the size of this relationship was greater for participants from Western than East Asian countries. The results point to the more negative impact of withdrawn and socially reticent behaviors for people from Western countries relative to those from East Asia.

The effects of two different incentives on recruitment rates of families into a prevention program.

This study experimentally manipulated two incentives for participation (monetary: paid participation for sessions and setting: group vs. individual) in a child behavior problem prevention program to analyze their effects on recruitment and retention of families. A population of 690 eligible families from 15 preschools located in socially disadvantaged neighborhoods was invited to participate in a parent training (PT) program. The study recruited parents by using advertisements that had information describing only the indicated condition (i.e., PT in group-unpaid, or PT individual-unpaid, or PT in group-paid, or PT individual-paid). Results demonstrate significant impact of payment on recruitment and initial attendance. Training setting alone (individual or group) did not significantly influence these rates. Editors' Strategic Implications: A compelling case is made for the utility of monetary incentives to increase proportions of low-income families in prevention research and programs. Evaluators and program designers should note the impressive use of the experimental design and hierarchical linear modeling to test the effects on recruitment.

Cognitive assessment of social anxiety: a comparison of self-report and thought listing methods.

The goal of the present study was to compare 2 cognitive assessment methods for social anxiety: a thought listing and a self-report method. The focus of this study was on the convergent and divergent validity of these methods using a multi-trait multi-method approach. Furthermore, treatment sensitivity was explored. Fifty-eight patients with social phobia completed thought listings followed by 2 different social stress tasks before and after an exposure group treatment (n = 33), or following a waiting period (n = 25). One task consisted of speaking in front of 2 confederates while the other task involved initiating a conversation with an opposite-sex confederate. Two questionnaires measuring positive and negative self-statements regarding public speaking and social interactions were also completed. To compare the balance of positive and negative thoughts, the State of Mind ratio [positive thoughts/(positive+negative thoughts)] was calculated for both cognitive assessment methods. Results demonstrate that methods related to social interaction anxiety showed better convergent validity than methods related to public speaking anxiety; however, public speaking methods captured treatment effects better than methods related to social interaction anxiety. This study questions the common assumption that different cognitive assessment methods measure the same construct.