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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Correction to: Coercive Parenting Mediates the Relationship between Military Fathers' Emotion Regulation and children's Adjustment.

The original version of this article unfortunately contained a mistake.

The Physiological Regulation of Emotion During Social Interactions: Vagal Flexibility Moderates the Effects of a Military Parenting Intervention on Father Involvement in a Randomized Trial.

To make prevention programs more effective and understand "what works for whom," evidence regarding what individual characteristics predict intervention responsiveness is needed. Previous studies have evaluated a military parent training program known as After Deployment Adaptive Parenting Tools/ADAPT, yet less is understood about the program's varying effects for fathers. We tested the physiological regulation of emotion during social interactions as a moderator predicting fathers' responsiveness in a randomized trial of ADAPT, in which emotion regulation was operationally measured through vagal flexibility (VF; dynamic changes in cardiac vagal tone). Families with a child aged between 4 and 13 years for whom physiological data were gathered (n = 145) were randomly assigned to ADAPT (14-week face-to-face group intervention) or a control group (services as usual). Fathers in these families were National Guard/Reserve members who had been deployed to war in Iraq and/or Afghanistan and recently returned. Prior to the intervention, cardiac data was collected in-home throughout a set of family interaction tasks and VF was operationalized as the changes in high frequency (HF) power of heart rate variability (HRV) from a reading task to a problem-solving task. Parenting behaviors were observed and coded based on theory-driven indicators pre-intervention and at 1-year follow-up. Results of structural equation modeling showed that VF significantly moderated fathers' intervention responsiveness, such that fathers with higher vs. lower VF exhibited more effective parenting at 1-year follow-up if they were randomized into ADAPT vs. the control group. This study is the first to demonstrate that parasympathetic vagal functioning may be a biomarker to predict response to a military parenting intervention to enhance parenting in combat deployed fathers. The implications for precision-based prevention are discussed.

Coercive Parenting Mediates the Relationship between Military Fathers' Emotion Regulation and children's Adjustment.

Military parents' combat-related posttraumatic stress disorder (PTSD) symptoms have been linked to poor parenting and child maladjustment. Emotion regulation (ER) difficulties are thought to underlie PTSD symptoms, and research has begun to link parental ER to parenting behaviors. Little empirical evidence exists regarding whether fathers' ER is associated with child adjustment and what may be the underlying mechanism for this association. This study investigated whether deployed fathers' ER was associated with child emotional and behavioral problems, and whether the associations were mediated by coercive parenting behaviors. The sample consisted of 181 deployed fathers with non-deployed female partners and their 4- to 13-year-old children. Families were assessed at three time points over 2 years. ER was measured using a latent construct of fathers' self-reports of their experiential avoidance, trait mindfulness, and difficulties in emotion regulation. Coercive parenting was observed via a series of home-based family interaction tasks. Child behaviors were assessed through parent- and child-report. Structural equation modeling revealed that fathers with poorer ER at baseline exhibited higher coercive parenting at 1-year follow-up, which was associated with more emotional and behavioral problems in children at 2-year follow-up. The indirect effect of coercive parenting was statistically significant. These findings suggest that fathers' difficulties in ER may impede their effective parenting behaviors, and children's adjustment problems might be amplified as a result of coercive interactions. Implications for the role of paternal ER on parenting interventions are discussed.

Bidirectional Relations Between Parenting Practices and Child Externalizing Behaviors in Formerly Homeless Families: A Random-Intercept Cross-Lagged Panel Analysis.

OBJECTIVE: This study examined the bidirectional relation between effective parenting practices and externalizing problems in children in homeless families. DESIGN: The sample comprised 223 children (M = 8.12 years) in 137 families living in temporary supportive housing, who participated in the Early Risers conduct problems prevention program lasting 2 years. Video-recorded observations of parent-child interactions were collected and rated by trained observers to assess effective parenting practices. Child externalizing problems were reported by their school teachers. Both variables were assessed at baseline prior to intervention and at 1- and 2-year post-baseline. RESULTS: Child externalizing problems at baseline were negatively associated with effective parenting from baseline to year 1 as well as from year 1 to year 2. Observed effective parenting practices at year 1 were negatively associated with child externalizing problems from year 1 to year 2. CONCLUSIONS: These findings underscore the presence of bidirectional influence processes between parents and children in high-risk families. Implications for intervention programs for high-risk families are discussed.