A Modified Menstrual Attitudes Scale: Heteronormative Attitudes, Sexism, and Attitudes Toward Menstruation in Male and Female Adults.

Social shame and stigma surround menstruation, which may compromise women's health and rights in various contexts. Men's attitudes are particularly important because men often hold positions of power that influence women's experience. This study examined factors associated with menstrual attitudes, including heteronormative attitudes, sexism, and family influences. A cross-sectional Qualtrics panel survey (n = 802; aged 18-44; 50.8% female) was performed. We tested a revised menstrual attitudes scale based on items drawn from previously validated measures. Data were analyzed using a structural equation modeling framework. Factor analysis identified and confirmed a 5-factor model for menstrual attitudes. Men endorsed more negative attitudes toward menstruation than women; however, this difference was largely explained by factors other than gender in the structural equation model. After controlling for family and demographic characteristics, attitudes toward openness and secrecy surrounding menstruation were most strongly associated with gender role expectations and hostile sexism. Benevolent sexism was associated with finding menstruation debilitating, denying menstrual symptoms, and endorsing avoidance of activities during menstruation. Heteronormative and sexist attitudes were associated with more negative menstrual attitudes, while increased menstrual knowledge was associated with more positive menstrual attitudes. The difference in menstrual attitudes between males and females was explained largely by heteronormative attitudes and sexism. This suggests that attitudes toward menstruation are closely linked to social ideals about men and women.

The effects of COVID-19 stressors and family life on anxiety and depression one-year into the COVID-19 pandemic.

The purpose of this study was to examine the effects of Coronavirus (COVID-19)-related stressors and family health on adult anxiety and depressive symptoms 1 year into the pandemic. The sample consisted of 442 adults living in the United States who were recruited via Amazon Mechanical Turk. Data were analyzed using multiple logistic regression. Results indicated that compared to a sample 1 month into the pandemic, participants in the current sample reported worse family health and increases in both positive and negative perceptions of the pandemic on family life and routines. COVID-19 stressors and perceived negative effects of the pandemic on family life increased the odds for moderate-to-severe depression and anxiety while having more family health resources decreased the odds for depression and anxiety symptoms. Participants reported lower odds for worse depression and anxiety since the beginning of the pandemic when they reported more positive family meaning due to the pandemic. The results suggest a need to consider the impact of family life on mental health in pandemics and other disasters.

Validation of the family health scale among heterosexual couples: a dyadic analysis.

BACKGROUND: The Family Health Scale (FHS) is a recently validated comprehensive measure of family health for use in survey research with the potential to also be used as a clinical measure. However, previous research has only validated the FHS among one member of the family rather than multiple family members. The objective of the study was to examine the psychometric properties of the FHS long- and short-form among married and cohabitating partners (dyads). METHOD: The sample for this study was comprised of 482 married or cohabitating heterosexual couples (dyads) who were parents of a child between the ages of 3-13, heterosexual, and living in the United States. Each member of the dyad completed a survey about his or her perception of family health, personal health, childhood experiences, and demographic characteristics. Confirmatory factor analyses (CFA) were conducted to examine the factor structure. Unidimensional, correlational, and second-order factor structures were examined using responses from both partners. The relationships between family health with individual health and demographic covariates were also examined. RESULTS: Women and men reported their family health similarly. The unidimensional factor structure had the best fit for the FHS short-form while either the unidimensional model or the second-order model would be appropriate for the FHS long-form. Household income, individual member mental health, and childhood experiences were associated with family health in the expected direction. CONCLUSION: The results demonstrate that the FHS is a valid and reliable family measure when examining family health among dyads including married and cohabitating heterosexual couples who have children.

Effects of positive and negative childhood experiences on adult family health.

BACKGROUND: The objective of the study was to determine the association between adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) with family health in adulthood. Prior research indicates that ACEs and PCEs affect individual physical and mental health in adulthood. However, little is known about how ACEs and PCEs affect family health. Families develop and function through patterns and routines which are often intergenerational. Therefore, a person's early experiences may influence their family's health in adulthood. METHOD: A survey was administered to 1030 adults through Qualtrics, with participants recruited using quota-sampling to reflect the demographic characteristics of U.S. adults. Participants completed a survey about their childhood experiences, four domains of family health (family social and emotional health processes, family healthy lifestyle, family health resources, and family external social supports), and demographic characteristics. Data were analyzed using structural equation modeling. RESULTS: After controlling for marriage, education, gender, race and age, ACEs were negatively associated with family social and emotional health processes and family health resources when accounting for PCEs; PCEs were positively associated with all four family health domains irrespective of ACEs. CONCLUSION: Childhood experiences affect family health in adulthood in the expected direction. Even in the presence of early adversity, positive experiences in childhood can provide a foundation for creating better family health in adulthood.

Differential effects of internalizing behaviors on academic functioning for girls versus boys: An analysis of developmental cascades from elementary to high school.

Youth's academic and emotional functioning are closely related, yet little is known about the timing and direction of relationships involving internalizing problems, which are characterized by over control of emotions, anxiety, and depression as well as multiple aspects of academic achievement. This study addresses these gaps using data from the Study of Early Child Care and Youth Development (N = 1,048) to examine the processes by which problems in one domain of functioning lead to problems in another, known as a "cascade effect." Results of longitudinal structural equation modeling indicate (a) a direct and indirect negative cascade effect from girls' internalizing problems to their school achievement in high school, (b) a positive contemporaneous association of 9th grade boys' internalizing problems with their cognitive achievement; and (c) ways in which demographic characteristics and adolescent social and maturational processes account for variation in functioning yet do not alter the processes by which the emotional and academic functioning interact. Results are discussed with regard to identifiying adolescents' internalizing problems, gender differences in the effects of internalizing problems on academic functioning, timing of evidence-based interventions, and implications for mental health promotion among girls.

Building a Foundation for Family Health Measurement in National Surveys: A Modified Delphi Expert Process.

INTRODUCTION: Families are the most proximal and powerful context for the development, promotion, and disruption of health of individuals across the life course. Despite families' critical role in health, U.S. nationally representative health surveys lack comprehensive and standardized assessments of family health and functioning. METHODS: To foster research on family health in population surveys, we developed a conceptualization of family health using a modified Delphi process with family health experts. Experts responded online to produce consensus definitions of 'family' and 'family health.' Guided by these definitions, they responded to a survey to create a list of concepts for measurement of family health and ranked the importance and measurability of those concepts. RESULTS: We achieved consensus among 15 family health experts on definitions of 'family' and 'family health.' Thirty-one family health concepts were organized into six domains, then ranked by relevance and importance as follows: (1) "Family relationships" and "family social context" tied for first priority, (2) "family member health, (3) "family health-related practices," (4) "family health resources," and (5) "management of time and activities." DISCUSSION: Social relationships and social environment were prioritized as more essential than other aspects of family environments typically assessed in population surveys, such as health practices and family members' illness and disease. This study develops the scientific groundwork needed to advance routine monitoring of family health in national health surveys and in child/family performance measures.

The longitudinal association between cognitive control capacities, suicidality, and depression during late adolescence and young adulthood.

This study examined the association between cognitive control capacities, suicidal thoughts and attempts, and depressive symptoms during late adolescence and young adulthood. The sample included 4192 participants (55.5% female) from the United States who participated in Waves III (2001-2002; respondent age 18-26 years) and IV (2007-2008; respondent age 24-33 years) of the National Longitudinal Study of Adolescent to Adult Health. Data were analyzed using structural equation modeling. Suicidality in late adolescence predicted depressive symptoms in young adulthood. Depressive symptoms were not predictive of later suicide ideation nor attempts. Working memory was associated with lower depressive symptoms. Higher verbal ability was associated with more suicidal thoughts but not attempts. Internal locus of control was associated with decreased depressive symptoms and suicidal thoughts/attempts in young adulthood. Findings suggest that cognitive control capacities developed in adolescence differentially predict depressive symptoms, suicidal thoughts, and suicide attempts in young adulthood.

WOMEN'S AGE AT FIRST MARRIAGE AND LONG-TERM ECONOMIC EMPOWERMENT IN EGYPT.

Sustainable Development Goal (SDG) 5 calls on nations to promote gender equality and to empower women and girls. SDG5 also recognizes the value of women's economic empowerment, entailing equal rights to economic resources and full participation at all levels in economic decisions. Also according to SDG5, eliminating harmful practices-such as child marriage before age 18-is a prerequisite for women's economic empowerment. Using national data for 4,129 married women 15-43 years who took part in the Egypt Labor Market Panel Survey (ELMPS 1998-2012), we performed autoregressive, cross-lagged panel analyses to assess whether women's first marriage in adulthood (at 18 years or older, as reported in 2006), was positively associated with their long-term post-marital economic empowerment, measured as their engagement in market work and latent family economic agency in 2012. Women's first marriage in adulthood had positive unadjusted associations with their market work and family economic agency in 2012. These associations persisted after accounting for market work and family economic agency in 2006, pre-marital resources for empowerment, and cumulative fertility. Policies to discourage child marriage may show promise to enhance women's long-term post-marital economic empowerment.

Growth in Adolescent Self-Regulation and Impact on Sexual Risk-Taking: A Curve-of-Factors Analysis.

Adolescent self-regulation is increasingly seen as an important predictor of sexual risk-taking behaviors, but little is understood about how changes in self-regulation affect later sexual risk-taking. Family financial stress may affect the development of self-regulation and later engagement in sexual risk-taking. We examined whether family financial stress influences self-regulation in early adolescence (age 13) and growth in self-regulation throughout adolescence (from age 13-17 years). We then assessed the effects of family financial stress, baseline self-regulation, and the development of self-regulation on adolescent sexual risk-taking behaviors at age 18 years. Using a curve-of-factors model, we examined these relationships in a 6-year longitudinal study of 470 adolescents (52% female) and their parents from a large northwestern city in the United States. Results indicated that family financial stress was negatively associated with baseline self-regulation but not with growth in self-regulation throughout adolescence. Both baseline self-regulation and growth in self-regulation were predictive of decreased likelihood of engaging in sexual risk-taking. Family financial stress was not predictive of later sexual risk-taking. Intervening to support the development of self-regulation in adolescence may be especially protective against later sexual risk-taking.

Family Financial Stress and Adolescent Sexual Risk-Taking: The Role of Self-Regulation.

The ability to control one's emotions, thoughts, and behaviors is known as self-regulation. Family stress and low adolescent self-regulation have been linked with increased engagement in risky sexual behaviors, which peak in late adolescence and early adulthood. The purpose of this study was to assess whether adolescent self-regulation, measured by parent and adolescent self-report and respiratory sinus arrhythmia, mediates or moderates the relationship between family financial stress and risky sexual behaviors. We assessed these relationships in a 4-year longitudinal sample of 450 adolescents (52 % female; 70 % white) and their parents using structural equation modeling. Results indicated that high family financial stress predicts engagement in risky sexual behaviors as mediated, but not moderated, by adolescent self-regulation. The results suggest that adolescent self-regulatory capacities are a mechanism through which proximal external forces influence adolescent risk-taking. Promoting adolescent self-regulation, especially in the face of external stressors, may be an important method to reduce risk-taking behaviors as adolescents transition to adulthood.

Child Marriage and Intimate Partner Violence in Rural Bangladesh: A Longitudinal Multilevel Analysis.

Child marriage (before age 18) is a risk factor for intimate partner violence (IPV) against women. Worldwide, Bangladesh has the highest prevalence of IPV and very early child marriage (before age 15). How the community prevalence of very early child marriage influences a woman's risk of IPV is unknown. Using panel data (2013-2014) from 3,355 women first married 4-12 years prior in 77 Bangladeshi villages, we tested the protective effect of a woman's later first marriage (at age 18 or older), the adverse effect of a higher village prevalence of very early child marriage, and whether any protective effect of a woman's later first marriage was diminished or reversed in villages where very early child marriage was more prevalent. Almost one-half (44.5 %) of women reported incident physical IPV, and 78.9 % had married before age 18. The village-level incidence of physical IPV ranged from 11.4 % to 75.0 %; the mean age at first marriage ranged from 14.8 to 18.0 years. The mean village-level prevalence of very early child marriage ranged from 3.9 % to 51.9 %. In main-effects models, marrying at 18 or later protected against physical IPV, and more prevalent very early child marriage before age 15 was a risk factor. The interaction of individual later marriage and the village prevalence of very early child marriage was positive; thus, the likely protective effect of marrying later was negated in villages where very early child marriage was prevalent. Collectively reducing very early child marriage may be needed to protect women from IPV.

Maternal Emotion Regulation and Adolescent Behaviors: The Mediating Role of Family Functioning and Parenting.

Prior research links poor maternal emotion regulation to maladaptive parenting and child behaviors, but little research is available on these relationships during the adolescent period. We use structural equation modeling to assess the influence of poor maternal emotion regulation, measured as emotional reactivity and distancing, on adolescent behaviors (measured as aggression and prosocial behaviors) among 478 adolescents (53 % female; baseline age 10-13 years) and their mothers over a 5 year period. We also tested the possible mediating roles of family functioning and parenting behaviors between maternal emotion regulation and adolescent behaviors. Results indicated that higher baseline maternal emotional distancing and reactivity were not directly predictive of adolescents' behaviors, but they were indirectly related through family functioning and parenting. Specifically, indulgent parenting mediated the relationship between maternal emotional reactivity and adolescent aggression. Maternal-reported family functioning significantly mediated the relationship between maternal emotional distancing and adolescent aggression. Family functioning also mediated the relationship between emotional distancing and regulation parenting. The results imply that poor maternal emotion regulation during their child's early adolescence leads to more maladaptive parenting and problematic behaviors during the later adolescent period. However, healthy family processes may ameliorate the negative impact of low maternal emotion regulation on parenting and adolescent behavioral outcomes. The implications for future research and interventions to improve parenting and adolescent outcomes are discussed.

Women's age at first marriage and postmarital agency in Egypt.

Early - or child - marriage (before age 18) may diminish women's ability to exercise agency, or their capacity to act upon their goals. Using a propensity score adjustment approach, we analyzed data from 2394 married women ages 35-49 years who participated in the 2006 Egypt Labor Market Panel Survey (ELMPS). We examined whether women's first marriage at age 18 or older was associated with their post-marital agency, measured in terms of their influence in family decisions, freedom of movement in public spaces, and unfavorable views about intimate partner violence against wives. In bivariate analyses, women's age at first marriage was positively associated with their decision-making and more equitable gender attitudes. However, once we controlled for selection into age-at-first-marriage groups, there were no significant differences between the two age-at-first-marriage groups in any dimension of women's agency. We examined the sensitivity of the non-significant age-at-first-marriage effects to possible violations of the strong ignorability assumption and the results did not alter our conclusions. The assumption that women's age at first marriage is a proxy for their post-marital agency, as defined here, warrants further study.

Maternal executive function and stress and children's behavior problem treatment outcomes.

This prospective, observational study was designed to investigate the relationship of mothers' executive function capacities and parenting stress to early dropout, appointment attendance, and outcomes of in-clinic delivery of parent management training to address children's behavior problems. We hypothesized that mothers' executive functions (EFs) would be prospectively and positively associated with adherence to children's behavioral treatment appointments and reduction in children's behavior problems and that mothers' stress levels would be inversely related to these outcomes. Mothers (n = 288) completed the Behavior Rating Inventory of Executive Function for Adults (EF) and Parenting Stress Index at the beginning of treatment. Children were 2-12 years old. Regression models evaluated the extent to which deficits in maternal EF and clinical levels of parenting stress contributed to the three outcomes. The 11% of mothers with clinically significant deficits in executive functioning were significantly (3 times) more likely to drop out early compared to mothers in the normal range. Almost one third of mothers reported clinically significant parenting stress. Their children were half as likely to achieve a positive behavior outcome, although stress was not significantly associated with attendance. Remaining in treatment is fundamental to being able to learn and practice the parenting skills necessary to manage young children's age-inappropriate behavior in positive ways. Clinical consideration of mothers' EF challenges may help prevent early treatment attrition and clinical management of parenting stress may further help improve children's treatment outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

U.S. Physicians' Training and Experience in Providing Trauma-Informed Care in Clinical Settings.

Trauma-informed care (TIC) is a comprehensive approach that focuses on the whole individual. It acknowledges the experiences and symptoms of trauma and their impact on health. TIC prioritizes physical and emotional safety through a relationship of trust that supports patient choice and empowerment. It provides a safe and respectful healing environment that considers specific needs while promoting a greater sense of well-being, patient engagement, and partnership in the treatment process. Given the prevalence of trauma, this descriptive cross-sectional study examined the attitudes and perspectives of U.S. physicians (N = 179; 67% males; 84% White; 43% aged 56-65) in providing trauma-informed care using an anonymous 29-item online survey administered by Reaction Data. Findings showed that 16% (n = 18) of physicians estimated that >50% of their patients have a history of trauma. Commonly perceived barriers to providing TIC were resource/time/administrative constraints, provider stress, limited awareness of the right provider to refer patients who experienced trauma, and inadequate TIC emphasis in medical education/training. Expanding physicians' knowledge base of trauma through training and organizational policy/support is crucial in enhancing their TIC competence, particularly in caring for patients with complex care needs whose social determinants increase their risk of exposure to adverse experiences that carry lasting physical and psychological effects.

Influence of Social Media Uses and Gratifications on Family Health among U.S. Parents: A Cross-Sectional Study.

Some research suggests that parents on social media have access to greater social support and health information. However, evidence also connects parental social media use to negative outcomes including increased parental stress, depression, and distraction. Using the uses and gratification theory, this study goes beyond measures of parents' individual mental health and explores social media use and its association with family well-being. Family health outcomes were predicted to vary with parents' use and gratifications of social media, with parents who use social media primarily for information and connection scoring higher on family health and parents who used social media for entertainment scoring worse on family health. The sample included 482 heterosexual married or cohabiting partners recruited through a Qualtrics panel. All participants were parents of children ages of 3-13, with mothers and fathers each completing the survey. Findings indicated that fathers' use of social media for entertainment and connecting with family and friends was associated with better family well-being and health resources (p < 0.01). However, mothers' use of social media did not have a statistically meaningful relationship with family health variables. There was no evidence that parental social media use was associated with negative family health outcomes. Longitudinal data is needed to determine the temporal relationship between social media use and family health. Public health professionals interested in improving family health may consider how to better reach fathers on social media to increase health resources.

Understanding the relationship between domestic and intimate partner violence, adverse childhood experiences, and chronic opioid use disorder: The patient perspective.

INTRODUCTION: Opioid dependence and misuse are a plague of epidemic proportions in our communities and globally. Prior trauma in childhood may contribute to opioid dependence, while one consequence of opioid misuse is increased risk for involvement as both perpetrators and victims in domestic and intimate partner violence (DV and IPV). The aims of this study were to understand the proportion of patients who identified as having an opioid use disorder (OUD), if OUD was associated with higher rates of DV and IPV as both perpetrators and victims, and whether adverse childhood experiences (ACEs) as well as demographic factors related to instability in their social life were higher among those with OUD compared to those without. METHODS: The sample consisted of 124 patients who were identified as having an OUD in their medical records based on ICD-10 codes. Each participant completed an anonymous survey about basic demographics, their alcohol, drug, and opioid intake, and their history of domestic and IPV. Descriptive statistics, univariate, and multivariate regression analyses were conducted in STATA 17.1 software. RESULTS: A sample of patients with an OUD diagnosis in their medical record found that 64 percent of patients acknowledged having a history of opioid addiction. Patients acknowledging OUD were more likely to not be married (divorced or single) (p < 0.01), younger than 50 years of age (p < 0.01), non-White (p < 0.01), and had higher average ACEs scores (p < 0.0X). Patients who reported OUD were also more likely to be both victims and perpetrators of DV/IPV compared to patients who denied OUD. DISCUSSION: OUD needs to be treated holistically to ensure that the adverse consequences of DV and IPV do not become a silent disease perpetuated on this population, their families, and society.

Positive adult experiences as turning points for better adult mental health after childhood adversity.

Background: The purpose of this study was to examine whether positive adult experiences (PAEs) were associated with lower odds for anxiety and depression even in the presence of high adverse childhood experiences (ACEs) or low positive childhood experiences (PCEs). Methods: The sample was comprised of 435 adults (48% female), ages 18-56 years and who were living in the United States. Participants completed a survey about their childhood experiences, PAEs, and mental health. A series of multiple logistic regression models were estimated in Stata 17 to examine the aims. Results: Positive childhood experiences were associated with higher PAE scores, but ACEs did not significantly correlate with PAEs. Positive adult experiences were associated with lower odds of moderate-to-severe anxiety and depression, especially among those who had experienced high ACEs or low PCEs. Younger adults were more likely to experience a positive benefit from PAEs compared to adults 35 years and older. Conclusion: Even when ACEs were high or PCEs were low, adults with high PAEs had lower odds for moderate-to-severe anxiety and/depression. Positive adult experiences may be an opportunity to turn the tide for individuals who experienced childhood adversity and/or low levels of support or connection.

The Association of COVID-19 Stressors and Family Health on Overeating before and during the COVID-19 Pandemic.

Prior studies have examined how stress and the family environment affect overeating, but less is known about how COVID-19 stressors and family health may affect overeating during the COVID-19 pandemic. The research questions included: (1) Did COVID-19-related stressors increase the risk for overeating among adults in the United States? (2) Did family health protect against overeating during a pandemic? The sample included 443 participants aged 18 years and older living in the United States who were recruited via Amazon Mechanical Turk. Stata version 16 was used to analyze the data using multiple linear regression. The results indicate that one year into the pandemic, COVID-19 stressors were associated with increased overeating, even after adjusting for overeating before the pandemic. More family health resources were associated with less overeating. These results indicate that although COVID-19 stressors were associated with overeating, greater family health resources helped prevent overeating. Interventions and policies that aim to increase health resources for families may be particularly beneficial at preventing overeating and obesity in the face of long- and short-term stress.

Examining relationships between positive and adverse childhood experiences with physical and mental health indicators in a low-income adult sample.

BACKGROUND: Emerging research on positive and adverse childhood experiences (PCEs and ACEs) indicates that both may be important to adult health, but little is understood about the pathways through which childhood experiences affect adult health. OBJECTIVE: The aims of this study were to 1) examine how shame may mediate the relationship between childhood experiences and health, and 2) whether PCEs moderated the relationship between ACEs, shame, and adult health. PARTICIPANTS AND SETTING: The sample consisted of 206 low-income adults ages 18-55 who were living in a community in the Intermountain West. METHODS: Participants were recruited at a local food bank and community center where various services for low-income residents were offered. Each participant completed a 15-20-minute survey. The data were analyzed using a structural equation modeling (SEM) framework. RESULTS: Shame mediated the relationship between both ACEs and PCEs with depression in the expected direction. Among participants with low-to-moderate PCEs, ACEs were directly associated with shame and tobacco usage. Among participants with high PCEs, ACEs were not associated with shame, depression, nor stress, and the relationship between ACEs and tobacco usage was attenuated. CONCLUSION: Shame may be an important pathway through which childhood experiences affect adult health. Additionally, promoting high levels of PCEs may mitigate the negative effects of early adversity on adult health.