The Implications of Intergenerational Relationships for Minority Aging: a Review of Recent Literature.

Purpose of Review: This study aims to understand how intergenerational relationships impact minority aging in the USA. We reviewed studies published in the last 5 years that examine both familial and non-familial intergenerational relationships. Recent Findings: Intergenerational relationships can have positive and negative implications for minority aging. Minority older adults benefit most from these relationships when they increase social interaction and/or offer social support by reducing acculturative stress, providing emotional closeness, or increasing access to tangible resources. At the same time, these relationships can be sources of strain as they lead to burden among already disadvantaged groups. Summary: Future studies should explore the impact of intergenerational relations among more diverse subgroups of older adults and identify mechanisms linking intergenerational relationships to health-related outcomes among minority older adults. Further, longitudinal cohort studies and randomized trials are needed to test mechanisms and evaluate the effectiveness of promising intergenerational interventions.

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.

Factors Associated With Health Care Delays Among Adults Over 50 During the COVID-19 Pandemic.

BACKGROUND: Adults over 50 have high health care needs but also face high coronavirus disease 2019 (COVID-19)-related vulnerability. This may result in a reluctance to enter public spaces, including health care settings. Here, we examined factors associated with health care delays among adults over 50 early in the COVID-19 pandemic. METHODS: Using data from the 2020 wave of the Health and Retirement Study (N = 7 615), we evaluated how race/ethnicity, age, geographic region, and pandemic-related factors were associated with health care delays. RESULTS: In our sample, 3 in 10 participants who were interviewed from March 2020 to June 2021 reported delays in medical or dental care in the early stages of the COVID-19 pandemic. Non-Hispanic Whites (odds ratio [OR]: 1.37; 95% confidence interval [CI]: 1.19-1.58) and those of other racial/ethnic backgrounds (OR: 1.31; 95% CI: 1.02-1.67) delayed care more than Non-Hispanic Blacks. Other factors associated with delayed care included younger age, living in the Midwest or West, knowing someone diagnosed with or who died from COVID-19, and having high COVID-19-related concerns. There were no differences in care delays among adults aged > 70; however, among those ≤ 70, those who knew someone diagnosed with COVID-19 were more likely to delay care than those who did not. Additionally, among those ≤ 70, Non-Hispanic Whites and those of other racial/ethnic backgrounds delayed care more than Non-Hispanic Blacks and Hispanics. CONCLUSIONS: There is considerable heterogeneity in care delays among older adults based on age, race/ethnicity, and pandemic-related factors. As the pandemic continues, future studies should examine whether these patterns persist.

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.

Parenting Interventions for Refugees and Forcibly Displaced Families: A Systematic Review.

Globally, an estimated 79.5 million individuals have been displaced, nearly 40% of whom are children. Parenting interventions may have the potential to improve outcomes for displaced families. To investigate this, we conducted a systematic review to identify the types of caregiver or parenting interventions that have been evaluated among displaced families, to assess their efficacy across a range of contexts, and to describe their cultural and contextual adaptations. The review followed PRISMA guidelines. At stage one, all articles describing caregiver/parenting interventions for forcibly displaced families were included to provide a scoping review of the state of the literature. At stage two, only randomized controlled trials (RCTs) and quasi-experimental designs were included, allowing for quantitative analysis of program effects. A total of 30 articles (24 studies) were identified in stage one. 95.8% of these articles were published in the past 10 years. Of these, 14 articles (10 studies) used an RCT or quasi-experimental design to assess program efficacy or effectiveness. Relative to control groups, those assigned to caregiving programs showed significant, beneficial effects across the domains of parenting behaviors and attitudes, child psychosocial and developmental outcomes, and parent mental health. Cultural adaptations and recruitment and engagement strategies are described. The evidence base for caregiving programs for displaced families has expanded in recent years but remains limited. Caregiving/parenting programs show promise for reducing the negative effects of forced displacement on families, but future studies are needed to understand which programs show the greatest potential for scalability.

Resilience of Emerging Adults After Adverse Childhood Experiences: A Qualitative Systematic Review.

INTRODUCTION: Even as children experience adversity, they can become resilient adults, in large part due to their social supports as emerging adults. OBJECTIVE: Authors examine constructs of social support applied to the concept of resilience among emerging adults having experienced adverse childhood experiences (ACE). METHOD: Authors conducted a meta-ethnography with six databases between January 1998 and October 2019. Inclusion criteria were as follows: (i) original peer-reviewed qualitative or mixed-method studies, (ii) sampling adults aged 18-35 years, (iii) reporting at least one ACE as defined by the World Health Organization, (iv) focused on resilience, and (v) in English. Data were collected from six electronic databases (MEDLINE, EMBASE, CINAHL, PsychINFO, Web of Science, and Google Scholar). Studies were appraised using the Critical Appraisal Skills Program Qualitative Checklist. Analysis drew on Bourdieu's constructs of capital following Noblit and Hare's methods. RESULTS: Thirteen studies of 277 emerging adults, aged 18-35 years old (mean 23 years), from six countries, reported resilience as "self-righting" appraisals. These were interdependent of their social supports and within a culturally determined sense of self-reliance. Self-reliance appeared to be a precursor shaping resilience of emerging adults with ACE. Self-reliance may deter self-compassion and, as a self-righting appraisal/capacity, may inhibit accessing social support. CONCLUSION: This review emphasizes the life stage of emerging adulthood regarding the development of self-righting appraisal skills, which, when enabled with reliance, others help to transform ACEs and allow resilience to grow.

Measuring child-rearing goals for parents with young children: A scoping review.

This scoping review summarizes and consolidates the parenting goals for young children captured in existing parent-report measures, and the characteristics of studies that employed them. Five electronic databases were systematically searched to identify original studies that used a self-report measure for parenting goals during the child's first 5 years. Characteristics of the parenting goals measures and the studies that employed them were extracted and synthesized. A deductive approach was used to reduce the parenting goals items across instruments into representative domains. Fourteen original parenting goals measures and their modifications (i.e., 24 unique measures in total) were identified in 44 research articles from 41 original studies. Items from these measures were synthesized into 33 representative domains. Findings will inform the direction of future research and the development of a comprehensive measure of parenting goals for parents with young children that can be applied across cultures, economic backgrounds, informants, and parenting contexts.

Esta revisión exploratoria resume y consolida los objetivos de crianza para los niños pequeños captados en medidas de informes actuales de los padres, así como las características de los estudios que las utilizaron. Se hicieron búsquedas sistemáticas en cinco bases de datos electrónicas para encontrar estudios originales en los que se utilizó un instrumento de medición de autoinforme para los objetivos de crianza durante los primeros cinco años del niño. Se extrajeron y se combinaron las características de las mediciones de los objetivos de crianza y los estudios que las utilizaron. Se usó un método deductivo para reducir los ítems de los objetivos de crianza de los instrumentos en áreas representativas. Se identificaron catorce instrumentos de medición de objetivos de crianza originales y sus modificaciones (p. ej.: 24 instrumentos de medición únicos en total) en 44 artículos de investigación de 41 estudios originales. Los ítems de estos instrumentos de medición se combinaron en 33 áreas representativas. Los resultados indicarán el rumbo de investigaciones futuras y el desarrollo de un instrumento de medición completo de los objetivos de crianza para padres con niños pequeños que se pueda aplicar a diferentes culturales, situaciones económicas, informantes y contextos de crianza.

A Family Systems Perspective of Elder Family Financial Exploitation: Examining Family Context Profiles.

OBJECTIVE: Informed by Family Systems Theory, this study examines the interwoven nature of intergenerational family structures and roles in which elder family financial exploitation (EFFE) takes place. METHOD: Data from a mixed-methods study were utilized to examine patterns of family structures and roles within and across 23 family systems. Participants were non-perpetrator/non-victim concerned family members (CFMs) who had experienced EFFE. RESULTS: Four family context profiles were identified, organized by the number and roles of victim(s) and perpetrator(s) in each family system, including: Single victim, Single perpetrator; Single victim, Multiple perpetrators; Two victims, Single perpetrator; and Two victims, Multiple perpetrators. It is possible for multiple perpetrators to be involved, with up to five perpetrators across three generations in our sample. DISCUSSION: Findings offer insight into the range of intergenerational family structures and roles affected by EFFE. Practitioners are encouraged to understand and address family contexts to improve EFFE intervention outcomes.

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.

Resilience and mental health during the COVID-19 pandemic: Findings from Minnesota and Hong Kong.

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.

The validity of ICD-11 PTSD and Complex PTSD in East Asian cultures: findings with young adults from China, Hong Kong, Japan, and Taiwan.

Background: The ICD-11 classifies posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) as two distinct diagnoses. Few studies have tested the validity of ICD-11 CPTSD in non-Western settings, particularly in Asia. Objective: This study assessed the factorial, concurrent, and discriminant validity of CPTSD symptoms with four samples of young adults from mainland China, Hong Kong, Japan, and Taiwan. Method: Young adults aged 18-24 years were recruited by convenience sampling and provided their data anonymously online. Study measures included the International Trauma Questionnaire (ITQ) to measure PTSD and CPTSD, and measures of childhood adversity, depression, anxiety, age, and sex. Confirmatory factor analysis (CFA) was performed for each sample to evaluate the validity of two CPTSD measurement models. Structural equation modelling (SEM) was used to determine the multivariate associations between study variables for the full sample. Results: A total of 1,346 young adults completed the survey. CFA showed both models of CPTSD examined fit the data well across all four samples. SEM findings showed that number of childhood adversities significantly associated with both PTSD and CPTSD factors; depression significantly associated with CPTSD factors but not PTSD, whereas anxiety significantly associated with both. Conclusions: Study findings provide evidence for PTSD and CPTSD as separate and valid diagnoses in Asia. More cross-cultural comparisons are needed to understand whether risks for either condition differ by geographical or sociocultural norms.

Antecedentes: La CIE-11 clasifica el trastorno de estrés postraumático (TEPT) y el trastorno de estrés postraumático complejo (TEPT-C) como dos diagnósticos distintos. Pocos estudios han probado la validez del TEPT-C de la CIE-11 en escenarios no occidentales, particularmente en Asia.Objetivo: Este estudio evaluó la validez factorial, concurrente y discriminante de los síntomas de TEPT-C de 4 muestras de adultos jóvenes de China continental, Hong Kong, Japón y Taiwán.Método: Fueron reclutados adultos jóvenes entre 18 y 24 años de edad a través de una muestra por conveniencia y proveyeron sus datos en forma anónima en línea. Las mediciones del estudio incluyeron el Cuestionario Internacional de Trauma (ITQ por sus siglas en inglés) para medir TEPT y TEPT-C y mediciones de adversidad en la infancia, depresión, ansiedad, edad y sexo. Se realizó el análisis factorial confirmatorio (CFA por sus siglas en inglés) para cada muestra para evaluar la validez de los dos modelos de medición de TEPT-C. Se usó el modelado de ecuaciones estructurales (SEM por sus siglas en inglés) para determinar las asociaciones multivariadas entre las variables del estudio para la muestra completa.Resultados: un total de 1.346 adultos jóvenes completaron la encuesta. La CFA mostró que ambos modelos de TEPT-C examinados se ajustan bien los datos en las cuatro muestras. Los hallazgos del SEM mostraron que el número de adversidades en la infancia se asociaba significativamente tanto con los factores de TEPT y TEPT-C; la depresión se asociaba significativamente para TEPT-C pero no para TEPT; mientras que la ansiedad se asociaba significativamente con ambos.Conclusiones: los hallazgos del estudio proveen evidencia para TEPT y TEPT-C como dos diagnósticos separados y válidos en Asia. Se necesitan más comparaciones transculturales para comprender si los riesgos de cualquiera de estas condiciones difieren geográficamente o por normas socioculturales.

Translation and validation of the Chinese ICD-11 International Trauma Questionnaire (ITQ) for the Assessment of Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD).

Background: Two stress-related disorders have been proposed for inclusion in the revised ICD-11: Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD). The International Trauma Questionnaire (ITQ) is a bespoke measure of PTSD and CPTSD and has been widely used in English-speaking countries. Objective: The primary aim of this study was to develop a Chinese version of the ITQ and assess its content, construct, and concurrent validity. Methods: Six mental health practitioners and experts rated the Chinese translated and back-translated items to assess content validity. A sample of 423 Chinese young adults completed the ITQ, the WHO Adverse Childhood Experiences International Questionnaire, and the Hospital Anxiety and Depression Scale. Among them, 31 participants also completed the English and Chinese versions of the ITQ administered in random order at retest. Four alternative confirmatory factor analysis models were tested using data from participants who reported at least one adverse childhood experience (ACE; N = 314). Results: The Chinese ITQ received excellent ratings on relevance and appropriateness. Test-retest reliability and semantic equivalence across English and Chinese versions were acceptable. The correlated first-order six-factor model and a second-order two-factor (PTSD and DSO) both provided an acceptable model fit. The six ITQ symptoms clusters were all significantly correlated with anxiety, depression, and the number of ACEs. Conclusions: The Chinese ITQ generates scores with acceptable psychometric properties and provides evidence for including PTSD and CPTSD as separate diagnoses in ICD-11.

Antecedentes: Dos trastornos relacionados con estrés han sido propuestos para su inclusión en la CIE-11 revisada: Trastorno de estrés postraumático (TEPT) y TEPT complejo (TEPTC). El Cuestionario Internacional de Trauma (CIT) esta diseñado para medir TEPT y TEPTC, y ha sido utilizado ampliamente en los países de habla inglesa. Objetivo. El objetivo principal de este estudio fue desarrollar una versión china del CIT y evaluar su validez concurrente, de contenido y constructo.Método: Seis profesionales de salud mental y expertos calificaron los items traducidos al chino y retraducidos para evaluar la validez de contenido. Una muestra de 423 adultos jóvenes chinos completó el CIT, el Cuestionario Internacional de Experiencias Adversas en la Infancia de la OMS y la Escala de Ansiedad y Depresión Hospitalaria. Entre ellos, 31 participantes también completaron las versiones en inglés y chino del CIT administrado en orden aleatorio al realizar la prueba nuevamente. Se probaron cuatro modelos confirmatorios alternativos de análisis factorial utilizando datos de los participantes que informaron al menos una experiencia adversa en la infancia (EAI; N = 314).Resultados: El CIT chino recibió calificaciones excelentes en relevancia y pertinencia. La fiabilidad test-retest y la equivalencia semántica entre las versiones en inglés y chino fue aceptable. El modelo de seis factores de primer orden correlacionado y uno de dos factores de segundo orden (TEPT y DSO) proporcionaron un ajuste aceptable. Los seis grupos de síntomas de CIT se correlacionaron significativamente con ansiedad, depresión y número de EAI.Conclusiones: El CIT chino genera cifras con propiedades psicométricas aceptables y proporciona evidencia para incluir el TEPT y el TEPTC como diagnósticos separados en la CIE-11.

Examining patterns of adversity in Chinese young adults using the Adverse Childhood Experiences-International Questionnaire (ACE-IQ).

Ample evidence supports significant and enduring associations between adverse childhood experiences (ACEs) and negative outcomes later in life. Subsets of ACEs (e.g. childhood maltreatment and household dysfunction) have been examined in Chinese populations, but no known study has comprehensively examined the full constellation of different types of ACEs or patterns of ACE exposure in Chinese samples. As a direct response to the call to establish a global ACEs surveillance framework, this study provides the first translation and validation of the World Health Organization ACE - International Questionnaire (ACE-IQ). Further, patterns of ACE exposure were identified through latent class analysis. The 29-item ACE-IQ was translated and back-translated from English to traditional Chinese to measure exposure to 13 categories of ACEs. The Chinese ACE-IQ demonstrated good content validity; the ACE-IQ domain subscales also showed satisfactory test-retest reliability and semantic equivalence. In a sample of 433 Chinese young adults, three patterns of ACE exposure were uncovered: Low ACEs (65.82%), Household Violence (24.94%), and Multiple ACEs (9.24%). Concurrent exposure to physical abuse, domestic violence, and emotional abuse (i.e. Household Violence) was a novel pattern found in this study sample, and suggests there may be traditional Chinese norms that potentiate risks for violent household environments in the absence of other household risk factors. Findings underscore the importance of examining ACE exposure within local contexts, as children's adverse experiences may be idiosyncratic to geographic, social, and cultural norms.

Media portrayal of a hidden problem: An analysis of Hong Kong newspaper coverage of child maltreatment in 2016.

The news media plays a vital role in providing child protection information and resources, shaping the public's understanding and perceptions of child maltreatment, and exposing system failures and setting policy agendas. To date, little is known about how child maltreatment is portrayed in the media in societies where these issues remain largely hidden and under-recognized. The purpose of the present study was to systematically examine newspaper coverage on child abuse and neglect in Hong Kong in order to assess how child maltreatment is currently presented and framed within public discourse. A total of 579 newspaper reports relevant to child maltreatment from four local newspapers in 2016 were reviewed. Similar to prior findings, cases involving sexual abuse received disproportionately more attention compared with other maltreatment types. The vast majority of news reports focused on specific cases or events, and seldom discussed child maltreatment as a broader social issue. Differences in reporting style and media framing were also compared by newspaper credibility, and for free versus paid newspapers. As a mass communication tool, more guidelines are needed to formulate public messages about child maltreatment that can improve individual, community, and structural capacities to prevent, identify, and respond to children who are victimized by abuse and neglect. This is especially important in jurisdictions where no mandatory reporting framework exists to help identify vulnerable children, and where the majority of child maltreatment is brought to the attention of authorities by families and those living within the child's community.