Linking child adjustment difficulties with mother's maladaptive parental behavior: The mediating roles of parental cognitions and parenting stress.

Child abuse is prevalent worldwide, with most of the burden in developing countries. To reduce and prevent child abuse occurrence, many efforts are directed toward reducing maladaptive parental behaviors (MPBs), a predictor of parents' risk of engaging in child abusive behaviors. MPBs have been associated with child (e.g., behavioral difficulties) and parent characteristics (e.g., parenting stress and parental cognitions), although little research tested for mediational pathways. This study aimed to test the pathways through which child and parent characteristics are linked to MPB. Consistent with the social information processing model of parenting, we hypothesized that child behavioral difficulties would exert an indirect influence on MPB through parenting stress and that parenting stress will exert a direct and indirect effect on MPB through parental cognitions (i.e., expectations, attitudes, and attributions). This study used data from 243 mothers of children aged between 2 and 9 years in Romania. Two-stage structural equation modeling was employed to test the hypothesized model. Results support the role of child behavior, parenting stress, and parental cognitions in predicting MPB (R2 = 0.69). Significant indirect effects were found from child behavior to MPB via parenting stress and parental cognitions. Direct effects from parenting stress and parental cognitions to MPB were significant. Findings show that parenting stress and parental cognitions are important mechanisms through which child behavioral difficulties influence maladaptive parental behavior, underscoring the need to focus on these mechanisms when assessing or intervening with families at risk for child abuse.

Family-focused intervention to promote adolescent mental health and well-being in Moldova and North Macedonia (FLOURISH): feasibility study protocol.

INTRODUCTION: Family-Focused Adolescent & Lifelong Health Promotion (FLOURISH) project will adapt, implement and evaluate a programme to support adolescent mental health and well-being through strategies, such as strengthening parenting practices, adolescent-caregiver relationships, adolescent and parent socioemotional skills, and social support. METHODS AND ANALYSIS: The project will focus on adolescents aged 10-14 years and their caregivers in North Macedonia and Moldova. The countries were selected based on implementation readiness of two organisations and a need for accessible evidence-informed services to help mitigate health risks due to economic, social and political challenges. Parenting for Lifelong Health (PLH) for Parents and Teens is a family-based programme developed for low-resource settings. PLH has been adapted with input from advisory groups. The programme includes additional components to strengthen impacts on adolescents: adolescent mental health tools, based on UNICEF's Helping Adolescents Thrive, adolescent peer support and participation booster. This pilot is first of three study phases. The pilot will be a feasibility testing of the adapted intervention and the assessment and implementation procedures to determine further refinements. The pilot will examine if the adapted programme is acceptable for adolescents, their families and providers, explore contextual factors relevant to embedding this programme into longer-term scale-up and investigate whether the programme can be delivered with fidelity and participation; whether the participants report changes in adolescent emotional and behavioural problems, well-being and other outcomes; and whether the study tools are feasible and appropriate. Pre-post adolescent and caregiver questionnaires will provide outcome data. Process evaluation will include attendance and fidelity data, and focus groups. We will examine delivery cost and resource requirements. ETHICS AND DISSEMINATION: The study was approved at the University of Klagenfurt (Austria), Medical Faculty at St. Cyril and Methodius University (North Macedonia) and National Committee of Ethical Expertise for Clinical Trials (Moldova). Through stakeholder engagement and dissemination, FLOURISH will advance scale-up of open-source family interventions. TRIAL REGISTRATION NUMBER: Trial registration: ID101095528; project page: https://www.flourish-study.org/about.html; https://www.linkedin.com/company/flourish-study/.

Co-Occurrence of Intimate Partner Violence Against Mothers and Maltreatment of Their Children With Behavioral Problems in Eastern Europe.

This study investigates the co-occurrence of intimate partner violence (IPV) against mothers and their risk of perpetrating child maltreatment (CM) in North Macedonia, the Republic of Moldova, and Romania. Risk factors for IPV, CM, and their co-occurrence were identified. Two samples (N1 = 112, N2 = 701) of mothers with children with behavioral problems were assessed. IPV was reported by 64% of mothers, CM by 96%, and their co-occurrence by 63%. Mothers exposed to emotional IPV reported more physical and emotional CM. Mothers exposed to physical IPV reported more physical CM. Mothers own history of CM and offspring's behavior problems were associated with IPV and CM co-occurrence.

Long-term Adverse Outcomes Associated With Teen Dating Violence: A Systematic Review.

CONTEXT: Evidence suggests that teen dating violence (TDV) is associated with long-term adverse outcomes, but these associations have not been systematically assessed. OBJECTIVES: To conduct a systematic review of the longitudinal associations between TDV and negative outcomes, including mental and physical health, reoccurrence of violence in intimate relationships, and high-risk behaviors (substance use and sexual behaviors). DATA SOURCES: Peer-reviewed articles published in English were searched in PsycINFO/Eric/PsycArticles, PubMed, and Web of Science database from inception to November 2022. STUDY SELECTION: Prospective studies that assessed TDV during adolescence, had a follow-up of at least ≥1 year, and evaluated the associations of TDV with health, violence in romantic intimate relationships, or risk behaviors were included. DATA EXTRACTION: Study characteristics, baseline data, and follow-up outcomes were extracted from included studies. RESULTS: Thirty-eight studies involving 23 unique samples were analyzed. Findings showed that TDV in adolescence was associated with future teen dating and intimate partner violence in adulthood. Studies also indicated that TDV was longitudinally associated with increasing high-risk behaviors (ie, marijuana and alcohol use) and poor mental health outcomes (particularly for victimization). There was unclear evidence on the longitudinal link between TDV and suicidal attempts. Significant associations between TDV and negative outcomes were reported more frequently among females compared with males. LIMITATIONS: Length of follow-up varied across studies. CONCLUSIONS: Dating violence in adolescence may represent a risk factor for a wide range of long-term outcomes. Female adolescents reporting TDV may be at higher risk of adverse outcomes compared with males.

Limitations of benefit finding as a coping mechanism for combat-related PTSD symptoms.

Benefit finding has been identified as a buffer of the combat exposure-PTSD symptom link in soldiers. However, benefit finding may have a limited buffering capacity on the combat-PTSD symptom link over the course of a soldier's post-deployment recovery period. In the present study, soldiers returning from Operation Iraqi Freedom (OIF) were surveyed at two different time periods post-deployment: Time 1 was 4 months post-deployment (n = 1,510), and Time 2 was at 9 months post-deployment (n = 783). The surveys assessed benefit finding, PTSD symptoms, and combat exposure. Benefit finding was a successful buffer of the cross-sectional relationship between combat exposure and PTSD reexperiencing symptoms at Time 1, but not at Time 2. In addition, the benefit finding by combat interaction at time 1 revealed that greater benefit finding was associated with higher symptoms under high combat exposure at Time 2 after controlling for PTSD arousal symptoms at Time 1. The results of the present study indicate that benefit finding may have a buffering capacity in the immediate months following a combat deployment, but also indicates that more time than is allotted during the post-deployment adjustment period is needed to enable recovery from PTSD. Theoretical implications are discussed.

The Role of Intimate Partner Violence, Couple Dissatisfaction and Parenting Behaviors in Understanding Parental Burnout.

Parental burnout (PB), a relatively new and under-studied construct, is defined as a condition resulting from chronic parenting stress. While recent research confirmed its negative associations with familial variables, such as relationship satisfaction and positive parenting practices, little is known about the role of intimate partner violence (IPV) and how it relates to parental burnout. The present study, therefore, aimed to extend existing knowledge on chronic parenting stress by 1) testing for the mediational role of couple dissatisfaction in explaining the link from IPV victimization to PB as well as the link from IPV victimization to dysfunctional parenting, and 2) investigating how specialist gender roles and parental responsibilities for child care relate to IPV victimization and PB. Data collection was part of an international collaboration on factors related to parental satisfaction and exhaustion across different countries. Self-report data from Austrian mothers (N = 121) were collected online and analyzed using structural equation modeling. Results indicated that couple dissatisfaction mediates the link from IPV victimization to PB, as well as IPV victimization to dysfunctional parenting. Furthermore, only specialist gender roles were significantly related to IPV, while parental responsibilities for child care did not significantly relate to experiences of violence. Additionally, neither specialist gender roles nor parental responsibilities were significantly associated with PB in the final model. Overall, our findings connect to family models, such as the Family System Theory and Spillover Theory, underscoring the importance of couples' relationship quality for understanding parental burnout and parenting behaviors in mothers.

Assessment of Psychosocial Programs to Prevent Sexual Violence During Adolescence: A Systematic Review and Meta-analysis.

Importance: Sexual violence is a public health problem that affects adolescents globally. To our knowledge, no meta-analysis of prevention programs for adolescent sexual violence has been conducted. Objective: To perform a systematic review and meta-analysis of randomized clinical trials evaluating the efficacy of psychosocial programs for preventing sexual violence during adolescence. Data Sources: Peer-reviewed articles published in English were searched in PsycINFO, ERIC, PsycArticles, PubMed, and Web of Science databases through December 2021. Study Selection: Studies were included if they were randomized clinical trials assessing the efficacy of a psychosocial prevention program targeting sexual violence and delivered to adolescents aged 10 to 19 years. Data Extraction and Synthesis: Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines were followed to identify studies. The quality of individual studies was assessed with the Revised Cochrane Collaboration Risk of Bias tool. A random-effects model was used to pool odds ratios (ORs). Exploratory subgroup and metaregression analyses were performed to evaluate the associations between moderators and effect sizes. Main Outcomes and Measures: Primary outcomes were perpetration of sexual violence, experience of sexual violence, and a composite measure of any perpetration or experience of sexual violence. Results: Data were analyzed from 20 trials involving 37 294 adolescents. Compared with control conditions, prevention programs were associated with a significant reduction in the perpetration (OR, 0.83; 95% CI, 0.73-0.95; P = .005) and experience (OR, 0.87; 95% CI, 0.78-0.98; P = .02) of sexual violence, as well as a 13% significant reduction of any sexual violence (OR, 0.87; 95% CI, 0.78-0.97; P = .009). Exploratory analyses of the combination of program setting and participant age indicated that programs that were delivered in school settings and targeted at adolescents aged 15 to 19 years yielded significantly larger effect sizes (Cochran Q = 4.8; P = .03) compared with programs that were either delivered outside of a school setting or targeted younger adolescents. Quality assessment of trials revealed concerns of risk of bias across several included studies. Conclusions and Relevance: In this meta-analysis, evidence suggested that prevention programs were associated with reducing adolescent sexual violence, especially when implemented at school with older adolescents. However, there is need for additional high-quality research. Prevention of adolescent sexual violence remains understudied compared with other similarly important public health prevention targets.

Online Health Information Seeking for Self and Child: An Experimental Study of Parental Symptom Search.

BACKGROUND: Parents often search the web for health-related information for themselves or on behalf of their children, which may impact their health-related decision-making and behaviors. In particular, searching for somatic symptoms such as headaches, fever, or fatigue is common. However, little is known about how psychological and relational factors relate to the characteristics of successful symptom-related internet searches. To date, few studies have used experimental designs that connect participant subjective search evaluation with objective search behavior metrics. OBJECTIVE: This study aimed to examine the features of web-based health-related search behaviors based on video-coded observational data, to investigate which psychological and relational factors are related to successful symptom search appraisal, and to examine the differences in search-related outcomes among self-seekers and by-proxy seekers. METHODS: In a laboratory setting, parents living in Austria (N=46) with a child aged between 0 and 6 years were randomized to search their own (n=23, 50%) or their child's (n=23, 50%) most recent somatic symptom on the web. Web-based activity was recorded and transcribed. Health anxiety, eHealth literacy, attitude toward web-based health information, relational variables, state of stress, participants' search appraisals, and quantitative properties of the search session were assessed. Differences in search appraisals and search characteristics among parents who searched for themselves or their children were examined. RESULTS: Across both groups, searches were carried out for 17 different symptom clusters. Almost all parents started with Google (44/46, 96%), and a majority used initial elaborated key phrases with >1 search keyword (38/45, 84%) and performed on average 2.95 (SD 1.83) search queries per session. Search success was negatively associated with health anxiety (rs=-0.39, P=.01), stress after the search (rs=-0.33, P=.02), and the number of search queries (rs=-0.29, P=.04) but was not significantly associated with eHealth literacy (rs=0.22, P=.13). Of note, eHealth literacy was strongly and positively correlated with satisfaction during the search (rs=0.50, P<.001) but did not significantly correlate with search characteristics as measured by search duration (rs=0.08, P=.56), number of performed search queries (rs=0.20, P=.17), or total clicks (rs=0.14, P=.32). No differences were found between parents searching for their own symptoms and parents searching for their child's symptoms. CONCLUSIONS: This study provides exploratory findings regarding relevant dimensions of appraisals for symptom-based information seeking on the web. Consistent with previous literature, health anxiety was found to be associated with poorer search evaluation. Contrary to expectations, eHealth literacy was related neither to search success nor to search characteristics. Interestingly, we did not find significant differences between self-seekers and by-proxy seekers, suggesting similar search and evaluation patterns in our sample. Further research with larger samples is needed to identify and evaluate guidelines for enhanced web-based health information seeking among parents and the general public.

Psychological violence in dating relationships among adolescents: A systematic review and meta-analysis of prevention programs.

Teen Psychological Dating Violence (TPDV) is a serious public health concern. However, there is limited evidence on the capacity of programs to prevent this form of violence. This study aimed to conduct a systematic review and meta-analysis of RCTs to evaluate the efficacy of prevention programs for TPDV. PsycINFO/Eric/PsycArticles, PubMed and Web of Science were searched from inception through January 2021 to identify RCTs of prevention programs for adolescents that reported a measure of TPDV. The effect sizes were computed as the difference between the prevention program and control group at post or follow-up assessment by calculating Hedges's g with a random-effect model. Thirteen trials met inclusion criteria and were included in the meta-analysis. There was a small but significant effect size in favor of the prevention group as compared to the control condition for victimization (g = 0.23; 95% CI, 0.10 to 0.37; p < 0.001) and perpetration (g = 0.24; 95% CI, 0.12 to 0.37; p < 0.001) of TPDV. Overall, the combined effect size for any TPDV perpetration/victimization was 0.22 (95% CI, 0.11 to 0.34; p < 0.001). Exploratory subgroup analysis showed that programs implemented at multiple levels (such as home, school, community) reported significantly larger effect sizes compared to single-level interventions. Significant differences in effect sizes were also associated with the type of scale used to assess TPDV. Current evidence suggests that intervention programs for TPDV may be effective, particularly when implemented at multiple levels. Further research focusing on refining tools to assess TPDV is needed.

Using Dyadic Modeling in Nursing Research: Introduction of Theory and Application.

Use of dyadic modeling in nursing has theoretical and practical importance, as the interpersonal processes related to health behaviors can be captured. Theoretical models focusing on dyadic coping with chronic illness and illness management are established in family nursing. However, few studies utilized dyadic designs in empirical research, as most studies are patient-centric or care partner-centric. With theoretical elaborations and examples, we first review how conventional health models have been extended using a dyadic perspective and then briefly review the major dyadic frameworks in nursing. Five frequently used dyadic models are described with examples from health and nursing research fields. Statistical applications and cultural considerations are reviewed. We conclude that dyadic modeling provides a useful lens for nursing research but continues to be underutilized.

Evaluating the Relationship Between Intimate Partner Violence-Related Training and Mental Health Professionals' Assessment of Relationship Problems.

Intimate partner violence (IPV) is a serious public health problem associated with increased risk of developing mental health conditions. Assessment of IPV in mental health settings is important for appropriate treatment planning and referral; however, lack of training in how to identify and respond to IPV presents a significant barrier to assessment. To address this issue, the World Health Organization (WHO) advanced a series of evidence-based recommendations for IPV-related training programs. This study examines the relationship between mental health professionals' experiences of IPV-related training, including the degree to which their training resembles WHO training recommendations, and their accuracy in correctly identifying relationship problems. Participants were psychologists and psychiatrists (N = 321) from 24 countries who agreed to participate in an online survey in French, Japanese, or Spanish. They responded to questions regarding their IPV-related training (i.e., components and hours of training) and rated the presence or absence of clinically significant relationship problems and maltreatment (RPM) and mental disorders across four case vignettes. Participants who received IPV-related training, and whose training was more recent and more closely resembled WHO training recommendations, were more likely than those without training to accurately identify RPM when it was present. Clinicians regardless of IPV-related training were equally likely to misclassify normative couple issues as clinically significant RPM. Findings suggest that IPV-related training assists clinicians in making more accurate assessments of patients presenting with clinically significant relationship problems, including IPV. These data inform recommendations for IPV-related training programs and suggest that training should be repeated, multicomponent, and include experiential training exercises, and guidelines for distinguishing normative relationship problems from clinically significant RPM.

Efficacy of Interventions to Prevent Physical and Sexual Dating Violence Among Adolescents: A Systematic Review and Meta-analysis.

Importance: Sexual and physical dating violence is prevalent among adolescents and is associated with adverse health effects. Objective: To conduct a systematic review and meta-analysis of randomized clinical trials to assess the efficacy of prevention programs for sexual and physical dating violence in adolescents. Data Sources: Search terms were combined for dating violence, adolescents, and randomized clinical trials in PsycINFO/Eric/PsycArticles, PubMed, and Web of Science databases from inception through April 2021. Study Selection: Included studies had a randomized design of any type examining the efficacy of an intervention to reduce dating violence among adolescents and provided at least 1 measure of sexual or physical dating violence. Data Extraction and Synthesis: Data extraction coded characteristics of trials, participants, and interventions and assessed risk of bias using the Revised Cochrane Collaboration Risk of Bias tool. Outcomes were pooled using a random-effects model. Subgroup and meta-regression analyses were performed to explore the target population and intervention factors associated with positive outcomes. Main Outcomes and Measures: The odds ratio (OR) was calculated for 3 different outcomes: (1) sexual dating violence, (2) physical dating violence, and (3) composite measures of sexual and physical dating violence. For each outcome, separate analyses were conducted for survivorship and perpetration scores. We also combined the scores of physical/sexual violence and perpetration/survivorship of teen dating violence into a single composite overall outcome including all studies. Results: Eighteen trials (22 781 adolescents) were included. Overall, interventions were associated with reduced physical and sexual dating violence (OR, 0.78; 95% CI, 0.69-0.89; P < .001). Separate analyses further indicated that this association was significant for physical violence perpetration (OR, 0.74; 95% CI, 0.59-0.92; P = .01) and survivorship (OR, 0.78; 95% CI, 0.64-0.95; P = .01). For sexual violence, the association was not statistically significant. Exploratory subgroup analyses revealed that trials targeting at-risk youth, older adolescents (age >15 years), and trials involving parents in the intervention reported significantly larger effect sizes. Meta-regression analyses did not show any significant associations between intervention effect sizes and length or intensity of the programs. Publication bias was observed, but the adjusted ORs remained significant. Three studies reported iatrogenic associations. Conclusions and Relevance: Findings from this study suggest that prevention programs may be effective in reducing physical teen dating violence, but there is unclear evidence of the effect on sexual violence outcomes. Further research assessing the active ingredients of interventions, especially in the area of sexual dating violence, is warranted.

Predicting smoking behavior: intention and future self-continuity among Austrians.

Smoking is a major public health problem in Austria, but relevant research and intervention is limited. Based on the Theory of Planned Behavior (TPB), the present study aimed to test the model utility in an Austrian sample. As future self-continuity is likely to impact on health behavior, we also hypothesized an extended TPB with future self-continuity could further explain the variance in smoking. Using a prospective design, 94 current smokers (74.5% women; Mage = 24.27 years; 61.7% daily smokers) from a university in South Austria completed the baseline and follow-up survey (one month after the baseline). Consistent with the TPB, intention and perceived behavioral control (PBC) significantly predicted smoking behavior; affective attitude and PBC were significantly associated with smoking intention. In contrast, cognitive attitude and subjective norm were unrelated to smoking intention. As hypothesized, the TPB explained 42% variance of smoking behavior and 31% variance of smoking intention. Participants' future self-continuity further explained the variance of smoking behavior. Our study demonstrates the utility of the TPB in understanding Austrian smoking behavior. The role of psychological perception of future self among smokers has been highlighted. Future smoking intervention may target PBC, affective attitude, as well as a life-span perspective.

Exploring Mental Health Professionals' Experiences of Intimate Partner Violence-Related Training: Results From a Global Survey.

Intimate partner violence (IPV) is a global public health problem that has been shown to lead to serious mental health consequences. Due to its frequent co-occurrence with psychiatric disorders, it is important to assess for IPV in mental health settings to improve treatment planning and referral. However, lack of training in how to identify and respond to IPV has been identified as a barrier for the assessment of IPV. The present study seeks to better understand this IPV-related training gap by assessing global mental health professionals' experiences of IPV-related training and factors that contribute to their likelihood of receiving training. Participants were French-, Spanish-, and Japanese-speaking psychologists and psychiatrists (N = 321) from 24 nations differing on variables related to IPV, including IPV prevalence, IPV-related norms, and IPV-related laws. Participants responded to an online survey asking them to describe their experiences of IPV-related training (i.e., components and hours of training) and were asked to rate the frequency with which they encountered IPV in clinical practice and their level of knowledge and experience related to relationship problems; 53.1% of participants indicated that they had received IPV-related training. Clinicians from countries with relatively better implemented laws addressing IPV and those who encountered IPV more often in their regular practice were more likely to have received training. Participants who had received IPV-related training, relative to those without training, were more likely to report greater knowledge and experience related to relationship problems. Findings suggest that clinicians' awareness of IPV and the institutional context in which they practice are related to training. Training, in turn, is associated with subjective appraisals of knowledge and experience related to relationship problems. Increasing institutional efforts to address IPV (e.g., implementing IPV legislation) may contribute to improved practices with regard to IPV in mental health settings.

Preventing child mental health problems in southeastern Europe: Feasibility study (phase 1 of MOST framework).

The prevalence of child emotional and behavioral problems is an international problem but is higher in low- and middle-income countries (LMIC) where there are often less mental health supports for families. Parenting programs can be an effective means of prevention, but must be low-cost, scalable, and suitable for the local context. The RISE project aims to systematically adapt, implement, and evaluate a low-cost parenting program for preventing/reducing child mental health problems in three middle-income countries in Southeastern Europe. This small pre-post pilot study is informed by the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework and tested the feasibility of the intervention, the implementation, and evaluation procedures: Phase 1 of the three-phase Multiphase Optimization Strategy (MOST) for program adaptation. Local facilitators delivered the Parenting for Lifelong Health (PLH) for Young Children program to parents of children aged 2-9 in North Macedonia, the Republic of Moldova and Romania in 2018. Parents completed assessments pre- and post-program. Results demonstrated positive pre-post change for participating families (N = 140) on various outcomes including child externalizing and internalizing symptoms and parenting behavior, in all three countries, all in the expected direction. Program participation was associated with positive outcomes in participating families. Based on the experiences of this pilot study, we outline the practical implications for the successful implementation of parenting programs in the three countries that will inform our next study phases, factorial experiment, and RCT.

El predominio de los problemas emocionales y conductuales de los niños es un problema internacional, pero es mayor en los países de ingresos bajos y medios donde generalmente hay menos asistencia para la salud mental de las familias. Los programas de crianza pueden ser un medio de prevención eficaz, pero deben ser de bajo costo, escalables y adecuados para el contexto local. El proyecto RISE tiene como finalidad adaptar, implementar y evaluar sistemáticamente un programa de crianza de bajo costo para prevenir o reducir los problemas de salud mental infantil en tres países de ingresos medios del Sudeste de Europa. Este pequeño estudio piloto previo y posterior está fundamentado por el marco de Alcance, Eficacia, Adopción, Implementación y Mantenimiento (RE-AIM, por sus siglas en inglés) y evaluó la viabilidad de los procedimientos de intervención, de implementación y de evaluación: Fase 1 de la Estrategia de Optimización Multifase (MOST) de tres fases para la adaptación del programa. Un grupo de moderadores locales impartió el programa Crianza para la Salud Durante Toda la Vida (Parenting for Lifelong Health, PLH) para Niños Pequeños a padres de niños de entre 2 y 9 años en Macedonia del Norte, República de Moldavia, y Rumania en 2018. Los padres completaron evaluaciones antes y después del programa. Los resultados demostraron cambios positivos después del programa para las familias participantes (N = 140) en varias respuestas, entre ellas, los síntomas de exteriorización y de interiorización de los niños y la conducta de crianza, en los tres países, todos en la dirección esperada. La participación en el programa estuvo asociada con resultados positivos en las familias participantes. Sobre la base de las experiencias de este estudio piloto, describimos las consecuencias prácticas para la implementación satisfactoria de los programas de crianza en los tres países que servirán como base para las fases de nuestro próximo estudio, del experimento factorial y del ensayo controlado aleatorizado.

The Science of Scale for Violence Prevention: A New Agenda for Family Strengthening in Low- and Middle-Income Countries.

Ending all violence against children by 2030 is a core part of Sustainable Development Goals 5 and 16. A number of promising violence reduction strategies have been identified in research studies. However, we lack an understanding of the implementation and impact of these programs in respect to their delivery at a large scale or within existing service systems, particularly in low- and middle-income countries (LMICs). We advocate for greater collaboration between researchers, policymakers, donors, governments, non-governmental organizations, and program managers and staff to study how violence prevention programs operate on a large scale. We describe a new initiative aiming to foster such collaborations in the field of family strengthening programs.

Interparental Relationship Adjustment, Parenting, and Offspring's Cigarette Smoking at the 10-Year Follow-up.

Familial influences on children's cigarette smoking have been established, yet little is known about whether these influences in childhood relate to offspring's smoking behavior in adolescence. Drawing on prior work showing that children's emotional and behavioral problems (i.e., internalizing and externalizing behavior problems) are influenced by both interparental and parent-child relationships, we examined whether children's emotional and behavioral problems would further predict their smoking behavior in adolescence. Two hundred and twenty-one families were followed from early childhood (Mage  = 4.05 years) to the 10-year follow-up. Interparental relationship adjustment and disagreement, dysfunctional parenting, and children's emotional and behavioral problems were reported by both mothers and fathers. Adolescents' self-reported cigarette smoking status was assessed along with other demographic variables. Using structural equation modeling, the hypothesis was only supported based on mothers' reports, suggesting that early couple relationship adjustment and parenting relate to children's emotional and behavioral problems, which associate with smoking behavior in adolescence. When the hypothesized model was tested with emotional and behavioral problems separately, only behavioral problems were related to adolescent smoking for both parents. Findings from this study support models of family environment and children's behavioral problems, providing evidence of the long-term links with adolescent cigarette smoking behaviors. Further family-focused research and preventive work, for instance, testing the combination of partner support and parent training, are needed.

Se han establecido las influencias familiares en el consumo de cigarrillos de los niños, sin embargo, se sabe poco acerca de si estas influencias en la niñez se relacionan con la conducta de consumo de cigarrillos de los niños en la adolescencia. Teniendo en cuenta trabajos anteriores que demuestran que los problemas conductuales y emocionales de los niños (p. ej.: los problemas de conductas de exteriorización e interiorización) están influenciados tanto por las relaciones interparentales como por las relaciones entre padres e hijos, analizamos si los problemas emocionales y conductuales de los niños predecirían, además, su conducta de consumo de cigarrillos en la adolescencia. Se siguió a doscientas veintiuna familias desde la primera infancia (edad promedio = 4.05 años) hasta el control a los diez años. Tanto las madres como los padres informaron adaptación y desacuerdo en las relaciones interparentales, crianza disfuncional y problemas conductuales y emocionales de los niños. Se evaluó la situación de consumo de cigarrillos autoinformada por los adolescentes junto con otras variables demográficas. Utilizando modelos de ecuaciones estructurales, se respaldó la hipótesis solo sobre la base de los informes de las madres, lo cual sugiere que la adaptación temprana en la relación de pareja y la crianza se relacionan con los problemas emocionales y conductuales de los niños, los cuales se asocian con la conducta de fumar en la adolescencia. Cuando el modelo hipotetizado se probó con problemas conductuales y emocionales por separado, solo los problemas conductuales se relacionaron con el consumo de cigarrillos de los adolescentes para ambos padres. Los hallazgos de este estudio respaldan los modelos de entorno familiar y los problemas conductuales de los niños, ya que ofrecen indicios de los vínculos a largo plazo con las conductas de consumo de cigarrillos en los adolescentes. Se necesitan más investigaciones centradas en la familia y trabajos preventivos, por ejemplo, la evaluación de la combinación de apoyo para padres y de capacitaciones para padres.

Cohabitation, Relationship Stability, Relationship Adjustment, and Children's Mental Health Over 10 Years.

Understanding risk factors for relationship dissolution and poor relationship adjustment among couples has been an active area of research in relationship science. One risk factor, non-marital cohabitation, has shown to predict higher rates of relationship dissolution and relationship instability in some samples, but the associations among German parents with children over time are less clear. In this study, we examined the links between non-marital cohabitation and 10-year outcomes (relationship dissolution, relationship adjustment over time, and child internalizing and externalizing symptoms) in 220 German families with preschool-aged children at the initial assessment followed into adolescence. Families were assessed 7 times over the 10 years and retention at the 10-year follow-up was over 92%. After accounting for multiple testing, only mother's report of better initial interparental communication predicted whether parents were likely to stay together over the course of the 10 years. Adolescents of parents who cohabited were at higher risk for externalizing symptoms 10 years later compared to children of married parents. In addition, although there were no differences between cohabiting couples and married couples at the initial assessment in relationship adjustment, cohabiting mothers who stayed with their partner over the 10 years showed significantly greater declines in relationship adjustment over the 10 years compared to married mothers. Findings indicate the need for further research that explores family structure and dynamics over time to inform refinement of prevention programs targeting relationships and children's mental health.

High sensitivity and specificity screening for clinically significant intimate partner violence.

The U.S. Preventive Services Task Force has recommended that clinicians screen patients for intimate partner violence (IPV). This article aims to develop and test the first screeners for clinically significant physical and psychological IPV (i.e., acts meeting criteria in the International Classification of Diseases (11th ed.; ICD-11; World Health Organization, 2019) and the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013). The goal was to derive screeners that (1) are maximally brief, while still achieving high sensitivity and specificity; (2) assess perpetration and victimization when either men or women are reporting; and (3) use ICD-11/DSM-5 criteria as the reference standard. Random samples of active duty service members at 82 installations worldwide were obtained via e-mail invitation (2006: N = 54,543; 2008: N = 48,909); their response rates were excellent for long general population surveys with no payment (2006: 44.7%, 2008: 49.0%). The population of spouses at the participating installation was invited by mailed postcard (2006: N = 19,722; 2008: N = 12,127; response rates-2006: 12.3%, 2008: 10.8%). Clinically significant physical intimate partner violence can be effectively screened with as few as four items, with sensitivities > 90% and specificities > 95%; clinically significant psychological intimate partner violence can be screened with two items. Men and women can be screened with equivalent accuracy, as can those committing the violence and those victimized by it. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Measuring COVID-19 Related Anxiety in Parents: Psychometric Comparison of Four Different Inventories.

BACKGROUND: The COVID-19 outbreak and the measures to contain the global pandemic can have an impact on the well-being and mental health status of individuals. Parents of young children are particularly at risk for high levels of parental stress due to the current public health crisis, which can impact parenting behaviors and children's well-being. Although different initial scales have been developed to measure COVID-19-related anxiety, they have not yet been tested sufficiently in parent samples. A brief measure of COVID-19-related anxiety is necessary for both quick assessment in practice and in larger epidemiological studies of parents. OBJECTIVE: The purpose of this study is to compare the distributions, validities, and reliabilities of four different COVID-19 anxiety scales: Fear of COVID-19 Scale, Coronavirus Anxiety Scale, Pandemic Anxiety Scale, and one subscale of the COVID Stress Scales. Based on the psychometric properties of these scales, we aim to provide recommendations for a brief unidimensional inventory to assess COVID-19-related anxiety among parents. METHODS: A cross-sectional web-based survey of 515 German-speaking parents (465 mothers, 90.3%) with at least one child aged 0-6 years was conducted during a 6-week period (June 29 to August 9, 2020). Half of the parents were recruited via Facebook parenting groups, while the other half were recruited through childcare centers. We psychometrically tested 25 items on COVID-19-related anxiety using the framework of classical test theory, including item analysis, correlational analysis of family variables, and exploratory factor analysis. Moreover, an item response theory approach was applied to estimate item discriminations and item difficulties. RESULTS: Based on the psychometric properties, three items of the Pandemic Anxiety Scale were identified as a single unidimensional factor. The adapted scale demonstrated acceptable internal consistency (α=.79), moderate to high item discrimination, strong positive intercorrelation with two other COVID-19 anxiety scales, and a small positive association with parenting stress. Mothers and fathers did not differ in total scores (t513=-0.79, P=.42). CONCLUSIONS: Factor analysis suggests that existing COVID-19-related anxiety scales measure different latent constructs of anxiety. Furthermore, all scales showed only small to moderate correlations with trait health anxiety, suggesting that COVID-19-related anxiety is distinct from general health anxiety. The adapted "disease anxiety" subscale of the Pandemic Anxiety Scale is an economical measure for assessing COVID-19-related anxiety in parents. Directions for future research are outlined.