Impulsivity profiles across five harmonized longitudinal childhood preventive interventions and associations with adult outcomes.

This study aimed to parse between-person heterogeneity in growth of impulsivity across childhood and adolescence among participants enrolled in five childhood preventive intervention trials targeting conduct problems. In addition, we aimed to test profile membership in relation to adult psychopathologies. Measurement items representing impulsive behavior across grades 2, 4, 5, 7, 8, and 10, and aggression, substance use, suicidal ideation/attempts, and anxiety/depression in adulthood were integrated from the five trials (N = 4,975). We applied latent class growth analysis to this sample, as well as samples separated into nonintervention (n = 2,492) and intervention (n = 2,483) participants. Across all samples, profiles were characterized by high, moderate, low, and low-increasing impulsive levels. Regarding adult outcomes, in all samples, the high, moderate, and low profiles endorsed greater levels of aggression compared to the low-increasing profile. There were nuanced differences across samples and profiles on suicidal ideation/attempts and anxiety/depression. Across samples, there were no significant differences between profiles on substance use. Overall, our study helps to inform understanding of the developmental course and prognosis of impulsivity, as well as adding to collaborative efforts linking data across multiple studies to better inform understanding of developmental processes.

Assessment of Feasibility and Acceptability of the Pathways for Parents After Incarceration Program.

Most incarcerated fathers have connections to their families, and the quality of their family relationships is important not only to their reentry success but also to shaping positive child and family outcomes. However, there is a lack of rigorous evidence about interventions designed to strengthen parent-child and other family relationships among formerly incarcerated parents. The purpose of this study was to develop and assess for feasibility and acceptability an intervention for formerly incarcerated fathers, co-parents, and their children. We created and implemented the Pathways for Parents after Incarceration Program (P4P), a multilevel intervention that focuses on strengthening positive parenting skills, building constructive co-parenting strategies, providing social support, and connecting families to needed specialized services. We delivered P4P virtually to 3 groups of participants, collecting data at several points. Results suggest that while the program was well liked and appreciated by participants and parent coaches and had a positive effect on parenting skills and attitudes, recruitment and retention were challenging. Findings suggest that P4P has the potential to support child and family well-being when fathers reenter by bolstering protective factors, and supporting access to necessary supports associated with improved reentry outcomes. Additional research is needed to address feasibility concerns and establish program efficacy.

Psychosis Symptom Trajectories Across Childhood and Adolescence in Three Longitudinal Studies: An Integrative Data Analysis with Mixture Modeling.

Psychotic-like experiences (PLEs) are common throughout childhood, and the presence of these experiences is a significant risk factor for poor mental health later in development. Given the association of PLEs with a broad number of mental health diagnoses, these experiences serve as an important malleable target for early preventive interventions. However, little is known about these experiences across childhood. While these experiences may be common, longitudinal measurement in non-clinical settings is not. Therefore, in order to explore longitudinal trajectories of PLEs in childhood, we harmonized three school-based randomized control trials with longitudinal follow-up to identify heterogeneity in trajectories of these experiences. In an integrative data analysis (IDA) using growth mixture modeling, we identified three latent trajectory classes. One trajectory class was characterized by persistent PLEs, one was characterized by high initial probabilities but improving across the analytic period, and one was characterized by no reports of PLEs. Compared to the class without PLEs, those in the improving class were more likely to be male and have higher levels of aggressive and disruptive behavior at baseline. In addition to the substantive impact this work has on PLE research, we also discuss the methodological innovation as it relates to IDA. This IDA demonstrates the complexity of pooling data across multiple studies to estimate longitudinal mixture models.

The Prospective Effects of Caregiver Parenting on Behavioral Health Outcomes for Children with Incarcerated Parents: a Family Resilience Perspective.

Rates of parental incarceration in the USA have increased dramatically over the past four decades. The Adverse Childhood Experiences study identified parental incarceration as one of several risk factors related to multiple health outcomes during childhood and adulthood. Parents and other caregivers are widely regarded as sources of resilience for children experiencing adversity, yet few studies have examined caregivers' parenting practices as sources of resilience for children with incarcerated parents. This study used secondary data from a longitudinal randomized controlled trial of the prison-based parent management training program Parenting Inside Out (PIO). Specifically, it included 149 caregivers (i.e., the non-incarcerated parent, extended family member, or other adult who provides the day-to-day caretaking of a child during parental incarceration) of children aged 2-14 years whose incarcerated parents were randomly assigned to receive PIO or the control condition. Path analysis was used to examine associations between caregivers' parenting, social support, self-efficacy, and change in child internalizing and externalizing symptoms across a 6-month period. Direct effects of caregivers' parenting were found on improvements in child behavioral health from baseline (conducted when the parent was incarcerated) to the 6-month follow-up (conducted after most parents had been released). Indirect effects were found for caregiver social support and self-efficacy. The findings highlight the importance of caregivers' adaptive parenting as a protective resource for children who experience parental incarceration and have implications for the design of preventive interventions for this underserved population.

Do Brief Lab-Based Interventions Decrease Coercive Conflict Within Couples and Parent-Child Dyads?

Coercive conflicts between parents and children and between couples are implicated in the pathogenesis of a variety of psychological and physical health problems. Despite its seeming importance to population health, there are no widely available, easy-to-use methods with demonstrated efficacy to engage coercive conflict and reduce it. Identifying and testing potentially efficacious and disseminable micro-interventions (i.e., interventions that can be delivered in under 15 minutes via computer or paraprofessional) for targets with cross-cutting health implications, such as coercive conflict, is the focus of the National Institutes of Health Science of Behavior Change initiative. We experimentally tested four micro-interventions targeting coercive conflict in couple and parent-child dyads in a within-between design. There were mixed but supportive findings for the efficacy of most of the micro-interventions. Attributional reframing, implementation intentions, and evaluative conditioning all reduced coercive conflict as assessed by some but not all measures of observed coercion. No findings indicated any iatrogenic effects. Interpretation bias modification treatment improved at least one measure of coercive conflict for couples, but not for parents and children; additionally, it increased self-reported coercive conflict. Overall, these results are encouraging and suggest that very brief and highly disseminable micro-interventions for coercive conflict are a fruitful direction for inquiry. Optimizing micro-interventions and deploying them across the health care infrastructure could tremendously enhance family functioning and, in turn, health behaviors and health (ClinicalTrials.gov IDs: NCT03163082, NCT03162822).

The Importance of Positive Social Support During Reentry From Prison: Examining the Role of Volunteer Mentoring.

Social support appears to be important in improving outcomes for incarcerated individuals during the reentry process not only in terms of general wellbeing but also in gaining employment and avoiding recidivism. Mentoring programs have become increasingly popular interventions that are intended to provide such support during reentry. However, research on mentoring programs is limited and tends to focus solely on the programs' impact on recidivism, a distal outcome. Through the use of semi-structured, in-depth interviews, this qualitative study focuses on more proximal outcomes, exploring how reentering individuals who are receiving volunteer mentoring through a transitional housing program define successful reentry and perceive the value of different types of support they received from their mentors. Participants identified several indicators of successful reentry and discussed the types of support that were helpful, harmful, or absent. Implications for practice and areas for future research are discussed.

Witnessing Parental Arrest As a Predictor of Child Internalizing and Externalizing Symptoms During and After Parental Incarceration.

Purpose: One in fourteen children in the United States experiences the incarceration of a parent with whom they have lived. Although prior research has established that witnessing the arrest of a parent is a common occurrence for children of criminal justice-involved parents, child outcomes following such an event are understudied. Little is known about the long-term impacts of witnessing an arrest on children and the extent to which they may vary by child age. Methods: Using longitudinal data from the Parent Child Study of mothers and fathers incarcerated in state prison, we examine the witnessing of parental arrest as an acute traumatic event and identify the extent to which this type of trauma predicts externalizing and internalizing symptoms for children during their parents' incarceration and following release. Results: Witnessing a parent's arrest predicted greater internalizing behavior concerns while parents were incarcerated, with a greater magnitude of effect for children under eight years of age. Six months post-release of the parent, children younger than age eight who witnessed the arrest showed significantly higher internalizing and externalizing behaviors. No effect was found for children ages eight years or older. Conclusion: Implications for future policies to reduce the likelihood of children witnessing parental arrests, as well as the potential benefit of screening for trauma when working with children with incarcerated parents, are discussed.

Early relational health: Innovations in child health for promotion, screening, and research.

Relational experiences during infancy and early childhood are key drivers for building health, social emotional development, and learning capacities, each vital for wellbeing. The U.S. child health sectors share a commitment to universal health promotion, prevention and early intervention, and a growing enthusiasm for the research-affirmed primacy of caregiver-child interactions during the critical first 1000 days of life. Given our nation's growing children's mental health crisis, racial justice awakening and the need to reimagine equitable supports for young families post-COVID19, the child health sectors seek new tools and clinical approaches that blend science-to-practice innovations with co-developed activities that are meaningful to families. This special section brings together papers about a journey of co-discovery between researchers, clinicians, and parents during the development and refinement of new video- and interview-based dyadic relational screening and monitoring tools. The collection of papers addresses a range of topics including early relational health (ERH), development and validation of the Early Relational Health Screen, its application within research and clinical settings, and thoughtful discussions from multiple perspectives. Informed by the diversity informed tenets, this journey highlights not only science-informed approaches, but also co-development with families of equitable approaches to understanding and serving children and their caregivers.

Las experiencias en las relaciones durante la infancia y la temprana niñez son conductores claves para fortalecer la salud, el desarrollo socio-emocional y las capacidades de aprendizaje, todas las cuales son vitales para el bienestar. Los sectores de salud infantil en los Estados Unidos comparten un compromiso para promover globalmente la salud, la prevención y la temprana intervención, así como un creciente entusiasmo por la primacía de las interacciones entre quien presta el cuidado y el niño, tal como las reafirma la investigación, durante los críticos primeros mil días de vida. Dada la creciente crisis de salud mental infantil de nuestro país, el despertar de la justicia racial y la necesidad de volver a conceptualizar los apoyos equitativos para familias jóvenes después del Covid-19, los sectores de salud infantil, buscan nuevas herramientas y acercamientos clínicos que mezclan las innovaciones de la ciencia a la práctica con actividades desarrolladas en conjunto que resultan significativas para las familias. Esta sección especial presenta artículos acerca de una trayectoria de descubrimiento en conjunto entre investigadores, profesionales clínicos y padres durante el desarrollo y afinamiento de nuevas herramientas de detección y supervisión de la relación diádica basadas en videos y entrevistas. El grupo de artículos aborda un número de temas que incluyen la temprana saludable relación (ERH), el desarrollo y la validez de la Detección de la Temprana Saludable Relación, su aplicación dentro de los campos de la investigación y clínicos, así como sensatas discusiones a partir de múltiples perspectivas. Respaldada por principios basados en la diversidad, esta trayectoria subraya no sólo los acercamientos cuya información proviene de la ciencia, sino también el desarrollo en conjunto con familias de equitativos acercamientos para comprender y servirles a los niños y a quienes los cuidan.

Les expériences relationnelles le bas âge et la petite enfance sont des facteurs clés pour la construction de la santé, le développement socio-émotionnel et les capacités d'apprentissage, qui sont indispensables au bien-être. Les secteurs de la santé de l'enfant aux Etats-Unis d'Amérique partagent un engagement envers la promotion universelle de la santé, la prévention et l'intervention précoce, et un enthousiasme grandissant pour la primauté des interactions personne prenant soin de l'enfant-enfant, affirmée par les recherches, durant les 100 premiers jours critique de la vie. Au vu de la croissance de la crise de santé mentale des enfants dans notre pays, du réveil de la justice raciale et du besoin de réimaginer les soutiens équitables pour les jeunes familles après le Covid19, les secteurs de la santé mentale de l'enfant cherchent de nouveaux outils et des approches cliniques qui mélange des innovations science-à-pratique avec des activités élaborées conjointement qui sont utiles et ont un sens pour les familles. Cette section spéciale rassemble des articles sur un voyage de codécouverte entre des chercheurs, des cliniciens, et des parents durant le développement et le perfectionnement d'un nouveau dépistage relationnel dyadique à partir d'entretiens et de vidéos, et d'outils de suivi. Cette collection d'articles porte sur un éventail de sujets y compris la Santé Relationnelle Précoce (SRP), le développement et la validation du Dépistage de Santé Relationnelle Précoce, son application dans des contextes de recherche et dans des contextes cliniques, et des discussions attentionnées de perspectives multiples. Informé par des principes fondés sur la diversité, ce voyage met en évidence non seulement des approches scientifiques mais aussi des co-développements avec des familles d'approches équitables à la compréhension et au service des enfants ainsi que des personnes prenant soin d'eux.

The context and development of the early relational health screen.

Early relational experiences are key drivers for developing social emotional capacities, educational achievement, mental health, physical health, and overall wellbeing. The child health sectors are committed to promotion, prevention, and early intervention that optimize children's health and development, often employing evidence-based screening as foundational practices. Despite a variety of validated parent-infant observational assessment tools, few are practical within busy practice settings, acceptable with all racial and ethnic groups and ready for universal adoption. In response to this need, a team of clinicians, early childhood educators, researchers and infant mental health specialists collaborated to develop and test a novel video-based, dyadic relational screening and monitoring tool, the Early Relational Health Screen (ERHS). This tool uniquely focuses on the early parent-child relationship (6-24 months), within the construct of early relational health (ERH). Initial testing demonstrated that the ERHS is a valid, reliable, feasible, and useful screening and monitoring tool for clinical applications. The ERHS was further developed within a population-based, prospective research study and adapted with brief video feedback for parents in the home visiting and child health sectors. The ERHS and its adaptations appear to advance ERH and equity within the transforming child health and public health care systems of today.

Las tempranas experiencias de relaciones afectivas son clave para desarrollar las capacidades socioemocionales, para los logros educativos, la salud mental, la salud física y el bienestar en general. Los sectores de salud infantil están comprometidos a promover, prevenir e intervenir a tiempo para que la salud de los niños y su desarrollo sean óptimos, a menudo empleando examinaciones basadas en la evidencia como prácticas fundamentales. A pesar de la variedad de válidas herramientas para la evaluación con base en la observación progenitor-infante, pocas son prácticas dentro del ocupado campo de la práctica, aceptables con todos los grupos raciales y étnicos, y pocas están listas para ser adoptadas en forma generalizada. Como respuesta a esta necesidad, un equipo formado por clínicos profesionales, educadores de la temprana niñez, investigadores y especialistas de la salud mental infantil colaboraron para desarrollar y probar una herramienta novedosa basada en videos, con el fin de examinar y darle seguimiento a la relación de la díada, el Examen del Bienestar de la Temprana Relación (ERHS). Esta herramienta de manera única se enfoca en la temprana relación progenitor-niño (6-24 meses), dentro del marco del temprano bienestar de la relación. La examinación inicial demostró que ERHS es una herramienta de examinación y seguimiento válida, confiable, posible y útil para la aplicación clínica. Entonces ERHS se desarrolló dentro de un estudio de investigación de probabilidades, con base en la población, y se adaptó con breves respuestas en video para progenitores en los sectores de visitas a casa y salud infantil. ERHS y sus adaptaciones parecen avanzar el temprano bienestar de la relación (ERH) y la equidad dentro de los sistemas de salud infantil y cuidado de salud pública en transformación hoy día.

Les expériences relationnelles sont des moteurs essentiels pour le développement des capacités socio-émotionnelles, la réussite scolaire, la santé mentale, la santé physique et le bien-être général. Les secteurs de la santé de l'enfant sont dédiés à la promotion, à la prévention et à l'intervention précoce qui optimisent la santé des enfants et leur développement, en employant souvent des dépistages fondés sur des données probantes en tant que pratiques fondamentales. En dépit d'une variété d'outils d'évaluation observationnelle parent-bébé validés, peu de ces outils sont pratique au sein d'un cabinet de pratique très occupé et peu sont acceptables pour tous groupes raciaux et éthiques ainsi que prêts pour une adoption universelle. Pour répondre à ce besoin une équipe de cliniciens, d'éducateurs de la petite enfance, de chercheurs et de spécialistes de la santé mentale du nourrisson ont collaboré afin de développer et de tester un outil innovateur et basé sur la vidéo de dépistage relationnel dyadique et de suivi, le Dépistage de Santé Relationnelle Précoce (en anglais Early Relational Health Screen dont nous gardons l'abréviation ici, ERHS). Cet outil se concentre uniquement sur la relation précoce parent-enfant (6-24 mois), dans le cadre de la construction de la santé relationnelle précoce. Les essais ont montré que l'ERHS est un outil de dépistage et de suivi valide, fiable, réalisable et utile pour les applications cliniques. L'ERHS a été plus profondément développé au sein d'une étude de recherches de prospection, basées sur certaines populations, et adapté avec de brefs commentaires vidéo pour les parents dans les secteurs des visites à domicile et de la santé de l'enfant. L'ERHS et ses adaptations semblent faire progresser la Santé Relationnelle Précoce et l'équité au sein des transformation de la santé de l'enfant et des systèmes de santé publique d'aujourd'hui.

A Randomized Controlled Trial of a Parent Management Training Program for Incarcerated Parents: Post-Release Outcomes.

The majority of incarcerated adults are parents. While in prison, most parents maintain at least some contact with their families. A positive connection with family during imprisonment is hypothesized to improve long-term success after release. One way in which departments of corrections attempt to facilitate positive connections with family is through prison-based parenting programs. One such program, developed in collaboration with the Oregon Department of Corrections, is the cognitive-behavioral parent management training program Parenting Inside Out (PIO). Outcomes due to PIO were examined within the context of a randomized controlled trial. Incarcerated parents from all correctional facilities in the state of Oregon were recruited to participate, and eligible parents who consented (N = 359) were transferred to participating releasing institutions. After initial assessment, parents were randomized to condition (i.e., PIO "intervention" condition or services-as-usual "control" condition) and then followed through the remainder of their prison sentences and to one year after release. Intervention condition participants were offered PIO prior to their release. Outcomes favoring participants in the intervention condition were found in areas of importance to parents and their children and families and to public health and safety at large, including a decreased likelihood of problems related to substance use and of engaging in criminal behavior during the first six months following release as well as a decreased likelihood of being arrested by police during the first year following release. The implications of the findings are discussed, including the critical need for scientifically rigorous research on multi-component parenting programs delivered during the reentry period.

"Self-report measures of coercive process in couple and parent-child dyads": Correction.

Reports an error in "Self-report measures of coercive process in couple and parent-child dyads" by Danielle M. Mitnick, Michael F. Lorber, Amy M. Smith Slep, Richard E. Heyman, Shu Xu, Lisanne J. Bulling, Sara R. Nichols and J. Mark Eddy (Journal of Family Psychology, 2021[Apr], Vol 35[3], 388-398). In the original article, the full acknowledgment of funding was missing in the author note and should have read "This work was supported by the National Institutes of Health (NIH) Science of Behavior Change Common Fund Program and the National Institute of Dental and Craniofacial Research through an award administered by the National Institute of Dental and Craniofacial Research [1UH2DE025980-01]." The online version of this article has been corrected. (The following abstract of the original article appeared in record 2020-49926-001). One of the most influential behavioral models of family conflict is G. R. Patterson's (1982) coercive family process theory. Self-reports for behaviors related to coercion (e.g., hostility toward a family member) abound; however, there are no self-report measures for coercive process itself, which is, by definition, a dyadic process. Operationalizations of coercive process are measured with behavioral observation, typically including sequential analyzed, microcoded behaviors. Despite its objectivity and rigor, coding of behavior observation is not always feasible in research and applied settings because of the high training, personnel, and time costs the observation requires. Because coercive process has been shown to predict a host of maladaptive outcomes (e.g., parent-child conflict, aggression, negative health outcomes) and given the complete absence of self-report measures of coercive process, we recently designed brief questionnaires to assess coercive process in couple (Couple Coercive Process Scale [CCPS]) and parent-child interactions (Parent-Child Coercive Process Scale [PCCPS]) and tested them via Qualtrics participant panels in samples recruited to mirror socioeconomic generalizability to U.S. Census data. The CCPS and PCCPS exhibited initial evidence of psychometric quality in measuring coercive process in couple and parent-child dyads: Both measures are unifactorial; have evidence of reliability, especially at higher levels of coercive process; and demonstrate concurrent validity with constructs in their nomological networks, with medium to large effect sizes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Prevention System Implementation and Reach: Attitudes and Environmental Predictors in a Randomized Controlled Trial of the NORTH STAR Prevention System.

Although many evidence-based interventions are well-established, our understanding of how to effectively implement and sustain those interventions in real-world settings is less well understood. We investigated predictors of implementation and reach in a randomized controlled trial of the NORTH STAR prevention system. One-third of U.S. Air Force (AF) bases worldwide were randomly assigned to NORTH STAR (n = 12) or an assessment-and-feedback-only condition (n = 12). Process data regarding implementation factors were collected from Community Action Team (CAT) members and observations of CAT processes. Results from a series of regression analyses indicated that change in leadership and community support, action planning processes, and perceived approach effectiveness from pre-action planning to follow-up predicted community action plan (CAP) implementation and that changes in barriers to implementation predicted CAP reach. Pre-action planning reports of CAT member self-efficacy and perceived approach effectiveness also predicted CAP implementation at 1-year follow-up. Future directions and practice recommendations are provided.

Promoting Strong Latino Families Within an Emerging Immigration Context: Results of a Replication and Extension Trial of a Culturally Adapted Preventive Intervention.

We conducted a randomized controlled trial (RCT) of Nuestras Familias: Andando Entre Culturas, a culturally adapted evidence-based parent management training (PMT) preventive intervention, with a sample of 241 Spanish-speaking Latino parents and their middle-school-aged children residing in an emerging immigration context. Scientifically rigorous studies of programs designed for this setting are rare. The intervention was designed to promote prosocial parenting practices and to prevent youth substance use and related problem behaviors. The RCT was designed as an extension and replication of a prior trial (Martinez & Eddy in Journal of Consulting and Clinical Psychology, 73, 841-851, 2005) which was also conducted in an emerging immigration context. Two key issues were of primary interest: intervention feasibility and intervention efficacy. Intervention feasibility was assessed through weekly session attendance, participation, and parent-reported session satisfaction as well as overall program satisfaction. Intervention efficacy was assessed by comparing changes within the intervention and control groups on parenting practices and youth adjustment from pre-intervention baseline to post-intervention termination 6 months later. Results provided support for the feasibility of delivering the intervention on a large scale within communities. Consistent with the prior trial, positive effects of the intervention were detected on parenting practices and on youth outcomes. Differential effects of the intervention were detected based on youth gender and nativity status, such that girls benefited the most with respect to tobacco use likelihood, and foreign-born youth benefited the most with respect to decreased depressive symptoms.Findings provide additional evidence for Nuestras Familias as an efficacious family-based intervention for Latino families within communities that are sites of emerging immigration in terms of both improving parenting practices and decreasing risk for youth substance use and related problem behaviors.

Self-report measures of coercive process in couple and parent-child dyads.

One of the most influential behavioral models of family conflict is G. R. Patterson's (1982) coercive family process theory. Self-reports for behaviors related to coercion (e.g., hostility toward a family member) abound; however, there are no self-report measures for coercive process itself, which is, by definition, a dyadic process. Operationalizations of coercive process are measured with behavioral observation, typically including sequential analyzed, microcoded behaviors. Despite its objectivity and rigor, coding of behavior observation is not always feasible in research and applied settings because of the high training, personnel, and time costs the observation requires. Because coercive process has been shown to predict a host of maladaptive outcomes (e.g., parent-child conflict, aggression, negative health outcomes) and given the complete absence of self-report measures of coercive process, we recently designed brief questionnaires to assess coercive process in couple (Couple Coercive Process Scale [CCPS]) and parent-child interactions (Parent-Child Coercive Process Scale [PCCPS]) and tested them via Qualtrics participant panels in samples recruited to mirror socioeconomic generalizability to U.S. Census data. The CCPS and PCCPS exhibited initial evidence of psychometric quality in measuring coercive process in couple and parent-child dyads: Both measures are unifactorial; have evidence of reliability, especially at higher levels of coercive process; and demonstrate concurrent validity with constructs in their nomological networks, with medium to large effect sizes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Patient aggression toward dentists.

BACKGROUND: Workplace violence toward health care professionals is both widespread and widely overlooked. Only 4 studies of aggression toward dentists have been published-none in the United States-with the prevalence of aggression ranging from 29% through 80%. The purpose of this study was to provide an initial estimate of rates of patient aggression in dental practices in the United States. METHODS: The authors surveyed 98 dentists recruited from the faculty and alumni network of a college of dentistry. Participants completed a confidential online survey assessing whether they had experienced any of 21 specific types of aggressive behaviors from their patients. RESULTS: Past-year aggression prevalence was 22.2%, 55.0%, and 44.4% for physical, verbal, and reputational aggression, respectively. Career prevalence was 45.5%, 74.0%, and 68.7% for physical, verbal, and reputational aggression, respectively. Rates did not differ by sex, race, ethnicity, specialty, age, years practicing, or average number of patients treated per day. CONCLUSIONS: Participants reported levels of physical, verbal, and reputational aggression at rates comparable with those of other health care professionals in the United States and abroad. Additional research with larger representative samples of dentists in the United States is necessary to confirm these prevalence estimates. Future research should also investigate predictors and outcomes of patient aggression and prevention and intervention strategies. PRACTICAL IMPLICATIONS: Substantial rates of patient aggression highlight the need to address this problem in dental practices. The authors discuss implications for the dental profession, including proactive steps that could be taken to reduce patient aggression in dental offices.

Patient aggression toward dental students.

Aggression from patients is one of the risks faced by healthcare workers during a typical work week. This risk begins during training. Although rates of patient aggression have been estimated for nursing students and medical residents, studies of aggression toward dental students have not been conducted. To begin to address this knowledge gap, we surveyed 160 D.D.S. student dentists in their third- or fourth years who were attending a large urban college of dentistry during the 2018-2019 academic year. Each class had approximately 375 students, leading to a response rate of 21%. Approximately 28% of students reported experiencing at least 1 instance of physical aggression, 86% reported experiencing at least 1 instance of verbal aggression, and 36% reported experiencing at least 1 instance of reputational aggression. There were no differences in rates of experienced aggression by age or gender, but Hispanic or Latinx students were more likely to experience physical and reputational aggression than non-Hispanic White or Asian students. We discuss implications for dental education, including modifications to training clinic procedures and curriculum additions or modifications that may help prepare students to prevent and address patient aggression within the dental clinic environment.

Outcomes from a Randomized Controlled Trial of the Relief Nursery Program.

An independent, randomized controlled trial of the community-developed, multiple-component Relief Nursery prevention program was conducted with families with young children considered "at risk" for child abuse and neglect. This established program, currently operating at multiple sites in the state of Oregon, comprises an integrated package of prevention services to children and families, including early childhood education, home visiting, and parent education and support, as well as other interventions tailored to the needs of each particular family. Families who contacted the Relief Nursery for the first time were randomly assigned to one of two conditions, the Full Program condition, whose members had access to all services available from the Relief Nursery, or the Respite Care condition, whose members had access only to respite care and referrals to services provided by other community agencies. A primary caregiver in each family was interviewed prior to intervention and then every 6 months across a period of 2 years. Standardized measures were collected on a variety of risk and protective factors related to child abuse and neglect. Analyses were conducted at the end of the study period. Differences were found between the conditions in terms of perceived helpfulness and satisfaction with services and in terms of social support, in each case favoring the Full Program condition. Implications of the findings for future studies of multicomponent child abuse prevention programs with similar characteristics to the Relief Nursery are discussed.

Rigorous Research on Existing Child Maltreatment Prevention Programs: Introduction to the Special Section.

Awareness of child maltreatment as a major public health problem in the US has increased in recent years. In response, major public initiatives have been launched to fund the delivery of evidence-based programs, such as home visiting, in an effort to promote child and family functioning and health and prevent maltreatment. While promising, the number of families served by these programs remains small relative to need. Further, many families across the US are served by community-designed and supported programs for which rigorous outcome evidence has never been collected. To broaden the evidence-base on child maltreatment prevention programs, and to encourage the use of rigorous research designs in community settings, the Children's Bureau sponsored four randomized controlled trials of established programs that had a limited or no evidence base. In this introduction to a special section of Prevention Science on the prevention of child maltreatment, an overview is provided on the epidemiology of maltreatment and the funding initiative that sponsored the four trials, and a call is made for further rigorous research by prevention scientists.

Intergenerational transmission of violence: The mediating role of adolescent psychopathology symptoms.

Evidence on the intergenerational continuity of intimate partner violence (IPV) suggests small to moderate associations between childhood exposure and young adult IPV involvement, suggesting an indirect effects model. Yet, few prospective studies have formally tested meditational mechanisms. The current study tested a prospective (over 9 years) moderated-mediational model in which adolescent psychopathology symptoms (i.e., internalizing, externalizing, and combined) mediated the association between exposure to IPV in middle childhood and young adult IPV perpetration. In a more novel contribution, we controlled for proximal young adult partner and relationship characteristics. The sample consisted of n = 205 participants, who were, on average, assessed for exposure to parent IPV at age 12.30 years, adolescent psychopathology symptoms at age 15.77 years, and young adult IPV at 21.30 years of age. Data suggest a small, significant direct path from IPV exposure to young adult perpetration, mediated only through adolescent externalizing. Gender moderation analyses reveal differences in sensitivity to exposure across developmental periods; for males, effects of exposure were intensified during the transition to adolescence, whereas for females, effects were amplified during the transition to adulthood. In both cases, the mediational role of psychopathology symptoms was no longer significant once partner antisocial behavior was modeled. Findings have important implications for both theory and timing of risk conveyance.

A Randomized Controlled Trial of a Long-Term Professional Mentoring Program for Children at Risk: Outcomes Across the First 5 Years.

Child outcomes due to a paid professional mentoring program, Friends of the Children (FOTC), were investigated across the first 5 years of an ongoing multi-site randomized controlled trial. Participants were 278 children attending kindergarten or first grade who were identified as "at risk" for adjustment problems during adolescence. The program was delivered through established nonprofit community-based organizations. Mentors were hired to work full time and were provided training, supervision, and support to work individually with small numbers of children. Recruitment took place across a 3-year period. Random assignment to the intervention condition or a services as usual control condition was conducted at the level of the individual, blocking on school and child sex. After the initial assessment, follow-up assessments were conducted every 6 months. Differences in growth curves across the elementary school years were examined in intent-to-treat analyses. Significant effects favoring FOTC were found in terms of caregiver ratings of positive school behavior and less trouble in school, with a trend for higher child behavioral and emotional strengths. Effect sizes were in the range typical in recent trials of youth mentoring.