Sexual and Dating Violence Prevention Programs for Male Youth: A Systematic Review of Program Characteristics, Intended Psychosexual Outcomes, and Effectiveness.

Sexual and dating violence (SDV) by male youth (≤ 25 years)-including sexual harassment, emotional partner violence, and rape-is a worldwide problem. The goal of this preregistered (PROSPERO, ID: CRD42022281220) systematic review was to map existing SDV prevention programs aimed at male youth, including their characteristics (e.g., content, intensity), intended psychosexual outcomes, and empirically demonstrated effectiveness, guided by the principles of the theory of planned behavior (TPB). We conducted searches in six online databases for published, peer-reviewed quantitative effectiveness studies on multi-session, group focused, and interaction based SDV prevention programs for male youth ending March 2022. After screening of 21,156 hits using PRISMA guidelines, 15 studies on 13 different programs, from four continents were included. Narrative analysis showed, first, broad ranges in program intensity (2-48 h total), and few program curricula included explicit discussion of relevant aspects of the TPB. Second, programs' main intended psychosexual outcomes were to change SDV experiences, or related attitudes, or norms. Third, significant effects were found mostly on longer term behaviors and short-term attitudes. Other theoretical proxies of SDV experiences, such as social norms and perceived behavioral control, were sparsely investigated; thus, program effectiveness on these outcomes remains largely unknown. Assessed with the Cochrane Risk of Bias Tool, moderate to serious risk of bias arose in all studies. We present concrete suggestions for program content, such as explicit attention to victimization and masculinity and discuss best practices for evaluation research, including assessments of program integrity, and examining relevant theoretical proxies of SDV.

Youth care in time of COVID-19: Experiences of professionals and adolescent clients with telehealth.

Measures aimed at preventing the COVID-19 virus from spreading restricted all aspects of public life, including possibilities for meeting in-person. Youth care professionals were forced to turn to telehealth tools, such as video calling and e-health methods, to be able to continue support and treatment of children, adolescents, caregivers, and families. This study consists of two qualitative interview studies on the experiences with and transition to telehealth during COVID-19: (1) interviews with youth care professionals (N = 20), and (2) interviews with adolescents who used mental health care support (N = 14). We specifically asked participants about five themes which were selected based on pre-COVID literature on telehealth: (1) tools (i.e., which programs are being used), (2) privacy, (3) methods (i.e., what was the same and what was different compared to in-person sessions), (4) relationship/therapeutic alliance, and (5) effectiveness (i.e., what was their impression of effectiveness of telehealth). The majority of professionals reported that they had very little to no experience with telehealth prior to the pandemic. Both professionals and adolescent clients mentioned benefits and limitations of telehealth. On several themes professionals and adolescent clients mentioned similar barriers in the transition to telehealth during COVID such as limitations of the available hard- and software (theme 1: tools); forced changes in the content and methods of the sessions (theme 3: methods); and difficulties with non-verbal communication (theme 4: alliance). However, whereas most professionals expressed the intention to keep using several aspects of telehealth after restrictions due to COVID are lifted, most adolescent clients expressed they see telehealth as a temporary solution and prefer meeting professionals in person. Their experiences and the barriers and enabling aspects they mentioned may provide important insights in the acceptability and usability of telehealth for youth care organizations, youth care professionals, researchers and higher educational training programs.

Exploring Parenting Profiles to Understand Who Benefits from the Incredible Years Parenting Program.

Behavioral parenting programs are a theory-driven and evidence-based approach for reducing disruptive child behavior. Although these programs are effective on average, they are not equally effective in all families. Decades of moderation research has yielded very few consistent moderators, and we therefore still have little knowledge of who benefits from these programs and little understanding why some families benefit more than others. This study applied a baseline target moderation model to a parenting program, by (1) identifying parenting profiles at baseline, (2) exploring their correlations with other family characteristics and their stability, and (3) assessing whether they moderate intervention effects on child behavior. Individual participant data from four Dutch studies on the Incredible Years (IY) parenting program were used (N = 785 caregiver-child dyads). Children (58.2% boys) were at risk of disruptive behavior problems and aged between 2 and 11 years of age (M = 5.85 years; SD = 1.59). Latent profile analyses indicated three distinct baseline parenting profiles, which we labeled as follows: Low Involvement (81.4%), High Involvement (8.4%), and Harsh Parenting (10.1%). The profiles caregivers were allocated to were associated with their education, minority status, being a single caregiver, and the severity of disruptive child behavior. We found neither evidence that baseline parenting profiles changed due to participation in IY nor evidence that the profiles predicted program effects on child behavior. Our findings do not support the baseline target moderation hypothesis but raise new questions on how parenting programs may work similarly or differently for different families.

Does caregivers' use of praise reduce children's externalizing behavior? A longitudinal observational test in the context of a parenting program.

Caregivers are often encouraged to praise children to reduce externalizing behavior. Although several theoretical perspectives suggest that praise works (e.g., praise reinforces positive behavior), others suggest it may not (e.g., children dismiss praise or experience it as controlling). This longitudinal-observational study examined whether (a) caregivers' praise and children's externalizing behavior were related; (b) an evidence-based parenting program increased caregivers' praise; (c) and increasing praise reduced children's externalizing behavior. Participants (387 caregiver-child dyads) were randomly assigned to a 14-session parenting program (aiming to improve parenting behavior, partly via praise) or a control group. Children (aged 4-8 years, 45% girls) scored at or above the 75th percentile on externalizing behavior problems. Caregivers (91% Caucasian, 85% born in the Netherlands, 50.5% highly educated) were mostly mothers (91%). At baseline, postintervention, and follow-up, we assessed caregivers' labeled and unlabeled praise via in-home observations, and children's externalizing behavior via caregiver-reports and observations. At baseline, caregivers' unlabeled praise was related to more (rather than less) externalizing behavior. The parenting program successfully increased praise and reduced caregiver-reported (but not observed) externalizing behavior; importantly, however, praise did not mediate the program's effect on caregiver-reported externalizing behavior. Although the program did not directly reduce observed externalizing behavior, it did so indirectly via labeled praise. Our results suggest that, although praise and externalizing child behavior are related, praise may not be a key mechanism underlying the effects of the parenting program. If praise has beneficial effects on children's externalizing behavior, these effects are probably limited to labeled praise. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Introduction to the special issue: Parenting and family dynamics in times of the COVID-19 pandemic.

On March 11, 2020, the World Health Organization declared the outbreak of COVID-19 a pandemic. The COVID-19 pandemic brought about worldwide challenges and had a profound impact on family dynamics, relationships, and routines. At the same time, the impact may differ largely due to regional differences in the numbers of infections and severity of preventive measures, as well as individual and contextual risk and protective factors. The aims of this special issue were therefore to (a) provide insight into the impact of the pandemic on the family system and (b) increase our understanding of how this impact may differ between families. This special issue consists of 13 original empirical studies that show how the pandemic affected families across different levels of the family system. At first sight, it seems that many families were able to cope relatively well with the stressors. Yet, for others the demands of the pandemic and pandemic-related measures seemed to exceed their capabilities and available resources. Importantly, the studies in this special issue suggest that the pandemic disproportionally affected children, caregivers and families who were already at risk. Together, the contributions to the special issue offer knowledge on the consequences of both the pandemic and preventive measures on family functioning. At the same time, it also raises questions on the long-term impact of the pandemic and its impact on families who are currently underrepresented in empirical research. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Parenting group composition does not impact program effects on children's conduct problems.

Many established parenting programs for children's conduct problems are delivered in groups. Various, and at times conflicting, beliefs exist about whether families fare better in groups with parents that are more similar to them, or in groups that are more diverse. We set out to test these beliefs empirically. We integrated data from four trials of the Incredible Years parenting program in the Netherlands, including 452 families (children age 2-10 years) participating in 44 parenting groups. We used multilevel regression to test whether families benefit more (or less) when they participate in a group with parents that are more similar to them in terms of ethnic background, educational level, and children's baseline conduct problems, Attention Deficit/Hyperactivity Disorder (ADHD) symptoms, and emotional problems. In addition, we tested whether relative group position effects were stronger for some families than for others (e.g., whether especially ethnic minority families benefit from groups that are more ethnically diverse). Families with more severe conduct problems benefited more, but they did not fare better (or worse) in groups where other families were more similar to them. Regarding the other group characteristics, families' relative group position did not predict parenting program effects on children's conduct problems. Our findings held across families with different sociodemographic backgrounds and different levels of children's ADHD symptoms and emotional problems. We found no evidence that parenting group composition impacts the effectiveness of the Incredible Years parenting program for children's conduct problems. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Longer-Term Outcomes of the Incredible Years Parenting Intervention.

Conduct problems can develop into behavior disorders and put children at risk for other mental health problems. Parenting interventions have been shown to successfully reduce conduct problems and are often expected to prevent the development of broader mental health problems. Few studies have evaluated the longer-term and broader effects of these interventions. To what extent are parenting intervention effects sustained in the years after the intervention? And do effects pertain to conduct problems specifically, or do they also affect broader aspects of children's mental health? We used a randomized controlled trial to assess the longer-term (2.5 years) effects of the Incredible Years parenting intervention on children's conduct problems in an indicated prevention setting (N = 387; 79% retention rate). Using a multi-method (survey and computerized tasks) and multi-informant (parents, teachers, and children) approach, we tested whether initial effects on conduct problems were sustained, and whether Incredible Years had broader effects on children's peer problems, emotional problems, attention-deficit/hyperactivity disorder (ADHD) symptoms, attention and inhibition deficits, and service use. Incredible Years, relative to control (no intervention), led to sustained reductions in parent-reported conduct problems (Cohen's d = 0.31), but not teacher- and child-reported conduct problems. There were no broader benefits: Incredible Years did not reduce children's peer problems, emotional problems, ADHD-symptoms, attention and inhibition deficits, or their service use. Improvements in parents' perceptions of child conduct problems sustained until 2.5 years later. Our findings do not show benefits of Incredible Years as a preventive intervention for children's broader mental health.

Effectiveness of a social problem solving training in youth in detention or on probation: An RCT and pre-post community implementation.

The effectiveness of a 10-session social problem-solving training (SPST) was evaluated in two independent studies in a juvenile justice (JJ) setting. In both studies, we aimed to examine main intervention effects on social problem-solving skills and recidivism, as well as differential effects as modulated by anger, anger regulation, and single nucleotide polymorphisms in the COMT gene. In Study 1, a randomized controlled trial (RCT), 289 male detainees (Mage= 14.95 years) were randomly assigned to SPST or treatment-as-usual (TAU). In Study 2, a pre-post community implementation, 187 youth (Mage = 16.03 years) on probation were assessed before and after SPST. No significant main effects of SPST on social problem solving or recidivism were shown in either study. With regard to differential effects, among youth in detention,COMT haplotypes predicted intervention effects on state anger. Moreover, independent of SPST, inward anger expression was associated with an increase in state anger from pre- to post and an increase in state anger with a decrease in social problem solving. Among youth on probation, COMT haplotypes predicted social problem-solving skills, and, in turn, an increase in social problem-solving skills decreased the odds of recidivism after SPST. The lack of main effects of SPST may be due to low program integrity in JJ settings. Juveniles' emotional and genetic characteristics might modulate the effectiveness of interventions in JJ settings. We recommend studying large samples to substantiate this observation.

Introduction to the Special Issue. Randomized Controlled Trials (RCTs) in Clinical and Community Settings: Challenges, Alternatives, and Supplementary Designs.

This article provides an overview of the contributions to the special issue on Randomized Controlled Trials (RCTs) in Clinical and Community Settings: Challenges, Alternatives, and Supplementary Designs. The article introduces the challenges of conducting RCTs in dynamic real-world settings and outlines the need to consider alternative and supplementary designs.

Co-occurring change in children's conduct problems and maternal depression: Latent class individual participant data meta-analysis of the Incredible Years parenting program.

Children vary in the extent to which they benefit from parenting programs for conduct problems. How does parental mental health change if children benefit less or more? We assessed whether changes in conduct problems and maternal depressive symptoms co-occur following participation in the Incredible Years parenting program. We integrated individual participant data from 10 randomized trials (N = 1280; children aged 2-10 years) and distinguished latent classes based on families' baseline and post-test conduct problems and maternal depressive symptoms, using repeated measures latent class analysis (RMLCA) and latent transition analysis (LTA). Classes differed mainly in severity of conduct problems and depression (RMLCA; 4 classes). Conduct problems reduced in all classes. Depressive symptoms did not change in most classes, except in a class of families where conduct problems and depression were particularly severe. Incredible Years led to a greater likelihood of families with particularly severe conduct problems and depression moving to a class with mild problems (LTA; 3 classes). Our findings suggest that for the majority of families, children's conduct problems reduce, but maternal depressive symptoms do not, suggesting relative independence, with the exception of families with severe depression and severe conduct problems where changes for the better do co-occur.

The greener the better? Does neighborhood greenness buffer the effects of stressful life events on externalizing behavior in late adolescence?

We tested whether neighborhood greenness is a promotive and/or a protective factor in the development of adolescent externalizing behavior problems and explored a possible mechanism of its effects via respiratory sinus arrhythmia (RSA) recovery after stress. Data from a longitudinal multi-method study on adolescents (N = 715) was used. Result showed that neighborhood greenness was neither a promotive nor a protective factor. However, adolescents who reported more stressful life events showed more externalizing behavior and -contrary to our expectation- this effect was stronger for adolescents who grew up in greener neighborhoods (vs. less green neighborhoods).

Families Who Benefit and Families Who Do Not: Integrating Person- and Variable-Centered Analyses of Parenting Intervention Responses.

OBJECTIVE: Families with disruptive child behavior are typically referred to services based on children's behavior alone, rather than on underlying mechanisms of disruptive behavior. Yet, the presence of the precise mechanisms targeted by services might be essential for intervention success. We integrated person- and variable-centered approaches to test whether families with combined disruptive child behavior and harsh/inconsistent parenting indeed benefit most from a behavioral parenting intervention in indicated prevention context, compared to families with disruptive child behavior but less harsh/inconsistent parenting, and families with less severe disruptive behavior. METHOD: Families (N = 387) of children aged 4 to 8 years (disruptive behavior >75th percentile) participated in a randomized trial of the Incredible Years parenting intervention (Trial NTR3594, www.trialregister.nl). We identified different response trajectories and tested whether families with combined child and parenting difficulties had a higher probability of responding well, compared to families with only child difficulties or less severe difficulties. RESULTS: Most intervention group families (82%) showed a nonresponse trajectory. A minority (18%) showed a response trajectory with strong reductions in disruptive behavior (Cohen's d =1.45). As expected, families with both child and parenting difficulties were most likely to respond: 20% more than families with only child difficulties, and 40% more than families with less severe difficulties. CONCLUSION: Incredible Years, as an indicated prevention program, benefits mainly families in which the mechanisms targeted by the intervention (ie, harsh/inconsistent parenting) is actually present, rather than all families. Careful matching of children to services based on assessments of both child and parenting behavior seems critical for intervention success. CLINICAL TRIAL REGISTRATION INFORMATION: ORCHIDS: Study on Children's Genetic Susceptibility to Their Environment; https://www.trialregister.nl; 3594.

What changes when? A reply to Beauchaine and Slep.

In their commentary, Beauchaine and Slep (2018) raise important issues regarding research on behavioral parenting training (BPT). In this reply we highlight key points of agreement and respond to issues that we feel require clarification. BPT has been repeatedly proven effective in decreasing disruptive child behavior (also in the work of our research team). Yet, there is much to learn about for whom and how BPT is effective. Specifically, assessing the how (i.e., mediation) comes with many challenges. One of these challenges is taking into account the timeline of change, and being able to infer causal mechanisms of change. We argue that cross-lagged panel models (which we, and many other scholars, used) are a valid and valuable method for testing mediation. At the same time, our results raise important questions, specifically about the timing and form of expected changes in parenting and child behavior after BPT. For example, are these changes linear and gradual or do they happen more suddenly? To select the appropriate design, assessment tools, and statistical models to test mediation, we need to state detailed hypotheses on what changes when. An important next step might be to assess multiple putative mediators on different timescales, not only before and after, but specifically also during BPT.

Dutch Norms for the Eyberg Child Behavior Inventory: Comparisons with other Western Countries.

The Eyberg Child Behavior Inventory (ECBI) is one of the most widely used and well-validated parent rating scales for children's disruptive behavior. This screening instrument is a short, targetted and easy to implement inventory with good psychometric properties and is normed for different countries, among which the United States, Spain, Sweden and Norway. The ECBI has been successfully used for research and clinical purposes, in several countries including The Netherlands. To date, Dutch studies have relied on Scandinavian or US norm scores. However, this may be problematic because of cross-cultural differences in the degree to which certain behaviors are seen as problematic by parents. The main goal of this paper therefore was to obtain norm scores for The Netherlands among 6462 Dutch children aged 4 to 8 years (Mage = 6.37 years; SD = 1.32; 50.6% boys). In line with previous research, we found small differences on the mean sum scores across children of different ages (intensity scale) and gender (intensity and problem scale). Therefore, Dutch norm scores were provided age- and gender specific. Our results showed that disruptive behavior of children in the most rural areas was reported as occurring less frequently and was seen as less problematic by parents compared to the disruptive behavior of children in less rural areas. Finally, we found that Dutch norm scores on the ECBI were significantly lower than US norm scores, and significantly higher on the intensity scale (but not the problem scale) than Norwegian and Swedish norm scores.

In the Eye of the Beholder? Parent-Observer Discrepancies in Parenting and Child Disruptive Behavior Assessments.

This study examined parent-observer discrepancies in assessments of negative child behavior and negative parenting behavior to shed more light on correlates with these discrepancies. Specifically, we hypothesized that informant discrepancy between observers and parents on child behavior would be larger when parents reported high levels of negative parenting (and vice versa) because high levels of these behaviors might be indicators of negative perceiver bias or patterns of family dysfunctioning. Using restricted correlated trait-models, we analyzed cross-sectional observation (coded with the Dyadic Parent-Child Interaction Coding System) and survey data (Eyberg Child Behavior Inventory and Parenting Practices Interview) of 386 Dutch parent-child dyads with children aged 4-8 years (Mage = 6.21, SD = 1.33; 55.30% boys). Small associations between parent-reported and observed child and parenting behavior were found, indicating high discrepancy. In line with our hypothesis, this discrepancy was higher when parents self-reported more negative parenting or more negative child behavior. Parent-observer discrepancy on negative child behavior was also predicted by child gender. For boys parents reported higher levels of negative child behavior than were observed, but for girls parents reported lower levels of negative child behavior than were observed. These findings suggest that informant discrepancies between observers and parents might provide important information on underlying, problematic family functioning and may help to identify those families most in need of help.

Does the Incredible Years reduce child externalizing problems through improved parenting? The role of child negative affectivity and serotonin transporter linked polymorphic region (5-HTTLPR) genotype.

In a randomized controlled trial, the Observational Randomized Controlled Trial of Childhood Differential Susceptibility (ORCHIDS study), we tested whether observed parental affect and observed and reported parenting behavior are mechanisms of change underlying the effects of the behavioral parent training program the Incredible Years (IY). Furthermore, we tested whether some children are more susceptible to these change mechanisms because of their temperamental negative affectivity and/or serotonin transporter linked polymorphic region (5-HTTLPR) genotype. Participants were 387 Dutch children between 4 and 8 years of age (M age = 6.31, SD = 1.33; 55.3% boys) and their parents. Results showed that although IY was successful in improving parenting behavior and increasing parental positive affect, these effects did not explain the significant decreases in child externalizing problems. We therefore found no evidence for changes in parenting behavior or parental affect being the putative mechanisms of IY effectiveness. Furthermore, intervention effects on child externalizing behavior were not moderated by child negative affectivity or 5-HTTLPR genotype. However, child 5-HTTLPR genotype did moderate intervention effects on negative parenting behavior. This suggests that in research on behavioral parent training programs, "what works for which parents" might also be an important question.

Perception is key? Does perceptual sensitivity and parenting behavior predict children's reactivity to others' emotions?

When interacting with other people, both children's biological predispositions and past experiences play a role in how they will process and respond to social-emotional cues. Children may partly differ in their reactions to such cues because they differ in the threshold for perceiving such cues in general. Theoretically, perceptual sensitivity (i.e., the amount of detection of slight, low-intensity stimuli from the external environment independent of visual and auditory ability) might, therefore, provide us with specific information on individual differences in susceptibility to the environment. However, the temperament trait of perceptual sensitivity is highly understudied. In an experiment, we tested whether school-aged children's (N=521, 52.5% boys, Mage=9.72years, SD=1.51) motor (facial electromyography) and affective (self-report) reactivities to dynamic facial expressions and vocalizations is predicted by their (parent-reported) perceptual sensitivity. Our results indicate that children's perceptual sensitivity predicts their motor reactivity to both happy and angry expressions and vocalizations. In addition, perceptual sensitivity interacted with positive (but not negative) parenting behavior in predicting children's motor reactivity to these emotions. Our findings suggest that perceptual sensitivity might indeed provide us with information on individual differences in reactivity to social-emotional cues, both alone and in interaction with parenting behavior. Because perceptual sensitivity focuses specifically on whether children perceive cues from their environment, and not on whether these cues cause arousal and/or whether children are able to regulate this arousal, it should be considered that perceptual sensitivity lies at the root of such individual differences.

Intervention Effectiveness of The Incredible Years: New Insights Into Sociodemographic and Intervention-Based Moderators.

We tested the effectiveness of the preventive behavioral parent training (BPT) program, The Incredible Years (IY), and the independent effects of previously suggested sociodemographic and intervention-based moderator variables (i.e., initial severity of externalizing problem behavior, child gender, social economic status, family composition, and number of sessions parents attended), in a large-scale randomized controlled trial. Questionnaire and observation data from 387 parents and children ages 4-8 years (Mage= 6.21, SD = 1.33, 55.30% boys) across pretest, posttest, and 4-month follow-up were analyzed, using full intention-to-treat analyses and correcting for multiple testing. IY was successful in decreasing parent-reported child externalizing behavior (Cohen's d = 0.20 at posttest, d = 0.08 at follow-up), increasing parent-reported (d = 0.49, d = 0.45) and observed (d = 0.06, d = 0.02) positive parenting behavior, and decreasing parent-reported negative parenting behavior (d = 0.29, d = 0.25). No intervention effects were found for reported and observed child prosocial behavior, observed child externalizing behavior, and observed negative parenting behavior. Out of 40 tested moderation effects (i.e., 8 Outcomes × 5 Moderators), only three significant moderation effects appeared. Thus, no systematic evidence emerged for moderation of IY effects. The present multi-informant trial demonstrated that many previously suggested moderators might not be as potent in differentiating BPT effects as once thought.