Dual trajectories of parenting self-efficacy and depressive symptoms in new, postpartum mothers and socioemotional adjustment in early childhood: A growth mixture model.

Postpartum depression and low parental self-efficacy (PSE) are risk factors for poor child behavior. Little is known, however, about the course of dual trajectories of cooccurring depressive symptoms and PSE or its impact on children's socioemotional development. This study sought to identify trajectories of postpartum PSE and depressive symptoms in new, first-time mothers using growth mixture modeling. Results demonstrated a class of women with "low risk" (88.8%) who manifested low levels of depression and high levels of PSE during the postpartum period; a second group of women, labeled "early risk" (6.3%) with high levels of depression that decreased over time but lower levels of PSE that remained fairly stable; and a final trajectory group deemed the "late-risk" class (4.9%) with initially low levels of depression and high levels of PSE that significantly increased and decreased, respectively, over the period. Early childhood trauma, parenting stress, and poor parenting practices were associated membership in a high-risk class. Mothers in the high-risk groups reported children with more aggressive and defiant behavior at age 3. We conclude by discussing the implications of our findings for developing effective and sensitive interventions.

La depresión posterior al parto y la autoeficacia de los padres (PSE) son factores de riesgo para la débil conducta del niño. Poco se sabe, sin embargo, acerca del curso de las trayectorias duales de síntomas depresivos que ocurren simultáneamente y PSE o su impacto en el desarrollo socioemocional de los niños. Este estudio se propuso identificar las trayectorias del PSE posterior al parto y los síntomas depresivos en nuevas, primerizas mamás usando un modelo de mezcla de crecimiento. Los resultados mostraron una clase de mujeres con 'bajo riesgo' (88.8%) que manifestaron bajos niveles de depresión y altos niveles de PSE durante el período posterior al parto; un segundo grupo de mujeres, llamado 'de temprano riesgo' (6.3%) con altos niveles de depresión que disminuyeron a lo largo del tiempo, pero más bajos niveles de PSE que se mantuvieron equitativamente estables; y un final grupo de trayectoria denominado la clase del 'riesgo tardío' (4.9%) con iniciales bajos niveles de depresión y altos niveles de PSE que significativamente aumentaron y disminuyeron, respectivamente, a lo largo del período. El trauma en la temprana niñez, el estés de crianza, así como las débiles prácticas de crianza fueron afiliaciones asociadas dentro de una clase de alto riesgo. Las mamás en los grupos de alto riesgo reportaron niños con conductas más agresivas y desafiantes a la edad de tres años. Concluimos con una discusión de las implicaciones de nuestros resultados para desarrollar intervenciones eficaces y sensibles.

La dépression postpartum et l'auto-efficacité parentale (abrégé en français ici AEP) sont des facteurs de risque pour les problèmes de comportement de l'enfant. On sait peu de choses, cependant, à propos du cours des trajectoires duels des symptômes dépressifs concomitants et l'AEP ou son impact sur le développement socio-émotionnel des enfants. Cette étude a cherché à identifier les trajectoires d'AEP postpartum et de symptômes dépressifs chez des mères étant mères pour la première fois, en utilisant un modèle de croissance mixte. Les résultats ont fait état d'une classe de femmes avec un "risque moindre" (88,8%) qui faisaient preuve de niveaux peu élevés de dépression et de niveaux élevés d'AEP durant la période postpartum; un deuxième groupe de femmes, appelé "risque précoce" (6,3%) avec des niveaux élevés de dépression qui ont décru au fil du temps et avec des niveaux plus bas d'AEP qui restaient relativement stables; et un groupe de trajectoire finale estimé comme étant la classe de 'risque tardif' (4,9%) avec initialement des niveaux moindres de dépression et des niveaux élevés d'AEP qui ont respectivement augmenté et baissé de manière importante, au fil de cette période. Le trauma de la petite enfance, le stress de parentage et de mauvaises pratiques parentales étaient liés à l'appartenance à la classe à haut risque. Les mères des groupes à risque élevé ont fait état d'enfants avec un comportement plus agressif et défiant à l'âge de trois ans. Nous concluons en discutant les implications pour le développement d'interventions efficaces et sensibles.

Longitudinal associations between marital quality and sleep quality in older adulthood.

The current study examined how changes in marital quality are associated with changes in sleep quality in older adults over an 8-year period. Older adults from the Health and Retirement Study completed measures of both marital support/strain and sleep quality in 2006, 2010, and 2014 (N = 4981). We used latent growth curve models to examine intraindividual change in support, strain, and sleep quality. Further, we examined interrelationships between changes in each of these three indicators. Results showed that higher marital quality was associated with better sleep at baseline. We also found that marital quality and sleep quality were coordinated over time-as marital quality increased, so did sleep quality. When this covariation was accounted, the prospective effects of baseline marital quality on changes in sleep quality were not found. The current study provided evidence for a long-term temporal coordination of marital quality and sleep quality in older adults.

Recognizing and Responding to the "Toxic" Work Environment: Worker Safety, Patient Safety, and Abuse/Neglect in Nursing Homes.

This grounded theory study examined how the certified nursing assistant (CNA) understands and responds to bullying in the workplace. Constant comparative analysis was used to analyze data from in-depth telephone interviews with CNAs ( N = 22) who experienced bullying while employed in a nursing home. The result of the analysis is a multistep model describing CNA perceptions of how, over time, they recognized and responded to the "toxic" work environment. The strategies used in responding to the "toxic" environment affected their care provision and were attributed to the development of several resident and worker safety outcomes. The data suggest that the etiology of abuse and neglect in nursing homes may be better explained by institutional cultures rather than individual traits of CNAs. Findings highlight the relationship between worker and patient safety, and suggest worker safety outcomes may be an indicator of quality in nursing homes.

Physical abuse of older adults in nursing homes: a random sample survey of adults with an elderly family member in a nursing home.

Few empirical studies have focused on elder abuse in nursing home settings. The present study investigated the prevalence and risk factors of staff physical abuse among elderly individuals receiving nursing home care in Michigan. A random sample of 452 adults with elderly relatives, older than 65 years, and in nursing home care completed a telephone survey regarding elder abuse and neglect experienced by this elder family member in the care setting. Some 24.3% of respondents reported at least one incident of physical abuse by nursing home staff. A logistic regression model was used to estimate the importance of various risk factors in nursing home abuse. Limitations in activities of daily living (ADLs), older adult behavioral difficulties, and previous victimization by nonstaff perpetrators were associated with a greater likelihood of physical abuse. Interventions that address these risk factors may be effective in reducing older adult physical abuse in nursing homes. Attention to the contextual or ecological character of nursing home abuse is essential, particularly in light of the findings of this study.

Elder abuse in nursing homes: an ecological perspective.

Population trends suggest that the next 20 years will witness a dramatic increase in the adult population aged 65 and older. Projected increases in the elderly population are expected to significantly increase the stress on family and professional caretakers. Stress, in the context of caregiving relationships, is a risk factor associated with increased prevalence of elder abuse in familial and institutional settings. As increasing numbers of older adults are moved from family caregiving to nursing home care settings, it becomes important to identify the pattern of elder abuse risk factors in nursing home facilities. An ecological model is proposed for better understanding the risk factors associated with elder abuse in nursing homes and the complex interaction of individual/person characteristics and contextual factors in institutional elder abuse. An ecological perspective to institutional elder abuse provides a framework for guiding and informing future research on the risk factors of nursing home abuse and, in turn, for the development of effective interventions and relevant social policies.

Neglect of older adults in Michigan nursing homes.

Although research on domestic elder abuse and neglect has grown over the past 20 years, there is limited research on elder neglect in nursing homes. The purpose of this study is to estimate the incidence of elder neglect in nursing homes and identify the individual and contextual risks associated with elder neglect. Data came from a 2005 random digit dial survey of individuals in Michigan who had relatives in long term care. Our analytic sample included 414 family members who had a relative aged 65 or older in nursing homes. Results showed that about 21% of nursing home residents were neglected on one or more occasion in the last 12 months. Two nursing home residents' characteristics reported by family members appear to significantly increase the odds of neglect: functional impairments in activities of daily living and previous resident-to-resident victimization. Behavior problems also are associated with higher odds of neglect (p = 0.078). Policy implications of these results are discussed.

A spatiotemporal analysis of the impact of COVID-19 on child abuse and neglect in the city of Los Angeles, California.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; COVID-19) has created an urgent need to identify child abuse and neglect (CAN) and efficiently allocate resources to improve the coordination of responses during a public health crisis. OBJECTIVE: To provide unique insights into the spatial and temporal distribution of CAN in relation to COVID-19 outcomes and identify areas where CAN has increased or decreased during the pandemic. PARTICIPANTS: Children under 18 years old reported to the Los Angeles Police Department for CAN. SETTING: CAN incidents in the city of Los Angeles. METHODS: Negative binomial regression was used to explore associations between the implementation of social distancing protocols and reported CAN during COVID-19. Spatiotemporal analysis identified locations of emerging hot and cold spots during the pandemic. Associations between neighborhood structural factors (e.g., school absenteeism, poverty, unemployment, housing insecurity and birth assets) and hot and cold spot patterns were explored. RESULTS: There was a statistically significant decline in reports of CAN during the COVID-19 pandemic but no significant trends following the implementation of social distancing measures (e.g. safer at home orders, school closures). Compared to consecutive cold spots, severe housing burden, the number of assets children have at birth, poverty, school absenteeism and labor force participation were significantly associated with new and intensifying hotspots of CAN during the COVID-19 pandemic. CONCLUSIONS: Our findings reinforce the utility of developing intervention strategies that minimize harm to children by targeting resources to specific challenges facing families enduring the COVID-19 experience.

Individual characteristics and the multiple contexts of adolescent bullying: an ecological perspective.

This paper uses an ecological perspective to explore the risk factors associated with bullying behaviors among a representative sample of adolescents aged 11-14 (n = 9816; X = 12.88; s = .9814). Data derived from the Health Behavior in School Children: WHO Cross-National Survey were used to model the relationship between bullying and media effects, peer and family support systems, self-efficacy, and school environment. Overall, the results of this study suggest that bullying increases among children who watch television frequently, lack teacher support, have themselves been bullied, attend schools with unfavorable environments, have emotional support from their peers, and have teachers and parents who do not place high expectations on their school performance. In addition, we found an inverse relationship between being Asian or African American, feeling left out of school activities and bullying. Our results lend support to the contention that bullying arises out of deficits in social climate, but that social support systems mediate bullying behavior irrespective of the student's racial/ethnic characteristics, parental income levels or media influences. Because the number of friends and the ability to talk to these friends increases the likelihood of bullying, we suggest that bullying is not simply an individual response to a particular environment but is a peer-group behavior. We conclude that limiting television viewing hours, improving student's abilities to access family support systems and improving school atmospheres are potentially useful interventions to limit bullying behavior.

The Importance of Investigating Abuser Characteristics in Elder Emotional/Psychological Abuse: Results from Adult Protective Services Data.

OBJECTIVES: Elder emotional/psychological abuse is the infliction of mental anguish on older adults through verbal or non-verbal acts. Using indicators based on existing literature, theoretically important abuser characteristics and victim vulnerabilities were collected using the Elder Abuse Decision Support System (EADSS) to test a theory of emotional/psychological abuse. METHOD: Eight-hundred-and-ten alleged emotional/psychological abuse cases were investigated by caseworkers in six Illinois adult protective services (APS) agencies; 466 individuals endorsed at least one item on the Older Adult Psychological Abuse Measure (OAPAM). RESULTS: Bivariate ordinary linear regression results established that all abuser characteristics were predictive of emotional/psychological abuse scores. In the hierarchical regression model where abuser characteristics were entered after victim vulnerabilities, abuser characteristics predicted emotional/psychological abuse above and beyond victim vulnerabilities (ΔR2 = 0.349, p < .001). Abuser risk and abuser's negative attitudes towards victims remained as significant predictors in the final model. Post hoc analysis identified significant items of abuser risk and negative attitudes, including: an emotionally draining relationship between abuser and victim, abuser's poor temper control, and abuser's angry feelings towards victims. DISCUSSION: Abuser weaknesses and strengths as highlighted in the theoretical framework should be further investigated for future prevention and intervention in cases of emotional/psychological abuse.

Individual and contextual determinants of resident-on-resident abuse in nursing homes: a random sample telephone survey of adults with an older family member in a nursing home.

Few empirical investigations of elder abuse in nursing homes address the frequency and determinants of resident-on-resident abuse (RRA). A random sample of 452 adults with an older adult relative, ≥65 years of age, in a nursing home completed a telephone survey regarding elder abuse experienced by that elder family member. Using a Linear Structural Relations (LISREL) modeling design, the study examined the association of nursing home resident demographic characteristics (e.g., age, gender), health and behavioral characteristics (e.g., diagnosis of Alzheimer's Disease, Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (IADLs), types of staff abuse (e.g., physical, emotional), and factors beyond the immediate nursing home setting (e.g., emotional closeness of resident with family members) with RRA. Mplus statistical software was used for structural equation modeling. Main findings indicated that resident-on-resident mistreatment of elderly nursing home residents is associated with the age of the nursing home resident, all forms of staff abuse, all ADLs and IADLs, and emotional closeness of the older adult to the family.

Social-relational risk factors for predicting elder physical abuse: an ecological bi-focal model.

Annually in the United States, 1 to 5 million older adults, 65 and above, are physically or sexually injured or mistreated by their caregivers in family settings. This study examined the prevalence and risk factors involved in elder physical abuse by adult child caregivers, moving from the immediate elderly parent/adult child relationship context to more distal social support contexts, utilizing a subsample of 203 elderly participants from the Midlife Development in the United States study (MIDUS II, 2004-2006). LISREL modeling examined causal pathways between elderly demographic characteristics, physical/emotional health, and behavioral and contextual characteristics from an ecological perspective. Data modeling was accomplished using Mplus, PAXW, and SYSTAT statistical software packages. Results indicate that latent factors including older adult health, social isolation of the older adult, and adult child characteristics were significantly associated with elder physical abuse, as mediated by the quality of the elderly parent/adult child relationship.

Family members' reports of abuse in Michigan nursing homes.

The objective of this article is to describe abuse and neglect of adults age 65 and older in Michigan nursing homes, as reported by members of their families. Using list-assisted random-digit dialing, data on abuse and neglect for a 12-month period were collected from individuals who had a relative age 65 or older in a Michigan nursing home. Of the nursing home residents represented in this analysis, the majority were female, Caucasian, and widowed. Neglect and caretaking mistreatment were the most frequent types of abuse reported. Comparison of these data with data from the National Ombudsman Reporting System suggests that family members constitute a sensitive source of data on abuse in nursing homes.

A social capital approach to the prevention of elder mistreatment.

The current demographic landscape features an increasing number of elderly individuals in the care of some trusted other. Being cared for by a trusted other raises the potential for mistreatment of the elder by that trusted other. The goal of this paper is to explore the possibility of preventing elder mistreatment by increasing the bridging and bonding social capital available to caretakers. Attending to social capital lets researchers expand their focus toward areas rarely examined through current stress-outcome models (e.g., interpersonal interactions). First, elder mistreatment and social capital are defined and discussed. Then, a model is forwarded that details how social capital might mitigate the effects of caretaker stress and decrease the probability that caretakers will engage in elder mistreatment in both home and long-term care institutional settings. Finally, implications for future research and practical intervention are discussed.

Elder abuse and neglect in Latino families: an ecological and culturally relevant theoretical framework for clinical practice.

There is a scarcity of theoretical frameworks capable of describing precursors and dynamics associated with elder abuse and neglect in Latino families. The present manuscript seeks to address this gap in the literature by presenting an integrative theoretical framework that fosters an ecological and cultural understanding of elder abuse and neglect among Latinos. The proposed model rests on the premise that Latino families caring for elder adults have the ability to adapt to the demands of aging only if they are supported by nurturing environments. The usefulness of the model is threefold. First, the proposed model describes elder abuse and neglect as multifactorial phenomena and identifies specific risk factors associated with the etiology and maintenance of elder abuse and neglect in Latino families. Second, the model provides clinical applications, including reflections about the therapists' need to extend their scope of practice beyond traditional family therapy interventions. A brief case study is presented that illustrates the clinical application of the model with a Latino family. Implications for future research are discussed.