Considering context: Current relationship satisfaction in a second-generation model of men's physical intimate partner violence.

Despite a half-century of scholarship devoted to explicating and disrupting the intergenerational transmission of family violence, it remains a prominent and destructive social force in the United States. Theoretical models have posited a variety of historical and concurrent risk and protective factors implicated in the trajectory from childhood violence exposure to adult perpetration. Using a second-generation model of intimate partner violence (IPV), we integrated social learning and attachment conceptualizations to examine pathways from family-of-origin violence to IPV perpetration among adult men. A sample of mixed-sex couples (N = 233) completed self-report measures related to social learning and attachment-based factors (e.g., violence in past relationships, child exposure, IPV attitudes, adult attachment) and participated in a 10-min conversation about a desired area for change in their relationship. Following, each partner participated in a video-mediated-recall procedure assessing their anger volatility and eliciting attributions of their partners' behavior. We tested mediation pathways (consistent with social learning and attachment theories) between violence in men's families of origin and their adult IPV perpetration as a function of relationship satisfaction. The proposed model fit the data well (CFI = 0.95) but had notable modifications from the hypothesized model. Generally, social-learning pathways were more consistent with the data. Relationship satisfaction interacted with some parameters. Results support theoretical advances in understanding IPV. Although exposure to violence in men's family of origin confers risk for later IPV, and a social learning developmental pathway is consistent with results, some of these effects are altered by relationship context.

Pre-existing parental stress and youth internalizing symptoms predict parent-reported COVID-related stress in military families.

Understanding the extent to which youth and families experienced COVID-related stress requires accounting for prior levels of stress and other associated factors. This is especially important for military families, which experience unique stressors and may be reluctant to seek outside help. In this prospective study, we examined the role of pre-pandemic family factors in predicting parent and youth stress during the COVID-19 pandemic. Participants were 234 families with at least one active-duty parent and a 3rd or 5th-grade child. Findings revealed that preexisting factors predicted youth and family COVID-related stress. Specifically, heightened pre-pandemic parental stress and youth internalizing symptoms were significant predictors of COVID-related stress. Implications for mental health professionals and other organizations supporting military parents and families during the COVID-19 pandemic as well as other times of upheaval are discussed.

Unlocking What Makes Military Behavioral Health Interventions Work, Stumble, or Fade Away.

INTRODUCTION: The Office of the Secretary of Defense and each of the services have made an unprecedented commitment to the prevention of sexual assault and related behavioral health phenomena. Indeed, the Department of Air Force has selected, in some cases tailored, and disseminated a wide array of evidence-based preventative programs, policies, and practices (EBPs) over the last few decades. However, many of these efforts seem to follow a predictable life course. EBPs are initially implemented with great enthusiasm, supported for a few years, then fall out of favor, and are replaced by a different effort. This research effort aims to build on the existing civilian implementation science research to (1) offer a military-specific model of sustained, high-quality implementation and (2) test this model in a series of interconnected studies. MATERIALS AND METHODS: New York University's Institutional Review Board approved the study protocols, and the Army's Human Research Protection Office provided permission to collect data. We conducted interviews first with prevention leaders in the services and at the Office of the Secretary of Defense level regarding factors that they thought helped or hurt the sustainment of EBPs. We used these interviews to identify EBPs currently implemented in Department of Air Force and selected four EBPs out of the 25 identified for intensive study. We then interviewed implementers of those four EBPs regarding what they thought helped or hurt the sustainment of that EBP. We also gathered information about the 25 currently implemented EBPs themselves and gathered policy and guidance, as well as leadership communication about those EBPs and the target problems they focus on. We coded this information to allow us to test EBP parameters and policy and leader communication that predict sustained high-quality implementation. We conducted over 100 observations of the 4 EBPs we are studying intensively and have collected quantitative data from implementers and participants to help us test factors related to sustained high-quality implementation within each of those 4 EBPs and across the EBPs. RESULTS: Several military-specific factors were nominated for inclusion in the military-specific model of implementation sustainment. The implementation of even highly standardized EBPs varies greatly. Implementers and participants are generally highly engaged, but implementers vary in the extent to which they understand the mechanisms of action for the EBP they are implementing. CONCLUSIONS: We recommend training implementers in the mechanisms of action in the EBPs they are expected to implement and including quality assurance as a component of prevention efforts in a manner more similar to how the military addresses aspects of the operational mission. By moving beyond counting classes and attendance, and specifying how to engage participants in the EBPs in the manner that produces the key outcomes, it is likely that EBPs will have more robust implementations that can be better sustained over time.

Leveraging technology to increase the disseminability of evidence-based treatment of dental fear: An uncontrolled pilot study.

OBJECTIVES: U.S. and global estimates indicate that over 30% of adults fear receiving dental care, including over 20% who have visited a dentist in the last year, leading to avoidance and degraded oral and systemic health. Although evidence-based cognitive-behavioral treatments for dental fear (CBT-DF) exist, they have little impact on the millions who seek dental care annually because they are not disseminable (6 h of in-chair time, delivered only in person at a few sites). We developed a disseminable CBT-DF stepped-care treatment comprising (Step 1) a mobile-health application and, for those who remain fearful, (Step 2) a 1-h, one-on-one psychological treatment session that allows practice during exposure to the patient's most-feared stimuli. We hypothesized that the treatment would (a) be rated highly on usability and credibility and (b) result in clinically consequential (i.e., lowering fear into the 0-3 "no/low fear" zone) and statistically significant changes in global dental fear. METHOD: Racially/ethnically diverse patients (N = 48) with moderate to severe dental fear were recruited; all completed Step 1, and n = 16 completed Step 2. RESULTS: As hypothesized, users found the stepped-care treatment highly usable, credible, and helpful. Critically, this stepped-care approach produced reductions in patients' dental fear that were both clinically consequential (with half no longer fearful) and statistically significant (d = 1.11). CONCLUSIONS: This usable, credible, stepped-care approach to dental fear treatment holds promise for liberating evidence-based CBT-DF from specialty clinics, allowing broad dissemination.