Different concepts of neighborhood safety and child internalizing and externalizing behaviors.

Neighborhood safety is defined inconsistently across epidemiologic studies - a conceptual problem that results in incomparable measurements, hampering the design of health interventions. Using child behavior problems (measured via the Child Behavior Checklist) as the outcome of interest, this study directly compared four measures of neighborhood safety: two of experienced safety and two of perceived safety, with each one measured at family and community levels. These included children's direct experience of harm, parental perceptions, community crime statistics, and community perceptions. In a sample of 3291 ten-year-olds from the Generation R cohort (living in municipal Rotterdam, Netherlands, 2013), all four measures were correlated (χ2 ≥ 9.2, P < 0.002 in pairwise chi-square comparisons), but ultimately identified different levels of risk for behavioral health. Direct experiences of harm, parental perceptions, and community crime statistics were all associated with increased child internalizing behaviors (ß = 3.12, ß = 2.10, and ß = 1.77, respectively), while only experiences of harm and parental perceptions were associated with increased externalizing behaviors (ß = 2.75 and ß = 1.31, respectively). These results provide novel evidence that the conceptual distinctions underlying different measures of neighborhood safety are meaningful for child mental health and should be considered in intervention design.

Effects of adverse childhood experiences on observed parenting and children's behavior problems among Jewish and Arab Muslim families in Israel.

Research points to the substantial impact of parents' exposure to adverse childhood experiences (ACEs) on parents and their children. However, most studies have been conducted in North America, and research on ACEs effects on observed parenting or on intergenerational transmission of ACE effects is limited. We therefore studied families from diverse ethnocultural backgrounds in Israel and examined whether mothers' ACEs hampered maternal sensitivity and the quality of the home environment and whether mothers' psychological distress mediated these links. We also explored whether mothers' ACEs predicted children's behavior problems indirectly through maternal psychological distress and whether maternal sensitivity and the home environment attenuated this mediating path. Participants were 232 mothers (Mchild age = 18.40 months, SD = 1.76; 63.36% non-ultra-Orthodox Jewish, 17.24% ultra-Orthodox Jewish, 19.40% Arab Muslim). Results showed mothers' ACEs were directly associated with decreased maternal sensitivity. Mothers' ACEs were indirectly associated with more behavior problems in children through mothers' higher psychological distress, and maternal sensitivity moderated this indirect link; it was significant only for mothers who showed lower sensitivity. Findings emphasize the significant role ACEs play in early mother-child relationships. The importance of including ACE assessment in research and practice with families of infants and toddlers is discussed.

Frightening maternal behavior over the first 2 years of life: effects on children's behavior problems in middle childhood.

Frightening maternal behavior is linked to infant disorganization, which predicts child behavioral problems. We examined continuity in frightening maternal behavior across the first 2 years by developing a new measure of anomalous/frightening (AN/FR) behavior that incorporates changes in parent-child interactions as children acquire symbolic representation. Maternal AN/FR behavior in toddlerhood also was examined in relation to later internalizing and externalizing symptoms. First-time mothers (N = 125) completed the Adult Attachment Interview (AAI) prenatally, and mother-child dyads were observed interacting at 8 months, in Strange Situations at 12-15 months, and playing at 24 months. Teachers rated children's behavior problems at 7 years. Mothers classified as Unresolved on the AAI displayed more Frightening (FR) behavior at 8 months. Mothers' FR behavior predicted both attachment disorganization at 12-15 months and maternal AN/FR behavior at 24 months, which then predicted children's internalizing symptoms at age 7. Infant disorganization was indirectly related to internalizing symptoms, mediated by maternal AN/FR behavior.

Within-dyad bidirectional relations among maternal depressive symptoms and child behavior problems from infancy through preschool.

Although dyadic theory focuses on the impact of a mother's mental health on her own child and the impact of a child's mental health on their own mother, commonly used statistical approaches are incapable of distinguishing the desired within-dyad processes from between-dyad effects. Using autoregressive latent trajectory modeling with structured residuals, the current study evaluated within-dyad, bidirectional associations between maternal depressive symptoms and child behavior problems from child age 1-4.5 years among a sample of low-income, Mexican American women (N = 322, Mage = 27.8) and their children. Women reported on maternal depressive symptoms and child behavior problems during laboratory visits at child age 1, 1.5, 2, 3, and 4.5 years. Results provide novel evidence of child-driven bidirectional association between maternal depressive symptoms and child behavior problems at the within-dyad level as early as child age 1 year and within-person stability in child behavior problems emerging early in life.

European gay fathers via surrogacy: Parenting, social support, anti-gay microaggressions, and child behavior problems.

The present study investigated child behavior problems, parenting styles, coparenting, and couple relationship satisfaction in 67 European gay father families via surrogacy and 67 European heterosexual parent families via unassisted conception, all with children aged 1.5-10 years (M = 3.57 years, SD = 2.09). The two family groups were matched for child age and gender. In the gay father group only, the associations between family anti-gay microaggressions, family/friend support, and other main variables also were explored. Children of gay fathers had fewer externalizing and internalizing problems compared to children of heterosexual parents. Also, gay fathers reported more effective parenting styles, greater coparenting quality, and higher couple relationship satisfaction compared to heterosexual parents. Overall, child externalizing problems (i.e., aggression, rule-breaking) and internalizing problems (i.e., anxiety, depression) were more strongly associated with being raised in a heterosexual parent family, more authoritarian parenting, and lower positive coparenting. Specific to the gay father sample, anti-gay microaggressions experienced by family members were associated with more child internalizing problems, lower positive coparenting, and lower social support from family and friends. These results refute concerns about possible detrimental effects on child development of surrogacy conception or of being raised by gay fathers. The results further suggest that family therapists treating child behavior problems should focus mainly on improving the coparenting relationship, reducing authoritarian/punitive parenting styles, and (for gay father families specifically) coping with anti-gay microaggressions and lack of social support outside the nuclear family.

Evaluating the Effect of Parent-Child Interactive Groups in a School-Based Parent Training Program: Parenting Behavior, Parenting Stress and Sense of Competence.

The Exploring Together program is a group-based parent training program that comprises separate parent, child, and teacher components, and a combined parent-child interactive component. A cluster-randomized trial design was used to compare the Exploring Together program with (Exploring Together; ET) and without (Exploring Together-Adapted; ET-Adapted) the parent-child interactive component. One hundred and thirty-six parents and their children (aged 5-10 years) with externalizing and/or internalizing problems participated in the trial, recruited from primary schools. There was a significant reduction in negative parenting behavior across both treatment groups (ET and ET-Adapted) but no significant improvement in positive parenting behaviors. Parenting self-efficacy improved significantly across both treatment groups however there was no significant change in parenting satisfaction or parenting stress. There was no consistent evidence of superiority of one version of the Exploring Together program over the other. Further investigation regarding treatment dosage and mastery of parenting skills associated with the program is warranted.

The Long and the Short of It: A Comparison of the Effectiveness of Parent-Child Care (PC-CARE) and Parent-Child Interaction Therapy (PCIT).

Research shows that parenting interventions struggle with keeping clients in treatment. The purpose of this study was to compare attrition and rates of improvement in caregiver-child dyads participating in either Parent-Child Care (PC-CARE), a brief, 7-session parenting intervention or Parent-Child Interaction Therapy (PCIT) over a 7-week period. Participants were 204 caregiver-child dyads referred to either PC-CARE (N = 69) or PCIT (N = 135) between 2016 and 2019. Children were aged 2-7 years, referred for treatment by county Behavioral Health Services, and Medicaid funded. Findings showed that PC-CARE participants were 2.5 times more likely than PCIT participants to complete 7 sessions, all other things being equal, and showed significantly greater rates of improvement during this timeframe in reported child behavior problems and parenting stress. In conclusion, compared with PCIT, PC-CARE showed greater retention and rate of improvement in child and parent outcomes over a comparable time period.

Prenatal Programming of Behavior Problems via Second-by-Second Infant Emotion Dynamics.

Fetal adaptations to prenatal maternal stress may confer high risk for childhood behavior problems, potentially operating via dynamic fluctuations in infants' emotions during mother-infant interactions. These fluctuations over time may give rise to behavior problems. Among a sample of 210 low-income mothers of Mexican origin and their 24-week-old infants, dynamic structural equation modeling was used to examine whether within-infant second-by-second emotion processes were predicted by maternal prenatal stress and predicted behavior problems at 36 and 54 months. The mean level around which infant negative affect fluctuated was related to prenatal stress, but not to childhood behavior problems. The volatility in infant negative affect, reflecting greater ebb and flow in infant negative affect during playful interaction, was predicted by prenatal stress and predicted enduring behavior problems in childhood. Results highlight a potential child-driven pathway linking prenatal exposure with childhood behavior problems via infant negative emotional volatility.

Methylation of the glucocorticoid receptor promoter in children: Links with parents as teachers, early life stress, and behavior problems.

The present study examined the effect of early life stress (ELS) on the glucocorticoid receptor gene (NR3C1) methylation, the associations between NR3C1 methylation and behavior problems, and the effect of the program Parents as Teachers (PAT) on NR3C1 methylation. Participants included 132 children, 72 assigned to the PAT intervention group and 60 to the PAT control group. Children were aged 3 years, and were living in psychosocially at-risk families. We assessed NR3C1 methylation of the NGFI-A binding regions of exon 1F via sodium bisulfite sequencing from saliva DNA. Results indicated that (a) children living in families receiving PAT had decreased methylation at one single cytosine-guanine dinucleotides (CpG) site; (b) current maternal depressive symptoms and parental disagreement were predictive of increased methylation of mean NGFI-A and three single CpG sites; and (c) increased methylation of mean NGFI-A and one single CpG site was significantly associated with increased internalizing and externalizing symptoms. In addition, mean NGFI-A was a mediator of the association between parental disagreement and a child's affective problems. These results suggest that PAT may contribute to preventing NR3C1 methylation in preschool children living in psychosocially at-risk situations, and confirm previous findings on the associations between ELS, NR3C1 methylation, and behavior problems.

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

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

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

Systematic Review and Meta-Analysis of the Effectiveness of Teacher Delivered Interventions for Externalizing Behaviors.

This systematic review and meta-analysis explores the effectiveness of teacher interventions supporting children with externalizing behaviors based on teacher and child outcomes. A systematic search was conducted using 5 electronic databases. From 5714 papers, 31 papers that included interventions delivered directly to teachers and aimed to benefit either teachers and/or children with externalizing behaviors were included. The review focused on qualified teachers working with children aged 2-13. The results of the current meta-analysis revealed a positive effect of teacher intervention on teacher and child outcomes, including the increased use of teacher-appropriate strategies, as well as significant and moderate improvements in teacher-child closeness, and small reductions in teacher-child conflict. For child outcomes, the interventions reduced externalizing behavior problems and ADHD symptoms and enhanced prosocial behavior. Only one fully blinded analysis for conduct problems was possible and revealed a moderate but significant reduction in favor of intervention. These findings provide evidence to support the role of teacher interventions for both teachers and children with externalizing behaviors. Future research should include more PBLIND measurements so that MPROX findings can be confirmed. More research should be done to evaluate the influence of teacher interventions on teachers' well-being.

Papa was a rollin' stone: how father's psychological distress impacts child's internalizing and externalizing symptoms.

While parental psychological distress is a commonly examined risk factor in the development and maintenance of child's emotional and behavioral problems, there is an incomplete understanding of the unique contribution of the father. The current study examines whether paternal psychological distress (i.e., depression, anxiety, and anger) exacerbates child's internalizing and externalizing behaviors, as well as whether a child's internalizing and externalizing behaviors exacerbate paternal psychological distress. The National Institute of Child and Human Development (NICHD)'s Study of Early Child Care and Youth Development (SECCYD) longitudinal dataset was utilized. A bivariate latent difference score model was applied to examine the interdependence of each member within the dyad. This novel statistical technique allowed for the examination of the influence of psychological distress in the father-child dyad across 10 years. Results indicated that paternal anger is a risk factor associated with the development and maintenance of internalizing and externalizing behaviors in children. Likewise, children's behavioral problems served as a contributing factor to paternal anger and anxiety. Results were nonsignificant for the effect of depression on change in internalizing and externalizing problems. The initial levels correlated with each other, but one did not affect the change in the other. Overall, the results have clinical implications, as they can be applied to the creation or modification of intervention plans by shifting the focus from the primary outcome being a decrease in child problem behavior to an overall reduction of psychological distress in the family unit.

Intimate Partner Violence and Food Insecurity Predict Early Behavior Problems Among South African Children over 5-years Post-Birth.

Households experiencing intimate partner violence (IPV) and food insecurity are at high risk of lifelong physical and behavioral difficulties. Longitudinal data from a perinatal home-visiting cluster-randomized controlled intervention trial in South Africa townships were used to examine the relationships between household settings and mothers' histories of risk and children's behavior problems at 3 and 5 years of age. IPV, food insecurity, maternal depressed mood, and geriatric pregnancy (at age of 35 or older) were consistently associated with children's internalizing and externalizing behavior problems. Aggressive behavior was more prevalent among 3- and 5-year olds boys, and was associated with maternal alcohol use. The effects of these factors on child behavior were more prominent than maternal HIV status. There is a continuing need to reduce IPV and household food insecurity, as well as supporting older, depressed, alcohol using mothers in order to address children's behavioral needs.

Bidirectional Spillover in the Family across the Transition to Parenthood.

Although family systems theory posits reciprocal causality between subsystems of the family, such as intimate partner violence exacerbating harsh parenting and vice versa, longitudinal studies with cross-lagged models have been used infrequently to test these principles. As guided by the spillover model, this study examined bidirectional associations between couple dysfunction, parent-child aggression risk, and child functioning across the transition to parenthood to determine whether and how disruptions in one subsystem relate to problems in other family subsystems. Participants were 201 first-time mothers and 151 fathers from a diverse community sample, evaluated during pregnancy, and reassessed two more times through their child's first 18 months of life. Individual and dyadic path model results indicate bidirectional spillover effects between parent-child aggression risk and child functioning for both mothers and fathers, and spillover from parent-child aggression risk to couple dysfunction for mothers but not fathers. However, limited spillover effects were identified between couple functioning and child adjustment, in contrast to previous work. Findings suggest that spillover can happen reciprocally and early in the family, supporting transactional models of behavior and highlighting the need for early family level intervention.

Aunque la teoría de sistemas familiares plantea una causalidad recíproca entre los subsistemas de la familia, como la violencia de pareja que exacerba la crianza hostil y viceversa, se han utilizado ocasionalmente estudios longitudinales con modelos de referencias cruzadas para evaluar estos principios. Guiado por el modelo de transferencia, este estudio analizó las asociaciones bidireccionales entre la disfunción de la pareja, el riesgo de agresión entre padres e hijos y el funcionamiento de los niños durante la transición a la paternidad a fin de determinar si y cómo las alteraciones de un subsistema se relacionan con los problemas en otros subsistemas familiares. Los participantes fueron 201 madres primerizas y 151 padres de una muestra comunitaria diversa evaluada durante el embarazo y reevaluada dos veces más a lo largo de los primeros 18 meses de vida de su hijo. Los resultados del modelo de ruta individual y diádico indican efectos de transferencia bidireccional entre el riesgo de agresión entre padres e hijos y el funcionamiento de los niños tanto para las madres como para los padres, y transferencia del riesgo de agresión entre padres e hijos a la disfunción de la pareja para las madres pero no para los padres. Sin embargo, se identificaron efectos escasos de transferencia entre el funcionamiento de la pareja y la adaptación de los niños en comparación con trabajos anteriores. Los resultados sugieren que la transferencia puede ocurrir recíprocamente y pronto en la familia, lo cual respalda modelos transaccionales de comportamiento y destaca la necesidad de una intervención temprana a nivel familiar.

Efficacy of the parenting support program on child behavior problems.

The study aimed to examine the efficacy of the Parenting Support Program (PSP) for reducing problem behaviors and increasing adaptive behaviors in young children aged 3 to 6. The PSP focuses on effective parenting skills and building positive interactions between parents and their children. Parents of children (n = 18 mothers and 11 fathers) were randomly assigned to an experiment group (EG) and a wait-list (WL) group. The EG attended a total of 12 individually delivered sessions. Data was gathered via parent and teacher report measures, observation and semi-structured interviews. The PSP was effective in increasing adaptive behaviors and decreasing behavior problems in children. The change in the children's score which fulfills the Reliable Change Index criteria in the EG was found to be higher than the WL group. However, fathers reported fewer improvements than mothers in the EG. Qualitative data supported the experimental study results demonstrating the efficacy of the PSP, and met the expectations of parents. Consequently, the PSP could be used as an intervention tool to decrease behavior problems and increase adaptive behaviors in young children.

Household Chaos and Child Behavior Problems Predict Maternal Well-being.

The aim of the study was to investigate predictors of maternal well-being in mothers of twins. As well as being important in its own right, maternal well-being is a crucial predictor of parenting (Belsky in Child Dev. 55(1):83, 1984). Based on previous research (Pike et al. in Int J Beh Dev. 30(1):55-66, 2006) we expected that household chaos (Confusion, Hubbub, and Order) and child behavior problems would predict maternal depression, stress and anxiety. The data for the study was taken from the Twins, Family and Behavior Study (TFaB) -- a longitudinal UK study of twins born in 2009 and 2010. One hundred and fifty-eight mothers of twins (Mchild age= 6.01 years, SDage = 0.50) reported on household chaos, child disruptive behaviors and their own well-being. Higher levels of household chaos were linked to maternal depressive, anxiety and stress related symptoms. More child behavior problems were related to more depressive and stress symptoms but not anxiety. The findings show promise for future research investigating different types of maternal well-being and suggested practical implications, such as intervening on concrete aspects of household chaos to improve maternal well-being.

Parenting activities and the transition to home-based education during the COVID-19 pandemic.

This study reports on parent-child dynamics during initial COVID-19 related school closures, based on cross-sectional analyses of a survey that utilized a convenience sampling approach. Data were collected in April 2020, approximately five weeks after the World Health Organization declared that the Coronavirus was a pandemic. Participants (N = 405) were adults recruited throughout the U.S. This study examines data from parents (69% mothers and 31% fathers) with at least one child 0-12 years of age. The majority were White (71%) and 41% had at least a bachelor's degree. The majority of parents (78%) were educating their child at home due to COVID-19. Most (77.1%) reported use of online tools for at-home education, including educational apps, social media, and school-provided electronic resources. More than one-third (34.7%) of parents said their child's behavior had changed since the pandemic, including being sad, depressed, and lonely. Most parents were spending more time involved in daily caregiving of their children since COVID-19. Two out of every five parents met the PHQ-8 criteria for major depression or severe major depression (40.0%) and the GAD-7 criteria for moderate or severe anxiety (39.9%). Multivariate analyses indicated that, compared to non-depressed parents, parents who met criteria for probable major or severe depression (B = -0.16, 95% CI = [-0.29, -0.02], p = .021) and parenting stress (B = -0.37, 95% CI = [-0.47, -0.27], p < .001) were negatively associated with parents' perceived preparation to educate at home. Compared to parents with minimal or mild anxiety, parents with moderate or severe anxiety reported higher child anxiety scores (B = 0.17, 95% CI = [0.06, 0.28], p = .002). Parenting stress was also positively associated with higher child anxiety scores (B = 0.40, 95% CI = [0.32, 0.48], p < .001). Content analyses of open-ended questions indicated that school closures were a significant disruption, followed by lack of physical activity, and social isolation. Overall, study results suggested that parents' mental health may be an important factor linked to at-home education and child wellbeing during the pandemic.

COVID-19, child's behavior problems, and mother's anxiety and mentalization: A mediated moderation model.

We examined the direct and indirect links between COVID-19, maternal anxiety symptoms, and child behavior problems as well as the mediation-moderation links of mothers' anxiety symptoms and mentalization skills with the prediction of child behavior problems. A sample of 140 Israeli mothers with preschool children comprised the study's two groups: A COVID-19 group (n = 53), recruited shortly after the pandemic outbreak, and a pre-COVID-19 group (n = 87), recruited prior to the pandemic. Mothers completed online questionnaires regarding their own anxiety symptoms (BSI anxiety subscale) and their children's internalizing and externalizing behaviors (CBCL). Maternal mentalization was assessed via the mind-mindedness representational procedure. Findings showed that mothers in the COVID-19 group experienced more anxiety symptoms and perceived their children as having more externalizing and internalizing behaviors compared to mothers in the pre-COVID-19 group. Mothers' anxiety symptoms mediated the effect of the pandemic on children's behaviors so that the higher the mothers' anxiety, the more externalizing and internalizing behaviors among the children. Mothers' mentalization moderated the association between the pandemic and the children's externalizing behaviors. Specifically, when mothers showed higher mentalization skills (higher mind-mindedness), the indirect effect of anxiety on the link between COVID-19 and children's externalizing behaviors was weaker compared to when mothers showed lower mentalization skills (lower mind-mindedness). The implications of these findings for preventive and treatment interventions that aim to reduce maternal anxiety and enhance mentalization skills to prevent children's behavior problems in the context of COVID-19 are discussed.

Fathers' and mothers' attachment styles, couple conflict, parenting quality, and children's behavior problems: an intervention test of mediation.

A diverse sample of 239 primarily low-income couples participated in a random controlled trial of the Supporting Father Involvement couples group intervention. In this report, we examined the value of adding measures of fathers' attachment style and parenting to mothers' measures in order to explain variations in children's behavior problems. We also tested the hypothesis that the link between intervention-induced reductions in couple conflict and reductions in anxious/harsh parenting can be explained by intervention effects on parents' attachment insecurity or on anxiety and depression. Fathers' attachment security and parenting behavior added significantly to mothers' in accounting for children's internalizing and externalizing problem behaviors. Fathers' anxious attachment style and anxiety/depression mediated the link between post-intervention reductions in parental conflict and anxious/harsh parenting. For mothers, only improvements in attachment security accounted for those links. The findings support the need for attachment researchers to consider the contributions of both parents to their children's development.

An Open Trial of Parent-Child Care (PC-CARE)-A 6-Week Dyadic Parenting Intervention for Children with Externalizing Behavior Problems.

Research shows that parenting interventions are plagued with the problem of early treatment termination. A brief 6-week intervention, parent-child care (PC-CARE) was developed to minimize the time investment for parents while maximizing the probability of improving behavioral problems of their 1-10 year old children. The purpose of this study was to determine the feasibility of PC-CARE and examine preliminary outcomes. The data were collected as part of an open trial in a community mental health clinic and included pre- and post-treatment performance outcomes, weekly measures of treatment progress, and assessments of treatment fidelity. Participants were 64 children and their primary caregivers, referred by physicians, social workers, or self-referred for help with their children's difficult behaviors. The retention rate was 94%. Results of analyses pre- to post-intervention scores showed significant improvements in child behavioral problems as well as improvements in parenting stress and positive parenting skills. The findings suggest that PC-CARE may be a beneficial treatment for children with disruptive behaviors, encourage future research into the efficacy of this brief parenting intervention, and its effectiveness in other populations and contexts.