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Objective: Interpersonal partner violence (IPV) is a pervasive social and public health problem worldwide. In the context of the response by the World Health Organization to this issue, proposals were developed to improve the usefulness of International Classification of Diseases (ICD-11) descriptions for helping clinicians to reliably identify relational problems and maltreatment (RPM), including IPV, as part of clinical practice. This study focuses on factors associated with the accuracy of diagnostic decisions made by mental health professionals (MHPs) around the world when using the proposed ICD descriptions for RPM with standardized clinical vignettes in an ICD-11 internet-based field trial study. Method: A total of 1,221 MHPs from ninety countries evaluated randomly assigned vignettes, which described patients presenting with or without RPM and with or without a co-occurring depressive or anxiety disorder. Results: Findings showed that increased diagnostic accuracy for RPM was associated with MHPs being female or having greater knowledge/experience of RPM, as well as with the absence of a mental disorder in the patient. Conclusions: Findings highlight the importance of providing IPV-related training programs for MHPs to (a) better identify and address IPV in mental health settings and (b) improve knowledge and understanding of the consequences of IPV for physical and mental health. [ABSTRACT FROM AUTHOR]

In the present investigation, we studied the development of 6 physically aggressive behaviors in infancy and toddlerhood, posing 3 questions (a) How do the prevalences of individual physically aggressive behaviors change from 8, 15, and 24 months? (b) Are there groups of children who show distinctive patterns in the way individual physically aggressive behaviors develop over time? (c) What are the behavioral pathways leading from 8- to 24-month acts of physical aggression? Mothers and fathers (N = 272) from a moderately at-risk population reported on their children's physical aggression at each time point. The results revealed the commonality of physical aggression at all ages studied and the diverging developmental patterns of individual behaviors. Some physically aggressive behaviors became less common (e.g., hair pulling), while others became more common (e.g., hitting), with age. Roughly 42% of the children exhibited an increased propensity, relative to their peers, to aggress at all ages. Kicking, biting, hair pulling, and pinching/scratching at 8 months were the first steps on behavioral pathways leading to physical aggression at 24 months. These pathways principally suggested heterotypic continuity in physical aggression.

Purpose/Objectives: A patient‐centered care (PCC) paradigm undergirds modern dental education. PCC is particularly relevant in the management of patient dental fear. The aims of this study were three‐fold: (a) to examine the preliminary psychometric properties of an author‐designed survey administered to explore dental fear knowledge and perceptions, (b) to assess how 4th‐year dental students regard dental fear, (c) and to investigate the relationship between students' knowledge and perceptions of dental fear and their clinical behavior. Methods: In 2022, 4th‐year dental students (N = 453) participated in a cross‐sectional study. Participants completed a 16‐item survey that assessed (a) knowledge and perceptions about dental fear, (b) common biases in patient fear assessment, and (c) patient management behaviors when fear is encountered. Exploratory factor analysis, descriptive statistics, and logistic regressions were run to address the study's aims. Results: Exploratory factor analysis revealed three factors, with the two strongest factors pertaining to beliefs about the importance of dental fear (α = 0.87) and self‐efficacy in managing fear (α = 0.74). Participants indicated that it is important to assess for dental fear and rated their self‐efficacy in ability managing it as high. Ratings on both factors slightly increased the odds of engaging in routine patient screening for dental fear. Students also displayed assessment biases commonly seen among practicing dentists. Conclusion(s): Results indicate educational gaps within the current behavioral‐science training for dental students. Changes to improve advanced dental students' appreciation of their patients' dental fear are warranted. [ABSTRACT FROM AUTHOR]

Commonly used scales of psychological intimate partner violence (ψIPV) for adolescents may not include sufficient items to measure adequately different forms of ψ aggressive behaviors. They may also characterize as harmful ψ aggressive behaviors occurring in non-conflictual or joking contexts. The current study examined a new scale, the Relationship Behavior Survey (RBS), which was designed to measure three different forms of ψIPV (denigrating, controlling, and intrusive behaviors) and the appraisals of the perpetrator's intent. Factor structure was examined, and incremental validity was tested by examining the relation of the RBS to general aggressive tendencies and physical IPV after accounting for the emotional abuse and threatening behavior subscales of the Conflict in Adolescent Dating Relationships Inventory (CADRI). Criterion validity and gender differences were also examined. Data were collected using an online survey from a national sample of 1,100 13 to 17-year-olds in the United States (51% identified as female, 80% as White) in a dating relationship. Confirmatory factor analysis supported one ψIPV construct for males and females. The RBS demonstrated incremental validity; criterion validity was supported for controlling intent for males and females and mistrust intent for females. Joking intent was the most reported intent for males and correlated unexpectedly with physical IPV. The RBS captures a larger range of ψIPV behaviors than the CADRI. The addition of intent appraisals provides important information to differentiate forms of ψIPV, particularly in relation to acts motivated by coercion and mistrust. [ABSTRACT FROM AUTHOR]

Two studies examined the impact of the implementation of the Field-tested Assessment, Intervention-planning, and Response (FAIR) system, a system-level intervention for determining whether allegations of family maltreatment meet threshold for abuse or neglect, on alleged recidivism. Data were collected at the 10 U.S. Army installations with the largest family maltreatment caseloads. Participants were family members who had an allegation of family maltreatment (i.e., child maltreatment or partner abuse) during one of the two study periods. Data were collected when Family Advocacy Program staff used the then-in-place system (Case Review Committee) and later the FAIR system. In Study 1, cases were followed for 6 months following the initial maltreatment allegation to measure the occurrence of subsequent allegations of any type. Additionally, at five installations, alleged victims of partner abuse were recruited into a study (Study 2) in which they anonymously reported on intimate partner violence via telephone. In Study 1, the advantage for the FAIR condition was concentrated in cases with unsubstantiated initial determinations; the mean relative risk reduction for recidivism was 0.48. In Study 2, FAIR extended median time to recidivism by approximately 170%. These results replicate and extend earlier findings that employing the FAIR system can result in decreased family maltreatment re-offense. [ABSTRACT FROM AUTHOR]

Objective: Suicidal members of the U.S. military often fail to disclose their suicidal urges and behaviors. Military suicide prevention efforts may therefore be enhanced if they also target less stigmatized psychosocial factors that may decrease risk of suicidality. In keeping with Bronfenbrenner's (1977, 1994) model, this study simultaneously examined 4 ecological levels (i.e., individual, family, workplace, and community) of factors variously associated with increased or decreased risk for suicidal ideation. Method: Active-duty U.S. Air Force members (N = 52,780; 79.3% male; 79.2% non-Hispanic White; mean age = 31.78 years, SD = 7.38) completed the 2006 Community Assessment survey (a biennial, anonymous survey conducted at 82 U.S. Air Force bases worldwide), including the Centers for Disease Control and Prevention's (2008) 5-item measure of past-year suicidality along with scales assessing an array of potential predictors. Results: The 1-year rate of suicidal ideation, defined as (a) more than rarely thinking about suicide or (b) ever seriously considering suicide, was approximately 4%. In multivariate models, for men and women, individual- (depressive symptoms and alcohol problems), family- (relationship satisfaction and intimate partner victimization), workplace- (hours worked), and community-level (social support) variables were retained in the final model. However, some sex differences in retained predictors were noted (e.g., men: dissatisfaction with the U.S. Air Force way of life; women: workplace relationship satisfaction and financial stressors). Conclusions: Addressing depressive symptoms and alcohol use, facilitating healthy relationship functioning, and increasing job satisfaction and social support may aid military suicide prevention efforts. These findings illustrate the importance of attending to multiple levels of potential influence when designing integrated suicide prevention and intervention programs. (Contains 2 footnotes and 3 tables.)

Objective: Intimate partner violence (IPV) is a serious health concern, but little is known about prevalence of IPV in the armed forces, as military members cope with the pressures of long-standing operations. Furthermore, previous prevalence studies have been plagued by definitional issues; most studies have focused on acts of aggression without consideration of impact (clinically significant [CS] IPV). This is the first large-scale study to examine prevalences of IPV, CS-IPV, and clinically significant emotional abuse (CS-EA) for men and women. Method: A United States Air Force-wide anonymous survey was administered across 82 bases in 2006 (N = 42,744) to assess IPV, CS-IPV, and CS-EA. Results: The adjusted prevalence of CS-IPV perpetration was 4.66% for men and 3.54% for women. Prevalences of IPV perpetration were 12.90% for men and 15.14% for women. CS-EA victimization was 6.00% for men and 8.50% for women. Sociodemographic differences in risk for violence were found for gender, race/ethnicity, pay grade, religious faith, marital status, and career type even after controlling for other demographic variables. Conclusions: Partner maltreatment is widespread in military (and civilian) samples. Men were more likely to perpetrate CS-IPV, whereas women were more likely to perpetrate IPV. Specific demographic risk factors were identified for different types of partner maltreatment (e.g., lower rank predicted higher risk for both perpetration and victimization across men and women). Other sociodemographic differences varied across severity (IPV vs. CS-IPV) and across gender. (Contains 5 tables.)

Hypothesized risk factors for men's and women's clinically significant intimate partner violence (CS-IPV) from four ecological levels (i.e., individual, family, workplace, community) were tested in a representative sample of active-duty U.S. Air Force members (N = 42,744). When considered together, we expected only individual and family factors to account for unique variance in CS-IPV perpetration. Hypothesized factors from all four ecological levels were related to men's CS-IPV perpetration bivariately, but, as expected, only individual and family factors accounted for unique variance across ecological levels. For women, only risk factors from the individual and family levels were significantly related to CS-IPV perpetration even bivariately. Results imply somewhat different risk profiles across gender and identify ecological risk factors of men's CS-IPV not previously studied.

Multivariate, biopsychosocial, explanatory models of mothers' and fathers' psychological and physical aggression toward their 3- to 7-year-old children were fitted and cross-validated in 453 representatively sampled families. Models explaining mothers' and fathers' aggression were substantially similar. Surprisingly, many variables identified as risk factors in the parental aggression and physical child abuse literatures, such as income, unrealistic expectations, and alcohol problems, although correlated with aggression bivariately, did not contribute uniquely to the models. In contrast, a small number of variables (i.e., child responsible attributions, overreactive discipline style, anger expression, and attitudes approving of aggression) appeared to be important pathways to parent aggression, mediating the effects of more distal risk factors. Models accounted for a moderate proportion of the variance in aggression.

This exploratory study was designed to address how multiple factors drawn from varying focal models and ecological levels of influence might operate relative to each other to predict partner aggression, using data from 453 representatively sampled couples. The resulting cross-validated models predicted approximately 50% of the variance in men's and women's partner aggression. The 3 strongest direct predictors of partner aggression for men and women were dominance/jealousy, marital adjustment, and partner responsibility attributions. Three additional direct paths to aggression for men were exposure to family-of-origin aggression, anger expression, and perceived social support. The 1 additional direct path for women was a history of their own aggression as a child or teenager. Implications for more integrative theories and intervention are discussed.

Hypotheses were tested about how moment-by-moment variation in mothers' negative emotion predicts harsh and lax discipline. Mother-toddler dyads interacted in a task designed to elicit challenging child behavior. Mothers viewed videotapes of their interactions and continuously rated their experienced emotion. Harsh discipline was associated with mothers' greater negative emotion intensity, greater dependence of mothers' emotion on toddlers' negative affect, and lower serial predictability of mothers' emotion. Laxness was also associated with greater emotion dependence on negative toddler affect and lower serial predictability but not with negative emotion intensity. The dependence of mothers' emotion on toddlers' rule violations was not associated with discipline. Dynamic emotion variables were not redundant with emotion intensity and therefore enhance our understanding of the role of emotion in discipline.

Hypotheses were tested about how moment-by-moment variation in mothers' negative emotion predicts harsh and lax discipline. Mother-toddler dyads interacted in a task designed to elicit challenging child behavior. Mothers viewed videotapes of their interactions and continuously rated their experienced emotion. Harsh discipline was associated with mothers' greater negative emotion intensity, greater dependence of mothers' emotion on toddlers' negative affect, and lower serial predictability of mothers' emotion. Laxness was also associated with greater emotion dependence on negative toddler affect and lower serial predictability but not with negative emotion intensity. The dependence of mothers' emotion on toddlers' rule violations was not associated with discipline. Dynamic emotion variables were not redundant with emotion intensity and therefore enhance our understanding of the role of emotion in discipline.

This paper describes two studies investigating the interrater agreement of severity scales for family maltreatment used in America's largest child and family maltreatment agency: the U.S. military's Family Advocacy Program (FAP). The USAF-FAP Severity Index is a multidimensional rating system for clinicians' evaluations of the severity of seven forms of family maltreatment: partner physical, emotional, and sexual abuse; child physical, emotional, and sexual abuse; and child neglect. The first study evaluated the reliability of the scale as it is used in the field. The second study compared a generalizable sample of clinicians' ratings to an established 'gold standard' of what the ratings should have been. The Severity Index demonstrated fair-to-good levels of reliability, suggesting that with minimal cost, investigating caseworkers can routinely assess, and make fairly reliable ratings of, the severity of seven forms of family maltreatment for each case they investigate. KEY WORDS: partner abuse; child abuse; child neglect; child maltreatment; family violence; severity; reliability., Over 900,000 children, or 13.9 per 1,000, are estimated to be maltreated each year in the United States (U.S. Department of Health and Human Services, 2000), with neglect (53.5%), physical [...]

Intimate partner violence (IPV) is a global public health problem that has been shown to lead to serious mental health consequences. Due to its frequent co-occurrence with psychiatric disorders, it is important to assess for IPV in mental health settings to improve treatment planning and referral. However, lack of training in how to identify and respond to IPV has been identified as a barrier for the assessment of IPV. The present study seeks to better understand this IPV-related training gap by assessing global mental health professionals' experiences of IPV-related training and factors that contribute to their likelihood of receiving training. Participants were French-, Spanish-, and Japanese-speaking psychologists and psychiatrists (N = 321) from 24 nations differing on variables related to IPV, including IPV prevalence, IPV-related norms, and IPV-related laws. Participants responded to an online survey asking them to describe their experiences of IPV-related training (i.e., components and hours of training) and were asked to rate the frequency with which they encountered IPV in clinical practice and their level of knowledge and experience related to relationship problems; 53.1% of participants indicated that they had received IPV-related training. Clinicians from countries with relatively better implemented laws addressing IPV and those who encountered IPV more often in their regular practice were more likely to have received training. Participants who had received IPV-related training, relative to those without training, were more likely to report greater knowledge and experience related to relationship problems. Findings suggest that clinicians' awareness of IPV and the institutional context in which they practice are related to training. Training, in turn, is associated with subjective appraisals of knowledge and experience related to relationship problems. Increasing institutional efforts to address IPV (e.g., implementing IPV legislation) may contribute to improved practices with regard to IPV in mental health settings. [ABSTRACT FROM AUTHOR]

Objective Concurrent and prospective predictors of suicidal ideation were examined in a sample of 318 United States Air Force Security Forces across a 1-year deployment in Iraq and 6- to 9-month follow-up. Method Participants included 294 male and 24 female Airmen ranging in age from 18 to 46 years, predominantly (67%) Caucasian. Measures included self-reports of postdeployment suicidal ideation, posttraumatic stress and depressive symptoms, alcohol use, combat experiences, relationship distress, social support, and postdeployment readjustment. Results Problem drinking before deployment prospectively predicted postdeployment suicidal ideation in univariate analyses. Depressive symptoms and problem drinking were significant independent predictors of postdeployment suicidal ideation. Findings demonstrated a ninefold increase in suicidal ideation among service members with even mild depressive symptoms if moderate problem drinking was also present. Conclusions Predeployment problem drinking may serve as a modifiable target for early intervention of suicidal ideation. Findings illuminate the compound risk of comorbid depressive symptoms and moderate problem drinking in predicting suicidal ideation. [ABSTRACT FROM AUTHOR]

The relationships and families of active duty (AD) service members have been tremendously strained by deployments and high operations' tempo. This study involves the first steps in developing a multilevel approach to preventing relationship problems that integrates universal, selective, and indicated prevention/intervention. Such an approach has tremendous empirical support for parenting problems, but no similar program exists for couple problems. We conducted two studies with U.S. Air Force Security Forces members. Study 1 elicited the target population's topics of highest interest. For almost all topics, 70% to 95% of participants who desired information reported being underserved by current prevention offerings (i.e., not receiving needed information). Using the top topics generated in Study 1, we developed prevention information/action planning sheets on 18 relationship issues. In Study 2, we had AD members who gave feedback on the form and content of the sheets. Overall, AD members believed that the sheets were moderately to very useful and were presented well, had pithy but comprehensive information and conveyed the content well. Results imply that a multilevel approach may be a useful complement to formal services in meeting underserved military members' needs and that further research and development of this dissemination vector for evidence-based information is warranted. [ABSTRACT FROM AUTHOR]