70 results on '"Gewirtz AH"'
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2. Young children's exposure to intimate partner violence: towards a developmental risk and resilience framework for research and intervention.
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Gewirtz AH and Edleson JL
- Abstract
This article employs a developmental risk and resilience framework to examine the impact of exposure to intimate partner violence on young children, particularly those facing economic hardship. In doing so, it reviews and weaves together two separate literatures, one on emotional and behavioral development in high-risk settings and the other on children exposed to adult domestic violence. The article ends by pointing to the need for further research and the promise that early interventions hold for helping children who are exposed to intimate partner violence and living in poverty. [ABSTRACT FROM AUTHOR]
- Published
- 2007
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3. Parenting Profiles in Military Families: Intervention-Related Transitions and Relationships to Child Adjustment.
- Author
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Lee SK, Gewirtz AH, and Piehler TF
- Abstract
Parenting programs aim to improve parenting quality, which may, in turn, support various aspects of child development, including behavior and mental health. However, parenting interventions show considerable heterogeneity in response patterns across different families, demonstrating that they are not one-size-fits-all programs. This variability points to a need for greater understanding of which families benefit most from these interventions and how to improve response among those who do not. Following this literature gap, this study employed a person-centered approach to identify different parenting profiles associated with heterogeneity in treatment responses to a family-based prevention interventions adapted for military families. This study used data from a randomized controlled trial of the ADAPT intervention for 336 US military families in which at least one parent had deployed to war. Latent profile analyses revealed three unobserved parenting profiles among mothers and fathers, reflecting High positive, Moderate positive, and Coercive parenting styles. Latent transition analysis (LTA) suggested that the ADAPT program led to improvements in parenting, particularly among mothers who began the program with moderate or typical levels of parenting skills, and that these positive changes in parenting may help to decrease child externalizing problems. For fathers, the ADAPT program was most effective in preventing declines in positive parenting among those with initially typical levels of positive parenting. Overall, study findings demonstrate considerable heterogeneity in parenting behavior among a sample of military families that is associated with variability in parent responses to the evidence-based parenting program., (© 2024. The Author(s).)
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- 2024
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4. Does Being In-Person Matter? Demonstrating the Feasibility and Reliability of Fully Remote Observational Data Collection.
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Basha SAJ, Cai Q, Lee S, Tran T, Majerle A, Tiede S, and Gewirtz AH
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Many conventional research methods employed in randomized controlled trials were not possible during the height of the COVID-19 pandemic. In particular, behavioral observations are nearly universally gathered in-person. Observational methods are valued for the rich, informative data they produce in comparison to non-observational methods and are a cornerstone of parenting and family research. COVID provided the opportunity to, and indeed necessitated, the transition to fully remote observation. However, little to no studies have investigated whether remotely collected observational data are methodologically sound. This paper assesses the feasibility of remote data collection by describing the transition between in-person and fully remote observational data collection during a Sequential, Multiple Assignment, Randomized Trial (SMART) of a parenting program that took place both before and during the pandemic. Using mixed-methods data from coders, the overall quality of video-recorded data collected both before and during COVID was examined. Coder reliability over time was assessed with intraclass correlation coefficients. Results suggest that the frequency of audio problems, the severity of visual problems, and the level of administration challenges decreased after transitioning to remote data collection. Additionally, coders showed good to excellent reliability coding remotely collected data, and reliability even improved on some measured tasks. Although challenges to remote data collection exist, this study demonstrated that observational data can be collected feasibly and reliably. As observational data collection is a key method to assess parenting practices, these findings should improve researcher confidence in utilizing remote observational methods in prevention science., (© 2024. The Author(s).)
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- 2024
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5. A Cross-Sectional Analysis of Factors Promoting Intergenerational Resilience in Adolescent Youth With Refugee Status.
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Hoffman SJ, Vukovich MM, Peterson BL, Fulkerson JA, Gewirtz AH, Fredkove WM, Davis A, and Gaugler JE
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- Humans, Adolescent, Female, Male, Cross-Sectional Studies, United States, Intergenerational Relations, Parents psychology, Refugees psychology, Resilience, Psychological
- Abstract
Background: Adolescent youth occupy a critical and complex position in refugee families who resettle in a third country., Objectives: We examined the potential impact of health- and family-related factors on the social and behavioral adjustment outcomes of refugee adolescent youth., Methods: Situated within an explanatory sequential mixed methods study, we used unadjusted and adjusted multinomial logistic regression to identify trauma, health, and socioecological characteristics of war-affected families associated with social and behavioral adjustment in 72 Karen adolescent youth resettled in the United States., Results: Factors related to the health and well-being of war-affected families, including parent mental and physical health, youth-reported family function, housing, and parent employment demonstrated important associations with youth adjustment., Conclusion: These findings, originating within the complex dynamics of resettled war-affected families, demonstrated the interconnectedness of adolescent and parent experiences and opportunities to advance resilience in youth navigating integration and supporting their families through those same processes., Competing Interests: All authors have no conflicts of interest to report., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2024
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6. What works better? 1-year outcomes of an effectiveness trial comparing online, telehealth, and group-based formats of a military parenting program.
- Author
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Gewirtz AH, DeGarmo DS, and Lee S
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- Humans, Male, Female, Child, Adult, Child, Preschool, Military Family psychology, Military Personnel psychology, Psychotherapy, Group methods, Parents education, Parenting, Telemedicine
- Abstract
Objective: The present study, conducted with a population of military families, examined the comparative effectiveness of three program formats of Adaptive Parenting Tools (ADAPT), a parenting program for families of school-aged children in which a National Guard or Reserve (NG/R) parent had returned from deployment to the post-9/11 conflicts. Despite well-documented need, parenting programs for NG/R families are scarce and often inaccessible. We predicted that both facilitator-delivered conditions (i.e., in-person group; individual telehealth) would result in stronger improvements in observed parenting than assignment to the online self-directed condition. We further proposed a noninferiority hypothesis wherein no significant difference would be detected between telehealth and group conditions., Method: Families ( N = 244; 87% Caucasian) were recruited from NG/R units in two midwestern states. Families (with a 5-12-year-old child) were randomized to one of three conditions: in-person multifamily group, individual telehealth, or an online, self-directed condition. The intervention was delivered using the same content across conditions, over 14 weeks (group, telehealth conditions) or 12 modules (online condition); either or both parents could participate., Results: Intent-to-treat analyses supported both hypotheses: families in both in-person group and telehealth conditions showed significant improvements to observed parenting at 1-year postbaseline compared with those assigned to the self-directed online condition., Conclusions: This is the first study to demonstrate that in-person group and telehealth parenting programs are equally effective and that both are superior to a self-directed online program. Limitations include differences between the session lengths in each format, as well as greater attrition in the in-person format. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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- 2024
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7. Linking observing and nonreactivity mindfulness to parenting: Moderated direct and indirect effects via inhibitory control.
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Zhang N, Zhang J, Gewirtz AH, and Deater-Deckard K
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- Adolescent, Child, Child, Preschool, Female, Humans, Parent-Child Relations, Parents, Male, Military Deployment statistics & numerical data, Mindfulness, Parenting psychology
- Abstract
To disentangle the effects of key dimensions of dispositional mindfulness on parenting, the present study tests the hypotheses that parental Nonreactivity moderates the association between Observing and effective parenting behaviors, and that parental inhibitory control mediates the relationship between Observing and parenting depending on levels of Nonreactivity. The sample consists of 294 fathers (95.9% deployed) and 313 mothers (81.5% nondeployed) from 336 military families with a child aged between 4 and 13 years at baseline. Parents reported Observing and Nonreactivity at baseline using the Five Facet Mindfulness Questionnaire and completed a computerized Go/No-Go task for assessing inhibitory control at baseline and 1-year follow-up. Families completed a series of in-home interaction tasks at baseline and 2-year follow-up, and effective parenting behaviors were observed and coded using a theory-driven, empirically validated coding system. Results showed that when fathers reported low Nonreactivity, the association between Observing and effective parenting behaviors 2 years later was negative, but this association became positive when fathers reported high Nonreactivity. Fathers' Observing was associated with decreased inhibitory control 1 year later when they reported low (vs. high) Nonreactivity, whereas mothers' Observing was associated with increased inhibitory control 1 year later when they reported high (vs. low) Nonreactivity. The hypothesized effect of inhibitory control as a mediator was not found. Understanding specificity in the effects of dispositional mindfulness dimensions on parenting behaviors will drive effective and efficient designs of mindful parenting interventions. Future research should use dismantling experimental designs to test the synergistic effects of Observing and Nonreactivity in parents. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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- 2024
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8. Parental efficacy after a military parenting program: A dyadic latent growth model.
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Cai Q, Basha S, and Gewirtz AH
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- Humans, Female, Parenting, Parents, Mothers, Military Personnel, Military Family
- Abstract
Parental efficacy is an important aspect of parenting and a key outcome in many parenting programs. However, most studies focus on mothers, and less is known about the relationship between coparents' parental efficacy over time following intervention, and how parental distress can impact parental efficacy. The current study (N = 271 heterosexual couples; 162 intervention and 109 control) used a dyadic latent growth model to explore the dependence structure of parental efficacy between couples 2 years after assignment to a military parenting program, After Deployment, Adaptive Parenting Tools or a control condition. Results revealed a significant intervention effect, with both mothers and fathers in the intervention group exhibiting quadratic changes over 2 years, while the control group remained relatively stable. Notably, mothers' baseline emotional distress and fathers' deployment length emerged as predictors in understanding parental efficacy improvement over time. This research underscores the importance of adopting a family systems perspective and considering emotional distress and environmental stressors in designing targeted interventions to support military families and enhance overall well-being., (© 2023 The Authors. Journal of Marital and Family Therapy published by Wiley Periodicals LLC on behalf of American Association for Marriage and Family Therapy.)
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- 2023
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9. Emotion socialization profiles in military parents: Associations with post-traumatic stress disorder.
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Giff ST, Renshaw KD, Denham SA, Martin LN, and Gewirtz AH
- Abstract
Military families face many difficulties, including a parent deploying to a warzone and the subsequent risk of returning with symptoms of posttraumatic stress disorder (PTSD). Symptoms of PTSD are associated with parenting difficulties; however, little is known about how PTSD symptoms may be associated with emotion socialization (ES), a set of processes crucial to children's emotional well-being. This project investigated observed ES behaviors in deployed and non-deployed parents in a sample of 224 predominantly White, non-Hispanic National Guard/Reserve (NG/R) families with deployed fathers, non-deployed mothers, and a child between the ages of 4 and 13. Parents completed self-report questionnaires and families engaged in videotaped parent-child discussions, which were coded for three types of ES behaviors. Latent profile analyses of the coded behaviors identified five profiles of parental ES: Balanced/Supportive, Balanced/Limited Expression, Unsupportive/Distressed, Unsupportive/Positive, and Involved/Emotive/Angry. Multinomial logistic regressions of each parent's profile membership on fathers' PTSD symptoms revealed no significant associations, while additional analyses including additional family factors revealed that greater father PTSD symptoms were associated with a greater likelihood of mothers being in the Balanced/Supportive profile compared to the Balanced/Limited Expression profile, particularly when children displayed average to low levels of emotion during discussion tasks. No other significant associations with PTSD symptoms were detected. Overall, in contrast to the hypotheses, the majority of these findings indicated that PTSD symptoms did not play a significant role in parental ES behaviors., (© 2023 Family Process Institute.)
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- 2023
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10. Intensity of Grandparent Caregiving, Health, and Well-Being in Cultural Context: A Systematic Review.
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Chan ACY, Lee SK, Zhang J, Banegas J, Marsalis S, and Gewirtz AH
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- Humans, United States, Family, Caregivers psychology, Ethnicity, Data Management, Grandparents psychology
- Abstract
Background and Objectives: Grandparents are key resources in grandchildren care globally. However, mixed findings indicated that multiple role engagement may enhance well-being and bring demands on grandparent caregivers in different contexts. This systematic review examines the association between the intensity of grandparent caregiving and their health and well-being (i.e., physical, mental, cognitive, and life satisfaction) by continent and country/region., Research Design and Methods: Systematic searches were conducted in 4 databases. Peer-reviewed articles with quantitative designs published between 1990 and November 2021 were identified. A rigorous selection process was followed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The studies were critically appraised, and their results were narratively synthesized., Results: Sixty-five articles from 29 countries/regions were included. Findings suggested a concave curvilinear relationship between the intensity of grandparent caregiving and their health and well-being, with the optimal caregiving intensity varying across sociocultural contexts. In Europe, Oceania, the Middle East, and South America, providing supplementary or occasional care seems beneficial for grandparents' health and well-being, especially supporting dual-earner families. In East Asia, economic resources appear to buffer the adverse effect of primary care on grandparents' well-being. In the United States, findings vary across ethnicity/race., Discussion and Implications: Collectively, the intensity of grandparent caregiving, health, and well-being is complicated by grandparents' roles in the family and cultural differences. Acknowledging the bidirectional relationship between well-being and grandparents' capacity for providing care, the well-being as outcome is a limitation. Despite so, this systematic review calls for culturally-tailored family programs to support grandparent caregiving., (© The Author(s) 2022. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
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- 2023
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11. Emotion Regulation Difficulties in Military Fathers Magnify Their Benefit from a Parenting Program.
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Zhang J, Zhang N, Piehler TF, and Gewirtz AH
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- Humans, Child, Preschool, Child, Adolescent, Male, Female, Parenting psychology, Emotions physiology, Fathers psychology, Mothers psychology, Military Personnel psychology, Emotional Regulation
- Abstract
Military service members who were exposed to combat-related traumatic events may exhibit emotion regulation problems, which can compromise emotion-related parenting practices (ERPPs). After Deployment, Adaptive Parenting Tools (ADAPT) is a preventive intervention developed for military families to improve parenting behaviors, including ERPPs. Parental emotion regulation difficulties may affect parents' responses to this parenting program. Thus, this study aimed to use a baseline target moderated mediation design to examine the intent-to-treat (ITT) effect of the ADAPT program on deployed fathers' emotion-related parenting practices (ERPPs) at the 1-year follow-up as well as the moderation and mediation effect of fathers' emotion regulation difficulties. The sample consisted of 181 deployed fathers and their 4-13-year-old children. At both baseline and 1 year, fathers' ERPPs (i.e., positive engagement, withdrawal avoidance, reactivity-coercion, and distress avoidance) were observed during a series of structured parent-child interaction tasks. Results of path analyses showed no ITT effects on fathers' ERPPs, but emotion regulation difficulties significantly moderated ITT effects on distress avoidance. Fathers with higher levels of emotion regulation difficulties at baseline showed decreases in distress avoidance behaviors at 1 year if randomized to the intervention condition. Emotion regulation difficulties also significantly mediated the program's effect on reductions in reactivity coercion for fathers with high levels of emotion regulation difficulties at baseline. These findings highlight parental emotion regulation as a key baseline target of the ADAPT program and provide insight into how and for whom a parenting program improves parenting practices., (© 2021. Society for Prevention Research.)
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- 2023
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12. The ADAPT Parenting Intervention Benefits Combat Exposed Fathers Genetically Susceptible to Problem Drinking.
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DeGarmo DS, Gewirtz AH, Li L, Tavalire HF, and Cicchetti D
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- Humans, Male, Fathers, Genetic Predisposition to Disease, Parenting, Alcoholism, Military Personnel
- Abstract
Testing a vantage sensitivity model from differential susceptibility theory (DST), we examined a G × E × I hypothesis; that is, whether a military parenting intervention program (I) might buffer a G × E susceptibility for military deployed fathers exposed to deployment combat stress and trauma. We hypothesized that combat stress (E, referring to the natural environmental factor) would lead to increases in problem drinking, and that the effect of problem drinking would be amplified by genetic predisposition (G) for drinking reward systems, substance use, and addictive behaviors (i.e., differential vulnerability). Providing a preventive intervention designed to improve post-deployment family environments (I, vantage sensitivity) is hypothesized to buffer the negative impacts of combat exposure and genetic susceptibility. The sample included 185 post-deployed military fathers who consented to genotyping, from a larger sample of 294 fathers enrolled in a randomized effectiveness trial of the After Deployment Adaptive Parenting Tools (ADAPT) intervention. Trauma-exposed military fathers at genetic susceptibility for problem drinking assigned to the ADAPT intervention reported significantly more reductions in risky drinking compared with fathers at genetic susceptibility assigned to the control group, with a small effect size for the G × E × I interaction (d = .2). Trial Registration. The ADAPT trial is registered at the US National Institutes of Health ( ClinicalTrials.gov ) # NCT03522610., (© 2022. Society for Prevention Research.)
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- 2023
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13. Effectiveness of GenerationPMTO to Promote Parenting and Child Adjustment: A Meta-Analytic Review.
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Cai Q, Chan ACY, Lee SK, Marsalis S, and Gewirtz AH
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- Child, Humans, Parenting psychology, Parents psychology
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GenerationPMTO is a theory- and evidence-based behavioral parenting program widely implemented in the past three decades. This systematic review and meta-analysis examined the effectiveness of twenty GenerationPMTO studies on parenting and child adjustment among 3893 families in six countries. Hedges' g from studies with pretest-posttest-controlled designs were computed and robust variance estimation (RVE) was used to deal with the effect size dependency. Results showed that GenerationPMTO significantly promoted parenting and child adjustment with moderate to high levels of heterogeneity. Specifically, GenerationPMTO improved parental discipline, parenting monitoring, skill encouragement, child externalizing problems, and child internalizing problems. Subgroup analyses revealed several important moderators, including type of comparison group, measurement, informant, risk of bias, etc. Intervention effects were quite robust across countries and multiple demographic characteristics. No publication bias across studies for parenting and child adjustment was detected. The revised Cochrane risk of bias for randomized trials (RoB 2) procedure was used to assess risk of bias within the included studies. Some studies showed a higher level of risk due to problems with the randomization process, missing data, low measurement quality, and reporting bias. Due to lack of data, we did not examine intervention effects on parental mental health or couple relationship quality. Future studies should test mediation models to understand the mechanisms of change and to identify moderators in order to understand the high levels of heterogeneity in GenerationPMTO studies., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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- 2022
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14. Mental health, risk and resilience among refugee families in Europe.
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Gewirtz AH, Muldrew L, and Sigmarsdóttir M
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- Adolescent, Adult, Child, Cross-Sectional Studies, Humans, Mental Health, Parenting, Mental Disorders, Refugees psychology
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Refugee children and families are at high risk of developing mental health conditions. The objective of this systematic review was to examine the current empirical literature on refugee mental health in Europe with a focus on children and families. A systematic search was conducted between January 2022 to June 2022 in PsychInfo, CINAHIL and PubMed. The search produced 2385 results and 62 articles met the selection criteria. Results showed that children had high rates of trauma exposure and were at higher risk of psychopathology than their host peers. Post-migration stressors impact mental health outcomes in adolescents and adults. However, most studies were self-report and cross-sectional and there were very few studies on refugee parenting or dyadic relationships., (Copyright © 2022 Elsevier Ltd. All rights reserved.)
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- 2022
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15. International psychological research addressing the early phase of the COVID-19 pandemic: A rapid scoping review and implications for global psychology.
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Obschonka M, Cai Q, Chan ACY, Marsalis S, Basha SAJ, Lee SK, and Gewirtz AH
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- Cross-Sectional Studies, Humans, Mental Health, SARS-CoV-2, United States, COVID-19, Pandemics
- Abstract
In March 2020, the World Health Organization (WHO) declared COVID-19 a global pandemic. Given that keeping abreast of international perspectives and research results is of particular importance for such massive global emergencies, we employed a scoping review methodology to rapidly map the field of international psychological research addressing this important early phase of the pandemic. We included a total of 79 studies, with data mostly collected between March and June 2020. This review aimed to systematically identify and map the nature and scope of international studies examining psychological aspects of the unfolding COVID-19 pandemic. We mapped key research themes, subfields of psychology, the nature and extent of international research collaboration, data methods employed, and challenges and enablers faced by psychological researchers in the early stages of the pandemic. Among the wide range of themes covered, mental health and social behaviours were the key themes. Most studies were in clinical/health psychology and social psychology. Network analyses revealed how authors collaborated and to what extent the studies were international. Europe and the United States were often at the centre of international collaboration. The predominant study design was cross-sectional and online with quantitative analyses. We also summarised author reported critical challenges and enablers for international psychological research during the COVID pandemic, and conclude with implications for the field of psychology., (© 2021 International Union of Psychological Science.)
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- 2022
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16. Inhibitory Control Moderates the Intervention Effects of a Preventive Parenting Program on Posttraumatic Stress Disorder Symptoms Among Male Service Members.
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Zhang J, Buchanan GJR, Monn AR, and Gewirtz AH
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- Emotions, Humans, Iraq War, 2003-2011, Male, Parenting psychology, Military Family psychology, Military Personnel psychology, Stress Disorders, Post-Traumatic prevention & control, Stress Disorders, Post-Traumatic psychology
- Abstract
Military servicemembers face substantial challenges due to war-related trauma exposure, including posttraumatic stress disorder (PTSD). Individuals with deficits in inhibitory control (IC) may have an increased risk of developing PTSD due to a reduced ability to regulate their cognitive responses to and disengage from trauma-related stimuli. After Deployment, Adaptive Parenting Tools (ADAPT) is a mindfulness-infused parenting program for military families that has also been found to have crossover effects on parental mental health. The present study examined whether fathers' IC at baseline affected their response to this emotional skills-focused intervention and further influenced their PTSD symptoms 1 year later. The sample included 282 male National Guard and Reserve (NG/R) service members who had recently been deployed to Iraq or Afghanistan. Fathers were randomly assigned to either the ADAPT program or a control condition, with IC measured at baseline and PTSD symptoms measured at baseline and 1-year follow-up. Intent-to-treat analyses revealed no significant main effect of the intervention on fathers' PTSD symptoms. However, fathers' IC moderated intervention effects on PTSD symptoms, f
2 = 0.03. The intervention had more beneficial effects on reducing fathers' PTSD symptoms for participants with low IC at baseline. These findings are consistent with compensatory effects in the risk moderation hypothesis, which suggests that prevention or intervention programs are more effective for high-risk subgroups., (© 2021 International Society for Traumatic Stress Studies.)- Published
- 2022
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17. A Conversion Crosswalk for the UCLA PTSD Reaction Index: Translating DSM-IV to DSM-5.
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Cheng CH, Lee SS, Lee SK, Bray C, Zimmerman T, and Gewirtz AH
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- Adolescent, Child, Diagnostic and Statistical Manual of Mental Disorders, Humans, Stress Disorders, Post-Traumatic diagnosis
- Abstract
The use of patient-reported measures in assessing mental health symptoms is common in both the research and clinical fields. With regard to assessing posttraumatic stress symptoms, there are specific versions of measures designed for child and adolescent populations in accordance with the fourth and fifth editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV and DSM-5, respectively). Different clinical thresholds, numbers of items, and score ranges may present obstacles for clinicians and researchers attempting to compare self-report ratings across different versions of a measure. The current study aimed to produce a score conversion crosswalk between two child/adolescent self-report measures of posttraumatic stress disorder (PTSD): the UCLA PTSD Reaction Index for DSM-IV (RI-IV) and DSM-5 (RI-5). Using item response theory (IRT), we calibrated both measures separately to derive scaled scores. The discrimination parameters ranged from 0.57 to 2.08 (SE = 0.09-0.17) for RI-IV and from 0.73 to 2.11 for RI-5 (SE = 0.07-0.13). The scaled scores were connected with equipercentile linking. Total scores based on common items between the two measures were used as anchors to enhance the linking results. A total of 1,486 children and adolescents completed the measure: 571 respondents filled out the RI-IV and 915 respondents filled out the RI-5. The results allow linked scores to be compared to establish recommended clinical cutoffs and help elucidate the implications of changes in the diagnostic criteria for the measurement of self-reported PTSD symptoms in children and adolescents., (© 2021 International Society for Traumatic Stress Studies.)
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- 2021
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18. Psychological implications of the COVID-19 pandemic around the world: Introduction to the special issue.
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Obschonka M, Gewirtz AH, and Zhu L
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- Communicable Disease Control trends, Humans, Pandemics, SARS-CoV-2, COVID-19 epidemiology, COVID-19 psychology, Global Health trends, Mental Health trends
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Although psychological researchers have long studied the implications of major crises, the outbreak and spread of the COVID-19 pandemic have confronted the global community of psychologists and psychological researchers with new challenges. This special issue contributes to the growing empirical literature on the immediate psychological implications of the COVID-19 pandemic. We present and discuss diverse work from authors that followed our call for papers in May 2020, shortly after the World Health Organisation declared COVID-19 a global pandemic. The studies focus on the early phases of the pandemic by addressing (a) implications of the pandemic for psychological well-being and mental health, (b) psychological effects of lockdown scenarios as well as (c) individual compliance with COVID-19 prevention and intervention measures. We conclude by highlighting the need for new research efforts, with a special focus on low- and middle-income regions, international research collaborations and cross-cultural research designs., (© 2021 International Union of Psychological Science.)
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- 2021
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19. Development and Preliminary Validation of the University of Minnesota's Traumatic Stress Screen for Children and Adolescents (TSSCA).
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Donisch K, Zhang Y, Bray C, Frank S, and Gewirtz AH
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- Adolescent, Child, Female, Humans, Male, Psychometrics, Reproducibility of Results, Sensitivity and Specificity, Trauma and Stressor Related Disorders, Mass Screening methods, Psychiatric Status Rating Scales standards, Stress Disorders, Traumatic diagnosis, Surveys and Questionnaires standards
- Abstract
Child and adolescent exposure to potential trauma experiences is pervasive. Given the prevalence, deleterious mental and physical effects, and economic cost of trauma exposure, child- and family-service systems are adopting trauma-informed approaches, including practices like trauma screening. Although a number of trauma-focused screening and assessment measures exist for youth, the majority are lengthy and inappropriate for universal administration. This study describes the development and preliminary validation of the Traumatic Stress Screen for Children and Adolescents (TSSCA), a six-item screening measure for trauma exposure and traumatic stress symptoms. Using two samples of youth presenting at community practice settings (n
1 = 134, n2 = 137), reliability, discriminative validity, and criterion-related validity were calculated for the TSSCA. Results support the TSSCA as an empirically derived, reliable, and valid screening measure for exposure to trauma and symptoms of traumatic stress for youth ages 7 to 18.- Published
- 2021
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20. Mechanisms Explaining the Relationship Between Maternal Torture Exposure and Youth Adjustment In Resettled Refugees: A Pilot Examination of Generational Trauma Through Moderated Mediation.
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Hoffman SJ, Vukovich MM, Gewirtz AH, Fulkerson JA, Robertson CL, and Gaugler JE
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- Adolescent, Cross-Sectional Studies, Female, Humans, Mothers, United States epidemiology, Refugees, Stress Disorders, Post-Traumatic, Torture
- Abstract
The intergenerational effects of trauma resulting from torture and war are complex and multi-faceted and have important implications for the family system. The current study aimed to identify key relationships between refugee maternal caregiver exposure to torture, mental health, and physical health with maternal-reported youth adjustment. Ninety-six Karen maternal caregivers originating from Burma and resettled in the United States participated in a cross-sectional, explanatory mixed methods study. Maternal mental health distress was found to mediate the relationship betweenmaternal torture experiences and youth adjustment, R
2 = .357. Physical health problems was found to moderate the degree to which mental health distress mediated the relationship between torture and war trauma experiences and youth adjustment, R2 = .409. The current study is significant in that it enhances our mechanistic understanding of factors relevant to the intergenerational effects of trauma within families where maternal caregivers experienced trauma from torture and/or war.- Published
- 2020
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21. The Need for Clinicians to Recognize Military-Connected Children.
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Gewirtz AH, Cozza SJ, and Kizer KW
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- Humans, Military Family statistics & numerical data, Military Medicine methods, Military Medicine statistics & numerical data, United States, Military Family psychology, Professional-Patient Relations
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- 2020
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22. Correction to: Coercive Parenting Mediates the Relationship between Military Fathers' Emotion Regulation and children's Adjustment.
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Zhang J, Palmer A, Zhang N, and Gewirtz AH
- Abstract
The original version of this article unfortunately contained a mistake.
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- 2020
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23. The Physiological Regulation of Emotion During Social Interactions: Vagal Flexibility Moderates the Effects of a Military Parenting Intervention on Father Involvement in a Randomized Trial.
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Zhang N, Hoch J, and Gewirtz AH
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- Adolescent, Adult, Child, Child, Preschool, Humans, Male, Middle Aged, Parenting, Young Adult, Emotions, Father-Child Relations, Military Personnel psychology, Self-Control psychology
- Abstract
To make prevention programs more effective and understand "what works for whom," evidence regarding what individual characteristics predict intervention responsiveness is needed. Previous studies have evaluated a military parent training program known as After Deployment Adaptive Parenting Tools/ADAPT, yet less is understood about the program's varying effects for fathers. We tested the physiological regulation of emotion during social interactions as a moderator predicting fathers' responsiveness in a randomized trial of ADAPT, in which emotion regulation was operationally measured through vagal flexibility (VF; dynamic changes in cardiac vagal tone). Families with a child aged between 4 and 13 years for whom physiological data were gathered (n = 145) were randomly assigned to ADAPT (14-week face-to-face group intervention) or a control group (services as usual). Fathers in these families were National Guard/Reserve members who had been deployed to war in Iraq and/or Afghanistan and recently returned. Prior to the intervention, cardiac data was collected in-home throughout a set of family interaction tasks and VF was operationalized as the changes in high frequency (HF) power of heart rate variability (HRV) from a reading task to a problem-solving task. Parenting behaviors were observed and coded based on theory-driven indicators pre-intervention and at 1-year follow-up. Results of structural equation modeling showed that VF significantly moderated fathers' intervention responsiveness, such that fathers with higher vs. lower VF exhibited more effective parenting at 1-year follow-up if they were randomized into ADAPT vs. the control group. This study is the first to demonstrate that parasympathetic vagal functioning may be a biomarker to predict response to a military parenting intervention to enhance parenting in combat deployed fathers. The implications for precision-based prevention are discussed.
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- 2020
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24. Psychological distress and communication quality in military couples after deployment to war.
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Zamir O, Gewirtz AH, Cheng CH, Zhang N, and Lavee Y
- Subjects
- Adult, Female, Humans, Longitudinal Studies, Male, Middle Aged, Anxiety psychology, Interpersonal Relations, Military Family psychology, Military Personnel psychology, Psychological Distress, Spouses psychology, Stress Disorders, Post-Traumatic psychology
- Abstract
Previous research has found elevated levels of psychological distress (i.e., posttraumatic stress, depressive and anxiety symptoms) among veterans. Existing theory and evidence show how psychological distress is associated with marital disruptions. Only a few studies, however, have tested the link between psychological distress and couple communication quality in military couples, most of which were cross-sectional and employed self-report measures. The current study investigated whether psychological distress predicts changes in observed communication quality across 1 year in 228 couples consisting of male service members, who were deployed to Iraq and/or Afghanistan, and their nondeployed female partners. Psychological distress was indicated by self-reported posttraumatic stress disorder, depressive, and anxiety symptoms. Communication quality was assessed using observed couple interactions. The results of an actor-partner interdependence model showed that men's psychological distress predicted men's lower communication quality at one year after accounting for baseline communication quality. Women's psychological distress did not predict their communication quality, and each partner's psychological distress did not predict changes in their partner's communication quality over time. Consistent with previous findings on civilian populations, our findings highlight the long-term effects of psychological distress among service members on their communication behaviors with their intimate partners, and emphasize the importance of targeting psychological symptoms of service members following deployment to war. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
- Published
- 2020
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25. Coercive Parenting Mediates the Relationship between Military Fathers' Emotion Regulation and children's Adjustment.
- Author
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Zhang J, Palmer A, Zhang N, and Gewirtz AH
- Subjects
- Adolescent, Adult, Affective Symptoms psychology, Child, Child, Preschool, Female, Follow-Up Studies, Humans, Male, Military Deployment psychology, Military Family psychology, Adaptation, Psychological, Behavioral Symptoms psychology, Child Behavior psychology, Coercion, Emotional Regulation, Father-Child Relations, Fathers psychology, Military Personnel psychology, Parenting psychology
- Abstract
Military parents' combat-related posttraumatic stress disorder (PTSD) symptoms have been linked to poor parenting and child maladjustment. Emotion regulation (ER) difficulties are thought to underlie PTSD symptoms, and research has begun to link parental ER to parenting behaviors. Little empirical evidence exists regarding whether fathers' ER is associated with child adjustment and what may be the underlying mechanism for this association. This study investigated whether deployed fathers' ER was associated with child emotional and behavioral problems, and whether the associations were mediated by coercive parenting behaviors. The sample consisted of 181 deployed fathers with non-deployed female partners and their 4- to 13-year-old children. Families were assessed at three time points over 2 years. ER was measured using a latent construct of fathers' self-reports of their experiential avoidance, trait mindfulness, and difficulties in emotion regulation. Coercive parenting was observed via a series of home-based family interaction tasks. Child behaviors were assessed through parent- and child-report. Structural equation modeling revealed that fathers with poorer ER at baseline exhibited higher coercive parenting at 1-year follow-up, which was associated with more emotional and behavioral problems in children at 2-year follow-up. The indirect effect of coercive parenting was statistically significant. These findings suggest that fathers' difficulties in ER may impede their effective parenting behaviors, and children's adjustment problems might be amplified as a result of coercive interactions. Implications for the role of paternal ER on parenting interventions are discussed.
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- 2020
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26. Mothering under political violence: Post-traumatic symptoms, observed maternal parenting practices and child externalising behaviour.
- Author
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Zamir O, Gewirtz AH, Dekel R, Lavi T, and Tangir G
- Subjects
- Adult, Child, Female, Humans, Longitudinal Studies, Male, Middle Aged, Stress Disorders, Post-Traumatic psychology, Child Behavior psychology, Mothers psychology, Parenting psychology, Stress Disorders, Post-Traumatic etiology, Violence psychology
- Abstract
Using the family stress model as our conceptual framework, we explored whether observed maternal parenting practices (positive and coercive) account for the associations between mothers' post-traumatic stress symptoms and children's externalising behaviours. Mothers' self-reported post-traumatic stress symptoms, observed maternal practices, and reports of children's externalising behaviour were collected from 123 Israeli mothers and their children, who were exposed to ongoing rocket attacks in southern Israel. A structural equation model revealed that mothers' post-traumatic stress symptoms were linked with greater maternal coercive parenting practices, which in turn were associated with more externalising behaviours in children. The study highlights the crucial role of maternal distress and mothers' parenting skills in the development of externalising behaviours in children exposed to chronic political violence. These results suggest that prevention interventions designed to promote parenting skills for mothers exposed to political violence may be beneficial for children's healthy development., (© 2018 International Union of Psychological Science.)
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- 2020
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27. Bidirectional Relations Between Parenting Practices and Child Externalizing Behaviors in Formerly Homeless Families: A Random-Intercept Cross-Lagged Panel Analysis.
- Author
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Zhang J, Lee SK, Piehler TF, Gewirtz AH, and August GJ
- Abstract
Objective: This study examined the bidirectional relation between effective parenting practices and externalizing problems in children in homeless families., Design: The sample comprised 223 children ( M = 8.12 years) in 137 families living in temporary supportive housing, who participated in the Early Risers conduct problems prevention program lasting 2 years. Video-recorded observations of parent-child interactions were collected and rated by trained observers to assess effective parenting practices. Child externalizing problems were reported by their school teachers. Both variables were assessed at baseline prior to intervention and at 1- and 2-year post-baseline., Results: Child externalizing problems at baseline were negatively associated with effective parenting from baseline to year 1 as well as from year 1 to year 2. Observed effective parenting practices at year 1 were negatively associated with child externalizing problems from year 1 to year 2., Conclusions: These findings underscore the presence of bidirectional influence processes between parents and children in high-risk families. Implications for intervention programs for high-risk families are discussed., Competing Interests: Conflict of Interest Disclosures: Each author signed a form for disclosure of potential conflicts of interest. No authors reported any financial or other conflicts of interest in relation to the work described.
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- 2020
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28. Trait Mindfulness and Anger in the Family: A Dyadic Analysis of Male Service Members and their Female Partners.
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Zhang N, Piehler TF, Gewirtz AH, Zamir O, and Snyder JJ
- Subjects
- Adolescent, Adult, Child, Child, Preschool, Female, Humans, Male, Middle Aged, Parent-Child Relations, Young Adult, Anger physiology, Emotional Regulation physiology, Family Relations, Military Family, Military Personnel, Mindfulness, Personality physiology
- Abstract
Anger-related problems have been documented among post-deployed service members who returned home, posing risks to their well-being and increasing distress in their families. Trait mindfulness (acting with awareness, nonjudging, and nonreactivity) has been associated with lower self-reported anger. Using actor-partner interdependence models, we tested the association between trait mindfulness and parental anger observed in parent-child and couple interactions. The sample consisted of 155 dyads of male National Guard/Reserve members who had been recently deployed and returned, and their female non-deployed partners. Results showed that fathers' and mothers' nonreactivity was negatively associated with their own observed anger, indicating that parents who reported higher nonreactivity exhibited lower anger. Mothers' nonreactivity was also negatively associated with observed fathers' anger in the same family such that fathers exhibited lower anger when their female partner reported higher nonreactivity. Nonreactivity facilitates emotion regulation and its cultivation may reduce anger in post-deployed military families., (© 2019 American Association for Marriage and Family Therapy.)
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- 2020
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29. Effects of the After Deployment: Adaptive Parenting Tools (ADAPT) intervention on fathers and their children: A moderated mediation model.
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Gewirtz AH, Snyder J, Zamir O, Zhang J, and Zhang N
- Subjects
- Adolescent, Adult, Child, Child, Preschool, Female, Humans, Male, Middle Aged, Mothers psychology, Stress, Psychological psychology, Young Adult, Emotional Regulation physiology, Father-Child Relations, Fathers psychology, Military Personnel psychology, Parenting psychology
- Abstract
Deployment to war is associated with disruptions to emotion regulation and parenting. Using data from a randomized controlled trial, we examined whether fathers with poorer emotion regulation would differentially benefit from the After Deployment, Adaptive Parenting Tools program, a 14-session group-based parenting intervention. Prior analyses of the intervention demonstrated benefits to observed couple parenting and children's adjustment, but not to fathers' observed parenting. In this study we examined whether intervention effects on fathers' observed distress avoidance were moderated by baseline emotion regulation, and whether reduced distress avoidance was associated with improved observed parenting and reduced children's internalizing symptoms. A subset of the full randomized controlled trial sample (181 families with a father who had returned from deployment to war in Iraq or Afghanistan, a nondeployed mother, and a target child aged 4-13) completed measures at baseline, 12-months, and 24-months postbaseline. Results indicated that fathers high in baseline emotion regulation difficulties assigned to the intervention group showed reductions in observed distress avoidance at 12 months compared to controls, which were subsequently associated with improvements in observed parenting practices and reductions in children's internalizing symptoms at 24 months. The results suggest a role for personalizing parenting programs for fathers high in emotion dysregulation.
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- 2019
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30. Do Less Mindful Mothers Show Better Parenting via Improvements in Trait Mindfulness Following a Military Parent Training Program?
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Zhang N, Zhang J, and Gewirtz AH
- Abstract
Parental deployment to war poses risks to children's healthy adjustment. The After Deployment Adaptive Parenting Tools (ADAPT) program was developed for post-deployed military families to promote children's well-being through improving effective parenting. ADAPT combines behavior management with emotion socialization skills for parents, using brief mindfulness practices to strengthen emotion regulation. We used a three-wave longitudinal, experimental design to examine whether ADAPT improved parental trait mindfulness (PTM), and whether the effect was moderated by baseline PTM. We also investigated whether improved PTM was associated with behavioral, cognitive, and emotional aspects of parenting such as self-reported parental locus of control (PLOC), self-reported parental emotion socialization (PES), self-reported and observed behavioral parenting skills. We analyzed data from a randomized controlled trial (RCT) of the ADAPT, with a focus on mothers ( n = 313) who were either deployed (17.9%) or non-deployed and partnered with a husband who had been recently deployed to Iraq and/or Afghanistan and returned (82.1%). Families identified a 4-13-year-old target child (Mean age = 8.34, SD = 2.48; 54.3% girls) and were randomized into ADAPT (a group-based 14-week program) or a control condition (services as usual). At baseline, 1-year, and 2-year follow-up, PTM, PLOC, PES, and parenting skills were self-reported, whereas home-based family interactions involving parents and the child were video-taped and assessed for observed behavioral parenting skills such as discipline and problem-solving using a theory-based coding system. Results showed that mothers with lower baseline PTM reported higher PTM at 1-year while mothers with higher baseline PTM reported lower PTM at 1-year. PTM at 1-year was associated with improved self-reported parenting skills and supportive PES at 2-year, as well as indirectly associated with improved PLOC and reduced nonsupportive PES at 2-year through PTM at 2-year. No associations between PTM and observed parenting skills were detected. We discuss the implications of these findings for incorporating mindfulness practices into behavioral parenting interventions and for personalized prevention considering parents' pre-existing levels of trait mindfulness as a predictor of intervention responsivity.
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- 2019
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31. Implementing an Evidence-Based Intervention for Children in Europe: Evaluating the Full-Transfer Approach.
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Sigmarsdóttir M, Forgatch MS, Guðmundsdóttir EV, Thorlacius Ö, Svendsen GT, Tjaden J, and Gewirtz AH
- Subjects
- Adolescent, Child, Europe, Female, Humans, Male, Delivery of Health Care methods, Evidence-Based Medicine methods
- Abstract
This study evaluated the implementation outcomes of GenerationPMTO, an evidence-based parenting intervention for child and adolescent behavior problems, in three European countries. The implementation approach was full transfer, in which purveyors train a first generation (G1) of practitioners; adopting sites assume oversight, training, certification, and fidelity assessment for subsequent generations (Forgatch & DeGarmo, 2011; Forgatch & Gewirtz, 2017). Three hundred therapists participated in trainings in GenerationPMTO in Iceland, Denmark, and the Netherlands. Data are from the implementation's initiation in each country through 2016, resulting in 6 generations in Iceland, 8 in Denmark, and 4 in the Netherlands. Therapist fidelity was measured at certification with an observation-based tool, the Fidelity of Implementation Rating System (Knutson, Forgatch, Rains, & Sigmarsdóttir, 2009). Candidates in all generations achieved fidelity scores at or above the required standard. Certification fidelity scores were evaluated for G1 candidates, who were trained by the purveyor, and subsequent generations trained by the adopting implementation site. In each country, certification fidelity scores declined for G2 candidates compared with G1 and recovered to G1 levels for subsequent generations, partially replicating findings from a previous Norwegian study (Forgatch & DeGarmo, 2011). Recovery to G1 levels of fidelity scores was obtained in Iceland and the Netherlands by G3; in Denmark, the recovery was obtained by G5. The mean percentage of certification in each country was more than 80%; approximately 70% of certified therapists remained active in 2017. Findings support full transfer as an effective implementation approach with long-term sustainability and fidelity.
- Published
- 2019
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32. Does Giving Parents Their Choice of Interventions for Child Behavior Problems Improve Child Outcomes?
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Gewirtz AH, Lee SS, August GJ, and He Y
- Subjects
- Adult, Child, Decision Making, Shared, Female, Humans, Male, Precision Medicine, Treatment Outcome, Child Behavior Disorders therapy, Choice Behavior, Parents
- Abstract
Empowering consumers to be active decision-makers in their own care is a core tenet of personalized, or precision medicine. Nonetheless, there is a dearth of research on intervention preferences in families seeking interventions for a child with behavior problems. Specifically, the evidence is inconclusive as to whether providing parents with choice of intervention improves child/youth outcomes (i.e., reduces externalizing problems). In this study, 129 families presenting to community mental health clinics for child conduct problems were enrolled in a doubly randomized preference study and initially randomized to choice or no-choice conditions. Families assigned to the choice condition were offered their choice of intervention from among three different formats of the Parent Management Training-Oregon Model/PMTO (group, individual clinic, home based) and services-as-usual (child-focused therapy). Those assigned to the no-choice condition were again randomized, to one of the four intervention conditions. Intent-to-treat analyses revealed partial support for the effect of parental choice on child intervention outcomes. Assignment to the choice condition predicted teacher-reported improved child hyperactivity/inattention outcomes at 6 months post-treatment completion. No main effect of choice on parent reported child outcomes was found. Moderation analyses indicated that among parents who selected PMTO, teacher report of hyperactivity/inattention was significantly improved compared with parents selecting SAU, and compared with those assigned to PMTO within the no-choice condition. Contrary to hypotheses, teacher report of hyperactivity/inattention was also significantly improved for families assigned to SAU within the no-choice condition, indicating that within the no-choice condition, SAU outperformed the parenting interventions. Implications for prevention research are discussed.
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- 2019
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33. Improving parental emotion socialization in military families: Results of a randomized controlled trial.
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Zhang N, Zhang J, Gewirtz AH, and Piehler TF
- Subjects
- Adult, Checklist, Child, Child, Preschool, Depression diagnosis, Depression psychology, Female, Humans, Male, Middle Aged, Military Personnel psychology, Stress Disorders, Post-Traumatic diagnosis, Stress Disorders, Post-Traumatic psychology, Adaptation, Psychological, Afghan Campaign 2001-, Education, Nonprofessional, Emotional Intelligence, Iraq War, 2003-2011, Military Family psychology, Socialization
- Abstract
Prior research indicates that children of deployed parents are at risk for emotional problems, suggesting the utility of preventive efforts for military families. Effective parental socialization of children's emotions is protective for children's development, and parental experiential avoidance may impede parental emotion socialization, yet intervention studies in this area are lacking. This study examined the impact of a parenting program, After Deployment Adaptive Parenting Tools (ADAPT), on parental emotion socialization postintervention (6 months postbaseline) and whether intervention effects were moderated by parental experiential avoidance. The sample included 336 families (294 fathers and 313 mothers) with at least 1 deployed parent and a focal child aged 4-12. Families were randomized into either ADAPT (a 14-week group-based intervention) or control group. Self-reported data on parental emotion socialization and experiential avoidance were analyzed using structural equation modeling. Results showed that mothers who were assigned to the intervention had significant improved supportive emotion socialization and reduced nonsupportive emotion socialization at postintervention compared with controls. Mothers with higher levels of experiential avoidance assigned to the intervention group had higher levels of supportive emotion socialization at postintervention. No significant intervention effects were found in fathers. This study provides support for the effects of the ADAPT program on maternal emotion socialization at 6-month postbaseline, and the role of experiential avoidance as a moderator. We discuss findings in relation to the different parental roles that mothers and fathers play in postdeployed families, as well as implications for personalized intervention programming. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
- Published
- 2018
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34. Deficits in Inhibitory Control May Place Service Members at Risk for Posttraumatic Stress Disorder and Negative Parenting Behavior Following Deployment-Related Trauma.
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Monn AR, Zhang N, and Gewirtz AH
- Subjects
- Adult, Child, Child, Preschool, Female, Humans, Male, Military Family psychology, Father-Child Relations, Inhibition, Psychological, Military Personnel psychology, Parenting psychology, Stress Disorders, Post-Traumatic psychology
- Abstract
This study examined the mediating role of posttraumatic stress disorder (PTSD) symptoms in the association between deployment-related trauma exposure and parenting behaviors in reserve-component military service members and whether this association was contingent upon parent inhibitory control (IC). Participants were 181 postdeployed fathers and their children. Fathers completed a neurospychological test of IC and self-report measures of trauma exposure and PTSD symptoms. Measures of parenting behaviors (positive engagement and reactivity coercion) were obtained from direct observation of father-child interaction. Results demonstrated that (a) fathers' PTSD symptoms indirectly mediated the effect of trauma exposure on both measures of parenting (i.e., negative indirect effect for positive engagement, point estimate = -.0045, 95% CI [-.0107, -.0003], and positive indirect effect for reactivity coercion, point estimate = .0061, 95% CI [.0007, .0146]); (b) fathers' IC skills moderated the association between trauma exposure and PTSD, β = .14, p = .043, such that the association was positive and significant for fathers with high and medium IC but nonsignificant for fathers with low IC; and (c) the indirect effect of trauma exposure on both parenting measures through PTSD was dependent upon IC, point estimate = .0341, 95% CI [.0005, .0687]. These findings indicate that fathers with low IC skills tended to have higher rates of PTSD symptoms and related negative parenting behaviors, even for individuals with relatively low degrees of deployment-related trauma exposure. Results highlight the importance of IC as a potential moderating factor in the association between trauma exposure, PTSD, and parenting., (© 2018 International Society for Traumatic Stress Studies.)
- Published
- 2018
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35. A Recovery Capital and Stress-Buffering Model for Post-deployed Military Parents.
- Author
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DeGarmo DS and Gewirtz AH
- Abstract
We tested a recovery capital model for military families employing the After Deployment, Adaptive Parenting Tools (ADAPT) randomized control trial, a longitudinal preventive intervention study of 336 post-deployed military parents. Recovery resources included measures of social capital (parenting support, observed partner support behaviors), personal capital (parenting efficacy, education), and community capital (the ADAPT behavioral parent-training intervention). We hypothesized higher levels of recovery capital would buffer the negative impact of military stress on growth in post-traumatic stress disorder (PTSD) symptoms for deployed and civilian parents. Outcome data were evaluated with three waves across 2-years. Hypotheses were tested with latent growth models in a structural equation modeling framework. Military stress was assessed by reports of exposure to combat and battle aftermath. Recovery capital was measured by reported support for parenting and direct observation of behavioral interactions during problem-solving discussions of deployment-related stressors. Fathers had higher levels of military-related stress and PTSD symptoms over time compared to mothers. Growth curve models showed that fathers were characterized by individual differences in 2-year average levels of PTSD symptoms while mothers were characterized by individual differences in initial status and linear growth trajectories. Results supported a recovery capital model. Higher levels of parenting efficacy and parenting support were associated with lower PTSD symptoms, representing common pathways for both mothers and fathers. Similarly, parenting support operated as a moderating buffer for both parents. That is, effects of military trauma exposure on psychological distress were lower for mothers and fathers with higher levels of parenting support relative to parents with lower levels. Regions of significance indicated that half a standard deviation above the mean of support was beneficial for mothers, while one and half standard deviations were needed to impact the effects of trauma on fathers' PTSD. For mothers assigned to the ADAPT parent training intervention - but not fathers - the intervention was associated with linear reductions in PTSD symptoms over 2 years. The recovery capital model explained 36% of the variance in father outcomes and 46% for mothers. The intervention obtained a medium effect size in reducing mothers' symptoms ( d = 0.41). Implications for prevention and treatment within a recovery capital model are discussed.
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- 2018
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36. Do Parent Preferences for Child Conduct Problem Interventions Impact Parenting Outcomes? A Pilot Study in Community Children's Mental Health Settings.
- Author
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He Y, Gewirtz AH, Lee S, and August G
- Subjects
- Adult, Child, Child, Preschool, Double-Blind Method, Female, Humans, Male, Middle Aged, Pilot Projects, Young Adult, Child Behavior Disorders therapy, Choice Behavior, Conduct Disorder therapy, Family Relations psychology, Internal-External Control, Parenting psychology, Psychotherapy methods
- Abstract
A pilot, doubly randomized preference trial was conducted to investigate the impact of providing parents preferences on parenting outcomes. Families with children having conduct problems were randomly assigned to a choice group in which they received their preferred treatment among the four intervention options or a no-choice group in which they were randomized assigned to one of the four options. Results of mixed-effects models showed that parents in the choice group who selected Parent Management Training-Oregon Model (PMTO) had better parenting outcomes over time compared to parents in the choice group who selected child therapy. It highlights the importance of incorporating parent preferences in the delivery of evidence-based treatments., (© 2018 American Association for Marriage and Family Therapy.)
- Published
- 2018
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37. A Call for Theoretically Informed and Empirically Validated Military Family Interventions.
- Author
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Gewirtz AH
- Abstract
Although multiple evidence-based family interventions exist, less than a handful have been developed or rigorously tested specifically for military families. Indeed, few interventions available to military families are theory based or empirically validated; most have good face validity but little data on efficacy or effectiveness. This article argues for an emphasis on the rigorous evaluation, via pragmatic randomized controlled trials, of theory-based family interventions to strengthen and support military families. Data are provided from a theory-based, empirically validated parenting program for families (After Deployment, Adaptive Parenting Tools, or ADAPT) to demonstrate the potential for randomized controlled trials to yield rich data about family functioning beyond program outcomes. Opportunities to generate theoretically informed, evidence-based family interventions for military families will contribute not only to testing theories about military families but also to advancing well-being for the next generation of service members and their families.
- Published
- 2018
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38. Parent Engagement in Online Mindfulness Exercises Within a Parent Training Program for Post-Deployed Military Families.
- Author
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Zhang N, Rudi JH, Zamir O, and Gewirtz AH
- Abstract
Mindfulness has drawn increased attention in prevention programs targeting parents. Commonly, mindfulness-based programs are provided to reduce parental stress and improve child outcomes. Less often, researchers incorporate a mindfulness-informed approach, integrating a low dose of mindfulness exercises into an existing evidence-based parent training model. Little is known about participant engagement with mindfulness exercises in such programs. This non-experimental study focuses on families who are at risk for impaired parenting due to the unique stressor of a parent's deployment to war. The goal is to examine military parents' online engagement in mindfulness exercises and associations between engagement and dispositional mindfulness within a web-enhanced parent training program. Online tracking records and self-reported data were obtained from 370 military parents (207 families) who were assigned to the program; at 6-month follow-up, 68.6% of these parents were retained (at least one parent reported from 75.4% of families). Results showed that nearly half (44.6%) of the parents engaged with the exercises. Participants who attended face-to-face group sessions (i.e., attendees) engaged throughout the intervention period whereas participants who never attended group sessions (i.e., non-attendees) mostly engaged during the first month in the program. Attendees and mothers engaged more than non-attendees and fathers. While engaged parents self-reported increased dispositional mindfulness at 6-month follow-up compared to baseline, only mothers' engagement accounted for a significant proportion of the variance (3%) in dispositional mindfulness at 6-month follow-up, after controlling for covariates. Implications for incorporating online mindfulness exercises into parent training are discussed in the context of programming for military families.
- Published
- 2018
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39. Testing a Military Family Stress Model.
- Author
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Gewirtz AH, DeGarmo DS, and Zamir O
- Subjects
- Adaptation, Psychological, Adult, Afghan Campaign 2001-, Child, Child, Preschool, Female, Gulf War, Humans, Iraq War, 2003-2011, Male, Marriage psychology, Parents psychology, United States, Family Relations psychology, Military Family psychology, Occupational Diseases psychology, Parenting psychology, Stress Disorders, Post-Traumatic psychology
- Abstract
The current study examines a military family stress model, evaluating associations between deployment-related stressors (i.e., deployment length/number, posttraumatic stress disorder [PTSD] symptoms) and parent, child, parenting, and dyadic adjustment among families in which a parent had previously deployed to Iraq or Afghanistan in the recent conflicts. Married families (N = 293) with at least one child between the ages of 4 and 12 were recruited from a Midwestern state. Service members were from the Reserve Component (National Guard or Reserves); fathers (N = 253) and/or mothers had deployed (N = 45) to the recent conflicts in the Middle East. Multiple-method (observations of parenting and couple interactions; questionnaires) and multiple informant measures were gathered online and in the homes of participants, from parents, children, and teachers. Findings demonstrated associations between mothers' and fathers' PTSD symptoms and a latent variable of child adjustment comprising teacher, parent, and child report. Mothers' but not fathers' PTSD symptoms were also associated with dyadic adjustment and parenting practices; parenting practices were in turn associated with child adjustment. The results are discussed in terms of their implications for military family stress research and interventions to support and strengthen parents and families after deployment., (© 2017 Family Process Institute.)
- Published
- 2018
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40. Correction to: After Deployment, Adaptive Parenting Tools: 1-Year Outcomes of an Evidence-Based Parenting Program for Military Families Following Deployment.
- Author
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Gewirtz AH, DeGarmo DS, and Zamir O
- Abstract
The authors would like to indicate the corrections to Table 2 of the above referenced article, below. The note is missing, and the CACE indirect coefficients should be .18** and .16** instead of .16** and .15**. The corrected table is shown below.
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- 2018
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41. After Deployment, Adaptive Parenting Tools: 1-Year Outcomes of an Evidence-Based Parenting Program for Military Families Following Deployment.
- Author
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Gewirtz AH, DeGarmo DS, and Zamir O
- Subjects
- Adult, Child, Child, Preschool, Evidence-Based Practice, Female, Humans, Male, Middle Aged, Outcome Assessment, Health Care, Program Evaluation, Young Adult, Adaptation, Psychological, Military Family, Military Personnel, Parenting
- Abstract
Despite significant stressors facing military families over the past 15 years of wars in Iraq and Afghanistan, no parenting programs adapted or developed for military families with school-aged children have been rigorously tested. We present outcome data from the first randomized controlled trial of a behavioral parent training program for families with a parent deployed to Iraq or Afghanistan. In the present study, 336 primarily National Guard and Reserve families with 4-12-year-old children were recruited from a Midwestern state. At least one parent in each family had deployed to the recent conflicts: Operations Iraqi or Enduring Freedom, or New Dawn (OIF/OEF/OND). Families were randomized to a group-based parenting program (After Deployment, Adaptive Parenting Tools (ADAPT)) or web and print resources-as-usual. Using a social interaction learning framework, we hypothesized an indirect effects model: that the intervention would improve parenting, which, in turn, would be associated with improvements in child outcomes. Applying intent-to-treat analyses, we examined the program's effect on observed parenting, and children's adjustment at 12-months post baseline. Controlling for demographic (marital status, length, child gender), deployment variables (number of deployments), and baseline values, families randomized to the ADAPT intervention showed significantly improved observed parenting compared to those in the comparison group. Observed parenting, in turn, was associated with significant improvements in child adjustment. These findings present the first evidence for the effectiveness of a parenting program for deployed military families with school-aged children.
- Published
- 2018
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42. PTSD as a moderator of a parenting intervention for military families.
- Author
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Chesmore AA, Piehler TF, and Gewirtz AH
- Subjects
- Adult, Child, Child, Preschool, Female, Humans, Male, Family Therapy methods, Military Family psychology, Military Personnel psychology, Parent-Child Relations, Parenting psychology, Stress Disorders, Post-Traumatic psychology
- Abstract
The stress of multiple deployments and exposure to combat places service members at risk for posttraumatic stress disorder (PTSD), which may detrimentally affect parenting. Evidence-based parenting programs have been successful in promoting adaptive parenting practices among families exposed to stress. However, the effects of preventive interventions on parenting may vary by military parent's PTSD. The current study includes families who participated in a randomized controlled trial of a parenting intervention for military families known as After Deployment, Adaptive Parenting Tools (ADAPT). Families were randomized to either a 14-week, group-based parenting program or a comparison group. Participants included families with 4- to 12-year-old children in which at least 1 parent deployed to Iraq or Afghanistan (N = 336; 945 individuals). Structural equation modeling was used to examine parent self-reported PTSD as a potential moderator of the relationship between intent-to-treat status and effective parenting practices 12 months postbaseline while accounting for baseline effective parenting, length and number of deployments, and family demographics. Father PTSD was a significant moderator, such that the intervention was less effective for fathers who met clinical levels of PTSD. No significant moderation effects were found among mothers. These findings may have important implications for the development of future evidence-based parenting programs. (PsycINFO Database Record, ((c) 2018 APA, all rights reserved).)
- Published
- 2018
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43. Parent Discrepancies in Ratings of Child Behaviors Following Wartime Deployment.
- Author
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Chesmore AA, He Y, Zhang N, and Gewirtz AH
- Subjects
- Adult, Child, Family Characteristics, Female, Humans, Internal-External Control, Interpersonal Relations, Male, Time Factors, War Exposure, Child Behavior, Depression psychology, Fathers psychology, Military Personnel psychology, Mothers psychology, Stress Disorders, Post-Traumatic psychology
- Abstract
Researchers have shown that parents often disagree in their ratings of their children's behavior, and that these discrepancies are typically related to child and family characteristics (e.g., child's age, parent psychopathology). Few studies, however, have examined discrepancies in how mothers and fathers rate child behavior during a stressful family context such as a parent's wartime deployment. The present study of 174 military families (children aged 6 to 11 years; 54.0% female) examined whether family factors (parental sense of control, marital satisfaction) and contextual risk factors related to a parent's wartime deployment (number and length of deployments, battle experiences, and posttraumatic stress disorder [PTSD] symptoms) were associated with discrepancies in how mothers and fathers rated internalizing and externalizing behaviors in their children. Using a latent congruency model, our results showed that when parents self-reported higher levels of PTSD symptoms, both mothers, β = -.33, p = .021, and fathers, β = .41, p = .026, tended to also report higher levels of internalizing symptoms in their child, relative to what their spouse reported. In comparison to mothers, fathers also tended to report higher levels of child externalizing symptoms, β = .44, p = .019. Our findings may help clinicians understand how parent mental health within a stressful family context relates and/or informs a parent's ratings on assessments of his or her child's internalizing and externalizing symptoms., (Copyright © 2018 International Society for Traumatic Stress Studies.)
- Published
- 2018
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44. Letter from the new Editor-in-Chief.
- Author
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Gewirtz AH
- Published
- 2017
- Full Text
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45. The contribution of maternal care and control, and community type to children's adjustment to political violence.
- Author
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Tangir G, Dekel R, Lavi T, Gewirtz AH, and Zamir O
- Subjects
- Adult, Child, Child Behavior psychology, Cross-Sectional Studies, Female, Humans, Male, Mother-Child Relations, Multivariate Analysis, Regression Analysis, Socioeconomic Factors, Stress Disorders, Post-Traumatic, Adaptation, Psychological, Crime Victims psychology, Exposure to Violence psychology, Mothers psychology, Parenting psychology, Social Environment
- Abstract
Objectives: This study explored the behavioral and emotional adjustment of Israeli school-age children who are exposed to political violence. Based on Bronfenbrenner's (1986) ecological model and ecological model of psychosocial trauma (Harvey, 2007), we examined the direct contribution of exposure, gender, maternal characteristics (mother's posttraumatic stress symptoms [PTSS], maternal care and maternal control), and community type (development town vs. kibbutz), to school-age children's adjustment. In addition, we examined whether maternal characteristics and community type moderated the association between exposure and adjustment., Method: There were 121 mother-child dyads from the development town of Sderot (n = 62) and from the surrounding kibbutzim (n = 58) participated., Results: Revealed that being a boy, living in Sderot, and mothers' higher PTSS, contributed directly to children's total difficulties (i.e., externalizing and internalizing problems), and that maternal control moderated the association between personal exposure and children's total difficulties. Furthermore, being a girl and mother's higher PTSS and higher maternal control contributed directly to children's PTSS. Mother's PTSS moderated the association between personal exposure and children's PTSS. Maternal care was not associated with children's adjustment., Conclusions: Both the child's gender and the type of community in which he or she lives are associated with maternal distress and children's adjustment to political violence. (PsycINFO Database Record, ((c) 2017 APA, all rights reserved).)
- Published
- 2017
- Full Text
- View/download PDF
46. Actor-Partner Associations of Mindfulness and Marital Quality After Military Deployment.
- Author
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Zamir O, Gewirtz AH, and Zhang N
- Abstract
Objective: To explore dyadic associations between mindfulness and marital quality and gender differences in these associations-that is, the relation of each dyad member's mindfulness with his or her own marital quality and with his or her partner's marital quality., Background: Recent studies have demonstrated the benefits of mindfulness for marital quality. However, associations of mindfulness and marital quality within and between partners are still unclear. In addition, despite marital challenges associated with deployment to war, the benefits of mindfulness for marital quality in military couples is yet unknown., Method: A sample of 228 military couples following deployment of the male partner to recent conflicts in Iraq or Afghanistan completed an online survey measuring mindfulness and marital quality., Results: Actor-partner interdependence (APIM) analysis showed that, for both men and women, greater mindfulness was associated with one's own and one's partner's higher marital quality. There were no gender differences in this pattern., Conclusion: Mindfulness engenders intra- and interpersonal benefits for the marital system in men and in women following deployment to war., Implications: The results emphasize the importance of a dyadic approach when examining the role of mindfulness in marital or family relations, and suggest that interventions designed to facilitate change in marital relationships in the context of deployment may benefit from integrating mindfulness-based training.
- Published
- 2017
- Full Text
- View/download PDF
47. Introduction to the Special Section: Advances in psychological prevention and treatment interventions to promote children's mental health.
- Author
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Gewirtz AH and Youssef A
- Subjects
- Causality, Child, Evidence-Based Medicine methods, Humans, Randomized Controlled Trials as Topic methods, Research Design, School Health Services, Health Promotion methods, Mental Disorders prevention & control, Mental Health
- Abstract
This paper introduces the Special Section on Advances in Psychological Prevention and Treatment Interventions to Promote Children's Mental Health. The three articles in the Special Section provide perspectives on the adaptation, evaluation, and implementation of evidence-based psychological interventions for children in countries in Northern and Eastern Europe, and Latin America. The articles highlight disparate methodologies for the examination of intervention data, including addressing causal inference in the absence of availability of true experiment data (i.e., randomised controlled trial data), randomised trial data from a school-based prevention programme, and predictors of change in an evidence-based treatment programme. Together, the articles highlight the movement of evidence-based practices into routine care settings and emerging strategies for settings in which randomised trial data are not yet available. They demonstrate the contribution of psychological research to the advancement of practices for improving children's mental health., (© 2017 International Union of Psychological Science.)
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- 2017
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48. Fostering resilience in National Guard and Reserve families: A contextual adaptation of an evidence-based parenting program.
- Author
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Pinna KL, Hanson S, Zhang N, and Gewirtz AH
- Subjects
- Adult, Child, Child, Preschool, Female, Humans, Male, Parents psychology, Stress, Psychological psychology, Adaptation, Psychological, Military Family psychology, Parents education, Resilience, Psychological
- Abstract
Military deployment of a parent is a risk factor for children's internalizing and externalizing problems. This risk may be heightened in National Guard and Reserve (NG/R) families who tend to be isolated from other NG/R families and do not benefit from the centralized support system available to active duty families living on military bases. Isolation and trauma-related disorders may complicate the adjustment of military families during reintegration. An evidence-based parent training intervention was modified to meet the unique needs of recently deployed NG/R parents and their spouses, and the modified program was evaluated in a randomized controlled trial. The current study examines engagement and satisfaction with the program. Modifications such as employment of military-connected facilitators sought to maximize engagement in and satisfaction with the program. Engagement and satisfaction were examined between mothers and fathers, as well as between groups led by a military-connected facilitator and those led by civilian facilitators. Significantly greater engagement was noted for groups that were led by a military-connected facilitator (p = .01). There were no differences between genders in attendance rates, though greater positive group experiences were reported by mothers versus fathers (p = .01). Results are discussed in the context of engagement and satisfaction reported for similar programs. Implications for working with military families are also considered. (PsycINFO Database Record, ((c) 2017 APA, all rights reserved).)
- Published
- 2017
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49. Stressful life events and perceived parental control in formerly homeless families: Impact on child-internalizing symptoms.
- Author
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Utržan DS, Piehler TF, Gewirtz AH, and August GJ
- Subjects
- Child, Child, Preschool, Female, Humans, Internal-External Control, Male, Child Behavior psychology, Ill-Housed Persons psychology, Life Change Events, Parenting psychology
- Abstract
Research has neglected the potential role of perceived parental control as a moderator between stressful life events (SLEs) and child-internalizing symptoms. Using secondary data from the Early Risers "Skills for Success" Program (August, Realmuto, Hektner, & Bloomquist, 2001), this study examined the impact of perceived parental control on the association between SLEs and child internalizing symptoms in formerly homeless families. The sample consisted of 137 families with 223 children between 4 and 12 years of age (M = 8.1, SD = 2.3) living in supportive housing sites in Minneapolis, Minnesota. Participants completed measures assessing the number of SLEs experienced (e.g., unemployment of parent, death of loved one, serious illness, homelessness), perceived parental control, and child-internalizing symptoms. In this sample, 65% of children (n = 144) experienced at least 1 SLE with an average experience of 2 SLEs (M = 2.0, SD = 1.9, range = 0-7). A regression analysis found that experiencing more SLEs and a perceived absence of parental control over child behavior were positively associated with child-internalizing symptoms. A significant interaction between SLEs and perceived absence of parental control over child behavior in predicting child internalizing symptoms was also found. These findings suggest that children of parents who model appropriate control are more likely to experience fewer internalizing symptoms in response to SLEs. (PsycINFO Database Record, ((c) 2017 APA, all rights reserved).)
- Published
- 2017
- Full Text
- View/download PDF
50. If You Build It, Will They Come? Patterns of Internet-Based and Face-To-Face Participation in a Parenting Program for Military Families.
- Author
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Doty JL, Rudi JH, Pinna KL, Hanson SK, and Gewirtz AH
- Subjects
- Adult, Child, Child, Preschool, Educational Status, Family Characteristics, Female, Humans, Income, Male, Motivation, Internet, Military Family, Parenting, Parents
- Abstract
Background: Some evidence suggests parents are drawn to media-based interventions over face-to-face interventions, but little is known about the factors associated with parents' use of Internet-based or Internet-enhanced programs, especially among military families. Research is needed to understand characteristics of parents who may be most likely to use online components or attend face-to-face meetings in order to ensure maximum engagement., Objective: In this study, we examined characteristics that predict various patterns of Internet use and face-to-face attendance in a parenting program designed for military families., Methods: An ecological framework guided analysis of differences in patterns of Internet-based use and face-to-face attendance by parents' demographic characteristics (gender, education, employment, and child age), incentives offered, and number of months the parent was deployed. We reported differences in the total number of online components completed over the 14 modules, total number of face-to-face sessions attended, and the use of different types of online components accessed (videos, downloadable handouts, mindfulness exercises, knowledge checks, and downloadable summaries). Then, we computed multinomial logistic regression accounting for nestedness (parents within families) to examine associations between demographic, programmatic, and military-related characteristics and patterns of engagement (use of online components and attendance at face-to-face sessions)., Results: Just over half (52.2%, 193/370) of the participants used the online components at least once, and the majority of participants (73.2%, 271/370) attended at least 1 face-to-face session. An examination of different patterns of participation revealed that compared with those who participated primarily in face-to-face sessions, parents who participated online but had little face-to-face participation were more likely to have received incentives than those who did not (95% CI 1.9-129.7). Among participants who had been deployed, those who had earned a 4-year degree (95% CI 1.0-2.2) and those who had been offered incentives to participate online (95% CI 2.1-58.6) were more likely to be highly engaged in online components and attend face-to-face compared with those who attended primarily face-to-face. However, those with a high number of months of deployment (95% CI 0.6-1.0) were less likely to be in the pattern of highly engaged in online components and face-to-face attendance. Compared with those who participated primarily face-to-face, deployed mothers were about 4 times more likely to engage in moderate online use with face-to-face attendance than deployed fathers (95% CI 1.21-11.83) and participate primarily online (95% CI 0.77-25.20)., Conclusions: Results imply that parents may be drawn to different delivery options of a parenting program (online components vs face-to-face sessions) depending on their education level, incentives to engage in online components, and their military-related experience. Results suggest potential directions for tailoring Internet-based interventions.
- Published
- 2016
- Full Text
- View/download PDF
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