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Although many studies have concluded that men and women engage in domestic violence at equal levels, existing studies have hardly focused on gender specific risk factors for domestic violence perpetration. Therefore, this study aimed to examine gender differences in criminogenic risk factors between Dutch male and female forensic outpatients who were referred to forensic treatment for domestic violence. Clinical structured assessments of criminogenic risk factors were retrieved for 366 male and 87 female outpatients. Gender differences were not only found in the prevalence and interrelatedness of criminogenic risk factors, but also in associations between criminogenic risk factors and treatment dropout. In men, risk factors related to the criminal history, substance abuse, and criminal attitudes were more prevalent than in women, whereas risk factors related to education/work, finances, and the living environment were more prevalent in women. Further, having criminal friends, having a criminal history, and drug abuse were associated with treatment dropout in men, whereas a problematic relationship with family members, housing instability, a lack of personal support, and unemployment were associated with treatment dropout in women. Finally, network analyses revealed gender differences in risk factor interrelatedness. The results provide important insights into gender specific differences in criminogenic risk factors for domestic violence, which support clinical professionals in tailoring treatment to the specific needs of male and female perpetrators of domestic violence.

Contains fulltext : 253697.pdf (Publisher’s version ) (Open Access) Background: The online mindset intervention The Growth Factory (TGF) has shown promising effects - increasing growth mindsets and perseverance and decreasing mental health problems among youth with intellectual disabilities (ID). Studying moderators and mediators of intervention effects is essential to elucidate for whom and why TGF works. Using a randomised controlled trial design, we examined youth's baseline mindset, gender, age, level of ID and intervention satisfaction as moderators of TGF effects and examined whether the intervention effects of TGF on improvements in mental health were mediated by perseverance. Methods: The sample consisted of 119 participants with mild to borderline ID (Mage = 15.83; SD = 2.23), randomly assigned to the intervention (n = 60) or passive control group (n = 59). Participants reported mindsets, perseverance, internalising, externalising, attention and total mental health problems at pre-test, at post-test and at 3-month follow-up. Additionally, youth in the intervention group graded their satisfaction with a score at the end of each session. Results: Findings indicated that the effectiveness of TGF was not affected by participants' baseline mindsets, age and ID level. TGF was more effective in reducing internalising problems in girls and increasing perseverance in boys. In addition, in the intervention group TGF was more effective in improving internalising, externalising and total mental health problems for youth who reported higher levels of intervention satisfaction at post-test. Finally, TGF indirectly decreased internalising and externalising problems at follow-up through improvements in perseverance reported at post-test. Conclusions: TGF offers a universal, ‘add-on’ mindset intervention complementing usual care programmes. It improves mindsets, perseverance and mental health in youth with ID. Both practical and theoretical implications are discussed. 16 p.

This qualitative study sheds light on how the different phases of refuge and resettlement shape parents' perceptions of their parenting. We used in-depth interviews to examine parents' accounts of how war and refuge gave rise to different stressors, and how these in turn shaped parenting. We interviewed 27 Syrian refugee parents recently settled in the Netherlands (16 families) twice, using a grounded theory approach. We distinguished five phases of refuge, namely prewar, war, flight, displacement, and resettlement. During flight and displacement, stressors associated with financial and material losses appeared to induce parental empathy for children's suffering, which seemed to increase parental leniency. Stressors emerging from family separation during displacement, however, were reported to burden parents and to lead to uncertainty, which seemed to compromise parental warmth and sensitive discipline. While narratives suggest that families reacted in similar ways during the phases of war, flight, and displacement, differences seemed to emerge during the resettlement phase. Some parents stated that in resettlement, they experienced post-traumatic growth (e.g., increased compassion for their children) and were more autonomy supporting than before the war. Other parents seemed to struggle with accepting and supporting their children's emotions and appeared to resort more readily to parental control. Our findings suggest that emotional exhaustion plays a key role in how parents viewed their parenting changed during refuge, and that individual differences in parents' abilities to recover from emotional exhaustion played a key role in shaping parenting in resettlement.Este estudio cualitativo aclara cómo las distintas fases del asilo y el reasentamiento determinan las percepciones de los padres con respecto a la crianza de sus hijos. Utilizamos entrevistas detalladas para analizar las explicaciones de los padres de cómo la guerra y el asilo provocaron diferentes factores desencadenantes de estrés, y de cómo estos a su vez moldearon la crianza. Entrevistamos a 27 padres refugiados sirios asentados recientemente en los Países Bajos (16 familias) dos veces utilizando un enfoque de teoría fundamentada. Distinguimos cinco fases del asilo, por ejemplo, la preguerra, la guerra, la huida, el desplazamiento y el reasentamiento. Durante la huida y el desplazamiento, los factores desencadenantes de estrés asociados con las pérdidas económicas y materiales aparentemente provocaron empatía en los padres por el sufrimiento de los niños, lo cual pareció aumentar la indulgencia de los padres. Sin embargo, se informó que los factores desencadenantes de estrés que surgieron por la separación de la familia durante el desplazamiento agobiaron a los padres y condujeron a la incertidumbre, lo cual aparentemente comprometió la amabilidad de los padres y la disciplina sensible. Si bien las historias sugieren que las familias reaccionaron de maneras similares durante las fases de la guerra, la huida y el desplazamiento, parecieron surgir diferencias durante la fase del reasentamiento. Algunos padres declararon que en el reasentamiento vivieron un crecimiento postraumático (p. ej.: una mayor compasión por sus hijos) y que fomentaron más la autonomía que antes de la guerra. A otros padres les costó aceptar y apoyar las emociones de sus hijos, y recurrieron más fácilmente al control parental. Nuestros resultados sugieren que el agotamiento emocional juega un papel fundamental en cómo los padres observaron un cambio en la crianza durante el asilo, y que las diferencias individuales en las habilidades de los padres para recuperarse del agotamiento emocional jugaron un papel clave a la hora de determinar la crianza en el reasentamiento.

Current interrater reliability (IRR) coefficients ignore the nested structure of multilevel observational data, resulting in biased estimates of both subject- and cluster-level IRR. We used generalizability theory to provide a conceptualization and estimation method for IRR of continuous multilevel observational data. We explain how generalizability theory decomposes the variance of multilevel observational data into subject-, cluster-, and rater-related components, which can be estimated using Markov chain Monte Carlo (MCMC) estimation. We explain how IRR coefficients for each level can be derived from these variance components, and how they can be estimated as intraclass correlation coefficients (ICC). We assessed the quality of MCMC point and interval estimates with a simulation study, and showed that small numbers of raters were the main source of bias and inefficiency of the ICCs. In a follow-up simulation, we showed that a planned missing data design can diminish most estimation difficulties in these conditions, yielding a useful approach to estimating multilevel interrater reliability for most social and behavioral research. We illustrated the method using data on student-teacher relationships. All software code and data used for this article is available on the Open Science Framework: https://osf.io/bwk5t/. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Research questionAre unmet needs for psychosocial counselling, peer support and friends/family support in parents directly and/or indirectly related to the mental health of parents and their donor-children?DesignA cross-sectional sample of 214 parents participated in this quantitative study via an online questionnaire. The sample comprised mothers and fathers in a heterosexual relationship (n = 85), mothers in a lesbian relationship (n = 67) and single mothers (n = 62). Parents were recruited via three Dutch fertility clinics and four network organizations. Unmet support needs were measured with an adapted version of the Unmet Needs for Parenting Support questionnaire, changing the original items into items about donor conception. The items were derived from a qualitative study and checked by experts in donor conception. The parents' mental health was measured with the Adult Self Report and the donor-children's mental health with the Child Behaviour Checklist. A multigroup mediation analysis was conducted to explore relationships between parents’ unmet support needs and their child's mental health, with the parents’ mental health as a possible mediator.ResultsThere were no direct relations between parents’ unmet support needs and the mental health of donor-children. Unmet needs for psychosocial counselling, peer support and friends/family support for parents and children's mental health were indirectly related through the mental health of the parents: 0.074 (CI 95% = 0.013–0.136; P = 0.017), 0.085 (CI 95% = 0.018–0.151; P = 0.036) and 0.063 (CI 95% = 0.019–0.106; P = 0.013), respectively.ConclusionsWe recommend that fertility clinics, network organizations and authorities for infertility counsellors make their support available to parents for extended periods after their treatment. Further qualitative studies are necessary to assess how to relieve unmet support needs during donor sperm treatment.

Interaction with unfamiliar partners is a component of social life from infancy onward. Yet little is known about preverbal communication with strangers. This study compared the development of infant communication with strangers to communication with mothers and fathers and examined the contribution of temperament to partner-specific communication patterns. A sample of 58 infants was observed at four and eight months during separate home-based face-to-face interactions with three partners (mother, father, and stranger). Infant visual, facial, and vocal communication behaviors were coded microanalytically. Each parent reported on infant temperament at both ages. Multilevel regression analyses indicated that infants gazed longer at strangers than at fathers, exhibited less smiling to strangers than to mothers, and produced fewer vocalizations with strangers than with either parent. Both age and temperament moderated these differences. Vocal communication with fathers became more frequent at eight months; smiling to mothers was accentuated among infants with higher levels of temperamental surgency. Importantly, levels of communication behaviors with strangers were concurrently and longitudinally associated with those with mothers and fathers. Overall, findings suggest that infant emotional communication patterns are modulated by individual temperamental differences and are reproduced in and over time, though at different levels, when interacting with novel partners.

This study examines specific exploration activities in students’ visual arts portfolios from secondary education. Creating original visual arts products requires exploration according to Getzels and Csiksentmihalyi (The creative vision. A longitudinal study of problem finding in Art. New York: John Wiley & Sons Inc., 1976). Obtaining insight about the contribution of specific exploration activities to the originality of arts products is important for designing and supporting learning in arts education. The aim of this study is to examine the contribution of activities within three types of exploration: association, combination, and abstraction to originality of visual arts designs. Data consist of 196 portfolio events showing exploration activities and art designs, from 11 Grade 11 visual arts students. Portfolio events were coded for three different types of exploration: association, combination, and abstraction, on a dimension of ascending abstractness. We coded activities within each of these types, on a scale of remoteness, to determine the metaphorical distance. Visual originality of each portfolio event was assessed using the comparative judgment method. Multilevel regression analyses showed all three types of exploration significantly contributed to originality of visual designs. In total, 31% of the variance in originality at portfolio events level was explained by these types of exploration. In general, the more remote exploration activities were, the more original the visual design. These findings are discussed related to the literature on creative processes.

Objective: To investigate whether mindfulness-based childbirth and parenting (MBCP) or enhanced care as usual (ECAU) for expectant couples decreases fear of childbirth (FOC) and nonurgent obstetric interventions during labor and improves newborn outcomes. Design: Randomized controlled trial. Setting: Midwifery settings, the Netherlands, April 2014-July 2017. Population: Pregnant women with high FOC (n = 141) and partners. Methods: Allocation to MBCP or ECAU. Hierarchical multilevel and intention-to-treat (ITT) and per-protocol (PP) analyses. Main outcome measures: Primary: pre-/postintervention FOC, labor anxiety disorder, labor pain (catastrophizing and acceptance), and preferences for nonurgent obstetric interventions. Secondary: rates of epidural analgesia (EA), self-requested cesarean birth (sCB), unmedicated childbirth, and 1- and 5-minute newborn's Apgar scores. Results: MBCP was significantly superior to ECAU in decreasing FOC, catastrophizing of labor pain, preference for nonurgent obstetric interventions, and increasing acceptance of labor pain. MBCP participants were 36% less likely to undergo EA (RR 0.64, 95% CI [0.43-0.96]), 51% less likely to undergo sCB (RR 0.49, 95% CI [0.36-0.67]), and twice as likely to have unmedicated childbirth relative to ECAU (RR 2.00, 95% CI [1.23-3.20]). Newborn's 1-minute Apgar scores were higher in MBCP (DM −0.39, 95% CI [−0.74 to −0.03]). After correction for multiple testing, results remained significant in ITT and PP analyses, except EA in ITT analyses and 1-minute Apgar. Conclusions: MBCP for pregnant couples reduces mothers’ fear of childbirth, nonurgent obstetric interventions during childbirth and may improve childbirth outcomes. MBCP adapted for pregnant women with high FOC and their partners appears an acceptable and effective intervention for midwifery care.

Background: Supporting students during collaborative learning in mathematics is challenging for teachers. We developed the Small-Group Scaffolding Tool (SGS-Tool) to assist teachers regarding how and when to offer support. The tool is based on three characteristics of scaffolding small groups at the group level: contingency to the group, phasing out content support when the group can continue independently, and transferring responsibility for learning to the group.Method: We investigated whether the scaffolding behavior of teachers using the SGS-Tool was more adapted to the group level than that of teachers not using the tool. Participants were four teachers and their seventh grade classes. The topic was Early Algebra. We analyzed teachers’ scaffolding behavior with one group during five lessons.Findings: The SGS-Tool offered teachers support when the groups discussed mathematics, but adaptations of the tool are needed. Overall, the SGS-Tool seems to be a promising tool for supporting mathematics teachers in scaffolding groups at the group level.Contribution: Our study provides insight into what scaffolding small groups at the group level entails and how teachers can apply it.

Abstract. The objective of the present study was to examine whether different methods for dealing with dependency in meta-analytic structural equation modeling (MASEM) lead to different results. Four different methods for dealing with dependent effect sizes in MASEM were applied to empirical data, including: (1) ignoring dependency; (2) aggregation; (3) elimination; and (4) a multilevel approach. Random-effects two-stage structural equation modeling was conducted for each method separately, and potential moderators were examined using subgroup analysis. Results demonstrated that the different methods of dealing with dependency in MASEM lead to different results. Thus, the decision on which approach should be used in MASEM-analysis should be carefully considered. Given that the multilevel approach is the only approach that includes all available information while explicitly modeling dependency, it is currently the theoretically preferred approach for dealing with dependency in MASEM. Future research should evaluate the multilevel approach with simulated data.

Background: This study examines participant satisfaction and effectiveness of the online mindset intervention ‘The Growth Factory’ (TGF) for youth with intellectual disabilities using a randomised controlled trial design. Method: Youth with mild to borderline intellectual disabilities (N = 119; 12–23 years) were randomly assigned to TGF (n = 60) or control group (n = 59). Primary outcome measures were mindsets and perseverance. Secondary outcomes were empowerment, mental health problems, self-esteem, treatment motivation, therapeutic alliance and challenge seeking. Measurements were conducted at pre-test, post-test and at 3 and 6 months follow-up. Results: TGF had positive effects on perseverance, mental health problems, self-esteem and therapeutic alliance at post-test. TGF had follow-up effects on mental health problems (3 months), mindset of intelligence (3 and 6 months) and mindset of emotion and behaviour (6 months). Conclusions: TGF offers a promising add-on intervention complementing usual care programmes accelerating improvements in mindsets and mental health in youth with intellectual disabilities.

Intensive longitudinal data is increasingly used to study state-like processes such as changes in daily stress. Measures aimed at collecting such data require the same level of scrutiny regarding scale reliability as traditional questionnaires. The most prevalent methods used to assess reliability of intensive longitudinal measures are based on the generalizability theory or a multilevel factor analytic approach. However, the application of recent improvements made for the factor analytic approach may not be readily applicable for all researchers. Therefore, this article illustrates a five-step approach for determining reliability of daily data, which is one type of intensive longitudinal data. First, we show how the proposed reliability equations are applied. Next, we illustrate how these equations are used as part of our five-step approach with empirical data, originating from a study investigating changes in daily stress of secondary school teachers. The results are a within-level (ωw), between-level (ωb) reliability score. Mplus syntax for these examples is included and discussed. As such, this paper anticipates on the need for comprehensive guides for the analysis of daily data.

Purpose Mokken scale analysis (MSA) is an attractive scaling procedure for ordinal data. MSA is frequently used in health-related quality of life research. Two of MSA's prime features are the scalability coefficients and the automated item selection procedure (AISP). The AISP partitions a (large) set of items into scales based on the observed item scores; the resulting scales can be used as measurement instruments. There exist two issues in MSA: First, point estimates, standard errors, and test statistics for scalability coefficients are inappropriate for clustered item scores, which are omnipresent in quality of life research data. Second, the AISP insufficiently takes sampling fluctuation of Mokken’s scalability coefficients into account. Methods We solved both issues by providing point estimates and standard errors for the scalability coefficients for clustered data and by implementing a Wald-based significance test in the AISP algorithm, resulting in a test-guided AISP (T-AISP), that is available for both nonclustered and clustered test scores. Results We integrated the T-AISP into a two-step, test-guided MSA for scale construction, to guide the analysis for nonclustered and clustered data. The first step is performing a T-AISP and select the final scale( s ). For clustered data, within-group dependency is investigated on the final scale(s). In the second step, the strength of the scale(s) is determined and further analyses are performed. The procedure was demonstrated on clustered item scores obtained from administering a questionnaire on quality of life in schools to 639 students nested in 30 classrooms. Conclusions We developed a two-step, test-guided MSA for scale construction that takes into account sample fluctuation of all scalability coefficients and that can be applied to item scores obtained by a nonclustered or clustered sampling design.

Alliance is a robust contributor to the outcome of adult, youth, and family therapy, but little is known about therapists’ contributions to the alliance in conjoint family treatment. We investigated the predictive value of therapists’ personality, clinical experience and observed alliance building behaviors for mid-treatment alliance as reported by therapists and family members. Participants were 77 parents and 21 youth from 57 families receiving home-based family treatment from 33 therapists. Therapist openness to experience and agreeableness as well as therapists’ in-session engagement and emotional connection behaviors predicted more positive therapists’ and family members’ reports of the alliance. Therapist neuroticism, extraversion and conscientiousness predicted more negative alliance-reports. In-session safety behaviors also predicted more negative alliance-reports, but this finding was only significant for therapists’ and not family members’ reports of the alliance. Clinical experience did not predict quality of alliances. We conclude that training and supervision of family therapists could benefit from focusing on emotional connection with and active engagement of family members in treatment, and from increasing self-awareness of the impact of their personality on alliances with family members.

This study examines the extent to which secure residential youth care in the Netherlands complies with children’s rights as laid down in the United Nations Convention on the Rights of the Child (uncrc) and the Dutch Youth Act. Residential group climate was measured with the Prison Group Climate Instrument (pgci), which assesses quality of group care from the perspective of the three basic needs for human self-determination: contact, autonomy and competence. Results indicate that children’s rights are a subsidiary issue in secure residential youth care in The Netherlands, because groups workers and staff have insufficient understanding of children’s rights and Dutch legislation on youth care. Dutch law allows secure facilities to make their own policy on youth care delivery, but it seems that policies are insufficiently explicit about children’s rights. Results of this study can be used to work on the fulfilment of children’s rights in secure residential youth care.

In family treatment, building and evaluating multiple alliances with family members is complex. We investigated the occurrence and development of discrepancies between therapists' alliances with different family members, and therapists’ evaluation of these multiple alliances and discrepancies. Participants were 92 parents and 61 children and adolescents from 61 families receiving home‐based family treatment. Family members, therapists, and observers reported early and mid‐treatment alliance. We found significant discrepancies, with strongest alliances with mothers, followed by fathers, and then youths. Differences became smaller during treatment. Therapist‐reports yielded similar discrepancies as compared to client self‐reports and observer‐reports. At T1, the correlation between therapist‐ and client self‐reports was moderate and significant for alliances with mothers, but insignificant for alliances with fathers and youths. At T2, these correlations were large for alliances with mothers and fathers, but not for youths. Our findings demonstrate that therapists have stronger alliances and are more congruent in their alliance perspective with parents (especially mothers) versus youths.

This longitudinal study investigated reciprocal associations among various professional identity tensions and Dutch primary student teachers’ teacher identity. Students (N = 201, 82.9% female) completed the professional identity tensions scale and the teacher identity measurement scale across three waves. Random intercept cross-lagged panel models showed that five out of nine investigated professional identity tensions were negatively associated with teacher identity at the inter-individual level. At the intra-individual level, no significant cross-lagged relationships were detected. Our findings imply that the development of professional identity tensions and teacher identity are not automatically interrelated and should, therefore, be both explicitly addressed in teacher education. The development of the relationship between professional identity tensions and teacher identity: A quantitative longitudinal study among Dutch primary student teachers.

Objectives We evaluated the effects of the family mindfulness-based intervention (MBI) “MYmind” for children with ADHD and their parents, and examined child and parent predictors of child outcome. Methods Using a pragmatic quasi-experimental waitlist design, children aged 7–19 years (n = 167), clinically referred with a DSM-IV ADHD diagnosis, and both their parents completed waitlist (average waiting time was 8 weeks), pre-test, post-test, 8-week, and 1-year follow-up measurements. MYmind consisted of eight weekly 1.5-h mindfulness-based group sessions for children and parallel for parents, and a follow-up session. We assessed children’s and both parents’ ADHD symptoms and other psychopathology, child executive function, parental stress, parental overreactivity, and mindful parenting. Results Multilevel analyses revealed medium-to-large effect-sized reduced child ADHD symptoms between pre- and post-test, becoming stronger at follow-ups, while no waitlist effects occurred. Parents above the ADHD threshold improved on adult ADHD symptoms with similar sized effects. Children’s and parents’ other psychopathology, child executive function, parental overreactivity, and mindful parenting improved, whereas parental stress only improved at 1-year follow-up. Child age, child gender, ADHD medication, parental ADHD, and parent participation did not predict child outcome. Parent gender however interacted with parental ADHD to predict child outcome; children of fathers (but not mothers) above the ADHD threshold improved more than children of fathers below the ADHD threshold at post-test and at 8-week follow-up. Reduced paternal ADHD from pre- to post-test mediated this effect. Conclusions Family MBI (MYmind) may reduce childhood ADHD and improve parental functioning. Fathers with ADHD symptoms appear important in helping offspring with ADHD.

The association between two ordinal variables can be expressed with a polychoric correlation coefficient. This coefficient is conventionally based on the assumption that responses to ordinal variables are generated by two underlying continuous latent variables with a bivariate normal distribution. When the underlying bivariate normality assumption is violated, the estimated polychoric correlation coefficient may be biased. In such a case, we may consider other distributions. In this paper, we aimed to provide an illustration of fitting various bivariate distributions to empirical ordinal data and examining how estimates of the polychoric correlation may vary under different distributional assumptions. Results suggested that the bivariate normal and skew-normal distributions rarely hold in the empirical datasets. In contrast, mixtures of bivariate normal distributions were often not rejected.

Conducting a power analysis can be challenging for researchers who plan to analyze their data using structural equation models (SEMs), particularly when Monte Carlo methods are used to obtain power. In this tutorial, we explain how power calculations without Monte Carlo methods for the χ2 test and the RMSEA tests of (not-)close fit can be conducted using the Shiny app “power4SEM”. power4SEM facilitates power calculations for SEM using two methods that are not computationally intensive and that focus on model fit instead of the statistical significance of (functions of) parameters. These are the method proposed by Satorra and Saris (Psychometrika 50(1), 83–90, 1985) for power calculations of the likelihood ratio test, and that described by MacCallum, Browne, and Sugawara (Psychol Methods 1(2) 130–149, 1996) for RMSEA-based power calculations. We illustrate the use of power4SEM with examples of power analyses for path models, factor models, and a latent growth model.

Background: Gender incongruent children report lower self-perception compared to the norm population. This study explored differences in self-perception between children living in their gender role assigned at birth and children living in their experienced gender role. Method: The self-perception questionnaire was administered to 312 children referred to the Center of Expertise on Gender Dysphoria ‘Amsterdam UMC’. Social transition status was determined by parental interviews. 2 (social transition) by 2 (sex assigned at birth) ANCOVA’s were conducted. Results: Children living in their assigned gender role reported comparable self-perception to children living in their experienced gender role. Birth assigned girls living in their assigned gender role reported poorer self-perception on ‘athletic competence’, compared to girls living in their experienced gender role. Birth assigned boys living in their assigned gender role reported poorer on ‘scholastic competence’ and ‘behavioral conduct’ compared to boys living in their experienced gender role. Conclusions: Social transition did not show to affect self-perception. Self-perception was poorer for birth assigned boys living in their experienced gender role. For birth assigned girls this was reversed. Future studies should give more insight in the role of social transitions in relation to child development and focus on other aspects related to self-perception.

Prenatal expectations about what children will be like after birth may provide a context for how parents perceive their infant's actual temperament. We examined how these expectations and perceptions are associated and together predict early parenting behavior, with parenting behavior in turn predicting changes in temperament. Reports of 125 families (N = 122 fathers; N = 123 mothers; sample 1) about their expectations of their unborn child's temperament (negative affectivity, surgency, regulation, T1), their infant's temperament at 4 and 12 months post-partum (T2 and T3), and their hostile, responsive, warm, and overprotective parenting (T2) were included. We also included data from an independent sample of 168 mothers (sample 2), with the same measures, except that mothers reported on Big Five personality traits at T1. Results indicated that in both samples, parents' expectations were positively associated with perceptions of infant temperament. Prenatal expectations and newborn temperament independently predicted parenting behavior, and maternal and paternal parenting in turn predicted infant temperament at T3, controlling for infant temperament at T2. Although overall findings indicated associations between (expectations of) a more difficult temperament and more negative/less positive parenting, significant combinations of specific traits and parenting behaviors were sample-specific—indicating that more research is necessary to draw a conclusion about specific links. Both maternal and paternal expectations about their unborn child's temperament appear to carry over into the postpartum reality and provide a context for shaping early interactions between caregivers and their children, which may further shape the developing temperament of the child.

The choice of cortisol sampling times in early childhood studies varies widely. Given that recommendations on sampling protocols are largely based on adults, the present study aimed to broaden current knowledge by examining how reliably cortisol measures obtained at different daytimes would reveal between-individual differences in toddlers’ cortisol levels. Parents were instructed to take 10 saliva samples consecutively (five per day) from their toddler (N = 19; Mage = 15.8 months, SDage = 4.2 months). Intra-class correlations (ICCs) were computed to evaluate cortisol reliability. Cortisol samples taken in the morning between 30 and 80 min after awakening and bedtime samples were most reliable in differentiating between children (ICCs ≥.80). Wake-up cortisol samples taken within the first 30 min after awakening and afternoon samples showed moderate reliabilities (ICCs = .64), whereas the reliability of noon samples was poor (ICC = .43). Therefore, when investigating cortisol in young children while being restricted to a few samples only, assessing cortisol in the morning (at least 30 min after awakening) and at bedtime would be advisable.

Meta‐analytic structural equation modeling (MASEM) refers to fitting structural equation models (SEMs) (such as path models or factor models) to meta‐analytic data. Currently, fitting MASEMs may be challenging for researchers that are not accustomed to working with R software and packages. Therefore, we developed webMASEM; a web application for MASEM. This app implements the one‐stage MASEM approach, and allows users to apply MASEM in a user‐friendly way. The aim of this article is to provide a tutorial on one‐stage MASEM and a practical guide to webMASEM. We will pay specific attention to how the data should be structured and prepared for webMASEM, because mistakes in this step may lead to faulty results without receiving an error message. The use of webMASEM is illustrated with an analysis of a meta‐analytic path model in which the path coefficients are moderated by a study‐level variable, a meta‐analytic factor model in which the factor loadings are moderated by a study‐level variable, and a meta‐analytic panel model in which the effects are moderated by a study‐level variable. All used datafiles and R scripts are available online.

Background: Researchers frequently use the responses of individuals in clusters to measure cluster-level constructs. Examples are the use of student evaluations to measure teaching quality, or the use of employee ratings of organizational climate. In earlier research, Stapleton and Johnson (2019) provided advice for measuring cluster-level constructs based on a simulation study with inadvertently confounded design factors. We extended their simulation study using both Mplus and lavaan to reveal how their conclusions were dependent on their study conditions. Methods: We generated data sets from the so-called configural model and the simultaneous shared-and-configural model, both with and without nonzero residual variances at the cluster level. We fitted models to these data sets using different maximum likelihood estimation algorithms. Results: Stapleton and Johnson’s results were highly contingent on their confounded design factors. Convergence rates could be very different across algorithms, depending on whether between-level residual variances were zero in the population or in the fitted model. We discovered a worrying convergence issue with the default settings in Mplus, resulting in seemingly converged solutions that are actually not. Rejection rates of the normal-theory test statistic were as expected, while rejection rates of the scaled test statistic were seriously inflated in several conditions. Conclusions: The defaults in Mplus carry specific risks that are easily checked but not well advertised. Our results also shine a different light on earlier advice on the use of measurement models for shared factors.

Background: Stability in foster care is paramount, since it enables children with a history of maltreatment to experience secure attachment relationships, and decreases the risk for behavioral and emotional problems when growing up. Objective: We investigated whether foster care interventions play a role in enhancing foster placement stability, in addition to several characteristics of foster children and foster families. Our hypothesis was that foster children of female gender, relatively young at start of the placement, with less previous foster care placements, staying in kinship care, placed with siblings (if they had any) and in a foster family receiving a training to enhance the foster parents’ knowledge on childhood trauma, an attachment-based video-interaction intervention or Treatment Foster Care, would experience significantly less breakdown in foster care. Method: A multilevel analysis was conducted on data from 2000 foster care placements in a 4 year period (2015–2018), concerning 1316 foster families (35.9% kin) and 1542 foster children (49.4% boys, Mage = 7.54 years). Results: The frequency of previous foster care placements (OR = 3.56) increased the risk for breakdown, and receiving the Basic Trust intervention (OR = 0.26) or Treatment Foster Care (OR = 0.11) decreased that risk. Other investigated variables were unrelated to breakdown when checked for the number of foster placements and the applied interventions. Conclusions: Foster care organizations should systematically monitor important risk factors for breakdown, in order to (timely) intervene if necessary to enhance the chances for continuity of foster care placements. Treatment seems to make a difference.

Addressing the learning crisis in low-income contexts remains a major concern. This paper analyses how active teaching and learning pedagogy (ATL) was implemented in secondary schools in Malawi to improve learning outcomes. Based on interviews with teachers and headteachers from five schools, the paper seeks to explore how ATL was understood and implemented, and what challenges were experienced from the perspectives of trained and untrained teachers. The findings reveal that ATL was positively viewed by all participants, as it was considered beneficial in improving students’ academic performance and skills development. All participants identified some key implementation challenges, including large classes, lack of materials, the use of English, long distance to school and poverty. The paper underscores the need to move away from a polarised view of pedagogy (direct instruction against ATL) and conceptualise active learning on a continuum.

Objective: PROMIS offers computerized adaptive tests (CAT) of patient-reported outcomes, using a single set of US-based IRT item parameters across populations and language-versions. The use of country-specific item parameters has local appeal, but also disadvantages. We illustrate the effects of choosing US or country-specific item parameters on PROMIS CAT T-scores. Study design and setting: Simulations were performed on response data from Dutch chronic pain patients (n = 1110) who completed the PROMIS Pain Behavior item bank. We compared CAT T-scores obtained with (1) US parameters; (2) Dutch item parameters; (3) US item parameters for DIF-free items and Dutch item parameters (rescaled to the US metric) for DIF items; (4) Dutch item parameters for all items (rescaled to the US metric). Results: Without anchoring to a common metric, CAT T-scores cannot be compared. When scores were rescaled to the US metric, mean differences in CAT T-scores based on US vs. Dutch item parameters were negligible. However, 0.9%–4.3% of the T-score differences were larger than 5 points (0.5 SD). Conclusion: The choice of item parameters can be consequential for individual patient scores. We recommend more studies of translated CATs to examine if strategies that allow for country-specific item parameters should be further investigated.

Structural equation modeling (SEM) has been proposed to estimate generalizability theory (GT) variance components, primarily focusing on estimating relative error to calculate generalizability coefficients. Proposals for estimating absolute-error components have given the impression that a separate SEM must be fitted to a transposed data matrix. This paper uses real and simulated data to demonstrate how a single SEM can be specified to estimate absolute error (and thus dependability) by placing appropriate constraints on the mean structure, as well as thresholds (when used for ordinal measures). Using the R packages lavaan and gtheory, different estimators are compared for normal and discrete measurements. Limitations of SEM for GT are demonstrated using multirater data from a planned missing-data design, and an important remaining area for future development is discussed.

Objectives Although the effectiveness of mindfulness-based intervention for various populations is well-documented, research examining these effects for police officers is limited. This study aimed to increase knowledge on (1) the effects of a mindfulness-based intervention in police officers and (2) potential mechanisms of change by relating changes in facets of mindful awareness to changes in stress. Methods In the present study, we investigated the effects of a 6-session group-based mindfulness-based intervention in police officers (n = 82) on self-report measures, using a quasi-experimental design consisting of a within-group 6-week baseline period; pre-test, 6-week intervention; and post-test, 6-week follow-up. Multilevel analyses were used to test intervention effects. Using structural equation modeling, we analyzed whether changes in facets of mindfulness were associated with changes in various types of stress. Results After the intervention, police officers significantly and substantially improved on stress (primary outcome), facets of mindful awareness (explanatory variables), and related secondary outcomes including somatic complaints, sleep disturbances, positive affect, happiness, and work ability, while in baseline period, outcome measures did not change. Effects remained significant or improved further during the follow-up period. Further, we found that increases in particularly the facets of mindful awareness of acting with awareness and non-judging were associated with reductions in stress. Conclusions Mindfulness-based intervention appears beneficial for police officers. Further, increases in both attention and acceptance skills such as acting with awareness and non-judging seem to be most important in explaining reductions of stress in police officers.

Conduct problems can develop into behavior disorders and put children at risk for other mental health problems. Parenting interventions have been shown to successfully reduce conduct problems and are often expected to prevent the development of broader mental health problems. Few studies have evaluated the longer-term and broader effects of these interventions. To what extent are parenting intervention effects sustained in the years after the intervention? And do effects pertain to conduct problems specifically, or do they also affect broader aspects of children’s mental health? We used a randomized controlled trial to assess the longer-term (2.5 years) effects of the Incredible Years parenting intervention on children’s conduct problems in an indicated prevention setting (N = 387; 79% retention rate). Using a multi-method (survey and computerized tasks) and multi-informant (parents, teachers, and children) approach, we tested whether initial effects on conduct problems were sustained, and whether Incredible Years had broader effects on children’s peer problems, emotional problems, attention-deficit/hyperactivity disorder (ADHD) symptoms, attention and inhibition deficits, and service use. Incredible Years, relative to control (no intervention), led to sustained reductions in parent-reported conduct problems (Cohen’s d = 0.31), but not teacher- and child-reported conduct problems. There were no broader benefits: Incredible Years did not reduce children’s peer problems, emotional problems, ADHD-symptoms, attention and inhibition deficits, or their service use. Improvements in parents’ perceptions of child conduct problems sustained until 2.5 years later. Our findings do not show benefits of Incredible Years as a preventive intervention for children’s broader mental health. Electronic Supplementary Information The online version contains supplementary material available at 10.1007/s11121-020-01176-6.

Studies have compared sexual minority mothers (mostly lesbian) to heterosexual mothers on mental health, but little research has compared sexual minority women with and without children. This was the first study to compare sexual minority women who did or did not have children, using a population-based sample with three age cohorts. Unlike prior convenience studies, this study finds parents more likely to be bisexual, in a relationship with a man, and non-urban. Bisexual parents scored higher than lesbian parents on psychological distress and lower on life satisfaction and happiness; they also reported less connection to the lesbian, gay, bisexual, and transgender (LGBT) community. Among lesbians, the oldest non-parents reported more happiness and less psychological distress than the youngest non-parents. Parents with other identities perceived more social support from friends and reported lower levels of internalized homophobia than bisexual parents. The results will help professionals and policymakers understand how parenthood status affects women across sexual identities.

Caregivers are often encouraged to praise children to reduce externalizing behavior. Although several theoretical perspectives suggest that praise works (e.g., praise reinforces positive behavior), others suggest it may not (e.g., children dismiss praise or experience it as controlling). This longitudinal-observational study examined whether (a) caregivers' praise and children's externalizing behavior were related; (b) an evidence-based parenting program increased caregivers' praise; (c) and increasing praise reduced children's externalizing behavior. Participants (387 caregiver-child dyads) were randomly assigned to a 14-session parenting program (aiming to improve parenting behavior, partly via praise) or a control group. Children (aged 4-8 years, 45% girls) scored at or above the 75th percentile on externalizing behavior problems. Caregivers (91% Caucasian, 85% born in the Netherlands, 50.5% highly educated) were mostly mothers (91%). At baseline, postintervention, and follow-up, we assessed caregivers' labeled and unlabeled praise via in-home observations, and children's externalizing behavior via caregiver-reports and observations. At baseline, caregivers' unlabeled praise was related to more (rather than less) externalizing behavior. The parenting program successfully increased praise and reduced caregiver-reported (but not observed) externalizing behavior; importantly, however, praise did not mediate the program's effect on caregiver-reported externalizing behavior. Although the program did not directly reduce observed externalizing behavior, it did so indirectly via labeled praise. Our results suggest that, although praise and externalizing child behavior are related, praise may not be a key mechanism underlying the effects of the parenting program. If praise has beneficial effects on children's externalizing behavior, these effects are probably limited to labeled praise. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

There is a lack of instruments assessing child-caregiver attachment relationships in early childhood to be used in attachment-based practice, in particular from a caregiver's perception, which is an important factor of clinical importance to take into account in parenting interventions targeting young children. Therefore, the 48-item Attachment Relationship Inventory-Caregiver Perception 2-5 years (ARI-CP 2-5) was developed. Survey data of 446 caregivers of 2- to 5-year-old children were collected, and a subsample of 83 caregivers participated in an observation study. Confirmatory factor analysis confirmed a four-factor structure of secure, avoidant, ambivalent, and disorganized attachment relationship. Indications of configural, metric, and scalar invariance were found for caregivers' and children's sex, children's age, and population (clinical vs. general population). The four scales showed sufficient internal consistency and significant associations with children's psychopathology, caregivers' general attachment representations, caregivers' mind-mindedness, and population type. Moreover, preliminary evidence for convergent validity with observational attachment measures was found. It is concluded that the ARI-CP 2-5 is a valid instrument that can be used as part of the screening and assessment of insecure attachment relationships.Hacen falta instrumentos que evalúen las relaciones de afectividad niño-cuidador en la temprana niñez para ser usados en la práctica que se basa en la afectividad, en particular desde la perspectiva del cuidador, lo cual es un factor clave de importancia clínica para tomar en cuenta en las intervenciones de crianza que se enfocan en niños pequeños. Por tanto, se desarrolló el Inventario de la Relación Afectiva - Percepción del Cuidador 2-5 años, que consta de 48 aspectos (ARI-CP 2-5). Se recogió información de encuesta de 446 cuidadores de niños de 2 a 5 años de edad, y un subgrupo muestra de 83 cuidadores participó en un estudio de observación. Los análisis de factores confirmatorios corroboraron una estructura de cuatro factores de la relación de afectividad que es segura, la que evita, la ambivalente y la desorganizada. Se encontraron indicaciones de invariabilidad en el aspecto configuracional, métrico y de escala en cuanto al género sexual de los cuidadores y del niño, la edad del niño, y la población (clínica y general). Las cuatro escalas mostraron una suficiente consistencia interna y asociaciones significativas con la sicopatología de los niños, las representaciones generales de afectividad del cuidador, la conciencia mental de los cuidadores, así como el tipo de población. Es más, se encontró una evidencia preliminar para la validez convergente con las medidas de afectividad de observación. Se concluye con que el ARI-CP 2-5 es un instrumento válido que puede usarse como parte de la detección y evaluación de las relaciones de afectividad inseguras.Il y a un manque d'instruments évaluant les relations d'attachement enfant-aidant naturel dans la petite enfance pouvant être utilisés dans une pratique basée sur l'attachement, en particulier sur la perception de l'aidant naturel, qui est un facteur important de l'importance clinique à prendre en compte dans les interventions de parentages ciblant les jeunes enfants. Par conséquent l'Inventaire de 48 articles de la Relation d'Attachement - Perception de l'Aidant Naturel 2-5 ans (abrégé en anglais ARI-CP 2-5) a été développé. Les données de sondage de 446 aidants naturels d'enfants de 2 à 5 ans ont été recueillies et un sous-échantillon de 83 aidants naturels ont participé à une étude d'observation. Une analyse factorielle confirmatoire a confirmé une structure à quatre facteurs de la relation d'attachement sécure, évitant, ambivalent et désorganisé. Des indications d'invariance configurale, métrique et scalaire ont été trouvées pour le sexe des aidants naturels et des enfants, l’âge des enfants, et la population (clinique par rapport à population générale). Les quatre échelles ont démontré une cohérence interne suffisante et des associations importantes avec la psychopathologie des enfants, les représentations de l'attachement générale des aidants naturels, l'esprit-qualité mentale et le type de population. De plus une preuve préliminaire de validité convergente ave les mesures observationnelles d'attachement a été trouvée. Nous concluons que l'ARI-CP 205 est un instrument valide qui peut être utilisé pour le dépistage et l’évaluation de relations d'attachement insécures.Entwicklung und Validierung des Inventars für Bindungsbeziehung - Eltern- bzw. Betreuer_innenperspektive 2-5 Jahre (ARI-CP 2-5): Psychometrische Struktur, externe Validität und Normen Es fehlen Instrumente zur Beurteilung der Bindungsbeziehungen zwischen Kleinkind und Bezugsperson, die in der bindungsbasierten Praxis verwendet werden können. Insbesondere fehlen hierbei Instrumente, die die Wahrnehmung der Bezugspersonen einschließen - ein Faktor von großer klinischer Bedeutung, der bei Elterninterventionen für Kleinkinder berücksichtigt werden sollte. Aus diesem Grund wurde das 48-Punkte-Inventar für Bindungsbeziehung - Eltern- bzw. Betreuer_innenperspektive 2-5 Jahre (ARI-CP 2-5) entwickelt. Von 446 Bezugspersonen 2-5-jähriger Kinder wurden Umfragedaten gesammelt und eine Teilstichprobe von 83 Bezugspersonen nahm an einer Beobachtungsstudie teil. Eine konfirmatorische Faktoranalyse ergab eine Vier-Faktoren-Struktur aus sicheren, vermeidenden, ambivalenten und unorganisierten Bindungsbeziehungen. Hinweise auf konfigurale, metrische und skalare Messinvarianz wurden für Geschlecht und Alter der Bezugspersonen und Kinder sowie für die Stichprobe (klinisch vs. allgemein) gefunden. Die vier Skalen wiesen ausreichende interne Konsistenz und signifikante Assoziationen mit der kindlichen Psychopathologie, den allgemeinen Bindungsrepräsentationen, dem Mind-Mindedness der Bezugspersonen und der Art der Stichprobe auf. Darüber hinaus wurden vorläufige Belege für konvergente Validität mit beobachtenden Bindungsmaßen gefunden. Es wird der Schluss gezogen, dass der ARI-CP 2-5 ein valides Instrument ist, das im Rahmen von Screenings und Beurteilungen unsicherer Bindungsbeziehungen verwendet werden kann.愛着関係調査票-2歳から5歳の養育者の認識 (ARI-CP 2-5)の開発と検証:心理検 査構造、外部の妥当性と規範 幼児期に幼児―養育者の愛着関係を評価する方策が不足しており、幼児を対象と した子育て介入において臨床的に考慮すべき重要な要素である愛着、特に愛着に 対する養育者の認識に基づいた実践に活用できない。そこで、48項目の愛着関係 調査票-2歳から5歳の養育者の認識 (ARI-CP 2-5)が開発された。446人の2歳から 5歳の子どもの養育者の調査データが収集され、二次標本として83人の養育者が 観察研究に参加した。確認的因子分析で安全型、回避型、抵抗/両価型、混乱型 の愛着という4因子の構造を確認した。養育者と子どもの性別、子どもの年齢、 集団 (臨床と一般) のために構成の指標と測定基準、およびスカラー不変性が発 見された。4つのスケールは十分な内的整合性を示し、子どもの精神病理、養育 者の一般的な愛着表現、養育者のマインドマインドネス、母集団のタイプとの間 に有意な関連を示した。さらに観察に基づいた愛着の評価とともに収束性妥当性 のための予備的証拠が見つかった。ARI-CP 2-5は、不安定型愛着関係のスクリー ニングと評価の一部として使用できる有効な手段であると結論付けられる。.摘 要:目前缺乏可用于依恋实践的评估儿童早期看护者依恋关系的工具, 特别是从看护者的感知角度, 这是针对幼儿的养育干预措施中需要考虑的一个重要临床因素。因此, 编制了含括48题的依恋关系 - 2-5岁儿童看护者感知量表 (ARI-CP 2-5)。收集了446名2-5岁儿童看护者的调查数据, 并以83名看护者子样本为被试进行观察研究。验证性因素分析证实了安全、回避、矛盾和无序依恋关系的四因素结构。在看护者和儿童性别、儿童年龄以及人群 (临床和一般人群) 中发现了构型、度量和标量不变性的迹象。四个量表显示出足够的内在一致性, 并与儿童的精神病理学、看护者的一般依恋表征、看护者的心智和人群类型显著相关。此外, 还发现了通过观察依恋措施聚合效度的初步证据。结论:ARI-CP 2-5是一种有效的工具, 可用于不安全型依恋关系的部分筛选和评估。.تطوير وتحقيق مقياس التعلق المرتبط بالعلاقات - تصورات مقدم الرعاية 2-5 سنوات دراسة البنية السيكوميترية والصلاحية الخارجية والمعايير هناك نقص في الأدوات التي تقيِّم العلاقات بين الأطفال ومقدمي الرعاية في مرحلة الطفولة المبكرة لاستخدامها في الممارسة القائمة على التعلق، ولا سيما من منظور مقدم الرعاية، والذي يعتبر عامل مهم من العوامل ذات الأهمية الاكلينيكية التي ينبغي مراعاتها في التدخلات الوالدية التي تستهدف الأطفال الصغار. ولذلك تم تطوير قائمة فحص التعلق من 48 عنصر - منظور مقدم الرعاية 2-5 سنوات (5-CP 2-ARI) وتم جمع بيانات استقصائية عن 446 من مقدمي الرعاية للأطفال الذين تبلغ أعمارهم سنتين إلى خمس سنوات، وشارك في دراسة الملاحظة عينة فرعية من 83 من مقدمي الرعاية. أكد تحليل العامل وجود أربعة عوامل تمثل بنية التعلق الآمن، والمتجنب، والمتناقض، والغير منظم. وأشارت النتائج إلى وجود مؤشرات لثوابت شكلية، وقياسية من حيث جنس مقدمي الرعاية والأطفال، وأعمار الأطفال، والتركيبة السكانية (العينة الإكلينيكية مقابل عامة السكان).وأظهرت المقاييس الأربعة اتساقًا داخليًا كافيًا وارتباطا إحصائياً مع الصحة النفسية للأطفال، والتصورات العامة للتعلق عندمقدمي الرعاية، والتصورات الذهنية لمقدمي الرعاية، ونوع السكان. وعلاوة على ذلك، وُجد دليل أولي على الصلاحية المتقاربة لمقاييس التعلق القائمة على الملاحظة. وتخلص الدراسةإلى أن مقياس (5-CP 2-ARI) يعتبر أداة صالحة يمكن استخدامها كجزء من فحص وتقييم علاقات التعلق غير الآمنة.

This study compared two single-group approaches for assessing measurement invariance across an observed background variable: restricted factor analysis (RFA) and moderated nonlinear factor analysis (MNLFA). In MNLFA models, heteroskedasticity can be accounted for by allowing the common-factor variance and the residual variances to differ as a function of the background variable. In contrast, RFA models assume homoskedasticity of both the common factor and the residuals. We conducted a simulation study to examine the performance of RFA and MNLFA under common-factor and residual homoskedasticity and heteroskedasticity. Results suggest that MNLFA and RFA with product indicators outperform RFA with latent moderated structural equations in conditions with heteroskedastic common-factors, and MNLFA outperforms RFA in conditions with residual heteroskedasticity. We provide an explanation for the robustness of RFA with product indicators to violations of common-factor homoskedasticity.

Objective: Pain interference and pain behavior are highly relevant outcomes in patients with rheumatoid arthritis (RA). The Patient-Reported Outcomes Measurement Information System (PROMIS) is a universally applicable set of item banks measuring patient-reported health, and if applied as computerized adaptive tests (CATs), more efficiently and precisely than current instruments. The objective was to study the psychometric properties of the Dutch-Flemish PROMIS pain interference (PROMIS-PI) and the PROMIS pain behavior (PROMIS-PB) item banks in patients with RA. Methods: A total of 2,029 patients with RA completed the full PROMIS-PI (version 1.1, 40 items), and 1,554 patients completed the full PROMIS-PB (version 1.1, 39 items). The following psychometric properties were studied: unidimensionality, local dependence, monotonicity and graded response model (GRM) fit, cross-cultural validity (differential item functioning [DIF] for language [Dutch versus Flemish]), other forms of measurement invariance, construct validity, reliability, and floor and ceiling effects. Results: The PROMIS-PI and PROMIS-PB banks were sufficiently unidimensional (Omega-hierarchical [Omega-H] 0.99, 0.95, and explained common variance 0.95, 0.78, respectively), had negligible local dependence (0.3–1.4% of item pairs), good monotonicity (H 0.75, 0.46), and a good GRM model fit (no misfitting items). Furthermore, both item banks showed good cross-cultural validity (no DIF for language), measurement invariance (no DIF for age, sex, administration mode, and disease activity), good construct validity (all hypotheses met), high reliability (>0.90 in the range of patients with RA), and an absence of floor and ceiling effects (0% minimum or maximum score, respectively). Conclusion: Both PROMIS-PI and PROMIS-PB banks showed good psychometric properties in patients with RA and can be used as CATs in research and clinical practice.

In psychological assessment of children, it is pivotal to establish from what age on self-reports can complement or replace informant reports. We introduce a psychometric approach to estimate the minimum age for a child to produce self-report data that is of similar quality as informant data. The approach makes use of statistical validity indicators such as person-fit and long-string indices, and can be readily applied to data commonly collected in psychometric studies of child measures. We evaluate and illustrate the approach, using self-report and informant-report data of the PedsQL, a pediatric health-related quality of life measure, from 651 child–mother pairs. To evaluate the approach, we tested various hypotheses about the validity of the self-report data, using the [Formula: see text] person-fit index as the validity indicator and the mother informant-data as a benchmark for validity. Results showed that [Formula: see text] discriminated between self-reports of younger and older children, between self-reports of children that completed the PedsQL alone or with a parent, and between self-reports and informant reports. We conclude that the validity-index approach has good potential for future applications. Future research should further evaluate the approach for different types of questionnaires (e.g., personality inventories) and using different validity indices (e.g., response-bias indices).

Purpose: This study evaluated the video-feedback intervention Basic Trust in families with internationally adoptive children aged 2–12 years. The intervention aims to reduce child attachment insecurity and behavior problems by enhancing mothers’ and fathers’ sensitivity and mind-mindedness (parents’ capacity to hold in mind the mind of their child). Method: Fifty-three adoptive families participated in a pretest, posttest, and 6-month follow-up assessment. Questionnaires on parenting stress, child attachment insecurity, and behavior problems were administered. Parents’ sensitivity was assessed from free-play observations at home, and mind-mindedness was measured with a describe-your-child interview. Results: Parents reported less child behavior problems, insecure and disorganized attachment, and parenting stress at posttest and follow-up. Parents’ mind-mindedness increased from pre- to post-test but not from pretest to follow-up. Parents’ sensitivity showed an improvement at follow-up. Conclusions: Future studies should investigate whether the present study’s positive results can be replicated under conditions of strict experimental control.

Popular belief holds that sexual behavior is evaluated more liberally for males than females. However, the assessment of this “sexual double standard” is controversial. Therefore, we investigated measurement equivalence of commonly used items to assess sexual double standards in previous research. Based on established measurement equivalence, we investigated whether adolescents endorsed a sexual double standard. Using data from 455 adolescents ( Mage = 14.51, SD = 0.64), confirmatory factor analyzes showed that the sexual double standard concept was measurement equivalent across sex, and partly across evaluations of the same and opposite sex. Factor analyzes demonstrated that there was not one, but two sexual double standards. Male adolescents evaluated male sexual behavior more liberally than female sexual behavior, but female adolescents evaluated female sexual behavior more liberally than male sexual behavior. This contradicts the traditional notion of the existence of one sexual double standard that favors male and suppresses female sexuality.

Course materials play a vital role in the foreign language classroom. Relatively little attention has been paid, however, to analyzing the activities that foster oral interactional ability in course materials for English as a foreign language (EFL). For the purpose of this study, a coding scheme was designed that focuses specifically on the development of interactional ability. This was used to analyse the three most commonly used EFL course books for pre-vocational learners in the Netherlands. The analysis revealed that course books focus more on developing language knowledge than on developing the ability to use this knowledge in interaction, that interactional strategies practice is missing, and that interactional practice is limited to the personal and public context. We conclude that EFL course books lag behind current theories of second language acquisition (SLA) in the practical application of activities focused on developing interactional ability. Recommendations to strengthen the link between theory and practice are made.

For the construction of tests and questionnaires that require multiple raters (e.g., a child behaviour checklist completed by both parents) a novel ordinal scaling technique is currently being further developed, called two-level Mokken scale analysis. The technique uses within-rater and between-rater coefficients to assess the scalability of the test. These coefficients are generalizations of Mokken's scalability coefficients. In this paper we derived standard errors for the two-level coefficients and for their ratios. The coefficients, the estimates, the estimated standard errors and the software implementation are discussed and illustrated using a real-data example, and a small-scale simulation study demonstrates the accuracy of the estimates.

The present study investigated (1) how social relationships with teachers and peers and self-esteem of students with social–emotional and behavioral difficulties (SEBD) in inclusive regular education (regular schools) and students with SEBD in exclusive special education (special schools) develop over time in comparison with each other and in comparison with their typically developing peers and (2) whether factors—present before students with SEBD received special education services—predicted social–emotional development in either educational setting. Thirty-six students with SEBD in regular schools, 15 students with SEBD in special schools, and 1,270 typically developing peers participated. We collected data when students with SEBD resided in regular education without additional support, and we followed the development of students with SEBD for 1.5 years with three additional measurements in either school setting. Data of typically developing peers were collected when they resided in a classroom of a participating student with SEBD. Using Bayesian statistics, we found that students with SEBD in special schools had more conflictual relationships with their teachers than typically developing peers, but these relationships improved over time. Students with SEBD in regular schools were less accepted among peers than typically developing students and peer acceptance was stable over time for all three groups. Self-esteem and development in self-esteem over time did not differ between groups. The current study shows that students with SEBD show different developmental trajectories in regular or special schools and that it is difficult to predict their social–emotional development by factors present before students with SEBD received special education services.

It is often unrealistic to assume normally distributed latent traits in the measurement of health outcomes. If normality is violated, the item response theory (IRT) models that are used to calibrate questionnaires may yield parameter estimates that are biased. Recently, IRT models were developed for dealing with specific deviations from normality, such as zero-inflation (“excess zeros”) and skewness. However, these models have not yet been evaluated under conditions representative of item bank development for health outcomes, characterized by a large number of polytomous items. A simulation study was performed to compare the bias in parameter estimates of the graded response model (GRM), polytomous extensions of the zero-inflated mixture IRT (ZIM-GRM), and Davidian Curve IRT (DC-GRM). In the case of zero-inflation, the GRM showed high bias overestimating discrimination parameters and yielding estimates of threshold parameters that were too high and too close to one another, while ZIM-GRM showed no bias. In the case of skewness, the GRM and DC-GRM showed little bias with the GRM showing slightly better results. Consequences for the development of health outcome measures are discussed.

Background: Meta-analysis (Glass, 1976) is a commonly used statistical technique to aggregate sample effect sizes of different independent primary studies in order to draw inferences concerning population effects. To extend the range of research questions that can be answered, new meta-analytic models have been developed, such as meta-analytic structural equation modeling (MASEM) (Becker, 1992, 1995; Cheung, 2014, 2015a; Cheung & Chang, 2005; Jak, 2015; Viswesvaran & Ones, 1995). In primary studies, an effect size may represent the strength and direction of the association between any two variables of interest. Such an effect size can be expressed in different ways, for example as Pearson product-moment correlation, Cohens’ d, biserial correlation, and point-biserial correlation. How an effect size is expressed depends on the nature of the variables (e.g., continuous or dichotomous), but also on the way the variables are measured or analyzed. If one of the two continuous variables is artificially dichotomized, one may express the effect size as a point-biserial correlation. However, this typically provides a negatively biased estimate of the true underlying Pearson product-moment correlation (e.g., Cohen, 1983; MacCallum, Zhang, Preacher, & Rucker, 2002). The biserial correlation on the other hand should generally provide an unbiased estimate (Soper, 1914; Tate, 1955). Bias in the effect size of any primary study may affect meta-analytic results in the same direction (Jacobs & Viechtbauer, 2017). Therefore, we may expect that the use of the point-biserial correlation for the relationship between an artificially dichotomized and continuous variable also biases MASEM-parameters. In the current study we will evaluate how using point-biserial correlations versus biserial correlations from primary studies may affects path coefficients, their standard errors, and model fit in MASEM. Based on the results, we expect to be able to inform researchers about which of the two investigated effect sizes is the most appropriate to use in MASEM-applications and under which conditions. Aim: Our aim is to investigate the effects of using (1) the point-biserial correlation and (2) the biserial correlation for the relationship between an artificially dichotomized variable and a continuous variable on MASEM-parameters and model fit. Specifically, our interest lies in path coefficients, standard errors of these coefficients, and model fit. Method: We simulated meta-analytic data according to a full mediation (hence overidentified) population model (see Figure 1), with a continuous predictor variable X, continuous mediator M, and a continuous variable Y as outcome. Depending on the condition, the predictor variable X is artificially dichotomized in all or a given percentage of the primary studies. We chose this population model because in educational research the median number of variables in a ‘typical’ meta-analysis is three (de Jonge & Jak, 2018) and because mediation is a popular research topic. Figure 1. Population model with fixed parameter values. Under this population model, random meta-analytic datasets were generated under different conditions. We systematically varied the following: (1) the size of the (standardized) path coefficient between X and M (.16, .23, .33), (2) the percentage of primary studies in which X was artificially dichotomized (25%, 75%, 100%), and (3) the cut-off point at which X was artificially dichotomized (at the median value, so a proportion of .05, or when groups become unbalance, at a proportion of .01). These choices were mainly based on typical situations in educational research. The size of the path coefficient, reflect the minimum, mean/median, and maximum pooled Pearson product-moment correlations in a ‘typical’ meta-analysis in educational research (de Jonge & Jak, 2018). The 75% primary studies that artificially dichotomize the variable X, is based on a comparable example of a meta-analysis in educational research (Jansen, Elffers, & Jak, 2019). We used between-study variances of .01. The number of primary studies in a meta-analysis was fixed at the median number of a ‘typical’ meta-analysis, which is 44 (de Jonge & Jak, 2018). Because we use a random-effects MASEM-method, the assumption is thus that the population comprises 44 subpopulations from which the 44 samples are drawn, and that the weighted mean of the subpopulation parameters equals the population parameter. Given a specific condition and the fixed number of 44 primary studies, we randomly sampled the within primary study sample sizes from a positively skewed distribution as used in Hafdahl (2007) with a mean of 421.75, yielding ‘typical’ sample sizes (de Jonge & Jak, 2018) for every iteration. We imposed 39% missing correlations (Sheng, Kong, Cortina, & Hou, 2016) by (pseudo) randomly deleting either variable M or Y from 26 of the 44 studies. In each condition, we generated 2000 meta-analytic datasets drawn from the 44 subpopulations, which we analyzed using (1) the point-biserial and (2) the biserial correlation as effect size between the artificially dichotomized predictor X and continuous mediator M. The full mediation model was fitted using random-effects two stage structural equation modeling (TSSEM) (Cheung, 2014) within the R-package ‘metaSEM’ (Cheung, 2015b). As recommended (Becker, 2009; Hafdahl, 2007), we used the weighted mean correlation across the included primary studies to estimate the sampling variances and covariances of the correlation coefficients in the primary studies. Next, over the converged simulated datasets, we (1) estimated the relative percentage bias in both path coefficients (less than 5% bias was considered negligible; Hoogland & Boomsma, 1998), (2) calculated the relative percentage bias of the standard errors of these path coefficients (less than 10% bias was considered acceptable; Hoogland & Boomsma, 1998), (3) calculated the rejection rates of the chi-square statistic of the model of Stage 2 (df = 1,  = .05) and tested whether the rejection rate significantly differed from the nominal -level with the proportion test, and (4) compared the theoretical chi-square distribution (df = 1) with the empirical chi-square distribution (by means of QQplots and the Kolmogorov-Smirnov test). Main Results: When the point-biserial correlation for the relation between an artificially dichotomized predictor and a continuous mediator was used, the path coefficient of this relationship in the population (βMX) seems systematically underestimated. When the biserial correlation was used instead of the point-biserial correlation, this path coefficient could be considered unbiased in each condition. The estimated path coefficient between the two continuous variables (βYM) could also be considered unbiased in all conditions, no matter if the biserial or point-biserial correlation was used. The relative percentage bias in the standard errors of all path coefficients could be considered as not substantial according to the criteria that were applied. However, we noticed that the relative percentage bias in the standard error of the path coefficient between the predictor and mediator (βMX) seems systematically negatively biased when the biserial correlation was used. We also found that the relative percentage bias in the standard error of the path coefficient between the continuous variables Y and M (βYM) seems systematically negative, regardless if the point-biserial or biserial correlation was used. In most conditions, the rejection rate of the chi-square test of model fit at Stage 2 of the random-effects TSSEM was slightly above the nominal -level, no matter if the point-biserial or biserial correlation was used. The results of the Kolmogorov-Smirnov test and QQplots show that when the biserial correlation was used, there was a statistically significant difference between the empirical chi-square distribution and the theoretical chi-square distribution in five of the 18 conditions. When the point-biserial correlation was used, there was a significant difference in the same five conditions plus in three other conditions. There seems to be no clear pattern in which conditions the distributions differed significantly or not. Expected Conclusions and Implications: We advise researchers who want to apply MASEM and want to investigate mediation to convert the effect size between any dichotomized predictor and continuous variable to a biserial correlation, not to a point-biserial correlation. References: Becker, B. J. (1995). Corrections to “using results from replicated studies to estimate linear models”. Journal of Educational and Behavioral Statistics, 20, 100–102. doi:10.2307/1165390 Becker, B. J. (2009). Model-based meta-analysis. In H. Cooper, L. V. Hedges, & J.C. Valentine (Eds.) The handbook of research synthesis and meta-analysis (2nd ed., pp. 377–395). New York: Russell Sage Foundation. Becker, B. J. (1992). Using results from replicated studies to estimate linear models. Journal of Educational Statistics, 17, 341–362. doi:10.2307/1165128 Cheung, M. W.-L. (2014). Fixed-and random-effects meta-analytic structural equation modeling: Examples and analyses in R. Behavior Research Methods, 46, 29–40. doi:10.3758/s13428-013-0361-y Cheung, M. W.-L. (2015a). Meta-analysis: A structural equation modeling approach. Chichester, United Kingdom: John Wiley & Sons. Cheung, M. W.-L. (2015b). metaSEM: An R package for meta-analysis using structural equation modeling. Frontiers in Psychology, 5, [1521]. https://doi.org/10.3389/fpsyg.2014.01521 Cheung, M. W.-L., & Chan, W. (2005). Meta-analytic structural equation modeling: a two-stage approach. Psychological methods, 10, 40-64. doi:10.1037/1082-989X.10.1.40 Cohen, J. (1983). The cost of dichotomization. Applied psychological measurement, 7, 249-253. https://doi.org/10.1177/014662168300700301 de Jonge, H., & Jak, S. (2018, June). A Meta-Meta-Analysis: Identifying Typical Conditions of Meta-Analyses in Educational Research. Paper presented at the conference Research Synthesis 2018 of Leibniz Institute for Psychology Information, Trier, Germany. http://dx.doi.org/10.23668/psycharchives.853 Glass, G. V. (1976). Primary, secondary, and meta-analysis of research. The Educational Researcher, 10, 3–8. doi:10.3102/0013189X005010003 Hafdahl, A. R. (2007). Combining correlation matrices: Simulation analysis of improved fixed-effects methods. Journal of Educational and Behavioral Statistics, 32, 180–205. doi:10.3102/1076998606298041 Hoogland, J. J., & Boomsma, A. (1998). Robustness studies in covariance structure modeling: An overview and a meta-analysis. Sociological Methods & Research, 26, 329–367. doi:10.1177/0049124198026003003 Jacobs, P., & Viechtbauer, W. (2017). Estimation of the biserial correlation and its sampling variance for use in meta‐analysis. Research synthesis methods, 8, 161-180. doi:10.1002/jrsm.1218 Jak, S. (2015). Meta-analytic structural equation modelling. Springer International Publishing. Jansen, D., Elffers, L., & Jak, S. (2019). The functions of shadow education in school careers: a systematic review. Manuscript submitted for publication. MacCallum, R. C., Zhang, S., Preacher, K. J., & Rucker, D. D. (2002). On the practice of dichotomization of quantitative variables. Psychological methods, 7, 19–40. doi:10.1037//1082-989X.7.1.19 Tate, R. F. (1955). The theory of correlation between two continuous variables when one is dichotomized. Biometrika, 42, 205–216. doi:10.2307/2333437 Sheng, Z., Kong, W., Cortina, J. M., & Hou, S. (2016). Analyzing matrices of meta‐analytic correlations: current practices and recommendations. Research synthesis methods, 7, 187-208. doi:10.1002/jrsm.1206 Soper, H. E. (1914). On the probable error of the bi-serial expression for the correlation coefficient. Biometrika, 10, 384–390. doi:10.2307/2331789 Viswesvaran, C., & Ones, D. (1995). Theory testing: Combining psychometric meta-analysis and structural equations modeling. Personnel Psychology, 48, 865–885. doi:10.1111/j.1744-6570.1995.tb01784.x

Objective To examine neurocognitive functioning of children exposed prenatally to carbamazepine, lamotrigine, levetiracetam or valproate monotherapy. Methods In a prospective observational study, children aged 6 or 7 years, identified from the European Registry of Antiepileptic Drugs and Pregnancy database in The Netherlands, were assessed using the Wechsler Intelligence Scale for Children and the developmental neuropsychological assessment. Maternal IQ was measured using Wechsler Adult Intelligence Scale. Assessors were blinded to drug exposures. Results One hundred and sixty-one children (one set of twins and 21 sibling pairs) of 139 mothers were included. As a group, children achieved average scores on neurocognitive outcomes. Children exposed to valproate (n = 22) performed lower on all six neurocognitive domains, especially language, than those exposed to carbamazepine (n = 32), lamotrigine (n = 82) or levetiracetam (n = 25). After controlling for maternal IQ and drug dose, the verbal IQ of valproate-exposed children was on average 9.1 points lower than those exposed to carbamazepine (95% confidence interval [CI] 1.3–17.0; p = 0.023), 10.3 lower than lamotrigine-exposed children (CI 3.4–17.3; p = 0.004) and 13.4 lower than levetiracetam-exposed children (CI 5.2–21.6; p = 0.002). No significant dose–effect was found. Virtually no significant differences were found between lamotrigine and levetiracetam or lamotrigine and carbamazepine exposed children. Conclusions Consistent with previous research, valproate-exposed children experienced more problems compared to three other common antiepileptic drugs, while children exposed to lamotrigine, carbamazepine or levetiracetam revealed little to no problems. This illustrates the need for systematic follow-up of prenatally exposed children, to support pre-pregnancy counseling and treatment decisions in women of reproductive age.

Organizations are confronted with a constant need for efficiency, which affects the working atmosphere, often typified by velocity, time pressure, competition, job insecurity, and information overload, which may lead to stress, burnout, work-life disbalance, and lowered work functioning. This study evaluated an 8-week, 1.5 h-per-week group-based standardized mindfulness program (“Finding peace in a frantic world”), applied on-site in a large multinational company. In a naturalistic longitudinal design self-selected employees (n = 150) completed measurements at wait-list, pre-test, post-test, and 2 and 6 months follow-up. Nearly all participants followed at least five out of eight sessions, were highly satisfied with the training (8.3 out 10), and almost 90% intended to continue with mindfulness practices. Primary outcomes were stress and risk for dropout from work. Using multilevel analyses, mean pre-test scores were compared to the other measurement occasions, and the rate of change in the training period (M = 67 days; SD = 12) was compared to the rate of change in the wait-list period (M = 29 days; SD = 8). Direct and long-term positive effects on risk for dropout from work (p p p

Parent−child interaction therapy (PCIT) is a short-term, evidence-based intervention for caregivers with children aged between 2 and 7 who exhibit behavioral problems. PCIT is effective, but has a high attrition rate ranging from 27% to 69%. We hypothesize that a low level of parental mind-mindedness—the parent’s propensity to treat the child as an intentional agent with its own thoughts and emotions—might contribute to premature attrition or cause families to profit less from treatment. To test these hypotheses, we performed a retrospective cohort study in a time-limited, home-based PCIT sample (n = 19) and in a clinic-based PCIT sample (n = 25), to investigate whether parents with a medium-high level of mind-mindedness differ from parents with a medium-low level of mind-mindedness in the outcome measures of PCIT (child’s behavioral problems, parenting skills and stress and mothers’ anxious and depressed symptoms). Furthermore, we examined if mind-mindedness was related to attrition and (for clinic-based PCIT only) number of sessions. Repeated measures ANOVA showed that mothers with a medium-high level of mind-mindedness displayed more improvement in two parenting skills benefiting a positive parent−child interaction. Furthermore, we found a group effect of mind-mindedness in the PCIT-home sample, with mothers with a medium-high level of mind-mindedness showing better results on most outcome measures. Our findings suggest that adding a mind-mindedness improving intervention prior to or during PCIT could benefit mothers with a medium to low level of mind-mindedness.

In deze studie onderzochten wij of de multimodale interventie voor kinderen met ernstige gedragsproblemen ‘Samen sterker Terug Op Pad’ (STOP4-7) zou kunnen leiden tot een afname van internaliserende en externaliserende gedragsproblemen bij kinderen, en een afname van opvoedstress bij ouders. Deze studie gebruikte een herhaalde metingen-design met een voormeting, nameting, en follow-up (6 maanden). De huidige steekproef bestond uit N = 836 kinderen van drie t/m acht jaar en maakte gebruik van zowel leerkracht- als ouderrapportage van probleemgedrag. De kinderen waren aangemeld bij entrea lindenhout in Nederland en bij verscheidene Vlaamse jeugdhulpinstellingen. Analyses toonden aan dat STOP4-7 leidde tot significante, klinisch relevante, en blijvende afnames van zowel externaliserend als internaliserend probleemgedrag, en ook leidde tot een significante afname van opvoedstress. De gerapporteerde afnames waren even sterk voor ouders van jongere en oudere kinderen, voor jongens en meisjes, en voor kinderen die bij aanvang van STOP4-7 minder of juist meer problemen hadden. Bijsluiter voor de praktijk Gedragsproblemen op jonge leeftijd zijn een risicofactor voor klinische problematiek op latere leeftijd. Wij onderzochten of het multimodale programma ‘Samen sterker Terug Op Pad’ (STOP4-7) externaliserend en internaliserend probleemgedrag van kinderen en opvoedstress van ouders vermindert. In het onderzoek werd gebruikgemaakt van data van meerdere informanten (ouders en leerkrachten), gekeken naar de klinische relevantie van de waargenomen veranderingen en naar voor wie STOP4-7 beter of minder goed werkt. Uit de resultaten blijkt dat deelname aan STOP4-7 leidde tot betekenisvolle, blijvende afnames van zowel externaliserend als internaliserend gedrag bij kinderen, en opvoedstress bij ouders. Meer dan 45% van de kinderen die voor STOP4-7 in de klinische range van probleemgedrag scoorden, keerden terug naar een “normaal”, gezond functioneren. Ook de afname van opvoedstress bij ouders was klinisch relevant. De gevonden afnames waren even sterk voor ouders van jongere en oudere kinderen, en voor jongens en meisjes. STOP4-7 lijkt verder het beste te werken voor kinderen die bij aanvang klinische gedragsproblemen vertonen. De bevindingen van dit onderzoek dragen bij aan de bewijskracht voor multimodale programma’s in het algemeen, en voor STOP4-7 in het bijzonder. Abstract This study examined whether the multimodal intervention program ‘Samen Sterker Terug Op Pad’ (STOP4-7; English translation: Together Stronger Back on Track) improved internalizing and externalizing behavior in children with severe behavioral problems. Additionally, this study assessed to what extent the intervention reduces parenting stress. We used pretest, posttest, and 6-month follow-up data from a sample of 836 children aged three to eight years old, analyzing both teacher- and parent report data on children’s problem behavior. Data were collected from children treated by mental health care organization entrea lindenhout in The Netherlands and various Flemish youth care organizations. Repated measures ANOVAs showed that STOP4-7 sorted significant, clinically relevant, and lasting improvements in externalizing and internalizing problem behavior and parenting stress. Similar improvements in children’s problem behavior were reported for older and younger children, boys and girls, and children presenting with fewer or more baseline behavioral problems.

This study examined to what extent the human–animal bond (HAB) had a positive impact on stress and self-esteem among detained juveniles participating in the prison-based dog training program Dutch Cell Dogs (DCD). Participants were 75 detained juveniles (mean age = 19.5, 86.7% male). Self-reported stress and self-esteem were assessed before the start of DCD (T1), after four weeks (halfway training/T2) and after eight weeks (end training/T3). Structured interviews and questionnaire items were used to measure the HAB quality and perceived reciprocity in the HAB at T2 and T3. Data were analyzed using Structural Equation Modeling. In the variable-centered approach analyses, only the cross-sectional positive association between HAB quality and self-esteem at T2 was significant in the cross-lagged panel models. None of the cross-lagged paths between the HAB and stress or self-esteem were significant. In the person-centered approach analyses, growth mixture modeling identified two patterns of self-esteem (“high stable” and “high decreasing”); however, these patterns were not predicted by HAB. Thus, in contrast to our hypotheses, the HAB did not predict improvements in detained juveniles’ stress and self-esteem. These findings underline the need for more research into the often-presumed role of HAB within prison-based dog training programs.

Background Mindfulness-Based Childbirth and Parenting (MBCP) is effective in increasing natural childbirth in pregnant women with high fear of childbirth (FOC) as compared to enhanced care as usual (ECAU). We aimed to examine through which pathway of action MBCP reaches this effect, based on a model of approaching or avoiding the challenges related to childbirth. Methods One hundred eleven pregnant women with high FOC were measured pre- and post-intervention on FOC (emotion pathway), catastrophic beliefs about labour pain (cognition pathway) and mindful awareness (attention pathway). A multiple mediation model was used to examine through which pathway the mechanism of change operated in relation to approach (i.e., natural childbirth) versus avoidance (i.e., self-requested caesarean section). Results It was found that greater mindful awareness (18% R2 = 0.18, F[1107] = 22.77, p Conclusions An increase in mindful awareness was the strongest mechanism of change for better adaptation to the challenges of childbirth. Decreases in neither FOC nor catastrophic beliefs about labour pain were identified as mechanisms of change. Additionally, the more one meditated, the more one was inclined towards a natural childbirth. MBCP enhances adaptation to the challenges of childbirth and less use of obstetric interventions in the presence of high FOC. Trial registration The Netherlands Trial Register (NTR; 4302).