Faculty Bibliography

The U.S. Preventive Services Task Force has recommended that clinicians screen patients for intimate partner violence (IPV). This article aims to develop and test the first screeners for clinically significant physical and psychological IPV (i.e., acts meeting criteria in the International Classification of Diseases (11th ed.; ICD-11; World Health Organization, 2019) and the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013). The goal was to derive screeners that (1) are maximally brief, while still achieving high sensitivity and specificity; (2) assess perpetration and victimization when either men or women are reporting; and (3) use ICD-11/DSM-5 criteria as the reference standard. Random samples of active duty service members at 82 installations worldwide were obtained via e-mail invitation (2006: N = 54,543; 2008: N = 48,909); their response rates were excellent for long general population surveys with no payment (2006: 44.7%, 2008: 49.0%). The population of spouses at the participating installation was invited by mailed postcard (2006: N = 19,722; 2008: N = 12,127; response rates-2006: 12.3%, 2008: 10.8%). Clinically significant physical intimate partner violence can be effectively screened with as few as four items, with sensitivities > 90% and specificities > 95%; clinically significant psychological intimate partner violence can be screened with two items. Men and women can be screened with equivalent accuracy, as can those committing the violence and those victimized by it. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

One of the most influential behavioral models of family conflict is G. R. Patterson's (1982) coercive family process theory. Self-reports for behaviors related to coercion (e.g., hostility toward a family member) abound; however, there are no self-report measures for coercive process itself, which is, by definition, a dyadic process. Operationalizations of coercive process are measured with behavioral observation, typically including sequential analyzed, microcoded behaviors. Despite its objectivity and rigor, coding of behavior observation is not always feasible in research and applied settings because of the high training, personnel, and time costs the observation requires. Because coercive process has been shown to predict a host of maladaptive outcomes (e.g., parent-child conflict, aggression, negative health outcomes) and given the complete absence of self-report measures of coercive process, we recently designed brief questionnaires to assess coercive process in couple (Couple Coercive Process Scale [CCPS]) and parent-child interactions (Parent-Child Coercive Process Scale [PCCPS]) and tested them via Qualtrics participant panels in samples recruited to mirror socioeconomic generalizability to U.S. Census data. The CCPS and PCCPS exhibited initial evidence of psychometric quality in measuring coercive process in couple and parent-child dyads: Both measures are unifactorial; have evidence of reliability, especially at higher levels of coercive process; and demonstrate concurrent validity with constructs in their nomological networks, with medium to large effect sizes. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Participation rates in couple relationship education (CRE) programs for low-income couples are typically low. We examined predictors of session attendance and early dropout (i.e., dropout after 1 session) among a sample of low-income, unmarried parents of a newborn (N = 467 couples) enrolled in an evidence-based CRE program. Predictors included demographics and socioeconomic status, as well as baseline indicators of relationship commitment, family and individual functioning, infant health, preventive health care utilization, and CRE coach perceptions of participant engagement and alliance in the first session of the program. Couples attended an average of 4.4 (SD = 2.5) of the 7 sessions, with nearly a quarter of couples dropping out after the first session. Attendance at fewer sessions was predicted by younger age. Early dropout was predicted by lower ratings of females' engagement and both partners' therapeutic alliance and, unexpectedly, by commitment. We discuss considerations for engaging low-income couples in CRE.

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

Child maltreatment and intimate partner abuse determinations often include judgments (e.g., severity) that go beyond whether or not the allegations are founded. Severity ratings inform multiple stakeholders (e.g., researchers, policymakers, clinicians, supervisors) and response pathways (e.g., "differential response" to child maltreatment). However, because severity guidelines typically only provide global direction for raters, these gradations are often of questionable reliability (and thus validity). Extending earlier work developing and implementing reliable and valid family maltreatment substantiation criteria (e.g., Heyman & Slep, 2006, 2009), a classification system for maltreatment severity was created, refined, and field-tested with a sample of clinicians from the largest maltreatment protection agency in the United States The goal was to develop operationalized criteria delineating mild, moderate, and severe maltreatment that could be consistently applied across types of maltreatment, raters, and clinics. To facilitate proper use, a computerized clinical decision support tool for the criteria was created. First, the severity classification system was piloted and refined at four sites throughout the United States. Then, clinicians at these sites (N = 28) and a master reviewer independently rated de-identified cases as part of the clinicians' routine assessments. Agreement between clinicians and the master reviewer was excellent for all types of maltreatment. Implications for practical dissemination are discussed.

Objective/UNASSIGNED:To examine couple and parenting outcomes from an American version of Couple CARE for Parents (CCP) in low-income, unmarried couples. Background/UNASSIGNED:We adapted an evidence-based, flexibly delivered program for use with low-income, unmarried couples, for whom the outcome literature is scarce. Method/UNASSIGNED:= 443) were recruited from maternity units and began CCP. They completed measures before, during, and immediately after the intervention, and 6 months later. Results/UNASSIGNED:Moderate psychological intimate partner violence (IPV) declined and perceived parenting efficacy increased over time; there was no change in severe psychological or physical IPV. Individuals with lower levels of relationship commitment than their partners showed improvement in relationship satisfaction, whereas those with similar or higher levels of commitment maintained their baseline levels despite being in a period of expected satisfaction decline. Conclusion/UNASSIGNED:CCP showed some signs of helping low-income couples during a stressful period and its flexible service delivery model allowed these couples to participate by reducing the impediments of transportation challenges, conflicting work schedules, and overall time poverty. Implications/UNASSIGNED:Practitioners interested in using CCP with low-income couples would likely maximize the impact by (a) focusing on pregnant, first-time parents; (b) integrating CCP within post-natal healthcare; and/or (c) assuming that a considerable minority of couples will avail themselves of only up to two sessions, and thus practitioners should front-load content, making other content optional or just-in-time. In addition, non-psychoeducational elements (e.g., gamification, easy computerized tasks to reduce angry responses, watching couple-themed movies) could enliven preventative offerings for perinatal couples.

To examine the concordance between patients' experience and expression of unpleasant emotions in a health care context, 21 patients presenting to a university dental clinic were observed for expressed unpleasant emotions and patients provided the intensity of their experienced unpleasant emotions. We found low convergence between experience and expression. Most of the time that patients experience unpleasant emotions they do not express them, and 80% of the time patients express unpleasant emotions they are not experiencing them at the time. Providers need to frequently check in with patients regarding their emotional experience during appointments, as it is infrequently accessible to providers.

The degree to which individual self-rated physical health and concordance of self-rated physical health between partners are associated with relationship satisfaction was examined in a community sample of 399 couples with children. Couples completed self-report assessments of physical health (general health and physical functioning) and relationship satisfaction. Results suggest unique associations between partners' general health and their own relationship satisfaction. Further, higher between-partner concordance in physical functioning was uniquely associated with higher relationship satisfaction in women. Understanding associations between health and relationship processes is crucial and has implications for future research on couple-based interventions to promote physical health.