Faculty Bibliography

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.

We evaluated the effectiveness of NORTH STAR, a community assessment, planning, and action framework to reduce the prevalence of several secretive adult problems (hazardous drinking, controlled prescription drug misuse, suicidality, and clinically significant intimate partner violence and child abuse [both emotional and physical]) as well as cumulative risk. One-third of US Air Force (AF) bases worldwide were randomly assigned to NORTH STAR (n = 12) or an assessment-and-feedback-only condition (n = 12). Two AF-wide, cross-sectional, anonymous, web-based surveys were conducted of randomly selected samples assessing risk/protective factors and outcomes. Process data regarding attitudes, context, and implementation factors were also collected from Community Action Team members. Analyzed at the level of individuals, NORTH STAR significantly reduced intimate partner emotional abuse, child physical abuse, and suicidality, at sites with supportive conditions for community prevention (i.e., moderation effects). Given its relatively low cost, use of empirically supported light-touch interventions, and emphasis on sustainability with existing resources, NORTH STAR may be a useful framework for the prevention of a range of adult behavioral health problems that are difficult to impact.

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.

If high-conflict family environments are cariogenic across cultures, and can be studied in cultures where both these environments and cariogenic dental practices are particularly prevalent, this would afford the opportunity to examine how these two pathways of risk might interact, laying the stage for culturally competent, integrated prevention efforts. The first investigation involved qualitative data about perceptions of oral health and family stressors in Grenadian families with school-aged children. The second study used a questionnaire and observational data to assess relations among oral health behaviors, relationship satisfaction, parenting, and child behavior; it also included a pilot study of Motivational Interviewing. Most of the themes discussed in focus groups suggested overlap between U.S. and Grenadian parents; possible culture-specific issues were high prevalence of single-parent homes, normativity of physical discipline, less preventive dental care, and more fatalistic view of oral health outcomes. Significant associations were found between parent and child oral health behaviors, between child externalizing and internalizing behaviors, and between family variables (e.g., relationship satisfaction, child behavior) and oral health behaviors (e.g., parent flossing, child brush time). The results strongly support the need for research on the relations between family functioning and oral health to be embedded within culture.

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.

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.

This study explored whether individual differences in self-reported emotional flooding were associated with observational behaviors and experienced and displayed anger during a 10-min problem solving discussion. A sample of 233 married or cohabiting couples, comprising 4 groups (distressed with intimate partner violence [IPV], distressed/nonIPV, satisfied/IPV, and satisfied/nonIPV) was recruited via random digit dialing. Consistent with predictions, both men's and women's flooding were positively associated with partners' negative affect variables, including partners' experienced and displayed anger, as well as positively associated with their own anger. A multinomial logistic regression revealed significant differences between flooding in prediction of couples' group status; specifically that higher levels of emotional flooding were reported by distressed and IPV couples compared with other types of couples. Finally, couples that included at least 1 member high on self-reported emotional flooding were less effective in solving problems during the conflict discussion. Implications and future directions are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) and International Classification of Diseases-11th Revision (ICD-11; proposed) now include criteria for clinically significant (a) intimate partner violence (IPV) and neglect and (b) child abuse and neglect. However, existing measures of IPV and child abuse do not allow for assessment of established criteria. The current study examines the convergent and response process validity of the Family Maltreatment (FM) measure of clinically significant physical and psychological IPV and child abuse. Participants (N = 126) completed the FM via computer and measures of IPV (Revised Conflict Tactics Scale; Straus, Hamby, Boney-McCoy, & Sugarman, 1996) and child abuse (Parent-Child Conflict Tactics Scale; Straus, Hamby, Finkelhor, Moore, & Runyan, 1998) via paper-and-pencil. Participants who endorsed acts of aggression on the FM completed an audio-recorded computerized interview recounting the 2 most severe incidents. Verbalized incidents (n = 138) were coded for clinically significant family maltreatment. Results largely supported the convergent validity of the FM. Agreement of acts endorsed on the FM with those endorsed on convergent measures was excellent for IPV and physical child abuse, yet poor for psychological child abuse. Further, in support of the response process validity of the FM, comparison with observer ratings of interviews indicated few "false positives" and no "false negatives" on the FM across the examined types of clinically significant IPV and child abuse. In summary, the FM is a promising measure for the assessment of clinically significant physical and psychological abuse as defined in the DSM-5 and ICD-11 (proposed). (PsycINFO Database Record (c) 2019 APA, all rights reserved).