Faculty Bibliography

Dysfunctional conflict resolution behaviors in couples have been long recognized as markers of relationship maladjustment and are, consequently, frequent targets of couple therapy. The process of flooding may play a role. Flooding is the subjective sense of being overwhelmed by the partner's negative affect, which is perceived as unexpected and intense, and feeling as though one's information processing is impaired. It has been theorized that flooding is so aversive as to lead to maladaptive conflict behaviors (e.g., conflict escalation or withdrawal) as attempts to terminate the offending input (i.e., partner anger). Despite strong theory describing the construct, there has been a lack of valid measures to assess it. In the present study, we evaluated the psychometric properties of a 15-item measure in a sample of 453 couples. Reasonable unifactoriality, excellent internal consistency, and high test-retest reliability were demonstrated. Furthermore, using a dyadic latent variable model, the IPFS showed strong structural validity and concurrent validity with measures of relationship satisfaction, intimate partner violence, anger, depressive symptoms, and observed negative conflict behaviors. The IPFS appears to be a promising, economical instrument to assess flooding, a process relevant for understanding dysfunctional couple conflict behaviors.

Recently in this journal, Weeland et al. (2018) published a thought-provoking article reporting moderating effects of children's serotonin transporter-linked polymorphisms (5-HTTLPR) on negative parenting during prevention with the Incredible Years series. Participants were parents and young children of 387 families enrolled in the Observational Randomized Control Trial of Childhood Differential Susceptibility study. An equally important finding, which we focus on in this comment, involved null effects for all tests of parenting as a mediator of prevention-induced improvements in children's externalizing behavior. Although such findings may seem surprising, both confirmations of and failures to confirm parenting change as a mediator of child behavior change are common in the prevention and intervention literatures. In this comment, we explore likely reasons for heterogeneity in findings, including both moderators of treatment effect size and methods used to test mediation. Common moderators of prevention and intervention response to Incredible Years include dose, parenting problems at intake, high-risk versus clinical nature of samples, how parenting is measured, and whether child training is included with parent training. All of these moderators affect power to detect mediation. We then discuss conceptual criteria for testing mediation in randomized clinical trials, and problems with interpreting mediating paths in cross-lag panel models. Although the gene effect reported by Weeland et al. is important, their cross-lag panel models do not provide strong tests of parenting as a mediator of child behavior change. We conclude with recommendations for testing mediation in randomized clinical trials.

Past research on the relation between hostility in intimate relationships and adiposity has yielded mixed findings. The present study investigated whether the association between relationship hostility and adiposity is moderated by people's biological reactions to couple conflict. Cohabiting adult couples (N = 117 couples) engaged in two conflict interactions, before and after which salivary cortisol levels were measured. Results revealed an association between relationship hostility and adiposity, but this association was concentrated among people with relatively low levels of cortisol reactivity to couple conflict. Results are interpreted in light of research demonstrating that cortisol reactivity can become blunted over time in response to repeated stressors. These results provide precision to etiological models of obesity by identifying cortisol reactivity as a factor that moderates the association between relationship hostility and adiposity. (PsycINFO Database Record

OBJECTIVES/OBJECTIVE:We sought to identify subgroups of individuals based on patterns of psychological health problems (PH; e.g., depressive symptoms, hazardous drinking) and family maltreatment (FM; e.g., child and partner abuse). METHOD/METHODS:We analyzed data from very large surveys of United States Air Force active duty members with romantic partners and children. RESULTS:Latent class analyses indicated six replicable patterns of PH problems and FM. Five of these classes, representing ∼98% of survey participants, were arrayed ordinally, with increasing risk of multiple PH problems and FM. A sixth group defied this ordinal pattern, with pronounced rates of FM and externalizing PH problems, but without correspondingly high rates/levels of internalizing PH problems. CONCLUSIONS:Ramifications of these results for intervention are discussed.

Over 1 in 5 dental patients report moderate to severe dental fear. Although the efficacy of cognitive-behavioral treatment (CBT) for dental fear has been examined in over 20 randomized controlled trials-with 2 meta-analyses finding strong average effect sizes ( d > 1)-CBT has received almost no dissemination beyond the specialty clinics that tested it. The challenge, then, is not how to treat dental fear but how to disseminate and implement such an evidence-based treatment in a way that recognizes the rewards and barriers in the US health care system. This mixed-method study investigated the potential of disseminating CBT through care from a mental health provider from within the dental home, a practice known as evidence-based collaborative care (EBCC). Two preadoption studies were conducted with practicing dentists drawn from a self-organized Practice-Based Research Network in the New York City metropolitan area. The first comprised 3 focus groups ( N = 17), and the second involved the administration of a survey ( N = 46). Focus group participants agreed that CBT for dental fear is worthy of consideration but identified several concerns regarding its appeal, feasibility, and application in community dental practices. Survey participants indicated endorsement of factors promoting the use of EBCC as a mechanism for CBT dissemination, with no factors receiving less than 50% support. Taken together, these findings indicate that EBCC may be a useful framework through which an evidence-based treatment for dental fear treatment can be delivered.

This phase of the NIH Science of Behavior Change program emphasizes an "experimental medicine approach to behavior change," that seeks to identify targets related to stress reactivity, self-regulation, and social processes for maximal effects on multiple health outcomes. Within this framework, our project focuses on interpersonal processes associated with health: coercive couple and parent-child conflict. Diabetes and poor oral health portend pain, distress, expense, loss of productivity, and even mortality. They share overlapping medical regimens, are driven by overlapping proximal health behaviors, and affect a wide developmental span, from early childhood to late adulthood. Coercive couple and parent-child conflict constitute potent and destructive influences on a wide range of adult and child health outcomes. Such interaction patterns give rise to disturbed environmental stress reactivity (e.g., disrupted sympathetic nervous and parasympathetic nervous systems) and a wide range of adverse health outcomes in children and adults, including dental caries, obesity, and diabetes-related metabolic markers. In this work, we seek to identify/develop/validate assays assessing coercion, identify/develop and test brief interventions to reduce coercion, and test whether changes in coercion trigger changes in health behaviors.

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

In the present investigation we consider and explain an apparent paradox in the measurement of corporal punishment with the Parent-Child Conflict Tactics Scale (CTS-PC): How can it have poor internal consistency and still be reliable? The CTS-PC was administered to a community sample of 453 opposite sex couples who were parents of 3- to 7-year-old children. Internal consistency was marginal, yet item response theory analyses revealed that reliability rose sharply with increasing corporal punishment, exceeding .80 in the upper ranges of the construct. The results suggest that the CTS-PC Corporal Punishment subscale reliably discriminates among parents who report average to high corporal punishment (64% of mothers and 56% of fathers in the present sample), despite low overall internal consistency. These results have straightforward implications for the use and reporting of the scale. (PsycINFO Database Record

The longitudinal course of the psychological health (PH) of United States Air Force (USAF) base communities in relation to risk and demographic factors was studied over a 5-year period. PH (clinically significant hazardous drinking, prescription drug misuse, depressive symptoms, suicidal thoughts and behaviors, intimate partner violence [IPV] and child abuse) and risk (personal and family adjustment, workplace adjustment, broader community adjustment) and demographic factors (age and gender distribution) were operationalized at the aggregate level for bases (N = 77) as measured in three large scale surveys of USAF active duty members. Bases whose members collectively exhibited greater levels of risk collectively experienced greater initial problems with alcohol and drug use, depression, suicidality, and physical IPV. Hazardous drinking more quickly increased at bases whose members were younger and more male, and at those with poorer initial aggregate personal adjustment and workplace adjustment. The challenges of studying the community-level course of PH are highlighted.