Faculty Bibliography

Aggression from patients is one of the risks faced by healthcare workers during a typical work week. This risk begins during training. Although rates of patient aggression have been estimated for nursing students and medical residents, studies of aggression toward dental students have not been conducted. To begin to address this knowledge gap, we surveyed 160 D.D.S. student dentists in their third- or fourth years who were attending a large urban college of dentistry during the 2018-2019 academic year. Each class had approximately 375 students, leading to a response rate of 21%. Approximately 28% of students reported experiencing at least 1 instance of physical aggression, 86% reported experiencing at least 1 instance of verbal aggression, and 36% reported experiencing at least 1 instance of reputational aggression. There were no differences in rates of experienced aggression by age or gender, but Hispanic or Latinx students were more likely to experience physical and reputational aggression than non-Hispanic White or Asian students. We discuss implications for dental education, including modifications to training clinic procedures and curriculum additions or modifications that may help prepare students to prevent and address patient aggression within the dental clinic environment.

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).

Cancer impacts spouse caregivers, especially when couples engage in dyadic coping around the cancer. Communication is a key factor in this process. Our goals were to describe cancer-related communication between advanced cancer patients and their spouse caregivers, and to describe how dyadic communication patterns are related to caregivers' reported burden and preparedness for caregiving. Caregivers completed measures of caregiver burden and preparedness for caregiving. Then, the patient and caregiver were asked to interact with each other in two structured discussions: a neutral discussion and a problem discussion focused on cancer. Discussions were coded using the Rapid Marital Interaction Coding System (RMICS2). Caregivers reported moderate levels of preparation and burden. Greater caregiver hostility communication predicted higher levels of caregiver burden, whereas greater caregiver dysphoric affect communication predicted lower levels of caregiver burden. Whereas positivity was more common than hostility in couples' communication, patient hostility was a significant predictor of caregiver preparedness. Patient neutral constructive problem discussion was also associated with increased caregiver preparedness. Caregiver outcomes are an understudied component to dyadic cancer research. Our paper describes observational data on cancer-related communication between caregivers and advanced cancer patients and communication's influence on caregiver outcomes. This work provides the foundation for future evidence-based communication interventions that may influence both patient and caregiver outcomes.

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.

OBJECTIVE:Short sleep duration is a common problem for both advanced cancer patients and their spouse caregivers. Sleep and distress have been shown to be interdependent in patient-caregiver and spouse dyads, yet virtually, no work has explored the dyadic effects of psychological distress on sleep in advanced cancer patients and spouse caregivers. The goal of the present study was to examine the dyadic impact of anxiety and depression on sleep duration in a sample of advanced cancer patients and their spouse caregivers. It was hypothesized that, for both patients and caregivers, anxiety and depression in individuals would be associated with sleep duration in both themselves (actor effects) and in their spouses (partner effects). METHOD/METHODS:Advanced cancer patients and their spouse caregivers (N = 87 dyads) completed cross-sectional questionnaires assessing demographic variables, subjective health, subjective sleep duration, and anxiety and depression symptoms. RESULTS:Controlling for sex, age, and subjective health, individuals' anxiety was negatively associated with their own and their partner's sleep duration. No significant actor or partner effects were found for depression. CONCLUSIONS:Results provided partial support for hypotheses. Although past work has demonstrated links between subjective sleep disturbance and anxiety/psychological distress, this is one of the first studies to examine partner effects of distress on sleep disturbance in advanced cancer patients and spouse caregivers.