Faculty Bibliography

In the present investigation, we examined the developmental viability of the externalizing behavior construct spanning the period from 8 to 24 months of age. A sample of 274 psychologically aggressive couples was recruited from hospital maternity wards and followed from childbirth through 24 months of age. Mothers and fathers completed questionnaire measures of infant physical aggression, defiance, activity level, and distress to limitations at 8, 15, and 24 months. The developmental viability of externalizing behavior at each age studied was suggested by several results. Physical aggression, defiance, activity level, and distress to limitations reflected the operation of a single underlying externalizing behavior factor. In some cases, these individual facets of externalizing behavior became more strongly associated with one another over time. The externalizing construct exhibited remarkable longitudinal stability, with the stability of physical aggression and defiance increasing with age. The externalizing behavior construct was concurrently and prospectively associated with several factors in its nomological network (e.g., interparental conflict and poor parental bond with the infant). Our findings suggest that externalizing behaviors coalesce into a psychologically meaningful construct by 8 months of infant life. Researchers who seek to chart the emergence of the externalizing behavior construct may now need to look to earlier months.

The consequences of deployment extend beyond the service member to impact the entire family. The current investigation evaluated the unique challenges of family reintegration for partnered service members using a prospective design. In total, 76 partnered service members who deployed on a year-long, high-risk mission to Iraq were assessed across the entirety of the deployment cycle, i.e., pre-, during, and postdeployment. At follow-up, nearly 1 in 5 partnered service members reported moderate to severe difficulties in multiple aspects of family reintegration. Prospective interpersonal indicators such as preparations for deployment as a couple, shared commitment to the military, and predeployment relationship distress predicted postdeployment family reintegration difficulties. Significant interpersonal risk factors were medium to large in their effect sizes. Airmen's willingness to disclose deployment- and combat-related experiences, and postdeployment relationship distress served as concurrent interpersonal correlates of difficulties with family reintegration. Intrapersonal factors, including posttraumatic stress symptoms and alcohol misuse were concurrently related to challenges with family reintegration; predeployment alcohol misuse also predicted subsequent family reintegration difficulties. Additional analyses indicated that pre- and postdeployment relationship distress, combat disclosure, and postdeployment alcohol misuse each contributed to family reintegration when controlling for other intra- and interpersonal risk factors. Implications for prevention and early intervention strategies as well as future research are discussed.

The relationships and families of active duty (AD) service members have been tremendously strained by deployments and high operations' tempo. This study involves the first steps in developing a multilevel approach to preventing relationship problems that integrates universal, selective, and indicated prevention/intervention. Such an approach has tremendous empirical support for parenting problems, but no similar program exists for couple problems. We conducted two studies with U.S. Air Force Security Forces members. Study 1 elicited the target population's topics of highest interest. For almost all topics, 70% to 95% of participants who desired information reported being underserved by current prevention offerings (i.e., not receiving needed information). Using the top topics generated in Study 1, we developed prevention information/action planning sheets on 18 relationship issues. In Study 2, we had AD members who gave feedback on the form and content of the sheets. Overall, AD members believed that the sheets were moderately to very useful and were presented well, had pithy but comprehensive information and conveyed the content well. Results imply that a multilevel approach may be a useful complement to formal services in meeting underserved military members' needs and that further research and development of this dissemination vector for evidence-based information is warranted.

Intimate partner violence (IPV) is a significant public health concern. To date, risk factor research has not differentiated physical violence that leads to injury and/or fear (i.e., clinically significant IPV; CS-IPV) from general physical IPV. Isolating risk relations is necessary to best inform prevention and treatment efforts. The current study used an ecological framework and evaluated relations of likely risk factors within individual, family, workplace, and community levels with both CS-IPV and general IPV to determine whether they were related to one type of IPV, both, or neither for both men and women. Probable risk and promotive factors from multiple ecological levels of influence were selected from the literature and assessed, along with CS-IPV and general IPV, via an anonymous, web-based survey. The sample comprised US Air Force (AF) active duty members and civilian spouses (total N = 36,861 men; 24,331 women) from 82 sites worldwide. Relationship satisfaction, age, and alcohol problems were identified as unique risk factors (in the context of the 23 other risk factors examined) across IPV and CS-IPV for men and women. Other unique risk factors were identified that differed in prediction of IPV and CS-IPV. The results suggest a variety of both established and novel potential foci for indirectly targeting partner aggression and clinically-significant IPV by improving people's risk profiles at the individual, family, workplace, and community levels. Aggr. Behav. 41:227-241, 2015. (c) 2014 Wiley Periodicals, Inc.

Child maltreatment is widespread and has a tremendous impact on child victims and their families. Over the past decade, definitions of child maltreatment have been developed that are operationalized, face valid, and can be reliably applied in clinical settings. These definitions have informed the revised Diagnostic and Statistical Manual (American Psychiatric Association, 2013) and are being considered for the International Classification of Disease-11 (World Health Organization). Now that these definitions are available in major diagnostic systems, primary healthcare providers and clinicians who see children and families are poised to help screen for, identify, prevent, and treat child maltreatment. This article reviews the definitions of maltreatment in these diagnostic systems, along with assessment and screening tools, and empirically supported prevention and intervention approaches.

Nuanced, multifaceted, and content valid diagnostic criteria for intimate partner violence (IPV) have been created and can be used reliably in the field even by those with little-to-no clinical training/background. The use of such criteria such as these would likely lead to more reliable decision making in the field and more consistency across studies. Further, interrater agreement was higher than that usually reported for individual mental disorders. This paper will provide an overview of (a) IPV's scope and impact; (b) the reliable and valid diagnostic criteria that have been used and the adaptation of these criteria inserted in the latest Diagnostic and Statistical Manual of Mental Disorders (DSM) and another adaptation proposed for the forthcoming International Statistical Classification of Diseases and Related Health Problems (ICD); (c) suggestions for screening of IPV in primary care settings; (d) interventions for IPV; and (e) suggested steps toward globally accepted programs.

BACKGROUND: The authors tested hypotheses that more noxious family environments are associated with poorer adult and child oral health. METHODS: A community sample of married or cohabiting couples (N = 135) and their elementary school-aged children participated. Dental hygienists determined the number of decayed, missing and filled surfaces via oral examination. Subjective oral health impacts were measured by means of questionnaires completed by the parents and children. The parents completed questionnaires about interparental and parent-to-child physical aggression (for example, pushing) and emotional aggression (for example, derision), as well as harsh discipline. Observers rated the couples' hostile behavior in laboratory interactions. RESULTS: The extent of women's and men's caries experience was associated positively with their partners' levels of overall noxious behavior toward them. The extent of children's caries experience was associated positively with the level of their mothers' emotional aggression toward their partners. CONCLUSIONS: Noxious family environments may be implicated in compromised oral health. Future research that replicates and extends these findings can provide the foundation to translate them into preventive interventions. PRACTICAL IMPLICATIONS: Noxious family environments may help explain the limitations of routine oral health preventive strategies. Interprofessional strategies that also address the family environment ultimately may prove to be more effective than are single modality approaches.

Intimate partner violence (IPV) is a significant public health concern. This study proposed and tested an ecological model of both general and clinically significant (i.e., injurious or fear-evoking) IPV perpetration (IPVPerp). Risk and promotive factors from multiple ecological levels of influence (i.e., individual, family, workplace, community) were hypothesized to be important in the prediction of IPVPerp. Although clinically significant IPVPerp and general IPVPerp were hypothesized to relate, specific risks for clinically significant IPVPerp were hypothesized. U.S. Air Force active duty members and civilian spouses (N = 34,861 men; 24,331 women) from 82 sites worldwide completed the 2006 Community Assessment, an anonymous online survey assessing IPVPerp along with a variety of potential risk and promotive factors. Final structural equation models for men and women, cross-validated in holdout samples, clearly supported the relevance of an ecological approach to IPVPerp. Factors from all 4 levels were associated with both general IPVPerp and clinically significant IPVPerp, with relatively distal community and workplace factors operating via more proximal individual and family level variables (e.g., relationship satisfaction). The results suggest a variety of both established and novel potential targets for indirectly targeting general and clinically significant IPVPerp by improving risk profiles at the individual, family, workplace, and community levels.

This study examined (a) the association between relationship functioning prior to and during deployment, and the frequency of communication during deployment; and (b) the association between relationship functioning and depression during deployment and their influence on service members' ratings of duty performance. Participants were 144 partnered Airmen assessed immediately before and during a one-year high-risk deployment to Iraq. Results showed an overall high frequency of partner communication during deployment. High relationship distress at predeployment predicted lower frequency of communication during deployment. Changes in relationship distress from before deployment to during deployment independently predicted frequency of communication, above and beyond predeployment distress levels. Level of relationship distress and depression during deployment independently predicted service members' ratings of impact on duty performance.

We evaluated the extent to which the externalizing behavior construct is self-organizing in the first 2 years of life. Based on dynamic systems theory, we hypothesized that changes in physical aggression, defiance, activity level, and distress to limitations would each be predicted by earlier manifestations of one another. These hypotheses were evaluated via mothers' and fathers' reports of 274 infants' externalizing behaviors at 8, 15, and 24 months of child age. Eight-month measures of physical aggression, activity level, and/or distress to limitations explained increases in physical aggression, defiance, activity level, and distress to limitations from 8 to 15 months. Increases in defiance and activity level from 15 to 24 months were predicted by 15-month physical aggression and/or distress to limitations. These findings suggest that the externalizing behavior construct is formed by dynamic interplay among its individual elements, particularly between 8 and 15 months.