Faculty Bibliography

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.

The psychometrics of the Parenting Scale's Overreactivity and Laxness subscales were evaluated using item response theory (IRT) techniques. The IRT analyses were based on 2 community samples of cohabiting parents of 3- to 8-year-old children, combined to yield a total sample size of 852 families. The results supported the utility of the Overreactivity and Laxness subscales, particularly in discriminating among parents in the mid to upper reaches of each construct. The original versions of the Overreactivity and Laxness subscales were more reliable than alternative, shorter versions identified in replicated factor analyses from previously published research and in IRT analyses in the present research. Moreover, in several cases, the original versions of these subscales, in comparison with the shortened versions, exhibited greater 6-month stabilities and correlations with child externalizing behavior and couple relationship satisfaction. Reliability was greater for the Laxness than for the Overreactivity subscale. Item performance on each subscale was highly variable. Together, the present findings are generally supportive of the psychometrics of the Parenting Scale, particularly for clinical research and practice. They also suggest areas for further development.

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.

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.

The association of environmental and genetic variation in caries with child externalizing behavior problems (inattention, hyperactivity, impulsivity, and defiance) was studied in a sample of 239 pairs of 3- to 8-year-old impoverished Brazilian twins. It was hypothesized that externalizing problems would show a stronger positive association with environmental than genetic variation in caries. Univariate twin models were estimated to parse variation in caries into three components: additive genetic (A), shared environment (C) and non-shared environment/error (E). Age-adjusted associations between externalizing problems and each variance component were tested. Contrary to the hypothesis, modest but very consistent negative associations were found between externalizing problems and both genetic and environmental variation in caries. Mutans streptococci and sweetness preference did not explain the negative associations of caries and externalizing problems. Externalizing problems in non-medicated children were associated with less dental decay that could be explained by both genetic and environmental factors. (c) 2014 S. Karger AG, Basel.

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.

Posttraumatic stress disorder (PTSD) is assessed across many different populations and assessment contexts. However, measures of PTSD symptomatology often are not tailored to meet the needs and demands of these different populations and settings. In order to develop population- and context-specific measures of PTSD it is useful first to examine the item-level functioning of existing assessment methods. One such assessment measure is the 17-item PTSD Checklist-Military version (PCL-M; Weathers, Litz, Herman, Huska, & Keane, 1993). Although the PCL-M is widely used in both military and veteran health-care settings, it is limited by interpretations based on aggregate scores that ignore variability in item endorsement rates and relatedness to PTSD. Based on item response theory, this study conducted 2-parameter logistic analyses of the PCL-M in a sample of 196 service members returning from a yearlong, high-risk deployment to Iraq. Results confirmed substantial variability across items both in terms of their relatedness to PTSD and their likelihood of endorsement at any given level of PTSD. The test information curve for the full 17-item PCL-M peaked sharply at a value of theta = 0.71, reflecting greatest information at approximately the 76th percentile level of underlying PTSD symptom levels in this sample. Implications of findings are discussed as they relate to identifying more efficient, accurate subsets of items tailored to military service members as well as other specific populations and evaluation contexts.

Although previous research has indicated an elevated prevalence of posttraumatic stress disorder (PTSD) and other mental health problems among veterans of Operations Iraqi Freedom and Enduring Freedom following deployment, most of this research has been cross-sectional and has focused on a limited range of military groups and outcome criteria. This investigation was a longitudinal study of U.S. Air Force security forces assigned to a year-long high-threat ground mission in Iraq to determine the degree to which airmen's emotional and behavioral health and committed relationships were adversely impacted by an extended deployment to a warzone. Participants were a cohort of 164 security forces airmen tasked to a 365-day deployment to train Iraqi police. Airmen completed study measures both prior to and 6-9 months following deployment. Rates of deterioration in individual and interpersonal adjustment were both significant and medium to large in magnitude of effect, d = 0.43 to 0.90. Results suggest that the negative effects of deployment are related to levels of traumatic experiences and do not spontaneously remit within the first 6-9 months following return from deployment-particularly among those service members having relatively lower levels of social support.

Dental fear affects over 20% of those presenting for treatment, leading to unnecessary pain and suffering, health and quality of life degradation, and increased financial and societal costs. In contrast to the broad dissemination of highly effective non-pharmaceutical treatment of other anxiety disorders, effective treatment of dental fear is anything but ubiquitous. Although this reflects the common-place problems for disseminating evidence based practices, it is also reflects that (a) dentists have neither the training in behavioral health treatment, nor the time, nor the reimbursement incentives to perform such treatment; (b) exceedingly few patients present to a mental health (MH) provider for dental fear; (c) there is no training or tradition placing MH providers in dental practices; and (d) all of the approximately 21 randomized, controlled trials of behavioral dental fear treatment were conducted by researchers at specialized university dental fear clinics, using participants who saw advertisements or were referred by health professionals for dental fear treatment. In this paper, we call for research (a) placing MH providers in the dental home - not just in dental fear specialty clinics - treating patients who present for dental treatment and within the confines of standard dental operations; (b) testing the acceptability and effectiveness of the intervention as administered by integrated MH professionals or by dental hygienists (a more af-fordable dissemination vector in the U.S. than dentists); (c) patient moderators of effectiveness; (d) anxiety facet and provider moderators of effectiveness; and (e) cost-effectiveness of placing dental fear treatment within the dental home