Risk for suicidal ideation in the U.S. Air Force: an ecological perspective

OBJECTIVE

Suicidal members of the U.S. military often fail to disclose their suicidal urges and behaviors. Military suicide prevention efforts may therefore be enhanced if they also target less stigmatized psychosocial factors that may decrease risk of suicidality. In keeping with Bronfenbrenner's (1977, 1994) model, this study simultaneously examined 4 ecological levels (i.e., individual, family, workplace, and community) of factors variously associated with increased or decreased risk for suicidal ideation.

METHOD

Active-duty U.S. Air Force members (N = 52,780; 79.3% male; 79.2% non-Hispanic White; mean age = 31.78 years, SD = 7.38) completed the 2006 Community Assessment survey (a biennial, anonymous survey conducted at 82 U.S. Air Force bases worldwide), including the Centers for Disease Control and Prevention's (2008) 5-item measure of past-year suicidality along with scales assessing an array of potential predictors.

RESULTS

The 1-year rate of suicidal ideation, defined as (a) more than rarely thinking about suicide or (b) ever seriously considering suicide, was approximately 4%. In multivariate models, for men and women, individual- (depressive symptoms and alcohol problems), family- (relationship satisfaction and intimate partner victimization), workplace- (hours worked), and community-level (social support) variables were retained in the final model. However, some sex differences in retained predictors were noted (e.g., men: dissatisfaction with the U.S. Air Force way of life; women: workplace relationship satisfaction and financial stressors).

CONCLUSIONS

Addressing depressive symptoms and alcohol use, facilitating healthy relationship functioning, and increasing job satisfaction and social support may aid military suicide prevention efforts. These findings illustrate the importance of attending to multiple levels of potential influence when designing integrated suicide prevention and intervention programs.

Child emotional aggression and abuse: definitions and prevalence

OBJECTIVE

Research on and intervention for child emotional abuse and emotional aggression toward children have been severely hampered because there have been no agreed-upon, clinically usable definitions.

METHODS

We have (a) proposed and field-tested a set of criteria to operationally define child emotional abuse for clinical settings and (b) used these criteria to design a parent-report measure of parental emotional aggression and child emotional abuse that could be used in research. In this paper, we review the development and field trials of these criteria for making substantiation decisions.

RESULTS

Agreement between master reviewers and field decisions was extremely high in a 5-site development trial (96% agreement, κ=.89) and a 41-site dissemination trial (90% agreement, κ=.73). We compare these criteria to other research criteria in the literature. We then present data collected using a self-report measure designed to parallel these criteria from an anonymous online survey of US Air Force personnel and their spouses. The final sample (N=52,780) was weighted to be representative of the United States civilian population. The prevalence of parents' emotionally aggressive acts was much higher than the prevalence of emotional abuse (acts plus impact), but rates of parents' acts of emotional aggression were lower than those typically reported in the literature. Additional analyses tested for differential effects due to gender of perpetrator (i.e., mothers or fathers), age of victim, and clustering within families. These factors did not drive rates of aggression or abuse.

CONCLUSIONS

In sum, the criteria developed and proposed appear to support reliable clinical decision making regarding child emotional abuse and can be translated to research survey tools that better capture the continuum of parents' emotional aggression and child emotional abuse than the measures that are currently available, advancing the state of the science with respect to child emotional abuse.

An initial evaluation of the role of emotion and impulsivity in explaining racial/ethnic differences in the use of corporal punishment

The authors sought to provide an initial evaluation of the hypothesis that corporal punishment is less strongly associated with parental emotion and impulsivity among African American ("Black") in contrast to European American ("White") parents. White-Latino and Black-Latino differences in corporal punishment, emotion, and impulsivity were explored, given the lack of existing theory predicting group differences. Couples with 3- to 7-year-old children were recruited via random digit dialing, and the parents completed questionnaires and an analog parent-child conflict task in the laboratory. Group differences were tested pooling mothers and fathers via dyadic data analyses. Black parents (N = 57) had more positive attitudes toward and used more corporal punishment than White parents (N = 730). Latino American parents' (N = 78) views and use of corporal punishment were similar to those of White parents. By and large, associations of corporal punishment with parents' impulsivity and emotion did not significantly vary by race/ethnicity. The present findings, although preliminary, do not support the emotion-impulsivity hypothesis of racial differences in the use of corporal punishment suggested by K. Deater-Deckard, K. A. Dodge, J. E. Bates, and G. S. Pettit (1996).

Estimating prevalences of sensitive problems from nonsensitive data

Accurate and regularly updated prevalences are critical to guide both prevention and policy. However, despite their impact on public health, the prevalence of behavioral and mental health problems such as child maltreatment and intimate partner violence (IPV) are collected infrequently (e.g., once per decade or less). The purpose of this study is to test the viability of using nonsensitive, dynamic variables to estimate prevalences of sensitive behavioral problems. Several archival data sets of partner and child maltreatment are used. Data sets are randomly divided into development and cross-validation subsets. Sequential, backward, stepwise logistic regression is used to derive estimation equations, which are then tested in the cross-validation subset. The results indicate that estimated prevalences are close to the measured prevalences. Confidence intervals (95%) are approximately the same as those that pertain to measured prevalences (± 1%-2%). In situations where it is either too expensive or too sensitive to assess a population regularly on a problem of interests, it appears as if policy makers and prevention planners can use regularly collected, nonsensitive data to estimate accurately the prevalence of unmeasured, sensitive outcomes.

Recent suicidal ideation and suicide attempts in a large-scale survey of the U.S. Air Force: prevalences and demographic risk factors

One-year prevalences of self-reported noteworthy suicidal ideation and nonfatal suicide attempts were assessed in a large sample of U.S. Air Force active duty members (N = 52,780). Participants completed the 2006 Community Assessment, which was conducted online. Over 3% of male and 5.5% of female participants reported having experienced noteworthy suicidal ideation during the previous year, and 8.7% of those with ideation reported a recent suicide attempt. Demographic factors predicting significantly increased risk for suicidal ideation included female gender, low rank, and non-Christian religious affiliation; unmarried men were also at increased risk. Groups that were at increased risk for nonfatal suicide attempts included low-ranking men and Hispanic women. Implications for prevention efforts are discussed.

Unique risk and protective factors for partner aggression in a large scale air force survey

The objective of this study is to examine risk factors of physical aggression against a partner in a large representative Active Duty Air Force sample. A stratified sample of 128,950 United States Active Duty members were invited to participate in an Air Force-wide anonymous online survey across 82 bases. The final sample (N = 52,780) was weighted to be representative of the United States Air Force. Backward stepwise regression analyses were conducted to identify unique predictors of partner physical aggression perpetration within and across different ecological levels (individual, family, organization, and community levels). Relationship satisfaction, alcohol problems, financial stress, and number of years in the military were identified as unique predictors of men's and women's perpetration of violence against their partner across ecological levels. Parental status, support from neighbors, personal coping, and support from formal agencies also uniquely predicted men's but not women's perpetration of violence across ecological levels. This study identified specific risk factors of partner violence that may be targeted by prevention and intervention efforts aimed at different levels of impact (e.g., family interventions, community-wide programs).

Unique risk and protective factors for partner aggression in a large scale air force survey

The objective of this study is to examine risk factors of physical aggression against a partner in a large representative Active Duty Air Force sample. A stratified sample of 128,950 United States Active Duty members were invited to participate in an Air Force-wide anonymous online survey across 82 bases. The final sample (N = 52,780) was weighted to be representative of the United States Air Force. Backward stepwise regression analyses were conducted to identify unique predictors of partner physical aggression perpetration within and across different ecological levels (individual, family, organization, and community levels). Relationship satisfaction, alcohol problems, financial stress, and number of years in the military were identified as unique predictors of men's and women's perpetration of violence against their partner across ecological levels. Parental status, support from neighbors, personal coping, and support from formal agencies also uniquely predicted men's but not women's perpetration of violence across ecological levels. This study identified specific risk factors of partner violence that may be targeted by prevention and intervention efforts aimed at different levels of impact (e.g., family interventions, community-wide programs).

Reliability of family maltreatment diagnostic criteria: 41 site dissemination field trial

R. E. Heyman and A. M. S. Slep developed and conducted an effectiveness trial of a diagnostic system for child and partner maltreatment. The current investigation tested the widespread dissemination of the diagnostic system at 41 child and partner maltreatment services sites (n = 549 partner maltreatment cases and n = 342 child maltreatment cases). Agreement between field and master reviewers' decisions was good for partner physical and emotional abuse (kappa = 0.83-0.84). Agreement was also good for child physical, emotional, and sexual abuse (kappa = 0.73-0.89) but lagged slightly for child neglect (kappa = 0.66). Thus, multifaceted and content valid family maltreatment diagnostic criteria can be disseminated reliably. Replication studies of interrater agreement of the diagnostic system in typical clinical and agency settings are necessary; however, the high levels of agreement in myriad field sites imply that consistency of maltreatment determinations is achievable in widespread use.

Changes in relationship satisfaction across the transition to parenthood: a meta-analysis

The U.S. government has recently spent several hundred million dollars to promote healthy relationships in new parents. The influx of money implies that relationships of new parents are at elevated risk for declining satisfaction and dissolution. This meta-analysis aggregates data from 37 studies that track couples from pregnancy to after the birth of the first child and 4 studies that track childless newlywed couples over time and compare couples who do and do not become parents. Results indicate significant, small declines in relationship satisfaction for both men and women from pregnancy to 11 months postbirth; 5 studies that followed couples for 12-14 months found moderate-sized declines. Seven variables moderated the decrease in relationship satisfaction from pregnancy to early parenthood. However, the decrease in satisfaction may not indicate anything unique about the transition to parenthood; the 4 studies following newlyweds indicated that those who do not become parents experience a decrease in relationship satisfaction similar to that of parents across a comparable span of time. Implications for prevention and future directions are discussed.

Distinguishing risk profiles among parent-only, partner-only, and dually perpetrating physical aggressors

This study addressed whether and how men and women who are not physically aggressive, physically aggressive toward only their children or their partners, or aggressive toward both children and their partners differ in their risk profiles. Risk factors unrelated to the partner or parenting role (e.g., impulsivity) and specific to one of these roles (e.g., negative parenting attributions or negative partner attributions) were examined using profile analysis. Dually aggressive men and women had the highest overall risk across all types of risk factors; nonaggressive men and women had consistently low risk. Individuals who were aggressive toward only their partners or their children had distinct risk profiles, with highest levels of risk on the role-specific variable sets. With the exception of parent-aggressive-only men, singly aggressive individuals' risk levels were significantly lower on role-independent and unrelated role-specific risk factors than they were on role-related risk factors. These results suggest theories of partner and parent aggression might gain precision if co-occurrence status were specifically taken into account.

Stability of physical and psychological adolescent dating aggression across time and partners

This study examined the stability of adolescent physical and psychological dating aggression across both time and partners in a sample of 664 high school students using both nonparametric and growth curve (GC) modeling techniques. Nonparametric and GC modeling tests demonstrated moderate levels of stability of all forms of aggression. Nonparametric tests also revealed higher rates of stability among those with relationship continuity. Although GC analyses indicated that significant increases in psychological aggression perpetration were associated with relationship continuity, staying with the same partner did not place adolescents at heightened risk for physical perpetration or physical or psychological victimization. Being female was associated with significant decreases in psychological victimization and perpetration across time. Findings demonstrate the importance of early prevention of dating aggression and the need to consider gender and relationship variables.

The association of promised consequences with child compliance to maternal directives

Noncompliance is a primary reason parents seek services for their young children. Research on socialization suggests that warning children about consequences is associated with greater compliance. In the current study, we test whether promised consequences (i.e., promises of parental responses to subsequent child behavior), compared with directives alone, were more strongly associated with compliance. We also tested whether some types of promised consequences were more strongly associated with compliance than others. Forty White mother-toddler (age 17-36 months) dyads were video recorded in a 30-min behavioral analogue situation. Interactions were coded using a derived coding scheme. Promised consequences were not found to be more strongly associated with compliance than were directives alone using sequential analyses; however, negative and immediate promised consequences were more strongly associated with compliance. Findings suggest that promising negative and immediate consequences for noncompliance may encourage compliance.

The differential association between change request qualities and resistance, problem resolution, and relationship satisfaction

Although research supports the negative sequelae of the "demand/withdrawal" pattern, research is scant on the impact of "nondemanding" change requests (e.g., specific, increasing, "we" requests). We hypothesize that such change requests will be associated with less partner withdrawal/resistance, better problem resolution, and greater relationship satisfaction. Seventy-two conversations between couples who were recruited through random digit dialing were coded for change request qualities. Results indicate that wife specific and "we" requests led to less husband resistance, and husband increasing and "we" requests led to less wife resistance. Greater percentages of wife and husband specific and "we" requests were related to better problem resolution in the conversation, and greater percentages of wife specific and "we" requests were related to greater wife satisfaction. Research and clinical implications are detailed.

Desired change in couples: gender differences and effects on communication

Using a sample (N = 453) drawn from a representative sampling frame of couples who are married or living together and have a 3 to 7 year-old child, this study investigates (a) the amount and specific areas of change desired by men and women, (b) the relation between relationship adjustment and desired change; and (c) the ways in which partners negotiate change. On the Areas of Change Questionnaire, women compared with men, wanted greater increases in their partners' emotional and companionate behaviors, instrumental support, and parenting involvement; men wanted greater increases in sex. Using the Actor-Partner Interdependence Model (Kenny, 1996), both men's and women's relationship adjustment predicted desired change (i.e., actor effects), over and above the effects of their partners' adjustment (i.e., partner effects); partner effects were not significant. Each couple was also observed discussing the man's and the woman's top desired change area. Both men and women behaved more positively during the partner-initiated conversations than during their own-initiated conversations. Women, compared with men, were more negative in their own and in their partners' conversations.

A translational research orientation to family violence

We discuss translational research and its application in family violence research by (a) discussing what translational research is, (b) describing a six-stage model of the translational research cycle, (c) pondering the implication of each stage for family maltreatment research, and (d) providing examples of areas ready for translational research relevant to family violence.

Public health approaches to family maltreatment prevention: resetting family psychology's sights from the home to the community

The authors review recent trends within the family maltreatment research field toward a public health approach, discuss the rationale for community-level interventions for family maltreatment, and sketch the history and development of community-level prevention approaches. Next, to illustrate the both the logistic and the scientific challenges of such work, the authors discuss the development and testing of an empirically guided, research-community partnership for the prevention of family maltreatment, the United States Air Force's NORTH STAR initiative (New Orientation to Reduce Threats to Health From Secretive Problems That Affect Readiness). Finally, recommendations are made for effective and disseminable family maltreatment prevention interventions.

Gender differences in dating aggression among multiethnic high school students

PURPOSE

(1) To assess prevalence of physical dating aggression and victimization among high school students; (2) to assess prevalence of mutual and exclusive aggression; (3) to determine whether aggression differs across ethnic groups and relationship type; and (4) to ascertain the likelihood of injury and breakup in individuals who reported that they were the recipients of physical aggression.

METHODS

Students (N = 2363) from seven multiethnic high schools participated. Because males in high school date females younger than they and the reverse for females, and because males and females may underreport aggression, only within gender comparisons were conducted.

RESULTS

More females reported engaging in physical aggression (40%) than reported being victims of aggression (30%). Fewer males reported engaging in physical aggression (24%) than reported being victims of physical aggression (31%). If physical aggression occurred, typically both partners were aggressive. For females, exclusive engagement in physical aggression (perpetration) was reported at higher rates than exclusively being the recipient of physical aggression (victimization) and vice versa for males. Dating aggression was less prevalent among male Asian students than other ethnic groups. Engaged males and females reported the highest rates of physical aggression. Injury was reported by over 25% of males and females who reported being the recipients of physical aggression.

CONCLUSIONS

Dating aggression intervention programs should address physical aggression of both males and females. Because approximately 30% of the high school males and females reported being the recipients of physical aggression by their partners, primary prevention efforts should occur before high school.

Child abuse in the context of domestic violence: prevalence, explanations, and practice implications

This article addresses the following questions: (a) How common is child abuse among domestically violent families? (b) Are there specific patterns of child abuse among domestically violent families? (c) What may explain occurrences of child abuse in domestically violent families? (d) How might domestic violence affect treatment for child abuse? We review research on child abuse in the context of domestic violence. We discuss implications of this research for service-delivery programs for domestically violent families.

Multivariate models of men's and women's partner aggression

This exploratory study was designed to address how multiple factors drawn from varying focal models and ecological levels of influence might operate relative to each other to predict partner aggression, using data from 453 representatively sampled couples. The resulting cross-validated models predicted approximately 50% of the variance in men's and women's partner aggression. The 3 strongest direct predictors of partner aggression for men and women were dominance/jealousy, marital adjustment, and partner responsibility attributions. Three additional direct paths to aggression for men were exposure to family-of-origin aggression, anger expression, and perceived social support. The 1 additional direct path for women was a history of their own aggression as a child or teenager. Implications for more integrative theories and intervention are discussed.