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Biggs AT, Seech TR, Johnston SL, Russell DW. Psychological endurance: how grit, resilience, and related factors contribute to sustained effort despite adversity. THE JOURNAL OF GENERAL PSYCHOLOGY 2024; 151:271-313. [PMID: 37697826 DOI: 10.1080/00221309.2023.2253955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/16/2023] [Indexed: 09/13/2023]
Abstract
Many concepts describe how individuals sustain effort despite challenging circumstances. For example, scholars and practitioners may incorporate discussions of grit, hardiness, self-control, and resilience into their ideas of performance under adversity. Although there are nuanced points underlying each construct capable of generating empirically sound propositions, the shared attributes make them difficult to differentiate. As a result, substantial confusion arises when debating how these related factors concomitantly contribute to success, especially when practitioners attempt to communicate these ideas in applied settings. The model proposed here-psychological endurance-is a unified theory to explore how multiple concepts contribute to sustained goal-directed behaviors and individual success. Central to this model is the metaphor of a psychological battery, which potentiates and sustains optimal performance despite adversity. Grit and hardiness are associated with the maximum charge of the psychological battery, or how long an individual could sustain effort. Self-control modulates energy management that augments effort required to sustain endurance, whereas resilience represents the ability to recharge. These factors are constrained by both psychological and physiological stressors in the environment that drain the psychology battery. Taken together, these ideas form a novel framework to discuss related psychological concepts, and ideally, optimize intervention to enhance psychological endurance.
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Sun Z, Song J, Chen J, Gan X, Li Y, Qiu C, Zhang W, Gao Y. Preventing and Mitigating Post-Traumatic Stress: A Scoping Review of Resilience Interventions for Military Personnel in Pre Deployment. Psychol Res Behav Manag 2024; 17:2377-2389. [PMID: 38912160 PMCID: PMC11192150 DOI: 10.2147/prbm.s459220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 06/08/2024] [Indexed: 06/25/2024] Open
Abstract
Purpose Resilience is considered as a protective factor that can assist individuals to reduce post-traumatic stress reactions. In recent years, armies in many countries have widely implemented resilience training programs before deployment to prevent or reduce post-deployment combat stress reactions. Therefore, this study aims to review what is known about resilience interventions for military personnel in pre deployment. Methods Based on Arskey and O'Malley's framework, a scoping review was completed. This review was performed through searching databases including PubMed, Embase, Web of Science, Medline and the Cochrane Library, and screening literature to extract data, finally summarizing the findings. Results A total of 25 studies focusing on resilience interventions for military personnel in pre deployment were involved and analyzed using intervention approaches, outcome measures, intervention effects, and so on. Conclusion Based on the existing evidence in this review, it is cautiously believed that the resilience intervention program for military personnel before deployment is effective. However, there is no single effective best method even the same type intervention can make different effects in different situations and populations. Therefore, the population differences and context should be fully considered in constructing and implementing program to build military personnel resilience.
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Affiliation(s)
- Zhanying Sun
- Graduate School, Chinese PLA Medical School, Beijing, 100853, People’s Republic of China
- Nursing Department, the First Medical Center, Chinese PLA General Hospital, Beijing, 100853, People’s Republic of China
| | - Jie Song
- Nursing Department, the First Medical Center, Chinese PLA General Hospital, Beijing, 100853, People’s Republic of China
| | - Jingru Chen
- Graduate School, Chinese PLA Medical School, Beijing, 100853, People’s Republic of China
| | - Xueyang Gan
- Graduate School, Chinese PLA Medical School, Beijing, 100853, People’s Republic of China
| | - Yi Li
- Department of Orthopedics, the Forth Medical Center, Chinese PLA General Hospital, Beijing, 100853, People’s Republic of China
| | - Chen Qiu
- Nursing Department, the First Medical Center, Chinese PLA General Hospital, Beijing, 100853, People’s Republic of China
| | - Weili Zhang
- Graduate School, Chinese PLA Medical School, Beijing, 100853, People’s Republic of China
| | - Yuan Gao
- Nursing Department, the First Medical Center, Chinese PLA General Hospital, Beijing, 100853, People’s Republic of China
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Corry NH, Radakrishnan S, Williams CS, Woodall KA, Stander VA. Longitudinal association of health behaviors and health-related quality of life with military spouse readiness. BMC Public Health 2024; 24:1341. [PMID: 38762717 PMCID: PMC11102189 DOI: 10.1186/s12889-024-18786-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 05/07/2024] [Indexed: 05/20/2024] Open
Abstract
BACKGROUND Unhealthy behaviors impose costs on health-related quality of life (HRQOL) reducing productivity and readiness among military members (Hoge et al., JAMA 295:1023-32, 2006; Mansfield et al. 362:101-9, 2010). Among married personnel in particular, patterns of spouse health behaviors may play an interdependent role. As a result, the identification of military spouse health factors related to readiness may inform strategies to screen for and identify those in need of greater support and enhance readiness. This study explored behavioral and HRQOL predictors and potential mediators of military spouse readiness utilizing data from the Millennium Cohort Family Study. METHODS The analytic sample comprised of 3257 spouses of active-duty, non-separated service members who responded to both waves 1 and 2 of the survey. Sample characteristics are described with respect to demographics (e.g., age, sex, race/ethnicity, etc.), readiness measures (i.e., military satisfaction, lost workdays, health care utilization, military-related stress, and satisfaction), health behaviors (i.e., exercise, sleep, smoking, and alcohol use) and HRQOL (Veterans RAND 12-Item Short Form Survey). We conducted multivariate mediation analyses to evaluate the role of mental and physical HRQOL as mediators between the baseline health behaviors and the health readiness outcomes at follow-up, while adjusting for spouse and service member demographics. RESULTS HRQOL had direct effects for all five readiness outcomes examined. Multiple health behaviors (insomnia, smoking, binge drinking, and exercise) were further significantly associated with spouse readiness outcomes, although most effects were mediated through HRQOL, suggesting this may be a useful index of military spouse readiness. Insomnia was the specific health behavior most consistently associated with poorer readiness across outcomes, and effects were only partially mediated by physical and mental HRQOL. CONCLUSIONS The results show spouse health behaviors are directly and indirectly (through HRQOL) associated with readiness indicators. This suggests that assessments of modifiable health behaviors (e.g., insomnia symptoms) and mental and physical HRQOL are important indicators of readiness among military spouses and should be used to inform future programs designed to improve population health.
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Affiliation(s)
- Nida H Corry
- Health Care Evaluation, NORC at the University of Chicago, Chicago, IL, USA
| | - Sharmini Radakrishnan
- Division of Health and Environment, Abt Associates, Rockville, MD, USA.
- , 10 Fawcett St, Cambridge, MA, 02138, USA.
| | | | - Kelly A Woodall
- , Leidos, Reston, VA, USA
- Deployment Health Research Department, Naval Health Research Center, San Diego, CA, USA
| | - Valerie A Stander
- Deployment Health Research Department, Naval Health Research Center, San Diego, CA, USA
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Nieforth LO, Leighton SC. Animal-assisted interventions for military families: a systematic review. Front Public Health 2024; 12:1372189. [PMID: 38813415 PMCID: PMC11135175 DOI: 10.3389/fpubh.2024.1372189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 03/14/2024] [Indexed: 05/31/2024] Open
Abstract
Introduction The incorporation of animals into interventions focused on military families is a relatively new concept. Though animal-assisted interventions (AAIs) have been studied in the context of military veterans, few studies incorporate members of the military family or focus on the family members' experiences. Methods This systematic review investigates the effects of AAIs on the wellbeing of military family members beyond the veteran themselves through three aims: (1) by describing the characteristics of AAIs for military family members, (2) by evaluating the quality of the methodology present within the current literature, and (3) by identifying key concepts and knowledge gaps within the findings reported to date. Results A total of nine articles met the criteria to be included in the review. Though the inclusion criteria and search terms included all types of animal-assisted interventions, the only interventions represented were service dogs (n = 4) and equine-assisted services (n = 5). Discussion Findings suggest AAIs could be beneficial in areas such as communication, relational bonds, and psychosocial well-being. Though additional research is necessary, AAIs may be an effective complementary intervention for military families.
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Affiliation(s)
- Leanne O. Nieforth
- Department of Comparative Pathobiology, Purdue University, West Lafayette, IN, United States
| | - Sarah C. Leighton
- Department of Psychology, College of Science, University of Arizona, Tucson, AZ, United States
- College of Veterinary Medicine, University of Arizona, Tucson, AZ, United States
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Guérin E, Richer I. Piloting the home ship: Understanding the deployment experience of Canadian Special Operations Forces Command spouses. MILITARY PSYCHOLOGY 2024; 36:168-183. [PMID: 38377246 PMCID: PMC10880494 DOI: 10.1080/08995605.2022.2153548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 10/04/2022] [Indexed: 12/24/2022]
Abstract
Special Operations Forces (SOF) members are frequently deployed to hostile environments for prolonged periods of time, and their families are exposed to unique difficulties and stressors. The purpose of this study was to describe the lived experience of Canadian Special Operations Forces Command (CANSOFCOM) spouses as it relates to the intensity of the SOF deployment process. As part of a larger study, semi-structured interviews were conducted with 29 spouses of CANSOFCOM members. The interviews were coded and analyzed using thematic analysis to identify the central dimensions of spouses' experience with deployment. Participants reflected on their experiences, from pre-deployment to post-deployment, and as they transitioned between deployments, across social/relational, practical/instrumental, and psychological/emotional dimensions. The findings raised important concerns regarding perpetual transitions for the family unit and exhaustion among spouses faced with a deployment loop that never closes. Although results echoed previous studies, in terms of the strain of solo-parenting and coping with children's emotional needs, communication and maintaining connections, these aspects were uniquely affected by repeated deployments, prolonged time away, operations security, and high organizational demands. Although many spouses acquired the strength and skills to cope with the lifestyle, the findings suggest several opportunities to tailor resources and support services to their dynamic needs.
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Affiliation(s)
- Eva Guérin
- Department of National Defence, Director General Military Personnel Research and Analysis, Ottawa, Ontario, Canada
| | - Isabelle Richer
- Department of National Defence, Director General Military Personnel Research and Analysis, Ottawa, Ontario, Canada
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Lee H, Kim JY. Effectiveness of the TSL (Thank you, Sorry, and Love) program for adaptability of military children. MILITARY PSYCHOLOGY 2023:1-11. [PMID: 37956156 DOI: 10.1080/08995605.2023.2276638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 09/25/2023] [Indexed: 11/15/2023]
Abstract
This study aims to assess the effectiveness of the TSL (Thank you, Sorry, and Love) program in enhancing the adaptability of military children in the Republic of Korea. A total of 30 military children were selected as participants and assigned to three groups: an experimental group receiving the TSL program, a comparison group receiving a resilience program, and a control group. Measures of adaptability (including resilience, perceived stress, depression, family function, and school adaptation) were administered to the military children at pre, post, and follow-up stages. The results reveal significant differences in adaptability between the TSL program participants and the other groups' participants at the post-intervention and follow-up assessments. These findings suggest that the TSL program has the potential to effectively enhance the adaptability of military children and maintain their adaptive capacities across various domains in the long term.
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Affiliation(s)
- Hyun Lee
- Center for Social Welfare Research, Yonsei University, Seoul, Republic of Korea
| | - Jae Yop Kim
- Department of Social Welfare, Social Welfare, Yonsei University, Seoul, Republic of Korea
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Marlotte L, Klomhaus A, Ijadi-Maghsoodi R, Aralis H, Lester P, Griffin Esperon K, Kataoka S. Implementing depression care in under-resourced communities: a school-based family resilience skill-building pilot randomized controlled trial in the United States. Front Psychol 2023; 14:1233901. [PMID: 37790229 PMCID: PMC10542892 DOI: 10.3389/fpsyg.2023.1233901] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 08/11/2023] [Indexed: 10/05/2023] Open
Abstract
Introduction Youth in under-resourced communities are more likely to have greater social risk factors for mental health needs yet have less access to needed care. School-based mental health services are effective in treating common disorders such as adolescent depression; however, few have a family-centered approach, which may especially benefit specific populations. Methods Utilizing a community-partnered approach, we adapted an established, trauma-informed, resilience skill-building family intervention for adolescents with depression. We conducted a small randomized controlled feasibility pilot of an adapted intervention in a large school district that serves predominately low-income, Latinx students in the Southwest United States between 2014-2017. Youth between the ages of 12-18 years old with a Patient Health Questionnaire (PHQ-8) score of 10 or higher, who spoke English or Spanish, were recruited from 12 school mental health clinics. Twenty-five eligible adolescents with depression and their participating caregivers were enrolled and randomly assigned to receive either the adapted intervention, Families OverComing Under Stress for Families with Adolescent Depression (FOCUS-AD), or usual care, Cognitive Behavioral Therapy (CBT) only. Most of the sample was Latinx and female. We evaluated feasibility, acceptability, and preliminary effectiveness. Results Among participants who completed standardized assessments administered at baseline and approximately five months post-randomization (n = 10 FOCUS-AD, n = 11 CBT only), effectiveness was explored by identifying significant changes over time in adolescent mental health within the FOCUS-AD and CBT only groups and comparing the magnitude of these changes between groups. Nonparametric statistical tests were used. We found the FOCUS-AD intervention to be feasible and acceptable; participant retention was high. Adolescent symptoms of depression (measured by the PHQ-8) improved significantly from baseline to follow-up for youth in both FOCUS-AD (median decrease [MD] = 10, p = 0.02) and control (MD = 6, p = 0.01) groups, with no significant difference across the two groups. Results were similar for symptoms of PTSD (measured by the Child PTSD Symptom Scale; FOCUS-AD MD = 12.5, p = 0.01; CBT only MD = 7, p = 0.04; no significant difference between groups). Conclusion Family-centered approaches to depression treatment among adolescents living in under-resourced communities may lead to improved mental health, although further research is warranted.
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Affiliation(s)
- Lauren Marlotte
- Division of Population Behavioral Health, Jane and Terry Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Alexandra Klomhaus
- Department of Medicine Statistics Core, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Roya Ijadi-Maghsoodi
- Division of Population Behavioral Health, Jane and Terry Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
- VA Health Service Research & Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States
| | - Hilary Aralis
- Division of Population Behavioral Health, Jane and Terry Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States
| | - Patricia Lester
- Division of Population Behavioral Health, Jane and Terry Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | | | - Sheryl Kataoka
- Division of Population Behavioral Health, Jane and Terry Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
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Blom BC, June ter Heide FJ, Nauta B, Mooren TM, Olff M. ‘Where am I in all of this?’ Impact of a morally injurious mission on the home front of Dutchbat III military Veterans. JOURNAL OF MILITARY, VETERAN AND FAMILY HEALTH 2023. [DOI: 10.3138/jmvfh-2022-0065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
LAY SUMMARY Research has shown time and time again that war has an impact on the mental well-being of Veterans and their families. But what does that impact look like when a mission is characterized by severe violations of norms and values (in other words, moral injury)? In this study, family members of Dutch Veterans talked about the impact on their lives of a mission gone bad in the former Yugoslavia, 25 years after it happened. Although most of the families were doing well, all of the families felt left alone in taking care of their Veterans after they returned and in dealing with negative press coverage. For the well-being of all, they expressed the need for more appreciation for and acknowledgement of Veterans and their families.
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Affiliation(s)
| | | | - Bart Nauta
- ARQ Knowledge Centre War Persecution and Violence, Diemen, The Netherlands
| | | | - Miranda Olff
- Center for Psychological Trauma in the Department of Psychiatry at the Amsterdam University Medical Center, Amsterdam, The Netherlands
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Sylvia LG, Chudnofsky R, Winklosky T, Mulzoff A, Francona J, Sampson B, Lynch E, Xu B, McCarthy MD, Gupta C, Denninger JW, Mehta DH, Park ER, Ohye B, Spencer T, Fricchione GL. Resilient Family
: A Pilot Study of a Stress Management Program for Military-Connected Families. Psychiatr Ann 2022. [DOI: 10.3928/00485713-20220506-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Public Safety Personnel Family Resilience: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095224. [PMID: 35564618 PMCID: PMC9099962 DOI: 10.3390/ijerph19095224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/14/2022] [Accepted: 04/23/2022] [Indexed: 12/07/2022]
Abstract
The families of public safety personnel (PSP) face demands that are unique to these occupations. Nonstandard work, trauma exposure, and dangerous work environments affect both workers and the families who support them. This narrative review aims to identify the stressors that PSP families experience and the support and resources needed to enhance family resilience. Due to a lack of research on PSP families, this review is a necessary first step to summarizing and interpreting a diverse body of research. The studies included addressed structural and emotional work-family conflict with reference to PSP sectors. A framework from the military family resiliency literature interprets the findings. Factors influencing family functioning and the availability and accessibility of resources provide clues about the type of skills and supports that PSP families rely on. Meaning-making, collaboration, a sense of coherence, and communication were identified as themes associated with intrafamilial processes. Extrafamilial themes included public perceptions, a lack of recognition for the roles families fulfill, and the need for information and education. The results suggest that the vulnerability of PSP families is variable and extrafamilial resources in the form of formal and informal supports are necessary to enhance family resiliency.
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Conceptualizing Emotion Regulation and Coregulation as Family-Level Phenomena. Clin Child Fam Psychol Rev 2022; 25:19-43. [PMID: 35098427 PMCID: PMC8801237 DOI: 10.1007/s10567-022-00378-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2022] [Indexed: 11/05/2022]
Abstract
The ability to regulate one’s emotions is foundational for healthy development and functioning in a multitude of domains, whereas difficulties in emotional regulation are recognized as a risk factor for a range of adverse outcomes in childhood, adolescence, and adulthood. Caregivers play a key role in cultivating the development of emotion regulation through coregulation, or the processes by which they provide external support or scaffolding as children navigate their emotional experiences. The vast majority of research to date has examined coregulation in the context of caregiver–child dyads. In this paper, we consider emotion regulation and coregulation as family-level processes that unfold within and across multiple family subsystems and explore how triadic and whole family interactions may contribute to the development of children’s emotion regulation skills. Furthermore, we will examine the implications of a family-centered perspective on emotion regulation for prevention of and intervention for childhood emotional and behavioral disorders. Because emotion regulation skills undergo such dramatic maturation during children’s first several years of life, much of our focus will be on coregulation within and across the family system during early childhood; however, as many prevention and intervention approaches are geared toward school-aged children and adolescents, we will also devote some attention to later developmental periods.
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Mogil C, Hajal N, Aralis H, Paley B, Milburn NG, Barrera W, Kiff C, Beardslee W, Lester P. A Trauma-Informed, Family-Centered, Virtual Home Visiting Program for Young Children: One-Year Outcomes. Child Psychiatry Hum Dev 2022; 53:964-979. [PMID: 33963489 PMCID: PMC8104463 DOI: 10.1007/s10578-021-01181-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/25/2021] [Indexed: 11/21/2022]
Abstract
Military-connected families face many challenges associated with military life transitions, including deployment separations. We report on a randomized controlled trial to evaluate the efficacy of Families OverComing Under Stress-Early Childhood (FOCUS-EC) delivered through an in-home, virtual telehealth platform. FOCUS-EC is a trauma-informed, family-centered preventive intervention designed to promote family resilience and well-being. Military-connected families with 3- to 6-year-old children (194 mothers; 155 fathers; 199 children) were randomized to FOCUS-EC or an online education condition. Parent psychological health symptoms, child behavior, parenting, and parent-child relationships were examined by parent-report and observed interaction tasks for up to 12 months. Longitudinal regression models indicated that FOCUS-EC families demonstrated significantly greater improvements than online education families in parent-reported and observational measures of child behavior, parenting practices, and parent-child interaction, as well as greater reductions in parent posttraumatic stress symptoms. Findings provide support for the benefit of a virtually-delivered preventive intervention for military-connected families.
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Affiliation(s)
- Catherine Mogil
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 760 Westwood Plaza, Room A8-225, Los Angeles, CA, 90024, USA.
| | - Nastassia Hajal
- grid.19006.3e0000 0000 9632 6718Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 760 Westwood Plaza, Room A8-225, Los Angeles, CA 90024 USA
| | - Hilary Aralis
- grid.19006.3e0000 0000 9632 6718Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 760 Westwood Plaza, Room A8-225, Los Angeles, CA 90024 USA
| | - Blair Paley
- grid.19006.3e0000 0000 9632 6718Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 760 Westwood Plaza, Room A8-225, Los Angeles, CA 90024 USA
| | - Norweeta G. Milburn
- grid.19006.3e0000 0000 9632 6718Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 760 Westwood Plaza, Room A8-225, Los Angeles, CA 90024 USA
| | - Wendy Barrera
- grid.19006.3e0000 0000 9632 6718Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 760 Westwood Plaza, Room A8-225, Los Angeles, CA 90024 USA
| | - Cara Kiff
- Private Practice, Los Angeles, CA USA
| | - William Beardslee
- grid.2515.30000 0004 0378 8438Baer Prevention Initiatives, Boston Children’s Hospital, Boston, MA USA
| | - Patricia Lester
- grid.19006.3e0000 0000 9632 6718Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 760 Westwood Plaza, Room A8-225, Los Angeles, CA 90024 USA
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Javida Z, Prior KN, Bond MJ. Predictive Validity of Resilience in the Treatment of Individuals With Anxiety and Depressive Disorders. J Psychosoc Nurs Ment Health Serv 2021; 59:35-41. [PMID: 34228571 DOI: 10.3928/02793695-20210322-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The current study sought to evaluate the predictive validity of resilience among individuals with anxiety and/or depressive disorders. Receiver operating characteristics were calculated for each of the 25-item and 10-item versions of the Connor-Davidson Resilience Scale, evaluated against psychological distress and treatment response, at screening and post-treatment. New referrals to an anxiety and related disorders clinic were recruited for this purpose (N = 672 at screening, N = 349 post-treatment). Robust cross-sectional associations between resilience and psychological distress and treatment response were noted and were strongest at post-treatment. However, the related sensitivity (63% to 66% at screening, 69% to 76% post-treatment), specificity (78% to 83% at screening, approximately 73% post-treatment), and areas under the curve (AUC; approximately 73% at screening, 78% to 82% post-treatment) were modest. Furthermore, there was minimal support for resilience as a predictor of recovery using the longitudinal data (sensitivity and specificity could not be determined, with AUC of approximately 68% for psychological distress and 56% for treatment response). Although a relatively large homogeneous sample was available for this study, analyses of specific diagnostic subgroups may offer valuable further insight. [Journal of Psychosocial Nursing and Mental Health Services, 59(7), 35-41.].
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Ebrahim MT, Alothman AA. Resilience and social support as predictors of post-traumatic growth in mothers of children with autism spectrum disorder in Saudi Arabia. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 113:103943. [PMID: 33799234 DOI: 10.1016/j.ridd.2021.103943] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/06/2021] [Accepted: 03/17/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND There are few studies about the role of resilience and social support in post-traumatic growth (PTG) in parents of children with autism spectrum disorder (ASD). AIM This study examined the relationship between social support, resilience, and PTG and the predictive role of resilience and social support related to PTG in Saudi Arabian mothers. METHODS AND PROCEDURES A survey-based quantitative study was conducted in 88 mothers aged 18-46 years (M = 33.5; SD = 8.02) who had a child with ASD. They were sampled from nine day care centers in Riyadh and the Central-Eastern-Southern region. OUTCOMES AND RESULTS The findings showed a significant positive correlation between perceived social support, resilience, and PTG, and revealed that Resilience-competence was the only significant predictor of PTG-personal strength, appreciation of life, spiritual change new possibilities, and total PTG, while positive acceptance of change was a significant predictor of PTG-relating to others. Moreover, social support from friends and significant others were significant predictors of PTG-total. CONCLUSIONS AND IMPLICATIONS We found that, for mothers of a child with ASD in Saudi Arabia, the biggest factors predicting post-traumatic growth were a notion of personal competence and social support from friends. Intervention is suggested to lower the risk of trauma.
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Affiliation(s)
- Mona Tawakkul Ebrahim
- Department of Educational Sciences, College of Education, Majmaah University, Majmaah, 11952, Saudi Arabia.
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Sullivan KS, Hawkins SA, Gilreath TD, Castro CA. Mental health outcomes associated with profiles of risk and resilience among U.S. Army spouses. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2021; 35:33-43. [PMID: 32437203 PMCID: PMC7679271 DOI: 10.1037/fam0000702] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The current study examined patterns of risk and protective factors among military families and associations with mental health diagnoses among U.S. Army spouses. Spouses (N = 3,036) completed a survey of family psychosocial fitness, which informed protective factors including coping, family cohesion, and social support. Survey results were linked with Department of Defense archival data, which provided information on military-specific risks, including relocation, deployments, and reunification, as well as mental health care diagnoses. The three-step method of latent profile analysis identified six profiles, suggesting significant heterogeneity in military families with respect to their access to resources and exposure to risk. The largest profile of families (40.48% of the sample) had limited risk exposure and considerable strengths. Variability in risk and protection across profiles was associated with statistically significant differences in the prevalence of mental health diagnoses among spouses (χ² = 108.968, df = 5, p < .001). The highest prevalence of mental health diagnoses among Army spouses (41.2%) was observed in the profile with the lowest levels of protective factors. Findings point to the importance of evaluating both concurrent risk and protective factors. Increasing access to resources may be a fruitful avenue for prevention among military families that are struggling. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | | | | | - Carl A Castro
- Center for Innovation and Research on Veterans and Military Families
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16
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Qualitative Study of NAMI Homefront Family Support Program. Community Ment Health J 2020; 56:1391-1405. [PMID: 32193852 DOI: 10.1007/s10597-020-00582-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 02/11/2020] [Indexed: 10/24/2022]
Abstract
The National Alliance on Mental Illness's Homefront program is a 6-week peer-taught program for family members of veterans and active duty soldiers. Homefront is associated with increased empowerment, coping, and knowledge, but little is known about member experiences. This study used telephone interviews to identify program components that are helpful or need improvement, and to compare the online and in-person program formats. Seventeen participants (7 online) and 17 instructors (3 online) were interviewed and qualitative data analysis suggested that the most helpful components were group discussion, lessons on veteran-specific issues, and coping skills workshops. Some suggested expanding Homefront to 8 or 10 weeks. The online program was convenient for those unable to attend otherwise, but participants cited some dissatisfaction with the discussion format. Instructors described teaching the program as rewarding and noted learning from the curriculum. Understanding the experiences of participants may inform the development of future psychoeducation programs.
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17
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Sullivan KS, Hawkins SA, Gilreath TD, Castro CA. Preliminary Psychometrics and Potential Big Data Uses of the U.S. Army Family Global Assessment Tool. ACTA ACUST UNITED AC 2020; 8:74-85. [PMID: 32884854 DOI: 10.1080/21635781.2019.1676334] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The purpose of the present study is to explore the psychometric properties of the U.S. Army's Family Global Assessment Tool (GAT), which assesses the psychosocial fitness of Army families. With data from 1,692 Army spouses, we examined the structure, reliability and validity of the GAT, using confirmatory factor analysis (CFA) and two validity studies. Fifty-three items and 9 factors were retained following CFA. This model provided a good fit, and scales demonstrated strong internal consistency. Bivariate correlations and results from a theoretically driven model provide preliminary evidence of validity. Findings support the usefulness of the GAT for measuring psychosocial fitness of Army spouses.
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Affiliation(s)
- Kathrine S Sullivan
- New York University, Silver School of Social Work, 1 Washington Square North, New York, NY 10003
| | - Stacy A Hawkins
- Research Facilitation Laboratory, Army Analytics Group, 20 Ryan Ranch Road, Suite 170, Monterey, CA 93940
| | - Tamika D Gilreath
- Transdisciplinary Center for Health Equity Research, Texas A&M University Department of Health and Kinesiology, College Station, TX 77843
| | - Carl A Castro
- Center for Innovation and Research on Veterans and Military Families, University of Southern California School of Social Work, 1150 S. Olive Street, Suite 1400, Los Angeles, CA 90015
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Kshtriya S, Kobezak HM, Popok P, Lawrence J, Lowe SR. Social support as a mediator of occupational stressors and mental health outcomes in first responders. JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 48:2252-2263. [PMID: 32841385 DOI: 10.1002/jcop.22403] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 06/09/2020] [Accepted: 06/11/2020] [Indexed: 06/11/2023]
Abstract
This cross-sectional study aimed to address whether occupational stressors are associated with adverse mental health outcomes in first responders via lower social support. A total of 895 first responders including emergency medical technicians, paramedics, and firefighters from 50 US States and the Virgin Islands (mean = 37.32, standard deviation = 12.09, 59.2% male, and 91.3% White) completed an online survey. Bivariate analyses indicated that occupational stressors were positively correlated with posttraumatic stress disorder (PTSD), major depression (MD), and generalized anxiety disorder (GAD) symptoms, and negatively correlated with social support, whereas social support was negatively correlated with PTSD, MD, and GAD symptoms. Mediation analyses revealed significant indirect effects of occupational stressors on PTSD, MD, and GAD symptoms via social support, after controlling for covariates. Although longitudinal research is needed for a more robust examination of this pathway, the results highlight the importance of social support in first responders. Efforts to augment the support systems of first responders are recommended.
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Affiliation(s)
- Sowmya Kshtriya
- Department of Psychology, Montclair State University, Montclair, New Jersey
| | - Holly M Kobezak
- Department of Psychology, Binghamton University, Binghamton, New York
| | - Paula Popok
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | | | - Sarah R Lowe
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut
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Brickell TA, Wright MM, Lippa SM, Sullivan JK, Bailie JM, French LM, Lange RT. Resilience is associated with health-related quality of life in caregivers of service members and veterans following traumatic brain injury. Qual Life Res 2020; 29:2781-2792. [DOI: 10.1007/s11136-020-02529-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2020] [Indexed: 11/30/2022]
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Combat Experience and Posttraumatic Stress Symptoms among Military-Serving Parents: a Meta-Analytic Examination of Associated Offspring and Family Outcomes. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 47:131-148. [PMID: 29687429 DOI: 10.1007/s10802-018-0427-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
In this meta-analysis, we review findings on the relationships between parental combat exposure and PTSD/PTSS in military-serving families and (1) parenting problems, (2) family maladjustment, and (3) offspring problems. We systematically searched for studies in PsycInfo, PsychArticles, Psychology and Behavior Sciences Collection, Published International Literature on Traumatic Stress (PILOTS), and PubMed/Medline as well as conducted manual searches. Search procedures identified 22 eligible studies, including 20 studies examining relationships between parental PTSD/PTSS and parenting, family, and/or offspring outcomes and 8 studies examining relationships between parental combat exposure and parenting, family, and/or offspring outcomes. Random effects meta-analytic models estimated omnibus associations between parental combat exposure/PTSD and pooled Family Difficulties, as well as individual relationships between parental combat exposure and PTSD/PTSS and parenting, family adjustment, and offspring outcomes. Small-to-moderate effect sizes were observed in the omnibus meta-analysis examining relationships between parental PTSD/PTSS and pooled Family Difficulties, and in the meta-analysis examining relationships between parental PTSD/PTSS and parenting problems, between parental PTSD/PTSS and poor family functioning, and between parental PTSD/PTSS and offspring problems. Associations between parental combat exposure and pooled Family Difficulties, as well as between parental combat exposure and parenting problems were smaller in magnitude. PTSD/PTSS among military-serving parents is associated with increased problems in the family environment, including parenting problems, family maladjustment, and offspring problems, whereas combat exposure alone is not as strongly associated with such family difficulties. Moderator analyses are presented and discussed as well. When military-serving parents show psychological symptoms, professionals should consider allocating resources to target broader family issues.
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21
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Briggs EC, Fairbank JA, Tunno AM, Lee RC, Corry NH, Pflieger JC, Stander VA, Murphy RA. Military Life Stressors, Family Communication and Satisfaction: Associations with Children's Psychosocial Outcomes. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2020; 13:75-87. [PMID: 32318230 PMCID: PMC7163866 DOI: 10.1007/s40653-019-00259-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Families experience multiple stressors as a result of military service. The purpose of this study was to examine facets of military life and family factors that may impact child psychosocial and mental health functioning. Using baseline data from the Millennium Cohort Family Study, this study examined family demographics and composition (age, number of children), military life stressors (injury, family, and deployment stressors), family communication and satisfaction as assessed by the Family Adaptability and Cohesion Evaluation Scale-IV, parental social functioning assessed via the Short Form Health Survey-36, and child mental health and behavioral functioning (parental reports of clinician-diagnosed mental health conditions such as depression) and an adapted version of the Strengths and Difficulties Questionnaire. Injury- and family-related military stressors were significant indicators of heightened risk for child mental health conditions, whereas greater levels of parental social functioning and family satisfaction were associated with lower risk of child mental health conditions. Differential associations were found in child functioning when military-related variables (e.g., service component), sociodemographic, and family composition factors (number and age of the children in the home) were examined. These findings underscore the importance of examining the "whole child" within the broader ecological and military family context to understand factors associated with children's mental and behavioral health. The results from the present study highlight the complex relationships that may be at play, which, in turn, have considerable implications for the development of policies to support children and families encountering multiple stressors related to a parent's military service.
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Affiliation(s)
- Ernestine C. Briggs
- UCLA-Duke University National Center for Child Traumatic Stress, Duke University School of Medicine, 1121 West Chapel Hill Street, Suite 201, Durham, NC 27701 USA
- Department of Psychiatry and the Behavioral Sciences, Duke University Medical Center, Durham, NC USA
- Center for Child and Family Health, Durham, NC USA
| | - John A. Fairbank
- UCLA-Duke University National Center for Child Traumatic Stress, Duke University School of Medicine, 1121 West Chapel Hill Street, Suite 201, Durham, NC 27701 USA
- Department of Psychiatry and the Behavioral Sciences, Duke University Medical Center, Durham, NC USA
- Mid-Atlantic Mental Illness Research, Education and Clinical Center (VISN 6 MIRECC), Durham VA Health Care System, Durham, NC USA
| | - Angela M. Tunno
- UCLA-Duke University National Center for Child Traumatic Stress, Duke University School of Medicine, 1121 West Chapel Hill Street, Suite 201, Durham, NC 27701 USA
- Department of Psychiatry and the Behavioral Sciences, Duke University Medical Center, Durham, NC USA
- Center for Child and Family Health, Durham, NC USA
| | - Robert C. Lee
- UCLA-Duke University National Center for Child Traumatic Stress, Duke University School of Medicine, 1121 West Chapel Hill Street, Suite 201, Durham, NC 27701 USA
- Department of Psychiatry and the Behavioral Sciences, Duke University Medical Center, Durham, NC USA
| | - Nida H. Corry
- Abt Associates, Research Triangle Park, Durham, NC USA
| | | | | | - Robert A. Murphy
- Department of Psychiatry and the Behavioral Sciences, Duke University Medical Center, Durham, NC USA
- Center for Child and Family Health, Durham, NC USA
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Effects of the After Deployment: Adaptive Parenting Tools (ADAPT) intervention on fathers and their children: A moderated mediation model. Dev Psychopathol 2019; 31:1837-1849. [DOI: 10.1017/s0954579419001238] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractDeployment to war is associated with disruptions to emotion regulation and parenting. Using data from a randomized controlled trial, we examined whether fathers with poorer emotion regulation would differentially benefit from the After Deployment, Adaptive Parenting Tools program, a 14-session group-based parenting intervention. Prior analyses of the intervention demonstrated benefits to observed couple parenting and children's adjustment, but not to fathers’ observed parenting. In this study we examined whether intervention effects on fathers’ observed distress avoidance were moderated by baseline emotion regulation, and whether reduced distress avoidance was associated with improved observed parenting and reduced children's internalizing symptoms. A subset of the full randomized controlled trial sample (181 families with a father who had returned from deployment to war in Iraq or Afghanistan, a nondeployed mother, and a target child aged 4–13) completed measures at baseline, 12-months, and 24-months postbaseline. Results indicated that fathers high in baseline emotion regulation difficulties assigned to the intervention group showed reductions in observed distress avoidance at 12 months compared to controls, which were subsequently associated with improvements in observed parenting practices and reductions in children's internalizing symptoms at 24 months. The results suggest a role for personalizing parenting programs for fathers high in emotion dysregulation.
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23
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Cunitz K, Bühler A, Willmund GD, Ziegenhain U, Fegert JM, Zimmermann P, Kölch MG. [Intervention programs for psychological stress in children of military personnel in the USA - Results of a systematic literature review with regard to transferability to Germany]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2019; 47:503-526. [PMID: 31269864 DOI: 10.1024/1422-4917/a000675] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Intervention programs for psychological stress in children of military personnel in the USA - Results of a systematic literature review with regard to transferability to Germany Abstract. Military personnel who have been deployed in war zones or other unstable regions are at an increased risk to develop mental health disorders, including posttraumatic stress disorder. Likewise, their children are at high risk to develop mental health problems as well as emotional and behavioral difficulties. Most research on prevalence of mental health problems as well as on interventions within this group was conducted in the USA. In Germany, no systematic intervention for children of military members focusing on their experiences of deployment exist. The systematic literature review aimed to analyze existing intervention programs in the USA, in particular for children of military members regarding evidence, type and addressed target group (parents, children, both). Compared to the social welfare and health care systems in the USA, the German systems are different. Hence, a second aim was to examine the transferability of these programs to the specific needs of children of German military members (Bundeswehr). 27 intervention programs could be included in the review. Programs, directly or indirectly, are addressing the needs of children of a deployed parent. They are usually focusing on the "emotional cycle of deployment" (phase of preparation of deployment, separation phase of deployment and the return of the deployed parent). The programs mainly focused on parenting skills, family reactions to stress, coping strategies of families, and the feeling of coherence within the family. Only 20 % of the interventions could be assigned to the type of indicated prevention. Nine interventions have shown positive effects (either in RCT or non-experimental designs). Several elements of the programs are transferable to the German situation of children of military members. In particular, contents which address the specific situation of families with a military member are desperately needed in Germany. Transferability is limited by the non-comparability of health care and social welfare systems in the USA and in Germany.
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Affiliation(s)
- Katrin Cunitz
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universitätsklinikum Ulm
| | - Antje Bühler
- Psychotraumazentrum der Bundeswehr, Bundeswehrkrankenhaus, Berlin
| | | | - Ute Ziegenhain
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universitätsklinikum Ulm
| | - Jörg M Fegert
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universitätsklinikum Ulm
| | - Peter Zimmermann
- Psychotraumazentrum der Bundeswehr, Bundeswehrkrankenhaus, Berlin
| | - Michael G Kölch
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universitätsklinikum Ulm.,Klinik für Psychiatrie, Neurologie, Psychosomatik und Psychotherapie im Kindes- und Jugendalter, Universitätsmedizin Rostock
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24
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Abstract
Resilience is defined as the dynamic ability to adapt successfully in the face of adversity, trauma, or significant threat. Some of the key early studies of resilience were observational studies in children. They were followed by research in adults, studies testing interventions to promote resilience in different populations, and a recent upsurge of studies on the underlying genomic and neurobiological mechanisms. Neural and molecular studies in preclinical models of resilience are also increasingly identifying active stress adaptations in resilient animals. Knowledge gained from animal and human studies of resilience can be harnessed to develop new preventive interventions to enhance resilience in at-risk populations. Further, treatment interventions focused on enhancing potentially modifiable protective factors that are consistently linked to psychological resilience can enrich currently available treatment interventions for individuals with posttraumatic stress disorder (PTSD). Translating our expanding knowledge of the neurobiology of resilience additionally promises to yield novel therapeutic strategies for treating this disabling condition. This review summarizes the vast field of resilience research spanning genomic, psychosocial, and neurobiological levels, and discusses how findings have led and can lead to new preventive and treatment interventions for PTSD.
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25
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The Emerging Empirical Science of Wisdom: Definition, Measurement, Neurobiology, Longevity, and Interventions. Harv Rev Psychiatry 2019; 27:127-140. [PMID: 31082991 PMCID: PMC6519134 DOI: 10.1097/hrp.0000000000000205] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
After participating in this activity, learners should be better able to:• Assess the empirical literature on wisdom• Evaluate a proposed model of wisdom development ABSTRACT: This article seeks to provide an overview of the empirical literature on wisdom in terms of its definitions and measurements, possible neurobiological basis, and evolutionary value, as well as changes with aging and potential clinical interventions to enhance components of wisdom. Wisdom may be defined as a complex human trait with several specific components: social decision making, emotion regulation, prosocial behaviors, self-reflection, acceptance of uncertainty, decisiveness, and spirituality. These components appear to be localized primarily to the prefrontal cortex and limbic striatum. Emerging research suggests that wisdom is linked to better overall health, well-being, happiness, life satisfaction, and resilience. Wisdom likely increases with age, facilitating a possible evolutionary role of wise grandparents in promoting the fitness of the species. Despite the loss of their own fertility and physical health, older adults help enhance their children's well-being, health, longevity, and fertility-the "Grandma Hypothesis" of wisdom. We propose a model of wisdom development that incorporates genetic, environmental, and evolutionary aspects. Wisdom has important implications at both individual and societal levels, and warrants further research as a major contributor to human thriving. There is a need for a greater emphasis on promoting wisdom through our educational systems from elementary to professional schools.
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Isaacs SA, Roman NV, Savahl S. The development of a family resilience-strengthening programme for families in a South African rural community. JOURNAL OF COMMUNITY PSYCHOLOGY 2018; 46:616-635. [PMID: 31682289 DOI: 10.1002/jcop.21962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 11/25/2017] [Accepted: 01/21/2018] [Indexed: 06/10/2023]
Abstract
The aim of this study was to develop a contextually based family resilience program. Also presented here is a literature review of family resilience interventions suggesting that these 3 processes are the basis for effective family functioning. A close collaboration with the community ensured an adequate understanding of the presenting family challenges and this article describes the process in developing a program based on these challenges. A 3-round Delphi design was used for the study with international and local experts (n = 10) in the field of family and resilience studies and community stakeholders (n = 5). The program has three main aims: to increase family connectedness, family communication processes and social and economic resources. Based on the findings of this study, 4 modules will be presented to participants, "about family," "talking together," "close together," and "working together." A description is provided of the program content and decisions regarding logistical program concerns.
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27
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Oblea PN, Badger TA, Hopkins-Chadwick DL. Effect of Short-Term Separation on the Behavioral Health of Military Wives. J Psychosoc Nurs Ment Health Serv 2018; 54:45-51. [PMID: 27245252 DOI: 10.3928/02793695-20160518-07] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 05/10/2016] [Indexed: 11/20/2022]
Abstract
In the current prospective observational study, the impact of short-term separation on female spouses of male military officers who were scheduled to participate in a resident training program was evaluated. Using pre- and post-survey designs, participants were assessed 2 weeks prior to separation and 2 weeks prior to their husbands' returns. Participants completed the following scales: the Multidimensional Scale of Perceived Social Support, Connor-Davidson Resilience Scale, Perceived Stress Scale, Relationship Assessment Scale, and Beck Depression Inventory II Scale. No significant differences were found in perceived social support, resilience, perceived stress, relationship satisfaction, or depression scores pre- and post-separation. As predicted, depression scores were positively correlated with perceived stress scores and negatively correlated with resiliency and relationship satisfaction scores. Women with higher levels of resilience experienced lower levels of post-separation stress. [Journal of Psychosocial Nursing and Mental Health Services, 54(6), 45-51.].
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28
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Lee EE, Martin AS, Tu X, Palmer BW, Jeste DV. Childhood Adversity and Schizophrenia: The Protective Role of Resilience in Mental and Physical Health and Metabolic Markers. J Clin Psychiatry 2018; 79:17m11776. [PMID: 29701938 PMCID: PMC6464641 DOI: 10.4088/jcp.17m11776] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 01/08/2018] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To determine the impact of childhood adversity and current (adulthood) resilience on mental and physical health and markers of metabolic function among adults with schizophrenia and nonpsychiatric comparison participants (NCs). METHODS We conducted a cross-sectional study of 114 participants with schizophrenia (DSM-IV-TR criteria) and 101 NCs aged 26-65 years during 2012-2017. Sociodemographic, clinical, and laboratory measures were examined. Childhood Trauma Questionnaire was used to retrospectively assess emotional abuse/neglect, physical abuse/neglect, and sexual abuse experienced during childhood. Connor-Davidson Resilience Scale was employed to measure resilience. RESULTS Persons with schizophrenia reported more severe childhood trauma, lower resilience, and worse mental and physical health and had worse metabolic biomarker levels than NCs. Trauma severity correlated with worse depression in the NCs (r = 0.34), but not in the schizophrenia group (r = 0.02). In both groups, trauma severity was associated with worse physical well-being, higher fasting insulin levels, and greater insulin resistance (P ≤ .02). Notably, resilience appeared to counteract effects of trauma and diagnosis on mental and physical health. The schizophrenia subgroup with high resilience and severe trauma reported mental and physical well-being and had glycosylated hemoglobin levels and insulin resistance scores that were comparable to those of NCs with low resilience and severe trauma. CONCLUSIONS To our knowledge, this is the first study to quantitatively assess effects of both childhood trauma and resilience in schizophrenia on health, notably metabolic function. Interventions to bolster resilience in the general population and in people with schizophrenia may improve outcomes for those with a history of childhood adversity.
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Affiliation(s)
- Ellen E. Lee
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States.,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, United States
| | - Averria Sirkin Martin
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States.,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, United States
| | - Xin Tu
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States.,Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, United States
| | - Barton W. Palmer
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States.,Veterans Affairs San Diego Healthcare System, San Diego, CA, United States
| | - Dilip V. Jeste
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States.,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, United States.,Department of Neurosciences, University of California, San Diego, CA, United States
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29
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Troxel WM, Trail TE, Jaycox LH, Chandra A. Preparing for Deployment: Examining Family- and Individual-Level Factors. MILITARY PSYCHOLOGY 2017. [DOI: 10.1037/mil0000110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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30
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Blackburn D. Out of uniform: psychosocial issues experienced and coping mechanisms used by Veterans during the military–civilian transition. JOURNAL OF MILITARY, VETERAN AND FAMILY HEALTH 2017. [DOI: 10.3138/jmvfh.4160] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Dave Blackburn
- Université du Québec en Outaouais, St Jerome, Québec, Canada
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31
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Resilience to emotional distress in response to failure, error or mistakes: A systematic review. Clin Psychol Rev 2017; 52:19-42. [DOI: 10.1016/j.cpr.2016.11.007] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 10/14/2016] [Accepted: 11/18/2016] [Indexed: 11/23/2022]
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32
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Cassels MT, White N, Gee N, Hughes C. One of the family? Measuring young adolescents' relationships with pets and siblings. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2017. [DOI: 10.1016/j.appdev.2017.01.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Finley EP, Pugh MJ, Palmer RF. Validation of a Measure of Family Resilience among Iraq and Afghanistan Veterans. MILITARY BEHAVIORAL HEALTH 2017; 4:205-219. [PMID: 28168094 DOI: 10.1080/21635781.2016.1153530] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Although interactions within veterans' families may support or inhibit resilient coping to stress and trauma across the deployment cycle, research on family resilience has been hampered by the lack of a brief assessment. Using a three-stage mixed-method study, we developed and conducted preliminary validation of a measure of family resilience tailored for Iraq and Afghanistan veterans (IAV), the Family Resilience Scale for Veterans (FRS-V), which was field-tested using a survey of 151 IAV. Our findings indicate the resulting 6-item measure shows strong initial reliability and validity and support the application of existing models of family resilience in this population.
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Affiliation(s)
- Erin P Finley
- South Texas Veterans Health Care System, The University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Mary Jo Pugh
- South Texas Veterans Health Care System, The University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Raymond F Palmer
- Department of Family and Community Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, Texas
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34
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Saltzman WR, Lester P, Milburn N, Woodward K, Stein J. Pathways of Risk and Resilience: Impact of a Family Resilience Program on Active-Duty Military Parents. FAMILY PROCESS 2016; 55:633-646. [PMID: 27597440 DOI: 10.1111/famp.12238] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Over the past decade, studies into the impact of wartime deployment and related adversities on service members and their families have offered empirical support for systemic models of family functioning and a more nuanced understanding of the mechanisms by which stress and trauma reverberate across family and partner relationships. They have also advanced our understanding of the ways in which families may contribute to the resilience of children and parents contending with the stressors of serial deployments and parental physical and psychological injuries. This study is the latest in a series designed to further clarify the systemic functioning of military families and to explicate the role of resilient family processes in reducing symptoms of distress and poor adaptation among family members. Drawing upon the implementation of the Families Overcoming Under Stress (FOCUS) Family Resilience Program at 14 active-duty military installations across the United States, structural equation modeling was conducted with data from 434 marine and navy active-duty families who participated in the FOCUS program. The goal was to better understand the ways in which parental distress reverberates across military family systems and, through longitudinal path analytic modeling, determine the pathways of program impact on parental distress. The findings indicated significant cross-influence of distress between the military and civilian parents within families, families with more distressed military parents were more likely to sustain participation in the program, and reductions in distress among both military and civilian parents were significantly mediated by improvements in resilient family processes. These results are consistent with family systemic and resilient models that support preventive interventions designed to enhance family resilient processes as an important part of comprehensive services for distressed military families.
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Affiliation(s)
- William R Saltzman
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA
| | - Patricia Lester
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA
| | - Norweeta Milburn
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA
| | | | - Judith Stein
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA
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Saltzman WR. The FOCUS Family Resilience Program: An Innovative Family Intervention for Trauma and Loss. FAMILY PROCESS 2016; 55:647-659. [PMID: 27734461 DOI: 10.1111/famp.12250] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
This article describes the core principles and components of the FOCUS Program, a brief intervention for families contending with single or multiple trauma or loss events. It has been administered nationally to thousands of military family members since 2008 and has been implemented in a wide range of civilian community, medical, clinical, and school settings. Developed by a team from the UCLA and Harvard Medical Schools, the FOCUS Program provides a structured approach for joining with traditional and nontraditional families, crafting shared goals, and then working with parents, children, and the entire family to build communication, make meaning out of traumatic experiences, and practice specific skills that support family resilience. Through a narrative sharing process, each family member tells his or her story and constructs a timeline that graphically captures the experience and provides a platform for family discussions on points of convergence and divergence. This narrative sharing process is first done with the parents and then the children and then the family as a whole. The aim is to build perspective-taking skills and mutual understanding, to reduce distortions and misattributions, and to bridge estrangement between family members. Previous studies have confirmed that families participating in this brief program report reductions in distress and symptomatic behaviors for both parents and children and increases in child pro-social behaviors and family resilient processes.
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Affiliation(s)
- William R Saltzman
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA
- Advanced Studies in Education & Counseling, California State University, Long Beach, CA
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Walsh F. Applying a Family Resilience Framework in Training, Practice, and Research: Mastering the Art of the Possible. FAMILY PROCESS 2016; 55:616-632. [PMID: 27921306 DOI: 10.1111/famp.12260] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
With growing interest in systemic views of human resilience, this article updates and clarifies our understanding of the concept of resilience as involving multilevel dynamic processes over time. Family resilience refers to the functioning of the family system in dealing with adversity: Assessment and intervention focus on the family impact of stressful life challenges and the family processes that foster positive adaptation for the family unit and all members. The application of a family resilience framework is discussed and illustrated in clinical and community-based training and practice. Use of the author's research-informed map of core processes in family resilience is briefly noted, highlighting the recursive and synergistic influences of transactional processes within families and with their social environment. Given the inherently contextual nature of the construct of resilience, varied process elements may be more or less useful, depending on different adverse situations over time, with a major crisis; disruptive transitions; or chronic multistress conditions. This perspective is attuned to the diversity of family cultures and structures, their resources and constraints, socio-cultural and developmental influences, and the viability of varied pathways in resilience.
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Affiliation(s)
- Froma Walsh
- Chicago Center for Family Health, School of Social Service Administration and Department of Psychiatry, University of Chicago, Chicago, IL
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Lester P, Aralis H, Sinclair M, Kiff C, Lee KH, Mustillo S, Wadsworth SM. The Impact of Deployment on Parental, Family and Child Adjustment in Military Families. Child Psychiatry Hum Dev 2016; 47:938-949. [PMID: 26797704 DOI: 10.1007/s10578-016-0624-9] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Since 9/11, military service in the United States has been characterized by wartime deployments and reintegration challenges that contribute to a context of stress for military families. Research indicates the negative impact of wartime deployment on the well being of service members, military spouses, and children. Yet, few studies have considered how parental deployments may affect adjustment in young children and their families. Using deployment records and parent-reported measures from primary caregiving (N = 680) and military (n = 310) parents, we examined the influence of deployment on adjustment in military families with children ages 0-10 years. Greater deployment exposure was related to impaired family functioning and marital instability. Parental depressive and posttraumatic stress symptoms were associated with impairments in social emotional adjustment in young children, increased anxiety in early childhood, and adjustment problems in school-age children. Conversely, parental sensitivity was associated with improved social and emotional outcomes across childhood. These findings provide guidance to developing preventive approaches for military families with young children.
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Affiliation(s)
- Patricia Lester
- Nathanson Family Resilience Center, Semel Institute for Neuroscience and Human Behavior, UCLA, 760 Westwood Plaza, A8-153, Los Angeles, CA, 90024, USA.
| | - Hilary Aralis
- Nathanson Family Resilience Center, Semel Institute for Neuroscience and Human Behavior, UCLA, 760 Westwood Plaza, A8-153, Los Angeles, CA, 90024, USA
| | - Maegan Sinclair
- Nathanson Family Resilience Center, Semel Institute for Neuroscience and Human Behavior, UCLA, 760 Westwood Plaza, A8-153, Los Angeles, CA, 90024, USA
| | - Cara Kiff
- Nathanson Family Resilience Center, Semel Institute for Neuroscience and Human Behavior, UCLA, 760 Westwood Plaza, A8-153, Los Angeles, CA, 90024, USA
| | - Kyung-Hee Lee
- Military Family Research Institute, Purdue University, West Lafayette, IN, USA
| | - Sarah Mustillo
- Department of Sociology, Notre Dame University, Notre Dame, IN, USA
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Interian A, Kline A, Perlick D, Dixon L, Feder A, Weiner MD, Goldstein MF, Hennessy K, St Hill L, Losonczy M. Randomized controlled trial of a brief Internet-based intervention for families of Veterans with posttraumatic stress disorder. JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT 2016; 53:629-640. [PMID: 27898154 DOI: 10.1682/jrrd.2014.10.0257] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Revised: 10/05/2015] [Indexed: 11/05/2022]
Abstract
Veterans with posttraumatic stress disorder (PTSD) and their families require resources to cope with postdeployment readjustment. Responding to this need, the current study examined a brief Internet-based intervention that provided Veterans' families with psychoeducation on postdeployment readjustment. Participants were 103 dyads of Veterans with probable PTSD and a designated family member/partner. Dyads were randomized to an intervention group, in which the family member completed the intervention, or to a control group with no intervention. Each member of the dyad completed surveys at baseline and 2 mo follow-up. Family member surveys focused on perceived empowerment, efficacy to provide support, and communication (perceived criticism and reactivity to criticism). Veteran surveys assessed perceived family support and communication. Results showed that Veterans in the intervention group reported decreases in reactivity to criticism but also decreased perceived family support. No significant differences were observed in outcomes reported by family members. This preliminary study provides an early understanding of this novel outreach program, as well as the challenges inherent with a very brief intervention. Future research can build on the current study by more closely evaluating the communication changes that occur with this form of intervention and whether greater intervention intensity is needed. CLINICAL TRIAL REGISTRATION Clinical Trials Identifier: NCT01554839.
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Affiliation(s)
- Alejandro Interian
- Mental Health and Behavioral Sciences, Department of Veterans Affairs (VA) New Jersey Health Care System, Lyons, NJ; and Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ
| | - Anna Kline
- Mental Health and Behavioral Sciences, Department of Veterans Affairs (VA) New Jersey Health Care System, Lyons, NJ; and Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ
| | - Deborah Perlick
- VA Veterans Integrated Service Network 3, Mental Illness Research, Education, and Clinical Center, Bronx, NY.,Department of Psychiatry, Icahn School of Medicine, Mount Sinai, New York, NY
| | - Lisa Dixon
- VA Veterans Integrated Service Network 3, Mental Illness Research, Education, and Clinical Center, Bronx, NY.,Department of Psychiatry, Columbia University, New York, NY
| | - Ann Feder
- VA Veterans Integrated Service Network 3, Mental Illness Research, Education, and Clinical Center, Bronx, NY
| | | | - Marjorie F Goldstein
- Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, NJ
| | - Kerry Hennessy
- National Development and Research Institutes Inc, New York, NY
| | | | - Miklos Losonczy
- National Development and Research Institutes Inc, New York, NY
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Snyder J, Gewirtz A, Schrepferman L, Gird SR, Quattlebaum J, Pauldine MR, Elish K, Zamir O, Hayes C. Parent-child relationship quality and family transmission of parent posttraumatic stress disorder symptoms and child externalizing and internalizing symptoms following fathers' exposure to combat trauma. Dev Psychopathol 2016; 28:947-969. [PMID: 27739388 PMCID: PMC5113136 DOI: 10.1017/s095457941600064x] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Transactional cascades among child internalizing and externalizing symptoms, and fathers' and mothers' posttraumatic stress disorder (PTSD) symptoms were examined in a sample of families with a male parent who had been deployed to recent military conflicts in the Middle East. The role of parents' positive engagement and coercive interaction with their child, and family members' emotion regulation were tested as processes linking cascades of parent and child symptoms. A subsample of 183 families with deployed fathers and nondeployed mothers and their 4- to 13-year-old children who participated in a randomized control trial intervention (After Deployment: Adaptive Parenting Tools) were assessed at baseline prior to intervention, and at 12 and 24 months after baseline, using parent reports of their own and their child's symptoms. Parents' observed behavior during interaction with their children was coded using a multimethod approach at each assessment point. Reciprocal cascades among fathers' and mothers' PTSD symptoms, and child internalizing and externalizing symptoms, were observed. Fathers' and mothers' positive engagement during parent-child interaction linked their PTSD symptoms and their child's internalizing symptoms. Fathers' and mothers' coercive behavior toward their child linked their PTSD symptoms and their child's externalizing symptoms. Each family member's capacity for emotion regulation was associated with his or her adjustment problems at baseline. Implications for intervention, and for research using longitudinal models and a family-systems perspective of co-occurrence and cascades of symptoms across family members are described.
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Affiliation(s)
- James Snyder
- Department of Psychology, Wichita State University
| | - Abigail Gewirtz
- Department of Family Social Sciences, University of Minnesota
| | | | | | | | | | - Katie Elish
- Department of Psychology, Wichita State University
| | - Osnat Zamir
- Department of Family Social Sciences, University of Minnesota
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Rochat TJ, Mitchell J, Stein A, Mkwanazi NB, Bland RM. The Amagugu Intervention: A Conceptual Framework for Increasing HIV Disclosure and Parent-Led Communication about Health among HIV-Infected Parents with HIV-Uninfected Primary School-Aged Children. Front Public Health 2016; 4:183. [PMID: 27630981 PMCID: PMC5005419 DOI: 10.3389/fpubh.2016.00183] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 08/17/2016] [Indexed: 11/22/2022] Open
Abstract
Advances in access to HIV prevention and treatment have reduced vertical transmission of HIV, with most children born to HIV-infected parents being HIV-uninfected themselves. A major challenge that HIV-infected parents face is disclosure of their HIV status to their predominantly HIV-uninfected children. Their children enter middle childhood and early adolescence facing many challenges associated with parental illness and hospitalization, often exacerbated by stigma and a lack of access to health education and support. Increasingly, evidence suggests that primary school-aged children have the developmental capacity to grasp concepts of health and illness, including HIV, and that in the absence of parent-led communication and education about these issues, HIV-exposed children may be at increased risk of psychological and social problems. The Amagugu intervention is a six-session home-based intervention, delivered by lay counselors, which aims to increase parenting capacity to disclose their HIV status and offer health education to their primary school-aged children. The intervention includes information and activities on disclosure, health care engagement, and custody planning. An uncontrolled pre-post-evaluation study with 281 families showed that the intervention was feasible, acceptable, and effective in increasing maternal disclosure. The aim of this paper is to describe the conceptual model of the Amagugu intervention, as developed post-evaluation, showing the proposed pathways of risk that Amagugu aims to disrupt through its intervention targets, mechanisms, and activities; and to present a summary of results from the large-scale evaluation study of Amagugu to demonstrate the acceptability and feasibility of the intervention model. This relatively low-intensity home-based intervention led to: increased HIV disclosure to children, improvements in mental health for mother and child, and improved health care engagement and custody planning for the child. The intervention model demonstrates the potential for disclosure interventions to include pre-adolescent HIV education and prevention for primary school-aged children.
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Affiliation(s)
- Tamsen J. Rochat
- Human and Social Development, Human Sciences Research Council, Durban, South Africa
- Africa Centre for Population Health, University of KwaZulu-Natal, Somkhele, South Africa
- MRC/Developmental Pathways to Health Research Unit, School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- Section of Child and Adolescent Psychiatry, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Joanie Mitchell
- Africa Centre for Population Health, University of KwaZulu-Natal, Somkhele, South Africa
| | - Alan Stein
- Section of Child and Adolescent Psychiatry, Department of Psychiatry, University of Oxford, Oxford, UK
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Ntombizodumo Brilliant Mkwanazi
- Africa Centre for Population Health, University of KwaZulu-Natal, Somkhele, South Africa
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- DST-NRF Centre of Excellence in Human Development, University of Witwatersrand, Johannesburg, South Africa
| | - Ruth M. Bland
- Africa Centre for Population Health, University of KwaZulu-Natal, Somkhele, South Africa
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- Institute of Health and Wellbeing and Royal Hospital for Sick Children, University of Glasgow, Glasgow, UK
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Monk JK, Ogolsky BG, Bruner V. Veteran Couples Integrative Intensive Retreat Model: An Intervention for Military Veterans and Their Relational Partners. JOURNAL OF COUPLE & RELATIONSHIP THERAPY 2016. [DOI: 10.1080/15332691.2015.1089803] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Wadsworth SM, Cardin JF, Christ S, Willerton E, O'Grady AF, Topp D, Coppola E, Lester P, Mustillo S. Accumulation of Risk and Promotive Factors Among Young Children in US Military Families. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2016; 57:190-202. [PMID: 27217322 DOI: 10.1002/ajcp.12025] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
In the families of the new cohort of war veterans now entering the civilian population in the United States are over two million young children (Cozza, Haskins & Lerner, 2013; Institute of Medicine, 2013). Several noteworthy studies have shown that children exposed to separation from a parent due to combat-related deployment are at elevated risk for a variety of negative consequences (Lester & Flake, 2013). Cozza et al. (2013) argue that existing studies of military children focus too much on the stresses or deficits they experience, failing to give sufficient attention to their strengths, the strengths of their families, or the supports around them. In the current study we focus on risk and promotive factors in the lives of children aged 0-10 in military families. We examine the likelihood of negative outcomes as functions of additive, cumulative, and interactive relationships between risk and promotive factors and children's outcomes. Risk factors, particularly parental depression, community poverty, and cumulative risk, were more strongly associated with children's outcomes than promotive factors. There was, however, a significant risk-protective relationship between accumulations of risk and promotive factors, consistent with promotive conditions operating in a protective fashion under conditions of elevated risk.
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Affiliation(s)
| | | | - Sharon Christ
- College of Health and Human Sciences, Purdue University, West Lafayette, IN, USA
| | - Elaine Willerton
- School of Marriage & Family Sciences, Northcentral University, Scottsdale, Arizona, USA
| | | | - David Topp
- Military Family Research Institute, Purdue University, West Lafayette, IN, USA
| | - Elizabeth Coppola
- Military Family Research Institute, Purdue University, West Lafayette, IN, USA
| | - Patricia Lester
- Nathanson Family Resilience Center, University of California, Los Angeles, CA, USA
| | - Sarah Mustillo
- Department of Sociology, University of Notre Dame, South Bend, IN, USA
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Brockman C, Snyder J, Gewirtz A, Gird SR, Quattlebaum J, Schmidt N, Pauldine MR, Elish K, Schrepferman L, Hayes C, Zettle R, DeGarmo D. Relationship of service members' deployment trauma, PTSD symptoms, and experiential avoidance to postdeployment family reengagement. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2016; 30:52-62. [PMID: 26437144 PMCID: PMC4804869 DOI: 10.1037/fam0000152] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
This research examined whether military service members' deployment-related trauma exposure, posttraumatic stress disorder (PTSD) symptoms, and experiential avoidance are associated with their observed levels of positive social engagement, social withdrawal, reactivity-coercion, and distress avoidance during postdeployment family interaction. Self reports of deployment related trauma, postdeployment PTSD symptoms, and experiential avoidance were collected from 184 men who were deployed to the Middle East conflicts, were partnered, and had a child between 4 and 13 years of age. Video samples of parent-child and partner problem solving and conversations about deployment issues were collected, and were rated by trained observers to assess service members' positive engagement, social withdrawal, reactivity-coercion, and distress avoidance, as well as spouse and child negative affect and behavior. Service members' experiential avoidance was reliably associated with less observed positive engagement and more observed withdrawal and distress avoidance after controlling for spouse and child negative affect and behavior during ongoing interaction. Service members' experiential avoidance also diminished significant associations between service members' PTSD symptoms and their observed behavior. The results are discussed in terms of how service members' psychological acceptance promotes family resilience and adaption to the multiple contextual challenges and role transitions associated with military deployment. Implications for parenting and marital interventions are described.
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Evaluation of a Family-Centered Preventive Intervention for Military Families: Parent and Child Longitudinal Outcomes. J Am Acad Child Adolesc Psychiatry 2016; 55:14-24. [PMID: 26703905 DOI: 10.1016/j.jaac.2015.10.009] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 09/23/2015] [Accepted: 10/23/2015] [Indexed: 11/23/2022]
Abstract
OBJECTIVE This study evaluates the longitudinal outcomes of Families OverComing Under Stress (FOCUS), a family-centered preventive intervention implemented to enhance resilience and to reduce psychological health risk in military families and children who have high levels of stress related to parental wartime military service. METHOD We performed a secondary analysis of evaluation data from a large-scale service implementation of the FOCUS intervention collected between July 2008 and December 2013 at 15 military installations in the United States and Japan. We present data for 2,615 unique families (3,499 parents and 3,810 children) with completed intake and at least 1 postintervention assessment. Longitudinal regression models with family-level random effects were used to assess the patterns of change in child and parent (civilian and military) psychological health outcomes over time. RESULTS Improvement in psychological health outcomes occurred in both service member and civilian parents. Relative to intake, parental anxiety and depression symptoms were significantly reduced postintervention, and these reductions were maintained at 2 subsequent follow-up assessments. In addition, we identified an improvement over time in emotional and behavioral symptoms and in prosocial behaviors for both boys and girls. We observed reductions in the prevalence of unhealthy family functioning and child anxiety symptoms, as well as parental depression, anxiety, and posttraumatic stress symptoms from intake to follow-up. CONCLUSION Longitudinal program evaluation data show sustained trajectories of reduced psychological health risk symptoms and improved indices of resilience in children, civilian, and active duty military parents participating in a strength-based, family-centered preventive intervention.
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Abstract
Understanding of psychopathology of mental disorder is evolving, particularly with availability of newer insight from the field of genetics, epigenetics, social, and environmental pathology. It is now becoming clear how biological factors are contributing to development of an illness in the face of a number of psychosocial factors. Resilience is a psychobiological factor which determines individual's response to adverse life events. Resilience is a human capacity to adapt swiftly and successfully to stressful/traumatic events and manage to revert to a positive state. It is fundamental for growth of positive psychology which deals with satisfaction, adaptability, contentment, and optimism in people's life. Of late, there has been a paradigm shift in the understanding of resilience in context of stress risk vulnerability dimension. It is a neurobiological construct with significant neurobehavioral and emotional features which plays important role in deconstructing mechanism of biopsychosocial model of mental disorders. Resilience is a protective factor against development of mental disorder and a risk factor for a number of clinical conditions, e.g. suicide. Available information from scientific studies points out that resilience is modifiable factor which opens up avenues for a number of newer psychosocial as well as biological therapies. Early identification of vulnerable candidates and effectiveness of resilience-based intervention may offer more clarity in possibility of prevention. Future research may be crucial for preventive psychiatry. In this study, we aim to examine whether resilience is a psychopathological construct for mental disorder.
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Affiliation(s)
- Amresh Shrivastava
- Department of Psychiatry, The Western University, Lawson Health Research Institute, London, Ontario N6C 0A7, Canada
| | - Avinash Desousa
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
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Rubio C, Osca A, Recio P, Urien B, Peiró JM. Work-family conflict, self-efficacy, and emotional exhaustion: A test of longitudinal effects. JOURNAL OF WORK AND ORGANIZATIONAL PSYCHOLOGY 2015. [DOI: 10.1016/j.rpto.2015.06.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Marek LI, Moore LE. Coming home: the experiences and implication of reintegration for military families. JOURNAL OF MILITARY VETERAN AND FAMILY HEALTH 2015. [DOI: 10.3138/jmvfh.3119] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction: Although military families are typically resilient in the face of adversity, the current literature suggests that the aftermath of deployment involves numerous stressors and difficulties for these families for a long period. Method: Using a sample of 380 US service members, 295 partners of US service members, and 136 adolescents who experienced a full deployment cycle of a service member parent, this study addresses the gaps in knowledge by examining how factors identified in prior research (reintegration stress and coping, preparation and expectations, family functioning and parental satisfaction, perceived adolescent changes between deployment and reintegration, and adolescents’ perception of family functioning) affect reintegration stress and coping for US service members, partners of US service members (someone who identifies as being in a significant relationship with a service member), and adolescents. Results: Better service member coping, satisfaction with family deployment coping, better preparation, and accurate expectations were all found to be associated with lower reintegration stress. Discussion: Findings point to the need for a systemic approach throughout the deployment cycle for better reintegration outcomes for military individuals and families.
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Affiliation(s)
- Lydia I. Marek
- Department of Human Development, Virginia Tech, Blacksburg, Virginia, USA
| | - Lyn E. Moore
- Department of Human Development, Virginia Tech, Blacksburg, Virginia, USA
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Cramm H, Norris D, Tam-Seto L, Eichler M, Smith-Evans K. Making military families in Canada a research priority. JOURNAL OF MILITARY VETERAN AND FAMILY HEALTH 2015. [DOI: 10.3138/jmvfh.3287] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Heidi Cramm
- School of Rehabilitation Therapy, Queen’s University, Kingston, Ontario, Canada
| | - Deborah Norris
- Department of Family Studies and Gerontology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Linna Tam-Seto
- School of Rehabilitation Therapy, Queen’s University, Kingston, Ontario, Canada
| | - Maya Eichler
- Department of Political and Canadian Studies, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Kimberley Smith-Evans
- Department of Political and Canadian Studies, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
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49
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Sandoz EK, Moyer DN, Armelie AP. Psychological Flexibility as a Framework for Understanding and Improving Family Reintegration Following Military Deployment. JOURNAL OF MARITAL AND FAMILY THERAPY 2015; 41:495-507. [PMID: 25099194 DOI: 10.1111/jmft.12086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Postdeployment reintegration may present an exceptional challenge to service members and their families; yet, overcoming this challenge seems to strengthen family relationships through a shared sense of purpose. Navigating family reintegration may be an important determinant of long-term psychological well-being. If the needs of military families are to be answered effectively, it is of critical importance to identify the skills that facilitate positive reintegration following deployment. This article proposes psychological flexibility as a group of interrelated skills that could be directly intervened on to facilitate not only resilience but also positive growth and development. This paper focuses on the conceptualization of family reintegration in terms of psychological flexibility, including common deficits observed in this population and potential goals of treatment. Video Abstract.
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50
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Mogil C, Hajal N, Garcia E, Kiff C, Paley B, Milburn N, Lester P. FOCUS for Early Childhood: A Virtual Home Visiting Program for Military Families with Young Children. CONTEMPORARY FAMILY THERAPY 2015. [PMID: 26543320 DOI: 10.1007/s10651-015-9327-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Affiliation(s)
- Catherine Mogil
- UCLA Semel Institute for Neuroscience and Human Behavior, Nathanson Family Resilience Center, 760 Westwood Plaza, Room A8-153, Los Angeles, CA 90095
| | - Nastassia Hajal
- UCLA Semel Institute for Neuroscience and Human Behavior, Nathanson Family Resilience Center, 760 Westwood Plaza, Room A8-153, Los Angeles, CA 90095
| | - Ediza Garcia
- UCLA Semel Institute for Neuroscience and Human Behavior, Nathanson Family Resilience Center, 760 Westwood Plaza, Room A8-153, Los Angeles, CA 90095
| | - Cara Kiff
- UCLA Semel Institute for Neuroscience and Human Behavior, Nathanson Family Resilience Center, 760 Westwood Plaza, Room A8-153, Los Angeles, CA 90095
| | - Blair Paley
- UCLA Semel Institute for Neuroscience and Human Behavior, Nathanson Family Resilience Center, 760 Westwood Plaza, Room A8-153, Los Angeles, CA 90095
| | - Norweeta Milburn
- UCLA Semel Institute for Neuroscience and Human Behavior, Nathanson Family Resilience Center, 760 Westwood Plaza, Room A8-153, Los Angeles, CA 90095
| | - Patricia Lester
- UCLA Semel Institute for Neuroscience and Human Behavior, Nathanson Family Resilience Center, 760 Westwood Plaza, Room A8-153, Los Angeles, CA 90095
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