Coping in context: The effects of long-term relations between interparental conflict and coping on the development of child psychopathology following parental divorce

A call for early, effective, and scalable parent education programs for high-conflict separated/divorcing parents: A synthesized perspective from prevention science and family law

Conflict between parents is stressful and disruptive to children living in the midst of parental separation or divorce. Although some level of post-separation/divorce conflict is understandable in an emotionally-charged separation/divorce, it undermines the extent to which parents protect their children from short- and long-term problems. In this article, we weave together a synthesized perspective informed by our respective training and experience in prevention science and family law on the role of parent education programs for high-conflict separating/divorcing parents. To do so, we first describe the research on the effects of high interparental conflict on children's outcomes and then discuss current approaches and challenges to reducing these negative effects by offering parent education programs for high-conflict separating/divorcing parents. Then, we propose and describe a new model for early, effective, and scalable parent education programs with the ultimate goal of protecting children after separation/divorce.

Preventing Mental Health Problems in Children After High Conflict Parental Separation/Divorce Study: An Optimization Randomized Controlled Trial Protocol

Parental divorce is a childhood stressor that affects approximately 1.1 million children in the U.S. annually. The children at greatest risk for deleterious mental health consequences are those exposed to high interparental conflict (IPC) following the separation/divorce. Research shows that children's emotional security and coping efficacy mediate the impact of IPC on their mental health. Interventions targeting their adaptive coping in response to IPC events may bolster their emotional security and coping efficacy. However, existing coping interventions have not been tested with children exposed to high post-separation/divorce IPC, nor has any study assessed the effects of individual intervention components on children's coping with IPC and their mental health. This intensive longitudinal intervention study examines the mechanisms through which coping intervention components impact children's responses to interactions in interparental relationships. A 23 factorial experiment will assess whether, and to what extent, three candidate intervention components demonstrate main and interactive effects on children's coping and mental health. Children aged 9-12 (target N = 144) will be randomly assigned to one of eight combinations of three components with two levels each: (1) reappraisal (present vs. absent), (2) distraction (present vs. absent), (3) relaxation (present vs. absent). The primary outcomes are child-report emotional security and coping efficacy at one-month post-intervention. Secondary outcomes include internalizing and externalizing problems at the three-month follow-up. Based on data from this optimization phase RCT, intervention components will be selected to comprise a multi-component intervention and assessed for effectiveness in a subsequent evaluation phase RCT.

Promotive and risk factors for children's mental health-Finnish municipal policymakers' and leading officeholders' views

Findings on children's mental health promotion at the policy level are scarce, and the perceptions of the municipal administration on factors affecting children's mental health have not been reported. This study describes the perspectives of policymakers and leading officeholders on promotive and risk factors for children's mental health in a socioecological context. The perspectives of Finnish policymakers (n = 15) and officeholders (n = 10) in municipalities were examined using semi-structured interviews. The data were analyzed using inductive content analysis and were categorized according to the five levels of a socioecological model of health promotion: public policy, community, organizational, interpersonal and individual levels. The public policy level emerged strongly in the findings, specifically strategic planning and implementation challenges related to the promotion of children's mental health in the municipality and state administration. At the community level, environmental factors promoting children's mental health as well as risk factors were described. The organizational level consisted of support, requirements and development needs in children's services. The importance of family and close networks at the interpersonal level, as well as the individual basis of mental health, were also evident. The integration and better collaboration of child and family services, the use of child rights impact assessment in political decision-making, and financial support from the state could contribute to improving strategic planning to support children's mental health at the municipal level.

Risk of non-fatal suicide attempt in individuals with substance use disorder: the roles of aggregate genetic liability and environmental exposures in a Swedish population-based cohort

BACKGROUND AND AIMS

Substance use disorder (SUD) is related to widespread adverse consequences, including higher suicidality. Shared genetic liability has been demonstrated between SUD and suicidality. Here, we measured the factors that contribute to increased risk of non-fatal suicide attempt among individuals with SUD by focusing upon aggregate genetic risks and both childhood and past-year environmental factors.

DESIGN

Longitudinal study. Family genetic risk scores and environmental factors (childhood, aged from 0 to 15 years, and the year preceding SUD registration) were used to predict the relative risk of non-fatal suicide attempt using Cox proportional hazards models. Additional analyses employed a co-relative design, accounting for genetic factors and shared familial environment, to test for potential causality.

SETTING AND PARTICIPANTS

Based on longitudinal Swedish registry data, 228 617 individuals with SUD registrations from 1991 to 2015 were included.

MEASUREMENTS

SUD and suicide attempts were identified using medical records (International Classification of Diseases codes). SUD was also identified using pharmacy and criminal registries.

FINDINGS

In multivariable analyses that jointly accounted for all the selected potential predictors, individuals with SUD were at higher risk for non-fatal suicide attempt if they had experienced a parental death [hazard ratio (HR) = 1.58; 95% confidence interval (CI) = 1.30, 1.93], were female (HR = 1.53, 95% CI = 1.49, 1.57), had low educational attainment (HR = 1.50, 95% CI = 1.46, 1.55), received social welfare (HR = 1.21, 95% CI = 1.17, 1.25) or had lived in a non-intact family (HR = 1.11, 95% CI = 1.08, 1.14). In co-relative analyses, low education was supported as a possible causal factor for suicide attempt. Aggregate genetic risks interacted with low education and being raised in a non-intact family, with increased prevalence of suicide attempt in people with high genetic risks and unfavorable environmental exposures.

CONCLUSIONS

Aggregate genetic liability, childhood environmental experiences and specific socio-economic indicators are important risk factors for non-fatal suicide attempt among individuals with substance use disorder.

Enhancing Daily Affect in Youth Experiencing High-Conflict Parental Divorce: A Multiple Baseline Trial of an Online Prevention Program

This study investigated the effects of a highly interactive, online cognitive-behavioral youth coping program: Children of Divorce-Coping with Divorce (CoD-CoD; Boring et al., 2015) on children exposed to high levels of interparental conflict (IPC). A multiple-baseline experimental design (N = 9) evaluated within-subject intervention effects on change in daily positive and negative affect before, during, and after the intervention (n_observations = 462). Participants were youth ages 11-16 who reported high exposure to IPC and whose parents had filed for divorce or parenting plan determinations in the prior year. A significant interaction effect indicated change in positive affect, but not negative affect, between the intervention and baseline phases. Positive affect linearly decreased during the baseline phase and flattened during the intervention phase. Results indicate that CoD-CoD was effective in interrupting a decline in youth-reported positive affect in a high-IPC sample, which may indicate a buffering effect against depression. Critical future directions include conducting large-scale randomized trials with children from high-IPC families to assess for whom the program is effective and assess long-term effects across a broad range of important outcomes.

Parental support, marital conflict, and stress as predictors of depressive symptoms among African American adolescents

Given the increase of depressive symptoms among adolescents, it is essential to investigate familial and temperamental correlates of depressive symptoms such as parental support, marital conflict, and stress. Thus, using a cross-sectional design, the current study examined whether parental support, marital conflict, and stress predicted depressive symptoms. Then, using structural equation modeling, this study tested whether stress mediated the relationships among parental support, marital conflict, and depressive symptoms among African American adolescents while controlling for sex (N = 883). Results suggest that maternal support negatively related to depressive symptoms in contrast to stress and marital conflict. However, paternal support and sex were not statistically associated with depressive symptoms. Mediation results suggest that stress explained the relationships among parental support, marital conflict, and depressive symptoms. Family therapy and depression reduction implications are discussed.

The Divorce Process and Child Adaptation Trajectory Typology (DPCATT) Model: The Shaping Role of Predivorce and Postdivorce Interparental Conflict

Divorce has been conceptualized as a process. Research has extensively demonstrated that it is pre/postdivorce family environment factors that primarily account for the variability in children’s adaptation over parental divorce process rather than the legal divorce per se. Amongst various factors, interparental conflict has been consistently identified as a prominent one. Surprisingly, a single source is still lacking that comprehensively synthesizes the extant findings. This review fills this gap by integrating the numerous findings across studies into a more coherent Divorce Process and Child Adaptation Trajectory Typology (DPCATT) Model to illustrate that pre/postdivorce interparental conflict plays crucial roles in shaping child adaptation trajectories across parental divorce process. This review also summarizes the mechanisms (e.g., child cognitive and emotional processes, coparenting, parent–child relations) via which pre/postdivorce interparental conflict determines these trajectories and the factors (e.g., child gender and age, child coping, grandparental support) that interact with pre/postdivorce interparental conflict to further complicate these trajectories. In addition, echoing the call of moving beyond the monolithic conceptualization of pre/postdivorce interparental conflict, we also review studies on the differential implications of different aspects (e.g., frequency versus intensity) and types (e.g., overt versus covert) of interparental conflict for child adjustment. Last, limitations of prior studies and avenues for future research are discussed. The proposed framework may serve as a common knowledge base for researchers to compare/interpret results, detect cutting edges of the fields, and design new studies. The specificity, complexity, nuance, and diversity inherent within our proposed model await to be more fully revealed.

Coping with Relationship Stress in Adolescence: A Decade in Review

At a moment in history when stress levels among adolescents are high and coping capacities are taxed, it seems timely and important to review a decade's accomplishments in elucidating how, and with what effects, adolescents cope with relationship stress. We provide an update on research about coping with parent, peer, and romantic stress and discuss the effectiveness of coping strategies across cultures, developmental periods, and levels of social stress. We explore relations between coping and other automatic and reflective responses to stress and highlight innovations in lab-based and ambulatory assessments. We recommend studies of variability in the success of coping at different intensities of relationship stress and research with real-time and repeated assessments to capture the process of coping.

Mothers susceptible to child maltreatment and requiring public health nurses' continuous support

OBJECTIVE

This study aimed to identify the characteristics of mothers who are at a high risk for future child maltreatment and therefore, require continuous support from public health nurses (PHNs) to prevent child maltreatment and those who do not require it.

DESIGN AND SAMPLES

This retrospective cross-sectional study included women who were registered in 2018 for being at risk for future child maltreatment and required help with childrearing in City A within the Tokyo metropolis.

MEASUREMENTS

Public health nurses registered data pertaining to each mother, including demographic data, family-related variables, assessment by PHNs, use of maternal and child healthcare services, and continuity of support from PHNs.

RESULTS

Of the 206 cases, the discontinued group-comprising those who no longer needed PHNs' support-included 83 cases (40.3%) and the continuing group-comprising those needed continuing support-included 123 cases (59.7%). Logistic regression analysis showed that those with marital conflicts, maternal mental instability, lack of parenting skills, and not moving out of the city were more likely to require continuous PHNs' support.

CONCLUSIONS

By identifying these factors, PHNs can identify new mothers who need continuous support and provide more concentrated care for them. Thus, support from PHNs can help prevent child maltreatment.

Adverse childhood experiences and police mental health

Purpose –

The purpose of this study is to examine cross-sectional associations between adverse childhood experiences (ACEs) and mental health among police officers.

Design/methodology/approach –

The sample was from the Buffalo Cardio-Metabolic Occupational Police Stress study data (132 male and 51 female officers). Standardized surveys were administered to participants. Regression coefficients were obtained from models adjusted for age, sex, race and alcohol intake. All statistical tests were performed using a statistical significance level at p < 0.05.

Findings –

Regression analyses showed significant positive associations between ACEs and mental health (Posttraumatic Stress Disorder [PTSD]: β = 1.70, p < 0.001 and depressive symptoms: β = 1.29, p < 0.001). Resiliency significantly modified the association between ACEs and PTSD. A positive and significant association was observed among officers with lower resiliency (β = 2.65, p < 0.001). The association between ACEs and PTSD was stronger among male officers compared to females (β = 2.66, p < 0.001 vs. β = 0.59, p ≤ 0.248, respectively).

Research limitations/implications –

Child abuse and development of PTSD or depression could not be traced through time as this was a cross-sectional study. Recall bias may affect results.

Practical implications –

PTSD and depression associated with ACEs can affect the interpretation of threat and can exacerbate emotional regulation in officers. An inquiry should be expanded regarding work assignments of victimized officers, such as child exploitation and pornography investigation.

Originality/value –

There are few studies on ACEs and the mental health of police officers. The present study is among the first to associate multiple police mental health issues with ACEs.

The Development, Evaluation, and Implementation of Parenting-focused Prevention Programs in Collaboration with Family Court

Promoting the well-being and best interests of children in separated and divorcing families is a shared value among family court professionals and prevention scientists who develop and evaluate intervention programs. This article chronicles the development, evaluation, and implementation of two programs - the New Beginnings Program (NBP), a parenting intervention for separated/divorcing parents and the Family Transitions Guide (FTG), an intervention designed to motivate high conflict separated/divorcing parents to attend the NBP. The development and evaluation of these programs was facilitated by a long-standing collaboration with Maricopa Family Court. We discuss the process of developing these programs, their underlying small theories, and the evaluation of their effects in randomized trials. We also describe our collaboration with the family court and ways that the court promoted the development and evaluation of these programs. Finally, we summarize lessons learned and discuss future directions to bolster the public health impact of evidence-based programs for separated/divorcing families.

Public health nurses' perceptions on promotive and risk factors for children's mental health: A qualitative interview study

AIM

To describe promotive and risk factors for children's mental health at the individual, interpersonal, organizational, community and public policy levels of the socioecological environment.

DESIGN

A descriptive qualitative interview study.

METHODS

Data were collected in Finland during autumn 2019 via semi-structured interviews. Participants (n = 23) comprised public health nurses who worked in child health clinics and school healthcare. Data were analyzed using inductive content analysis.

RESULTS

Several promotive and risk factors were identified to have affected children's mental health. Intra-family factors were the most important in the opinion of public health nurses, and they were most concerned about family related risk factors. In addition, the descriptions of nurses revealed that children are in a socially unequal position in terms of their place of residence. It was also uncovered that there were fewer social and healthcare and leisure services in small municipalities, the distances to services were longer, which was perceived to complicate the use of services, and the fear of stigma was greater.

CONCLUSION

According to public health nurses, factors at the individual, interpersonal, organizational, community and public policy levels of the socioecological environment affect children's mental health and overall well-being. Consequently, the promotion of children's mental health should be emphasized at every level of the society, considering the whole family.

IMPACT

This study indicated the importance of considering factors that affect children's mental health at all levels of the socioecological environment. The results can be reflected in the relation of the socioecological model of health promotion and used in planning the work of nurses in primary healthcare and other relevant nursing settings to emphasize promotive and preventive work.

Family Coping Strategies to Improve the Health of Family Members Living with Schizophrenia

Introduction: Schizophrenia is a serious mental illness that affects the thinking, emotions, relationships, and decision-making. One of the positive effects of treating schizophrenia in patients is family health. The family welfare management strategies provide help for coping, care preparation, organizing meetings, and mentoring. This study focuses on family coping strategies for improving the health of members living with schizophrenia.Methods: A cross-sectional design was used by choosing 160 respondents randomly. The inclusion criteria were family members accompanying control schizophrenia patients to the Public Health Center, with a minimum age of 18. The independent variable was family coping, which consist of two sub-variables (problem-focused coping mechanism and emotion-focused coping mechanism), while the dependent variable was family health, which consists of three sub-variables (efficient, satisfaction, and happiness). The SMART PLS (2.0 Version) was used to prove the impact of the variables.Results: The results indicated that family coping had a significant impact  on the health of the family. The hypothesis was taken from the value of the T-test on the structural model analysis, which shows T- statistics (13.966) > T-critical (1.96). The impact of family coping on the health is equal to 0.682 (OR). This means that if family coping is given one-unit value, it will increase the family health by 0.682 times.Conclusion: The implementation of the family coping strategy will improve the capacity of the family to clarify health issues encountered, resolve family behaviors effectively and minimize risk factors. Furthermore, the coping mechanisms chosen by families in facing stress will have an impact on the reduction of illness symptoms in the members with schizophrenia.

Longitudinal Effects of PostDivorce Interparental Conflict on Children's Mental Health Problems Through Fear of Abandonment: Does Parenting Quality Play a Buffering Role?

In a sample of 559 children (ages 9-18), researchers investigated whether: (a) fear of abandonment mediated the association between postdivorce interparental conflict (IPC) and mental health problems, and (b) parent-child relationship quality moderated the association between IPC and fear of abandonment. Mediation analyses indicated that pretest IPC predicted fear of abandonment 3 months later, which then predicted child- and teacher-reported mental health problems 10 months later. The hypothesized protective effect of a high-quality parent-child relationship was not observed. IPC predicted fear of abandonment for all children, except for those with low- and moderate-quality father-child relationships, for whom IPC was not significantly related to fear of abandonment. Findings highlight the need to optimize child coping programs and improve parenting-after-divorce programs to reduce IPC.