The direction of effects between parenting and adolescent affective well-being in everyday life is family specific

Examining Caregiver Practices During Adolescent Outpatient Alcohol Use and Co-Occurring Mental Health Treatment: Protocol for a Dyadic Ecological Momentary Assessment Study

BACKGROUND

Caregiver-involved treatments for adolescents with alcohol use disorder and co-occurring disorders (AUD+CODs) are associated with the best treatment outcomes. Understanding what caregiving practices during treatment improve core adolescent treatment targets may facilitate the refinement and scalability of caregiver-involved interventions. Caregiving is dynamic, varying by context, affect, and adolescent behavior. Caregiver-involved treatments seek to change momentary interactions between caregivers and their adolescents. Accordingly, this protocol outlines a dyadic ecological momentary assessment (EMA) study to examine caregiving practices during AUD+CODs treatment and their associations with adolescent core treatment targets (eg, alcohol craving and use, motivation to reduce or stop drinking, and internalizing and externalizing symptoms).

OBJECTIVE

This paper aims to describe the methods for examining momentary caregiving practices and adolescent core treatment targets during adolescent outpatient AUD+CODs treatment.

METHODS

We will recruit 75 caregiver-adolescent dyads from outpatient mental health clinics providing AUD+CODs treatment. Eligible families will have an adolescent who (1) is aged between 13 and 18 years; (2) meets the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, diagnostic criteria for AUD; (3) is enrolled in outpatient treatment at the time of recruitment; and (4) has a legal guardian willing to participate in the study. Caregivers and adolescents will complete an eligibility screening, followed by a baseline assessment during or as close as possible to the second week of treatment. During the baseline assessment, caregivers and adolescents will receive formal training in EMA procedures. Next, caregivers and adolescents will complete a 15-week EMA burst design consisting of three 21-day EMA periods with 3-week breaks between periods. Throughout the study, participants will also complete weekly reports regarding the skills learned or practiced during therapy. The three overarching aims to the proposed study are as follows: (1) examine momentary caregiving practices (eg, support, monitoring, substance use communication quality) and their associations with core treatment targets, (2) examine how these associations change throughout treatment, and (3) examine whether a caregiver report of learning or practicing parenting- or family-focused behaviors in treatment sessions is associated with changes in the use of caregiving practices in daily life.

RESULTS

The proposed study was informed by a pilot study assessing the feasibility and acceptability of dyadic EMA during adolescent AUD+COD treatment. Some benchmarks were met during this study (eg, ≥80% caregiver retention rate), although most benchmarks were not (eg, adolescent [772/1622, 47.6%] and caregiver [1331/1881, 70.76%] random prompt compliance was below the ≥80% target). Data collection is anticipated to begin in December of 2024. The proposed study is designed to be completed over 3 years.

CONCLUSIONS

Examining momentary caregiving practices using EMA has important implications for refining and scaling caregiver-involved interventions for AUD+CODs so that families who would benefit from caregiver-involved treatments can have access to them.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/63399.

Emotion Dynamics among Late Adolescents and Emerging Adults: The Role of Maternal Privacy Invasion Perceptions

Prior research suggests that youth experience immediate emotional distress following privacy invasion, but it is unclear whether and how persistent privacy invasion over longer periods destabilizes the intrapersonal emotional regulatory functions that privacy serves. This study investigated whether late adolescents and emerging adults who reported different patterns of maternal privacy invasion over a full academic year showed differences in emotion regulation, as reflected by the frequency and lability of negative and positive emotional experiences. Participants were first-year university students (n = 349; 60.2% female) in Hong Kong, aged 17 to 24 (MT1 = 18.20, SDT1 = 1.10). They self-reported maternal privacy invasion perceptions and negative and positive emotions 16 times, at bi-weekly intervals. Latent class growth analyses divided participants into a Higher Invasion Perceptions group (24.9%), a Moderate Invasion Perceptions group (46.4%), and a Lower Invasion Perceptions group (28.7%). A one-way MANCOVA examined potential differences in negative and positive emotion dynamics across groups, indexed by frequency (means) and instability (mean square of successive differences and probability of acute change). In line with predictions, both the Higher Invasion and Moderate Invasion groups reported higher negative emotion frequency and instability, compared to the Lower Invasion group. However, groups showed no significant differences regarding positive emotion frequency and instability. The findings indicate that perceptions of maternal privacy invasion predict youth's negative emotion regulation processes over their first collegiate year. Prolonged, higher levels of maternal privacy invasion may disrupt the intrapersonal regulatory functions that privacy serves over time.

Like No Other? A Family-Specific Network Approach to Parenting Adolescents

Numerous theories suggest that parents and adolescents influence each other in diverse ways; however, whether these influences differ between subgroups or are unique to each family remains uncertain. Therefore, this study explored whether data-driven subgroups of families emerged that exhibited a similar daily interplay between parenting and adolescent affective well-being. To do so, Subgrouping Group Iterative Multiple Model Estimation (S-GIMME) was used to estimate family-specific dynamic network models, containing same- and next-day associations among five parenting practices (i.e., warmth, autonomy support, psychological control, strictness, monitoring) and adolescent positive and negative affect. These family-specific networks were estimated for 129 adolescents (Mage = 13.3, SDage = 1.2, 64% female, 87% Dutch), who reported each day on parenting and their affect for 100 consecutive days. The findings of S-GIMME did not identify data-driven subgroups sharing similar parenting-affect associations. Instead, each family displayed a unique pattern of temporal associations between the different practices and adolescent affect. Thus, the ways in which parenting practices were related to adolescents' affect in everyday life were family specific.