Coping in adolescent children of HIV-positive and HIV-negative substance-abusing fathers

Integrating intimate partner violence and parenting intervention into residential substance use disorder treatment for fathers

Despite positive outcomes for the incorporation of gender- and motherhood-focused programing within substance use disorder treatment programs for women, a focus on gender and fatherhood has not been the focus of intervention or evaluation research for men in substance use disorder treatment. This was a mixed method study to examine the initial feasibility of incorporating a fatherhood-focused intervention within a substance use disorder treatment program for men. Forty-four fathers enrolled in a coordinated intervention for intimate partner violence and parenting. Interviews were conducted at baseline and follow-up to assess the impact of the intervention on anger, hostile thinking and emotion regulation problems. Focus groups were also conducted with the participants to gain further insight into their needs as fathers and their recommendations for interventions that they would find helpful. Results indicated a high prevalence of anger related thoughts at baseline that significantly decreased at follow up; there were also significant reductions in affect regulation problems. Importantly, 84.1% of participants completed the program in its entirety and were highly satisfied with the content. These findings suggest that Fathers for Change can be implemented, successfully, in a men's residential treatment program.

The Relationship of Personality and Behavioral Development from Adolescence to Young Adulthood and Subsequent Parenting Behavior

The purpose of the study was to examine the association of parental personality, behavior, and substance use during adolescence and adulthood as related to the later parent-offspring relationship. The sample consisted of 297 parents ( M age 32 yr.), who were first interviewed at earlier points in their lives in childhood and early adolescence at six points in time, extending from 1983 to 2002. Multiple regression models showed that parents with certain earlier personality and behavioral attributes, e.g., more rebelliousness and more frequent tobacco use, had a more difficult relationship with their children. Findings indicated an association between the cumulative number of psychosocial risk factors in the parents and difficulties in the parent-child relationship. The findings suggested that interventions designed to decrease youths' substance abuse may increase the likelihood that later when they are parents they will form nurturing relationships with their children.

Parent relationship quality buffers against the effect of peer stressors on depressive symptoms from middle childhood to adolescence

During the transition to adolescence, several developmental trends converge to increase the importance of peer relationships, the likelihood of peer-related stressors, and the experience of depressive symptoms. Simultaneously, there are significant changes in parent-child relationships. The current study sought to evaluate whether positive relationship quality with parents continued to serve a protective effect by buffering the relationship between stressful life events, especially peer stress, and increases in depressive symptoms throughout the transition to adolescence. Participants in a large (N = 692) 2-site accelerated longitudinal study were recruited in 3rd, 6th, and 9th grade and followed every 3 months for 1 year. At baseline, parents and youth reported on parent-child relationship quality, and every 3 months thereafter reported on their levels of stressors and depressive symptoms. Parent relationship quality moderated the relationship of person-level fluctuations in peer stressors, such that there was a stronger association between peer stressors and increases in depressive symptoms in youth with lower levels of positive parental relationship quality. This effect was specific to peer stressors. These results suggest that low levels of parent relationship quality leave youth particularly vulnerable to the depressogenic effects of peer stressors from childhood through adolescence.

Annual Research Review: Mental health and resilience in HIV/AIDS-affected children-- a review of the literature and recommendations for future research

BACKGROUND

To date, research on mental health in HIV-affected children (children who have an HIV-positive caregiver or live with the virus themselves) has focused on risk factors associated with the disease. However, simultaneous identification of factors that contribute to resilience in the face of risks is also needed. A greater understanding of modifiable protective processes that contribute to resilience in the mental health of children affected by HIV can inform the design of interventions that bolster naturally occurring supports and contribute to early prevention or better management of risks.

METHODS

We reviewed the recent literature on mental health and resilience in children and adolescents affected by HIV/AIDS. Literature searches of PsycInfo and PubMed were conducted during July-December 2011 consistent with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Qualitative and quantitative studies were included for review if primary research questions pertained to mental health and coping or protective processes in children and families affected by HIV/AIDS. All studies subject to full review were evaluated for quality using a modified Systematic Assessment of Quality in Observational Research (SAQOR) rating system.

RESULTS

One hundred and seventy one unique studies were returned from online searches of the literature and bibliography mining. Of these, 29 were evaluated as pertaining directly to mental health and resilience in families and children living with HIV/AIDS. Eight studies presented qualitative analyses. Ten quantitative studies examined individual resources contributing to child resilience and four quantitative studies looked at family-level resources. Ten studies also investigated community level interactions. Four presented findings from resilience-focused interventions.

CONCLUSIONS

There is a clear need for rigorous research on mental health and resilience in HIV-affected children and adolescents. The evidence base would greatly benefit from more standardized and robust approaches to thinking about resilience from an ecological perspective inclusive of resources at multiple levels and their interactions.

Protecting children from the consequences of divorce: a longitudinal study of the effects of parenting on children's coping processes

This study examines whether intervention-induced changes in mother-child relationship quality and discipline led to short-term (6 months) and long-term (6 years) changes in children's coping processes in a sample of 240 youth aged 9-12 years when assessed initially. Data were from a randomized, experimental trial of a parenting-focused preventive intervention designed to improve children's postdivorce adjustment. Three-wave prospective mediational analyses revealed that intervention-induced improvements in relationship quality led to increases in coping efficacy at 6 months and to increases in coping efficacy and active coping at 6 years. Tests of the mediated effects were significant for all 3 indirect paths. Results are discussed in terms of pathways to adaptive coping and implications for the implementation of preventive interventions targeting coping.

Drug abuse and responsible fathering: a comparative study of men enrolled in methadone maintenance treatment

AIM

Because very little is known about the parenting of drug-abusing men, this study was designed to document ways that drug abuse contributes to compromise of responsible fathering.

DESIGN, SETTING, PARTICIPANTS

Generalized linear models and data representing different dimensions of responsible fathering were used to clarify ways that the fathering of 106 men receiving methadone maintenance treatment differed from that of 118 men living in the same community with no history of alcohol or drug abuse.

MEASUREMENT

Men who enrolled in the study completed two structured interviews and a battery of five self-report measures selected to document current and historical dimensions of responsible fathering.

FINDINGS

When the opioid-dependent fathers were compared to the other fathers, there were significant differences in: (i) economic resources to support family formation; (ii) patterns of pair-bonding; (iii) patterns of procreation; and (iv) parenting behavior. When fathering of the youngest biological child was examined, the opioid-dependent fathers confirmed few differences in historical dimensions of fathering, but they reported significant differences in current dimensions reflecting: (i) constricted personal definitions of the fathering role; (ii) poorer relationships with biological mothers; (iii) less frequent residence with the child; (iv) less frequent provision of financial support; (v) less involvement in positive parenting; (vi) poorer appraisal of self as a father; and (vii) less satisfaction as a father.

CONCLUSIONS

The findings highlight ways that drug abuse contributes to compromise of responsible fathering, and they raise questions about ways that the drug abuse treatment system might better address parenting as a treatment issue for men.

Externalizing behaviors among children of HIV seropositive former and current drug users: parent support network factors as social ecological risks

Children affected by their parents' dual drug use and HIV/AIDS face considerable challenges to their psychosocial development, including parent dysfunction and foster care placement. While HIV/AIDS may increase parents' mobilization of social support, their drug use may restrict who is available to help them, with potential implications to the adjustment of their children with whom they remain in contact. This study sought to identify dually affected children's living situations, and parent and parent's support network factors as correlates of children's externalizing problem behaviors. An urban community sample of 462 HIV seropositive, current or former drug-using parents were queried about their children aged 5-15 years old. One hundred ninety-four children were reported by 119 parents. The outcome was children's externalizing behaviors of ever having been suspended or expelled from school, criminal-justice system involvement, or illicit drug or heavy alcohol use. Independent variables included kin and drug users in parent's support network. Generalized estimating equations were used to adjust for the potential correlation of children of the same parent. Among parents, 63% were mothers, 57% current opioid or cocaine users, 85% were African American, 35% had AIDS or CD<200, and 53% had high depressive symptoms (CES-D>or=16); median age was 38. Among children, median age was 12; 23% lived with the nominating parent, 65% with other family, and 11% in non-kin foster care. While only 34% of parents reported child custody, 43% reported daily contact with their child, and 90% reported high emotional closeness. Parents reported externalizing behaviors among 32% of the children. Logistic regression indicated that externalizing behavior was positively associated with parent's physical limitations and proportion of illicit drug users in parent's support network. A significant interaction was found indicating that the effect of parent's support network-level drug use was greater for children living with versus not living with the parent. The model adjusted for parent's current drug use and depressive symptoms, which were not significant. Results indicate that while only a minority of these dually affected children lived with the parent, the parents' physical limitations and embeddedness in drug using support networks, particularly if living with their children, was associated with the children's maladjustment. It is plausible that these factors interfere with parenting, expose the children to conflict or adverse social influences, or obligate children to assume caregiving for their parent. While dually affected children's contact with their parents may have important benefits, results suggest it presents ongoing needs for intervention with the children, their parents, and caregivers.

Children's coping strategies and coping efficacy: relations to parent socialization, child adjustment, and familial alcoholism

The relations of children's coping strategies and coping efficacy to parent socialization and child adjustment were examined in a sample of school-age children that included families in which some of the grandparents and/or parents had an alcoholism diagnosis. Parents and older children reported on the children's coping strategies; parents reported on their parenting behavior; and teachers reported on children's externalizing and internalizing problems. Measures of parent socialization were associated with parents' and children's reports of active coping strategies and parents' reports of both support-seeking coping and coping efficacy. Some of these relations were moderated by familial alcohol status. Children higher in parent-reported active/support-seeking coping and coping efficacy were rated lower in teacher-reported externalizing and internalizing adjustment problems. The findings were consistent with the view that active/support-seeking coping and coping efficacy mediated the association of parent socialization to children's psychological adjustment and that this relation was sometimes moderated by parental alcohol status.

Are fathers involved in pediatric psychology research and treatment?

BACKGROUND

Recently, there has been a growing awareness of the importance of the roles of fathers in understanding normative developmental processes. Increased attention has been given to the roles of fathers in the area of clinical child research and therapy. However, the presence of fathers in research and treatment in pediatric psychology has not been fully examined.

OBJECTIVE

To explore the status of including fathers in both research and treatment in the area of pediatric psychology.

METHOD

An extensive review of published research.

RESULTS

The findings suggest that pediatric psychology research lags even farther behind clinical child research in including fathers in research designs and analyzing for maternal and paternal effects separately. There is also a concomitant lack of inclusion of fathers in family-based interventions in pediatric psychology.

CONCLUSION

These patterns are discussed, with an emphasis on strategies to increase the inclusion of fathers in research and treatment of pediatric psychology issues. Future directions for researchers and clinicians are also included.

Helping adolescents cope with stress during stressful times

Increasing levels of stress in the daily lives of adolescents is an important health concern. Adolescents experience a variety of stressful situations and use a wide range of coping strategies to help effectively manage stress. Recent research on adolescent coping with stressful situations is reviewed. Findings support an association between coping and adolescent health problems, chronic physical illness, and mental health. More research is needed to investigate the long-term benefits of coping with stress on adolescent health and well-being. Specific recommendations for helping adolescents cope with stressful situations are discussed. Health care providers are encouraged to assess how adolescents cope with acute and chronic stressors and provide adolescents with information about coping with stressful situations.